SB 335: Pharmacists/Test and Treat/Influenza and Strep. - North Carolina

A1: ATG-13-V-1 → Edition 1 · 6 edits

MODERATE

This bill transforms from an amendment document into a complete legislative act allowing North Carolina pharmacists to perform influenza testing and treatment under specific conditions. The new version establishes formal definitions for clinical pharmacist practitioners and CLIA-waived tests, mandates insurance coverage parity for pharmacist services, and sets an October 1, 2025 effective date.

Scope change

The bill's scope expanded from a single amendment to a comprehensive act covering pharmacy practice definitions, insurance coverage requirements, and healthcare service regulations.

DEFINITION

Added formal definitions for 'clinical pharmacist practitioner' and 'CLIA-waived test' to establish legal standards for pharmacist testing capabilities.

ELIGIBILITY

Authorized pharmacists to order and perform influenza testing and treatment using approved CLIA-waived tests under statewide protocols.

REQUIREMENT

Established insurance coverage requirements mandating that health benefit plans cover pharmacist services if they would cover the same service from other healthcare providers.

Added provisions requiring insurers to accept pharmacist credentialing when facilities delegate credentialing agreements.

TIMELINE

Set the effective date for the new pharmacist testing and treatment provisions to October 1, 2025.

TECHNICAL

Removed amendment-specific formatting including amendment numbers, committee signatures, and amendment adoption language.

Filed → A1: ATG-13-V-1 · 4 edits

MODERATE

The bill was amended to change the amendment number and add specific instructions for moving to amend page 3, line 6, while removing the original filing date and sponsor information. The substantive legislative text regarding pharmacists' ability to test and treat for influenza and healthcare reimbursement coverage appears unchanged in the provided diff.

TECHNICAL

Header information was updated from 'Filed Senate' to 'Adopted' with new amendment tracking details.

Original filing date (Mar 19, 2025) and full sponsor list were removed.

New amendment instruction was added directing changes to page 3, line 6 regarding standing order protocols.

New signature lines for amendment sponsor and committee chair were added.

Edition 3 → Edition 4 · 2 edits

MINOR

The bill was updated from Edition 3 to Edition 4, primarily adding formatting markers and versioning information. The substantive policy content regarding pharmacist test-and-treat authority for influenza and strep infections remains unchanged, including the October 1, 2025 effective date and restrictions on controlled substances.

TECHNICAL

Version number updated from Edition 3 to Edition 4 with corresponding date changes (4/2/25 to 4/10/25) and version identifier changed from S335-v-3 to S335-v-4

Added blank lines and versioning headers in the document formatting

Edition 2 → Edition 3 · 4 edits

MODERATE

This bill version adds a Commerce and Insurance Committee substitute, expanding the bill's scope to include pharmacy benefits managers (PBMs) under the same coverage requirements as insurers. The bill also reorganizes sections and adds new provisions ensuring PBMs must follow the same prescription drug and pharmacy service coverage rules that apply to health benefit plans.

Scope change

The bill now explicitly extends coverage requirements to pharmacy benefits managers, who were not previously mentioned in the statute.

REQUIREMENT

Added new section requiring pharmacy benefits managers to comply with the same prescription drug and pharmacy service coverage requirements that apply to health benefit plans.

Removed the previous provision about services outside provider networks and related insurer obligations.

Added new section 2(c) requiring third-party administrators to follow the same coverage requirements as insurers.

TECHNICAL

Reorganized section numbering and added Commerce and Insurance Committee substitute adoption date.

Edition 1 → Edition 2 · 6 edits

MODERATE

This bill was amended to expand pharmacist testing and treatment authority beyond just influenza to include streptococcus infections, and to add stronger reimbursement protections for pharmacists. The changes also clarify definitions and add new requirements for how insurers must handle pharmacist services and claims.

Scope change

The bill's scope was expanded to include streptococcus infections in addition to influenza, and the definition of CLIA-waived tests was simplified. Reimbursement requirements were strengthened to ensure pharmacists receive equal coverage rates as other healthcare providers.

SCOPE

Expanded pharmacist testing and treatment authority to include streptococcus infections in addition to influenza

DEFINITION

Simplified the definition of 'CLIA-waived test' by removing references to CMS waiver determination and federal safety requirements

REQUIREMENT

Added new subsection requiring insurers to cover pharmacist services at no less than the same rate as other healthcare providers performing the same service

Added new subsection requiring insurers to accept claims regardless of whether submitted by pharmacist or pharmacy on their behalf

Added explicit prohibition on pharmacists treating conditions with controlled substances in Schedules I through IV

TECHNICAL

Removed references to statewide protocols requirement and updated bill version number from v-1 to v-2

Pharmacists/Test and Treat/Influenza and Strep.

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