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SB 2851

AN ACT RELATING TO BUSINESSES AND PROFESSIONS -- PHARMACISTS TEST-AND-TREAT AUTHORITY ACT

2026 Regular Session Introduced by Alana DiMario and 9 co-sponsors

Rhode Island would authorize pharmacists to independently test and treat certain conditions under statewide protocols, with required training and insurance coverage starting 2027.

04/30/2026 Committee recommended measure be held for further study
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Bill Summary · SB 2851

Summary of Bill SB 2851 (Rhode Island) – Pharmacists Test-and-Treat Authority Act

Date Introduced: March 4, 2026
Committee: Senate Health & Human Services
Sponsors: Lauria, DiMario, Valverde, Murray, Vargas, Mack, Kallman, Urso, Pearson, DiPalma (with several co-sponsors)

1) Purpose and Intent

  • Authorizes licensed pharmacists to independently test for and initiate treatment of certain conditions under statewide protocols.
  • Aims to improve timely access to care for common, self-limiting, and communicable conditions, reduce unnecessary ED/urgent care visits, and bolster health system capacity.
  • Builds on evidence that pharmacist-provided test-and-treat services can be safe, effective, and acceptable when conducted under evidence-based protocols.

2) Key Provisions and Changes

A. Creation of Pharmacists Test-and-Treat Authority (Chapter 5-19.4)

  • Establishes a new statutory framework: Pharmacists Test-and-Treat Authority Act.
  • Defines key terms including CLIA-waived tests, statewide protocols, and test-and-treat services (clinical assessment, CLIA-waived testing, interpretation, and initiation/adjustment/discontinuation of therapy under protocol).

B. Pharmacist Authority (5-19.4-4)

  • Pharmacists may independently provide test-and-treat services for conditions authorized by statewide protocols adopted by the Rhode Island Board of Pharmacy (in consultation with the Department of Health).
  • Permitted actions include:
    • Ordering, performing, and interpreting CLIA-waived tests.
    • Initiating, dispensing, administering, or prescribing medications.
    • Providing counseling, education, and referrals as indicated.
  • Pharmacists cannot provide test-and-treat for conditions not authorized by the protocol.

C. Authorized Conditions (5-19.4-5)

  • Protocols may cover:
    • Influenza
    • COVID-19
    • Group A streptococcal pharyngitis
    • Post-exposure prophylaxis (PEP) for certain STIs with available CLIA-waived testing (where testing availability does not delay treatment)
    • Additional conditions as deemed appropriate based on safety, evidence, and public health needs

D. Training, Competency, and Documentation (5-19.4-6 to 5-19.4-7)

  • Pharmacists must complete board-established education prior to providing services (disease-specific education, testing using CLIA-waived tests, patient assessment/referral, documentation/reporting).
  • Ongoing continuing education may be required to maintain authority.
  • Each test-and-treat encounter must be documented in a patient record.
  • With patient consent, pharmacists should notify the patient’s primary care provider within 7 business days when possible.
  • Compliance with public health reporting requirements.

E. Liability, Standard of Care (5-19.4-8)

  • Pharmacists are held to the standard of care applicable to pharmacists within their current scope of licensure.
  • The act does not create a higher standard of care or expand civil liability beyond existing law.

F. Reimbursement (5-19.4-9)

  • Test-and-treat services under this act are to be treated as covered health care services for state-regulated health plans (including Medicaid), subject to applicable billing rules.
  • The Office of the Health Insurance Commissioner and the Executive Office of Health and Human Services must implement appropriate actions to support reimbursement.

G. Rulemaking and Implementation Timeline (5-19.4-10)

  • Board of Pharmacy, in consultation with the Department of Health, must promulgate implementing rules within 6 months of the act’s effective date.

H. Severability (5-19.4-11)

  • Standard severability clause.

3) Insurance Coverage Requirements (Long-Term Provisions)

The bill adds multiple sections requiring coverage for pharmacist services across various types of health plans:

  • 27-18-96 (Accident and Sickness Insurance Policies)
  • 27-19-88 (Nonprofit Hospital Service Corporations)
  • 27-20-84 (Nonprofit Medical Service Corporations)
  • 27-41-101 (Health Maintenance Organizations)

Key elements across these sections:
- Beginning January 1, 2027, group health insurance contracts and group policies must provide coverage for pharmacist services within the scope of practice defined in § 5-19.1-2 if the plan would cover the equivalent physician, advanced practice nurse, or physician assistant service.
- No nonprofit medical service corporation may require supervision, signature, or referral by another provider as a condition of reimbursement for pharmacist services; however, reimbursement for duplicative services performed by both a pharmacist and another provider is not required.
- Plans must ensure an adequate number of pharmacists within the network of participating medical providers. Merely including pharmacies in the drug benefit does not satisfy network participation requirements.
- Coverage applies within the insurer’s provider network; insurers must provide coverage for pharmacist services outside the network if necessary to obtain the required services not available within the network.

4) Who Would Be Affected

  • Licensed pharmacists, who would obtain authority to perform CLIA-waived testing and initiate treatment under statewide protocols.
  • Rhode Island patients who access testing and treatment for included conditions via pharmacists.
  • Health insurers, Medicaid, and nonprofit health service corporations, which would need to cover pharmacist-provided test-and-treat services starting in 2027 and ensure network adequacy for pharmacist providers.
  • Primary care providers, who would be notified (where possible) of pharmacist interventions within 7 business days.
  • The Board of Pharmacy and Department of Health, which would implement protocols and rules managing practice scope and safety.

5) Timeline and Effective Date

  • Effective Date: January 1, 2027.
  • Rulemaking: Implementing rules due within 6 months after the act’s effective date.
  • Insurance coverage requirements: Begin applying to plans delivering or renewing on or after January 1, 2027.

6) Remarks

  • The bill is designed to expand access to timely testing and treatment, particularly for conditions where rapid management is beneficial to public health.
  • It sets forth safeguards including protocol-driven practice, required training, documented patient encounters, referral processes, and alignment with existing standards of care.
  • It also ensures reimbursement parity with comparable services provided by physicians or advanced practitioners, subject to plan-specific rules and network adequacy.

Compiled from official sources — confirm details with the bill’s official record.

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