Pharmacists/Test and Treat.

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
S 1
SENATE BILL 414

Short Title: Pharmacists/Test and Treat. (Public)
Sponsors: Senators Jones, Ford, and Moffitt (Primary Sponsors).
Referred to: Rules and Operations of the Senate
March 25, 2025
*S414-v-1*
A BILL TO BE ENTITLED 1
AN ACT TO ALLOW PHARMACISTS TO TEST AND TREAT FOR CERTAIN ILLNESSES 2
WITH CERTAIN MEDICATIONS APPROVED BY THE BOARD OF PHARMACY, TO 3
PROVIDE FOR FAIR AND EQUITABLE REIMBURSE MENT OF HEALTH CARE 4
SERVICES OR PROCEDUR ES THAT ARE PERFORME D BY A PHARMACIST 5
WITHIN THAT PHARMACI ST'S SCOPE OF PRACTI CE AND THAT ARE 6
EQUIVALENT TO SERVIC ES PERFORMED BY OTHE R HEALTH CARE 7
PROFESSIONALS, AND T O APPROPRIATE FUNDS TO THE DEPARTMENT OF 8
INSURANCE. 9
The General Assembly of North Carolina enacts: 10
SECTION 1.(a) G.S. 90-85.3 reads as rewritten: 11
"§ 90-85.3. Definitions. 12
… 13
(b2) "CLIA-waived test " means a laboratory test approved by the Food and Drug 14
Administration and determined by the Centers for Medicare and Medicaid Services to qualify for 15
a waiver under the federal Clinical Laboratory Improvement Amendments of 1 988 and safe for 16
use in non-laboratory settings. 17
(b3) "Clinical pharmacist practitioner" means a licensed pharmacist who meets the 18
guidelines and criteria for such title established by the joint subcommittee of the North Carolina 19
Medical Board and the North Carolina Board of Pharmacy and is authorized to enter into drug 20
therapy management agreements with physicians in accordance with the provisions of 21
G.S. 90-18.4. 22
…." 23
SECTION 1.(b) G.S. 90-85.3A reads as rewritten: 24
"§ 90-85.3A. Practice of pharmacy. 25
… 26
(b) A pharmacist may advise and educate patients and health care providers concerning 27
therapeutic values, content, uses, and significant problems of drugs and devices; assess, record, 28
and report adverse drug and device reactions; take and record patient histories relating to drug 29
and device therapy; administer drugs; monitor, record, and report drug therapy and device usage; 30
perform drug utilization reviews; and participate in drug and drug source sel ection and device 31
and device source selection as provided in G.S. 90-85.27 through G.S. 90-85.31. 32
… 33
(e) A pharmacist may order and perform a CLIA-waived test to do any of the following: 34
(1) Assist with clinical decision making related to the use and monitoring of 35
medications. 36
General Assembly Of North Carolina Session 2025
Page 2 Senate Bill 414-First Edition
(2) Treat influenza, COVID-19, pharyngitis caused by group A streptococcus, 1
and other health conditions screened by utilizing a CLIA -waived test , in 2
accordance with statewide protocols . A pharmacist shall not treat a health 3
condition under this section with any controlled substance classified in 4
Schedules I–IV." 5
SECTION 1.(c) This section becomes effective October 1, 2025. 6
SECTION 2.(a) Article 3 of Chapter 58 of the General Statutes is amended by adding 7
a new section to read: 8
"§ 58-3-241. Healthcare services provided by pharmacists. 9
(a) The following definitions apply in this section: 10
(1) Healthcare provider. – Either of the following: 11
a. An individual who is licensed, certified, or otherwise authorized under 12
Chapter 90 of the General Statutes to provide healthcare services in 13
the ordinary course of business or practice of a profession o r in an 14
approved education or training program. 15
b. A health care facility licensed under Chapter 131E or Chapter 122C of 16
the General Statutes and where healthcare services are provided to 17
patients. 18
(2) Healthcare services. – Any of the following health or medical procedures or 19
services rendered by a healthcare provider: 20
a. Testing, diagnosis, or treatment of a health condition, illness, injury, 21
or disease. This includes testing, diagnosis, or treatment rendered by a 22
pharmacist acting within the pharmacist's scope of practice. 23
b. Dispensing of drugs, medical devices, medical appliances, or medical 24
goods for the treatment of a health condition, illness, injury, or disease. 25
c. Administration of a vaccine or medication. 26
(3) Pharmacist. – An individual licensed to practice pharmacy under Article 4A 27
of Chapter 90 of the General Statutes or the relevant laws of another state. 28
(b) A health benefit plan offered by an insurer in this State shall cover healthcare services 29
provided by a pharmacist if all of the following conditions are met: 30
(1) The service or procedure was performed within the pharmacist 's lic ensed 31
lawful scope of practice. 32
(2) The health benefit plan would have covered the service if the service or 33
procedure had been performed by another healthcare provider. 34
(c) The participation of a pharmacy in a drug benefit provider network of a health benefit 35
plan shall not satisfy any requirement that insurers offering health benefit plans include 36
pharmacists in medical benefit provider networks." 37
SECTION 2.(b) G.S. 58-3-230 is amended by adding a new subsection to read: 38
"(d) Insurers that delegate credentialing agreements or requirements for pharmacists 39
licensed under Article 4A of Chapter 90 of the General Statutes or the relevant laws of another 40
state to a contracted healthcare facility shall accept the credentialing for all pharmacists employed 41
by, or contracted with, those healthcare facilities." 42
SECTION 2.(c) G.S. 58-3-200(d) reads as rewritten: 43
"(d) Services Outside Provider Networks. – No insurer shall penalize an insured or subject 44
an insured to the out-of-network benefit levels offered under the insured's approved health benefit 45
plan, including an insured receiving an extended or standing referral under G.S. 58-3-223, unless 46
contracting health care providers able to meet health needs of the insured are reasonably available 47
to the insured without unreasonable delay. Upon notice or request from the insured, the insurer 48
shall determine whether a health care provider able to meet the needs of the insured is available 49
to the insured without unreasonable delay by reference to the insured 's location and the specific 50
medical needs of the insured." 51
General Assembly Of North Carolina Session 2025
Senate Bill 414-First Edition Page 3
SECTION 2.(d) G.S. 58-56-26 is amended by adding a new subsection to read: 1
"(e) Notwithstanding any provision of this Article to the contrary, all requirements relating 2
to the coverage of prescrip tion drugs and pharmacy services under this Chapter that apply to 3
health benefit plans are applicable to a third -party administrator in the same way they are 4
applicable to an insurer." 5
SECTION 2.(e) Article 56A of Chapter 58 of the General Statutes is ame nded by 6
adding a new section to read: 7
"§ 58-56A-55. Health benefit plan requirements applicable. 8
All requirements relating to the coverage of prescription drugs and pharmacy services under 9
this Chapter that apply to health benefit plans are applicable to a pharmacy benefits manager in 10
the same way they are applicable to an insurer." 11
SECTION 2.(f) This section is effective October 1, 2025, and applies to insurance 12
contracts entered into, renewed, or amended on or after that date. 13
SECTION 3. The State Heal th Director, in consultation with the North Carolina 14
Board of Pharmacy and the North Carolina Medical Board, shall develop statewide protocols for 15
implementing Section 1(b) of this act. The statewide protocol shall include patient parameters 16
necessitating referral to a primary, urgent, or emergency care provider. 17
SECTION 4. Except as otherwise provided, this act is effective when it becomes 18
law. 19