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AB 186

Revises provisions governing pharmacists. (BDR 54-344)

2025 Regular Session Introduced by David Orentlicher

AB 186 expands Nevada pharmacists' scope to include limited prescribing, drug administration, CLIA-waived tests, and one-time refills, with Board oversight to boost rural access.

(No further action taken.)
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Bill Summary · AB 186

AB 186 — Revises provisions governing pharmacists (BDR 54-344)

Status: Introduced Jan 8, 2025; Passed Assembly Mar 20, 2025 (Ayes 53, Noes 17); transmitted to Senate and referred to committees (Ways & Means / Budget); first reprint and committee amendments adopted Apr 21, 2025; co‑sponsor added May 20, 2025. No further action as of Jun 3, 2025.

Purpose / Intent

AB 186 would modernize Nevada pharmacy law by expanding licensed pharmacists’ scope of practice to include limited independent prescribing, dispensing in certain circumstances, administration of drugs, and expanded laboratory testing authority — with regulatory oversight by the State Board of Pharmacy. The bill is framed to increase access to timely care (particularly in rural and underserved areas), leverage pharmacists as clinical providers, and permit regulatory implementation of standards and safeguards.

Key provisions

  • Prescribing authority: Authorizes a registered pharmacist to prescribe and dispense drugs and devices for health conditions that:
    • have been previously diagnosed;
    • are self‑limiting; or
    • are acute conditions diagnosed after a CLIA‑waived test (42 C.F.R. Part 493, Subpart A).
  • One‑time refill: Permits a pharmacist to dispense a one‑time refill of an existing prescription without practitioner authorization if the pharmacist judges that loss of access would harm the patient.
  • Controlled substances: Prohibits pharmacists from prescribing non‑FDA approved drugs. Amended language restricts pharmacists from prescribing controlled substances except in specific settings (inpatient per facility policy, outpatient clinics as part of multidisciplinary teams, hospice/palliative care, or substance use disorder treatment programs). Opioid prescribing is generally prohibited except as authorized under existing medication‑assisted treatment statutes (NRS 639.28079).
  • Drug administration and possession: Explicitly authorizes pharmacists to administer drugs and, generally, to possess/administer controlled substances and dangerous drugs consistent with the bill’s limits.
  • Laboratory authority: Authorizes pharmacists to order, perform, and (per conceptual amendments) interpret laboratory tests necessary for drug therapy and to perform CLIA‑waived/simple tests; allows registered intern pharmacists to be authorized by regulation; permits pharmacists to serve as laboratory director of an “exempt” laboratory.
  • Regulation and enforcement: Directs the State Board of Pharmacy to adopt regulations defining scope, standards of care, required liability insurance, and intern roles; prescribing/dispensing under the statute constitutes the practice of pharmacy and is subject to disciplinary action (suspension/revocation) for noncompliance.

Who would be affected

  • Pharmacists and intern pharmacists (expanded roles, new regulatory requirements and potential liability insurance).
  • Patients — increased access to “test-and-treat” services, chronic disease management, and one‑time refills.
  • Health care providers and systems — potential task‑shifting from primary care to pharmacists; operational coordination needs.
  • State Board of Pharmacy — charged with rulemaking and enforcement.
  • Payers — testimony sought reimbursement parity (not explicitly enacted in bill text); some conforming insurance provisions are referenced.

Support, opposition and policy considerations

  • Supporters: community pharmacy organizations, chain and pharmacy industry coalitions, clinical pharmacists, patient‑access advocacy groups — cite improved access, cost savings, and outcomes.
  • Opposition/concerns: Nevada Psychiatric Association raised concerns about diagnosis and treatment of mental health conditions, care coordination, and patient safety if pharmacists expand prescribing without clarified safeguards.
  • Implementation depends heavily on Board of Pharmacy regulations (scope, training, tests allowed, liability, and setting limitations).

Procedural notes

AB 186 advanced through the Assembly with amendments and reprints and was pending further Senate committee action as of the last recorded update (No further action taken by 2025‑06‑03).

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

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