GENERAL ASSEMBLY OF NORTH CAROLINA SESSION 2025 S D SENATE BILL DRS15151-NB-108 Short Title: Pharmacists/Test and Treat/Influenza. (Public) Sponsors: Senators Sawrey, Galey, and Burgin (Primary Sponsors). Referred to: *DRS15151 -NB-108* 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 REIMBURSEMENT OF HEALTH CARE 4 SERVICES OR PROCEDURES THAT ARE PERFORMED BY A PHARMACIST 5 WITHIN THAT PHARMACIST 'S SCOPE OF PRACTICE AND THAT ARE 6 EQUIVALENT TO SERVICES PERFORMED BY OTHER HEALTH CARE 7 PROFESSIONALS, AND TO 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 1988 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 selection 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 treat influenza by 34 utilizing a CLIA-waived test, in accordance with statewide protocols. A pharmacist shall not treat 35 FILED SENATE Mar 19, 2025 S.B. 335 PRINCIPAL CLERK General Assembly Of North Carolina Session 2025 Page 2 DRS15151-NB-108 a health condition under this section with any controlled substance classified in Schedules I 1 through IV." 2 SECTION 1.(c) This section becomes effective October 1, 2025. 3 SECTION 2.(a) Article 3 of Chapter 58 of the General Statutes is amended by adding 4 a new section to read: 5 "§ 58-3-241. Healthcare services provided by pharmacists. 6 (a) The following definitions apply in this section: 7 (1) Healthcare provider. – Either of the following: 8 a. An individual who is licensed, certified, or otherwise authorized under 9 Chapter 90 of the General Statutes to provide healthcare services in 10 the ordinary course of business or practice of a profession or in an 11 approved education or training program. 12 b. A health care facility licensed under Chapter 131E or Chapter 122C of 13 the General Statutes and where healthcare services are provided to 14 patients. 15 (2) Healthcare services. – Any of the following health or medical procedures or 16 services rendered by a healthcare provider: 17 a. Testing, diagnosis, or treatment of a health condition, illness, injury, 18 or disease. This includes testing, diagnosis, or treatment rendered by a 19 pharmacist acting within the pharmacist's scope of practice. 20 b. Dispensing of drugs, medical devices, medical appliances, or medical 21 goods for the treatment of a health condition, illness, injury, or disease. 22 c. Administration of a vaccine or medication. 23 (3) Pharmacist. – An individual licensed to practice pharmacy under Article 4A 24 of Chapter 90 of the General Statutes or the relevant laws of another state. 25 (b) A health benefit plan offered by an insurer in this State shall cover healthcare services 26 provided by a pharmacist if all of the following conditions are met: 27 (1) The service or procedure was performed within the pharmacist's licensed 28 lawful scope of practice. 29 (2) The health benefit plan would have covered the service if the service or 30 procedure had been performed by another healthcare provider. 31 (c) The participation of a pharmacy in a drug benefit provider network of a health benefit 32 plan shall not satisfy any requirement that insurers offering health benefit plans include 33 pharmacists in medical benefit provider networks." 34 SECTION 2.(b) G.S. 58-3-230 is amended by adding a new subsection to read: 35 "(d) Insurers that delegate credentialing agreements or requirements for pharmacists 36 licensed under Article 4A of Chapter 90 of the General Statutes or the relevant laws of another 37 state to a contracted healthcare facility shall accept the credentialing for all pharmacists employed 38 by, or contracted with, those healthcare facilities." 39 SECTION 2.(c) G.S. 58-3-200(d) reads as rewritten: 40 "(d) Services Outside Provider Networks. – No insurer shall penalize an insured or subject 41 an insured to the out-of-network benefit levels offered under the insured's approved health benefit 42 plan, including an insured receiving an extended or standing referral under G.S. 58-3-223, unless 43 contracting health care providers able to meet health needs of the insured are reasonably available 44 to the insured without unreasonable delay. Upon notice or request from the insured, the insurer 45 shall determine whether a health care provider able to meet the needs of the insured is available 46 to the insured without unreasonable delay by reference to the insured's location and the specific 47 medical needs of the insured." 48 SECTION 2.(d) G.S. 58-56-26 is amended by adding a new subsection to read: 49 "(e) Notwithstanding any provision of this Article to the contrary, all requirements relating 50 to the coverage of prescription drugs and pharmacy services under this Chapter that apply to 51 General Assembly Of North Carolina Session 2025 DRS15151-NB-108 Page 3 health benefit plans are applicable to a third-party administrator in the same way they are 1 applicable to an insurer." 2 SECTION 2.(e) Article 56A of Chapter 58 of the General Statutes is amended by 3 adding a new section to read: 4 "§ 58-56A-55. Health benefit plan requirements applicable. 5 All requirements relating to the coverage of prescription drugs and pharmacy services under 6 this Chapter that apply to health benefit plans are applicable to a pharmacy benefits manager in 7 the same way they are applicable to an insurer." 8 SECTION 2.(f) This section is effective October 1, 2025, and applies to insurance 9 contracts entered into, renewed, or amended on or after that date. 10 SECTION 3. The State Health Director, in consultation with the North Carolina 11 Board of Pharmacy and the North Carolina Medical Board, shall develop statewide protocols for 12 implementing Section 1(b) of this act. The statewide protocol shall include patient parameters 13 necessitating referral to a primary, urgent, or emergency care provider. 14 SECTION 4. Except as otherwise provided, this act is effective when it becomes 15 law. 16