Pharmacists; authorize to test for and administer treatment for minor, nonchronic health conditions.

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To: Public Health and Human
Services
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026

By: Representative Yancey

HOUSE BILL NO. 533

AN ACT TO AUTHORIZE A PHARMACIST TO TEST OR SCREEN FOR AND 1
INITIATE OR ADMINISTER TREATMENT FOR MINOR, NONCHRONIC HEALTH 2
CONDITIONS; TO DEFINE THE TERM "MINOR, NONCHRONIC HEALTH 3
CONDITION"; TO AUTHORIZE A PHARMACIST TO DELEGATE THE 4
ADMINISTRATIVE AND TECHNICAL TASKS OF PERFORMING CERTAIN TESTS TO 5
AN INTERN OR PHARMACY TECHNICIAN ACTING UNDER THE SUPERVISION OF 6
THE PHARMACIST; TO AUTHORIZE A PHARMACIST TO PROHIBIT THE DENIAL 7
OF REIMBURSEMENT UNDER HEALTH BENEFIT PLANS FOR SERVICES AND 8
PROCEDURES PERFORMED BY A PHARMACIST THAT ARE WITHIN THE SCOPE OF 9
THE PHARMACIST'S LICENSE, AND WOULD BE COVERED IF THE SERVICES OR 10
PROCEDURES WERE PERFORMED BY A PHYSICIAN, AN ADVANCED PRACTICE 11
REGISTERED NURSE, OR A PHYSICIAN ASSISTANT; TO AMEND SECTION 12
73-21-73, MISSISSIPPI CODE OF 1972, TO INCLUDE IN THE DEFINITION 13
OF THE TERM "PRACTICE OF PHARMACY", ORDERING, PERFORMING, AND 14
INTERPRETING CERTAIN TESTS AND INITIATING, ADMINISTERING, OR 15
MODIFYING DRUG THERAPY; TO BRING FORWARD SECTION 83-9-36, 16
MISSISSIPPI CODE OF 1972, WHICH RELATES TO PRESCRIBING 17
PRACTITIONERS, STEP THERAPY OR FAIL-FIRST PROTOCOLS AND OVERRIDE 18
PROCEDURES, FOR THE PURPOSE OF POSSIBLE AMENDMENT; AND FOR RELATED 19
PURPOSES. 20
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 21
SECTION 1. (1) A pharmacist may test or screen for and 22
initiate or administer treatment for minor, nonchronic health 23
conditions. For the purposes of this section, a "minor, 24
nonchronic health condition" means typically a short-term health 25
condition that is generally managed with noncontrolled drug 26
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therapies, minimal treatment, or self-care, and includes all of 27
the following: 28
(a) Influenza; 29
(b) Streptococcus; 30
(c) COVID-19; 31
(d) SARS-COV-2 or other respiratory illness, condition, 32
or disease; 33
(e) Lice; 34
(f) Urinary tract infection; 35
(g) Skin conditions, such as ringworm and athlete's 36
foot; 37
(h) Other emerging and existing public health threats 38
identified by the State Department of Health if permitted by an 39
order, rule, or regulation; and 40
(i) Other health conditions that can be screened 41
utilizing the waived test under the Clinical Laboratory 42
Improvement Amendments of 1988 (CLIA) that may be adopted by rule 43
of the State Board of Pharmacy. 44
(2) A pharmacist who tests or screens for and treats health 45
conditions under subsection (3) of this section may use any test 46
that may guide clinical decision making that the Centers for 47
Medicare and Medicaid Services has determined qualifies for a 48
waiver under CLIA or the federal rules adopted thereunder, or any 49
established screening procedures that can safely be performed by a 50
pharmacist. 51
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(3) A pharmacist may delegate the administrative and 52
technical tasks of performing a CLIA-waived test to an intern or 53
pharmacy technician acting under the supervision of the 54
pharmacist. 55
(4) A pharmacist may prohibit the denial of reimbursement 56
under health benefit plans for services and procedures performed 57
by a pharmacist that are within the scope of the pharmacist's 58
license and would be covered if the services or procedures were 59
performed by a physician, an advanced practice registered nurse, 60
or a physician assistant. 61
SECTION 2. Section 73-21-73, Mississippi Code of 1972, is 62
amended as follows: 63
73-21-73. As used in this chapter, unless the context 64
requires otherwise: 65
(a) "Administer" means the direct application of a 66
prescription drug pursuant to a lawful order of a practitioner to 67
the body of a patient by injection, inhalation, ingestion or any 68
other means. 69
(b) "Biological product" means the same as that term is 70
defined in 42 USC Section 262. 71
(c) "Board of Pharmacy," "Pharmacy Board," "MSBP" or 72
"board" means the State Board of Pharmacy. 73
(d) "Compounding" means (i) the production, 74
preparation, propagation, conversion or processing of a sterile or 75
nonsterile drug or device either directly or indirectly by 76
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extraction from substances of natural origin or independently by 77
means of chemical or biological synthesis or from bulk chemicals 78
or the preparation, mixing, measuring, assembling, packaging or 79
labeling of a drug or device as a result of a practitioner's 80
prescription drug order or initiative based on the 81
practitioner/patient/pharmacist relationship in the course of 82
professional practice, or (ii) for the purpose of, as an incident 83
to, research, teaching or chemical analysis and not for sale or 84
dispensing. Compounding also includes the preparation of drugs or 85
devices in anticipation of prescription drug orders based on 86
routine regularly observed prescribing patterns. 87
(e) "Continuing education unit" means ten (10) clock 88
hours of study or other such activity as may be approved by the 89
board, including, but not limited to, all programs which have been 90
approved by the Accreditation Council for Pharmacy Education. 91
(f) "Deliver" or "delivery" means the actual, 92
constructive or attempted transfer in any manner of a drug or 93
device from one (1) person to another, whether or not for a 94
consideration, including, but not limited to, delivery by mailing 95
or shipping. 96
(g) "Device" means an instrument, apparatus, implement, 97
machine, contrivance, implant, in vitro reagent or other similar 98
or related article, including any component part or accessory 99
which is required under federal or state law to be prescribed by a 100
practitioner. 101
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(h) "Dispense" or "dispensing" means the interpretation 102
of a valid prescription of a practitioner by a pharmacist and the 103
subsequent preparation of the drug or device for administration to 104
or use by a patient or other individual entitled to receive the 105
drug and includes delivery of the drug or device to the patient. 106
(i) "Distribute" means the delivery of a drug or device 107
other than by administering or dispensing to persons other than 108
the ultimate consumer. 109
(j) "Drug" means: 110
(i) Articles recognized as drugs in the official 111
United States Pharmacopeia, official National Formulary, official 112
Homeopathic Pharmacopeia, other drug compendium or any supplement 113
to any of them; 114
(ii) Articles intended for use in the diagnosis, 115
cure, mitigation, treatment or prevention of disease in man or 116
other animals; 117
(iii) Articles other than food intended to affect 118
the structure or any function of the body of man or other animals; 119
and 120
(iv) Articles intended for use as a component of 121
any articles specified in subparagraph (i), (ii) or (iii) of this 122
paragraph. 123
(k) "Extern" means a student in the professional 124
program of a school of pharmacy accredited by the Accreditation 125
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Council for Pharmacy Education who is making normal progress 126
toward completion of a professional degree in pharmacy. 127
(l) "Foreign pharmacy graduate" means a person whose 128
undergraduate pharmacy degree was conferred by a recognized school 129
of pharmacy outside of the United States, the District of Columbia 130
and Puerto Rico. Recognized schools of pharmacy are those 131
colleges and universities listed in the World Health 132
Organization's World Directory of Schools of Pharmacy, or 133
otherwise approved by the Foreign Pharmacy Graduate Examination 134
Committee (FPGEC) certification program as established by the 135
National Association of Boards of Pharmacy. 136
(m) "Generic equivalent drug product" means a drug 137
product which (i) contains the identical active chemical 138
ingredient of the same strength, quantity and dosage form; (ii) is 139
of the same generic drug name as determined by the United States 140
Adoptive Names and accepted by the United States Food and Drug 141
Administration; and (iii) conforms to such rules and regulations 142
as may be adopted by the board for the protection of the public to 143
assure that such drug product is therapeutically equivalent. 144
(n) "Interchangeable biological product" or "I.B." 145
means a biological product that the federal Food and Drug 146
Administration: 147
(i) Has licensed and determined as meeting the 148
standards for interchangeability under 42 USC Section 262(k)(4); 149
or 150
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(ii) Has determined is therapeutically equivalent 151
as set forth in the latest edition of or supplement to the federal 152
Food and Drug Administration's Approved Drug Products with 153
Therapeutic Equivalence Evaluations. 154
(o) "Intern" means a person who has graduated from a 155
school of pharmacy but has not yet become licensed as a 156
pharmacist. 157
(p) "Manufacturer" means a person, business or other 158
entity engaged in the production, preparation, propagation, 159
conversion or processing of a prescription drug or device, if such 160
actions are associated with promotion and marketing of such drugs 161
or devices. 162
(q) "Manufacturer's distributor" means any person or 163
business who is not an employee of a manufacturer, but who 164
distributes sample drugs or devices, and defined under paragraph 165
(i) of this section, under contract or business arrangement for a 166
manufacturer to practitioners. 167
(r) "Manufacturing" of prescription products means the 168
production, preparation, propagation, conversion or processing of 169
a drug or device, either directly or indirectly, by extraction 170
from substances from natural origin or independently by means of 171
chemical or biological synthesis, or from bulk chemicals and 172
includes any packaging or repackaging of the drug or device or 173
labeling or relabeling of the container of the drug or device for 174
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resale by pharmacies, practitioners, business entities or other 175
persons. 176
(s) "Misappropriation of a prescription drug" means to 177
illegally or unlawfully convert a drug, as defined in this 178
section, to one's own use or to the use of another. 179
(t) "Nonprescription drugs" means nonnarcotic medicines 180
or drugs that may be sold without a prescription and are 181
prepackaged and labeled for use by the consumer in accordance with 182
the requirements of the statutes and regulations of this state and 183
the federal government. 184
(u) "Person" means an individual, corporation, 185
partnership, association or any other legal entity. 186
(v) "Pharmacist" means an individual health care 187
provider licensed by this state to engage in the practice of 188
pharmacy. This recognizes a pharmacist as a learned professional 189
who is authorized to provide patient services. 190
(w) "Pharmacy" means any location for which a pharmacy 191
permit is required and in which prescription drugs are maintained, 192
compounded and dispensed for patients by a pharmacist. This 193
definition includes any location where pharmacy-related services 194
are provided by a pharmacist. 195
(x) "Prepackaging" means the act of placing small 196
precounted quantities of drug products in containers suitable for 197
dispensing or administering in anticipation of prescriptions or 198
orders. 199
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(y) "Unlawful or unauthorized possession" means 200
physical holding or control by a pharmacist of a controlled 201
substance outside the usual and lawful course of employment. 202
(z) "Practice of pharmacy" means a health care service 203
that includes, but is not limited to, the compounding, dispensing, 204
and labeling of drugs or devices; interpreting and evaluating 205
prescriptions; administering and distributing drugs and devices; 206
the compounding, dispensing and labeling of drugs and devices; 207
maintaining prescription drug records; advising and consulting 208
concerning therapeutic values, content, hazards and uses of drugs 209
and devices; * * * ordering, performing, and interpreting tests 210
authorized by the United States Food and Drug Administration (FDA) 211
and waived under the federal Clinical Laboratory Improvement 212
Amendments of 1988 (CLIA), and initiating, administering or 213
modifying of drug therapy; selecting drugs; participating in drug 214
utilization reviews; storing prescription drugs and devices; * * * 215
providing pharmacotherapeutic consultations; supervising 216
supportive personnel and such other acts, services, operations or 217
transactions necessary or incidental to the conduct of the 218
foregoing. 219
(aa) "Practitioner" means a physician, dentist, 220
veterinarian, or other health care provider authorized by law to 221
diagnose and prescribe drugs. 222
(bb) "Prescription" means a written, verbal or 223
electronically transmitted order issued by a practitioner for a 224
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drug or device to be dispensed for a patient by a pharmacist. 225
"Prescription" includes a standing order issued by a practitioner 226
to an individual pharmacy that authorizes the pharmacy to dispense 227
an opioid antagonist to certain persons without the person to whom 228
the opioid antagonist is dispensed needing to have an individual 229
prescription, as authorized by Section 41-29-319(3). 230
(cc) "Prescription drug" or "legend drug" means a drug 231
which is required under federal law to be labeled with either of 232
the following statements prior to being dispensed or delivered: 233
(i) "Caution: Federal law prohibits dispensing 234
without prescription," or 235
(ii) "Caution: Federal law restricts this drug to 236
use by or on the order of a licensed veterinarian"; or a drug 237
which is required by any applicable federal or state law or 238
regulation to be dispensed on prescription only or is restricted 239
to use by practitioners only. 240
(dd) "Product selection" means the dispensing of a 241
generic equivalent drug product or an interchangeable biological 242
product in lieu of the drug product ordered by the prescriber. 243
(ee) "Provider" or "primary health care provider" 244
includes a pharmacist who provides health care services within his 245
or her scope of practice pursuant to state law and regulation. 246
(ff) "Registrant" means a pharmacy or other entity 247
which is registered with the Mississippi State Board of Pharmacy 248
to buy, sell or maintain controlled substances. 249
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(gg) "Repackager" means a person registered by the 250
federal Food and Drug Administration as a repackager who removes a 251
prescription drug product from its marketed container and places 252
it into another, usually of smaller size, to be distributed to 253
persons other than the consumer. 254
(hh) "Reverse distributor" means a business operator 255
that is responsible for the receipt and appropriate return or 256
disposal of unwanted, unneeded or outdated stocks of controlled or 257
uncontrolled drugs from a pharmacy. 258
(ii) "Supportive personnel" or "pharmacist technician" 259
means those individuals utilized in pharmacies whose 260
responsibilities are to provide nonjudgmental technical services 261
concerned with the preparation and distribution of drugs under the 262
direct supervision and responsibility of a pharmacist. 263
(jj) "Written guideline or protocol" means an agreement 264
in which any practitioner authorized to prescribe drugs delegates 265
to a pharmacist authority to conduct specific prescribing 266
functions in an institutional setting, or with the practitioner's 267
individual patients, provided that a specific protocol agreement 268
between the practitioner and the pharmacist is signed and filed as 269
required by law or by rule or regulation of the board. 270
(kk) "Wholesaler" means a person who buys or otherwise 271
acquires prescription drugs or prescription devices for resale or 272
distribution, or for repackaging for resale or distribution, to 273
persons other than consumers. 274
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(ll) "Pharmacy benefit manager" has the same meaning as 275
defined in Section 73-21-153. 276
(mm) "Pharmacy services administrative organization" 277
means any entity that contracts with a pharmacy or pharmacist to 278
assist with third-party interactions and that may provide a 279
variety of other administrative services, including, but not 280
limited to, contracting with pharmacy benefit managers on behalf 281
of pharmacies and providing pharmacies with credentialing, 282
billing, audit, general business and analytic support. A covered 283
entity as defined in 42 USC Section 256b, including its pharmacy 284
or the transactions related to the 340B drug discount program of 285
any pharmacy contracted with the participating covered entity to 286
dispense drugs purchased through the 340B drug discount program, 287
shall not be considered to be a pharmacy services administrative 288
organization. 289
SECTION 3. Section 83-9-36, Mississippi Code of 1972, is 290
brought forward as follows: 291
83-9-36. (1) When medications for the treatment of any 292
medical condition are restricted for use by an insurer by a step 293
therapy or fail-first protocol, the prescribing practitioner shall 294
have access to a clear and convenient process to expeditiously 295
request an override of that restriction from the insurer. An 296
override of that restriction shall be expeditiously granted by the 297
insurer under the following circumstances: 298
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(a) The prescribing practitioner can demonstrate, based 299
on sound clinical evidence, that the preferred treatment required 300
under step therapy or fail-first protocol has been ineffective in 301
the treatment of the insured's disease or medical condition; or 302
(b) Based on sound clinical evidence or medical and 303
scientific evidence: 304
(i) The prescribing practitioner can demonstrate 305
that the preferred treatment required under the step therapy or 306
fail-first protocol is expected or likely to be ineffective based 307
on the known relevant physical or mental characteristics of the 308
insured and known characteristics of the drug regimen; or 309
(ii) The prescribing practitioner can demonstrate 310
that the preferred treatment required under the step therapy or 311
fail-first protocol will cause or will likely cause an adverse 312
reaction or other physical harm to the insured. 313
(2) The duration of any step therapy or fail-first protocol 314
shall not be longer than a period of thirty (30) days when the 315
treatment is deemed clinically ineffective by the prescribing 316
practitioner. When the prescribing practitioner can demonstrate, 317
through sound clinical evidence, that the originally prescribed 318
medication is likely to require more than thirty (30) days to 319
provide any relief or an amelioration to the insured, the step 320
therapy or fail-first protocol may be extended up to seven (7) 321
additional days. 322
(3) As used in this section: 323
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ST: Pharmacists; authorize to test for and
administer treatment for minor, nonchronic
health conditions.
(a) "Insurer" means any hospital, health, or medical 324
expense insurance policy, hospital or medical service contract, 325
employee welfare benefit plan, contract or agreement with a health 326
maintenance organization or a preferred provider organization, 327
health and accident insurance policy, or any other insurance 328
contract of this type, including a group insurance plan. However, 329
the term "insurer" does not include a preferred provider 330
organization that is only a network of providers and does not 331
define health care benefits for the purpose of coverage under a 332
health care benefits plan. 333
(b) "Practitioner" has the same meaning as defined in 334
Section 73-21-73. 335
(4) The provisions of Section 83-9-8.1 shall supersede the 336
provisions of this section to the extent of any conflict between 337
Section 83-9-8.1 and this section. 338
SECTION 4. This act shall take effect and be in force from 339
and after July 1, 2026. 340