2026 -- H 7921

========

LC005314

========

     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2026

____________

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- PHARMACISTS TEST-AND-TREAT

AUTHORITY ACT

     Introduced By: Representatives McGaw, Donovan, Tanzi, Boylan, Cruz, Furtado, Potter,
Giraldo, Kislak, and Cotter

     Date Introduced: February 27, 2026

     Referred To: House Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. The general assembly hereby finds that:

     (1) Timely access to testing and treatment for common, self-limiting, and communicable

conditions is essential to protecting public health.

     (2) Licensed pharmacists are among the most accessible health care professionals and are

trained in medication therapy management, clinical assessment, and patient counseling.

     (3) Expanding pharmacist authority to test for and treat certain conditions improves access

to care, reduces unnecessary emergency department and urgent care utilization, and supports health

system capacity.

     (4) Pharmacist-provided test-and-treat services have been demonstrated to be safe,

effective, and acceptable to patients when conducted pursuant to evidence-based protocols.

     SECTION 2. Title 5 of the General Laws entitled "BUSINESSES AND PROFESSIONS"

is hereby amended by adding thereto the following chapter:

CHAPTER 19.4

PHARMACISTS TEST-AND-TREAT AUTHORITY ACT

     5-19.4-1. Short title.

     This chapter shall be known and may be cited as the “Pharmacists Test-and-Treat Authority

Act”.

     5-19.4-2. Purpose.

     The purpose of this chapter is to authorize licensed pharmacists to independently test for

and initiate treatment of certain conditions.

     5-19.4-3. Definitions.

     As used in this chapter, the following terms shall have the following meanings:

     (1) “Board” means the board of pharmacy established pursuant to §§ 5-19.1-3 through 5-

19.1-6.

     (2) “CLIA-waived test” means a laboratory test categorized as waived under 42 CFR §

493.15

     (3) “Department” means the department of health.

     (4) “Pharmacist” means an individual licensed under chapter 19.1 of title 5 ("pharmacies").

     (5) “Test-and-treat service” means the performance of a clinical assessment, the ordering

or administration of a clinical laboratory improvement amendments (CLIA)-waived test, the

interpretation of test results, and the initiation, modification, or discontinuation of drug therapy

pursuant to a statewide protocol.

     5-19.4-4. Authority to provide test-and-treat services.

     (a) Notwithstanding any provision of law to the contrary, a pharmacist may independently

provide test-and-treat services for conditions authorized by statewide protocol adopted by the board

pursuant to §§ 5-19.4-5 and 5-19.4-10.

     (b) A pharmacist acting pursuant to this chapter may:

     (1) Order, perform, and interpret CLIA-waived tests;

     (2) Initiate, dispense, administer, or prescribe medications; and

     (3) Provide patient counseling, education, and referral as clinically indicated.

     (c) A pharmacist shall not provide test-and-treat services for any condition not expressly

authorized by statewide protocol.

     5-19.4-5. Authorized conditions.

     (a) The board, in consultation with the department, shall adopt statewide protocols

authorizing pharmacist test-and-treat services for conditions including, but not limited to:

     (1) Influenza;

     (2) COVID-19;

     (3) Group A streptococcal pharyngitis;

     (4) Post exposure prophylaxis (PEP) for sexually transmitted infections for which CLIA-

waived testing is available, unless testing is not readily available and delay in treatment may

increase risk of infection; and

     (5) Any additional condition determined by the board to be appropriate based on safety,

LC005314 - Page 2 of 7

evidence, and public health needs.

     (b) In adopting or amending protocols, the board shall consider:

     (1) Evidence-based clinical guidelines;

     (2) Diagnostic reliability of available tests;

     (3) Medication safety and appropriateness; and

     (4) Referral criteria and exclusion conditions.

     5-19.4-6. Training and competency.

     (a) Prior to providing test-and-treat services, a pharmacist shall complete education

requirements established by the board, which may include:

     (1) Disease-specific education;

     (2) Use and interpretation of CLIA-waived tests;

     (3) Patient assessment and referral; and

     (4) Documentation and reporting requirements.

     (b) The board may require ongoing continuing education as a condition of continued

authority for a pharmacist to provide test-and-treat services pursuant to the provisions of this

chapter.

     5-19.4-7. Documentation and communication.

     (a) A pharmacist shall document each test-and-treat encounter in a patient record consistent

with board rules and regulations adopted pursuant to § 5-19.4-10.

     (b) Upon patient consent, the pharmacist shall make reasonable efforts to notify the

patient’s primary care provider, if one exists, of the service provided within seven (7) business

days.

     (c) Pharmacists shall comply with all applicable public health reporting requirements.

     5-19.4-8. Liability and standard of care.

     (a) A pharmacist providing services pursuant to the provisions of this chapter shall be held

to the standard of care applicable to pharmacists practicing within their scope of licensure.

     (b) Nothing in this chapter shall be construed to create a higher standard of care or to

expand civil liability beyond existing law.

     5-19.4-9. Reimbursement.

     (a) Test-and-treat services provided pursuant to this chapter shall constitute covered health

care services for purposes of reimbursement under state-regulated health insurance plans and

Medicaid, subject to applicable billing requirements.

     (b) The office of the health insurance commissioner and the executive office of health and

human services shall take actions necessary to implement this section.

LC005314 - Page 3 of 7

     5-19.4-10. Rulemaking authority.

     The board of pharmacy, in consultation with the department of health, shall promulgate

rules and regulations necessary to implement and enforce the provisions of this chapter. The rules

and regulations shall be promulgated no later than six (6) months after the effective date of this

chapter.

     5-19.4-11. Severability.

     If any provision of this chapter or its application is held invalid, the invalidity shall not

affect other provisions or applications of the chapter that can be given effect without the invalid

provision or application.

     SECTION 3. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance

Policies" is hereby amended by adding thereto the following section:

     27-18-96. Coverage for pharmacists’ services.

     (a) Every group health insurance contract, or every group hospital or medical expense

insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state, by

any health insurance carrier, on or after January 1, 2027, shall provide coverage for the services

within the lawful scope of practice of pharmacists as defined in § 5-19.1-2 if the plan would have

provided coverage if the service had been performed by a physician, advanced practice nurse, or

physician assistant. No nonprofit medical service corporation may require supervision, signature,

or referral by any other healthcare provider as a condition of reimbursement to a pharmacist;

provided that, no nonprofit medical service corporation may be required to pay for duplicative

services actually rendered by both a pharmacist and any other healthcare provider.

     (b) The health plan shall include an adequate number of pharmacists in its network of

participating medical providers. The participation of pharmacies in the plan network’s drug benefit

does not satisfy the requirement that plans include pharmacists in their networks of participating

medical providers.

     (c) The healthcare benefits outlined in this section shall apply only to services delivered

within the health insurer’s provider network; provided that, all health insurers shall be required to

provide coverage for those benefits mandated by this section outside of the health insurer’s provider

network where it can be established that the required services are not available from a provider in

the health insurer’s network.

     SECTION 4. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service

Corporations" is hereby amended by adding thereto the following section:

     27-19-88. Coverage for pharmacists’ services.

     (a) Every group health insurance contract, or every group hospital or medical expense

LC005314 - Page 4 of 7

insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state, by

any health insurance carrier, on or after January 1, 2027, shall provide coverage for the services

within the lawful scope of practice of pharmacists as defined in § 5-19.1-2 if the plan would have

provided coverage if the service had been performed by a physician, advanced practice nurse, or

physician assistant. No nonprofit medical service corporation may require supervision, signature,

or referral by any other healthcare provider as a condition of reimbursement to a pharmacist;

provided that, no nonprofit medical service corporation may be required to pay for duplicative

services actually rendered by both a pharmacist and any other healthcare provider.

     (b) The health plan shall include an adequate number of pharmacists in its network of

participating medical providers. The participation of pharmacies in the plan network’s drug benefit

does not satisfy the requirement that plans include pharmacists in their networks of participating

medical providers.

     (c) The healthcare benefits outlined in this section shall apply only to services delivered

within the health insurer’s provider network; provided that, all health insurers shall be required to

provide coverage for those benefits mandated by this section outside of the health insurer’s provider

network where it can be established that the required services are not available from a provider in

the health insurer’s network.

     SECTION 5. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service

Corporations" is hereby amended by adding thereto the following section:

     27-20-84. Coverage for pharmacists’ services.

     (a) Every group health insurance contract, or every group hospital or medical expense

insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state, by

any health insurance carrier, on or after January 1, 2027, shall provide coverage for the services

within the lawful scope of practice of pharmacists as defined in § 5-19.1-2 if the plan would have

provided coverage if the service had been performed by a physician, advanced practice nurse, or

physician assistant. No nonprofit medical service corporation may require supervision, signature,

or referral by any other healthcare provider as a condition of reimbursement to a pharmacist;

provided that, no nonprofit medical service corporation may be required to pay for duplicative

services actually rendered by both a pharmacist and any other healthcare provider.

     (b) The health plan shall include an adequate number of pharmacists in its network of

participating medical providers. The participation of pharmacies in the plan network’s drug benefit

does not satisfy the requirement that plans include pharmacists in their networks of participating

medical providers.

     (c) The healthcare benefits outlined in this section shall apply only to services delivered

LC005314 - Page 5 of 7

within the health insurer’s provider network; provided that, all health insurers shall be required to

provide coverage for those benefits mandated by this section outside of the health insurer’s provider

network where it can be established that the required services are not available from a provider in

the health insurer’s network.

     SECTION 6. Chapter 27-41 of the General Laws entitled "Health Maintenance

Organizations" is hereby amended by adding thereto the following section:

     27-41-101. Coverage for pharmacists’ services.

     (a) Every group health insurance contract, or every group hospital or medical expense

insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state, by

any health insurance carrier, on or after January 1, 2027, shall provide coverage for the services

within the lawful scope of practice of pharmacists as defined in § 5-19.1-2 if the plan would have

provided coverage if the service had been performed by a physician, advanced practice nurse, or

physician assistant. No nonprofit medical service corporation may require supervision, signature,

or referral by any other healthcare provider as a condition of reimbursement to a pharmacist;

provided that, no nonprofit medical service corporation may be required to pay for duplicative

services actually rendered by both a pharmacist and any other healthcare provider.

     (b) The health plan shall include an adequate number of pharmacists in its network of

participating medical providers. The participation of pharmacies in the plan network’s drug benefit

does not satisfy the requirement that plans include pharmacists in their networks of participating

medical providers.

     (c) The healthcare benefits outlined in this section shall apply only to services delivered

within the health insurer’s provider network; provided that, all health insurers shall be required to

provide coverage for those benefits mandated by this section outside of the health insurer’s provider

network where it can be established that the required services are not available from a provider in

the health insurer’s network.

     SECTION 7. This act shall take effect on January 1, 2027.

========

LC005314

========

LC005314 - Page 6 of 7

EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- PHARMACISTS TEST-AND-TREAT

AUTHORITY ACT

***

     This act would authorize pharmacists to order, perform and interpret CLIA-waived tests

authorized by statewide protocol and prescribe medications. This act would further permit for such

test-and-treat authority to be covered by all health insurance carriers.

     This act would take effect on January 1, 2027.

========

LC005314

========

LC005314 - Page 7 of 7