Current through March 2026

Alabama

• November/December 2025 — Alabama Proposes Virtual Verification Rule. Alabama proposed a new rule permitting virtual (remote) verification processes, signaling further modernization of pharmacy verification requirements.

• September/October 2025 — Alabama Approves Amendment for Off-Site Order Entries. The Board of Pharmacy approved a rule amendment authorizing pharmacists to enter prescription orders from off-site locations, expanding remote pharmacy capabilities statewide.

• November/December 2024 — Board Drafts Policy Statement Clarifying Reciprocity Licensing Requirements. The Board issued a policy statement addressing ambiguities in reciprocal licensure requirements for pharmacists seeking to transfer licensure to or from the state.

• June 2024 — Alabama Expands Authorization of Pharmacist Dispensing of Emergency Refills. Alabama expanded the conditions under which pharmacists may dispense emergency refills, improving medication continuity for patients who urgently need prescription access.

• March 2024 — Permanent Rule Allows Pharmacists to Perform Tasks Outside Permitted Facility. Permanent rules now allow Alabama pharmacists to perform certain tasks outside of a permitted pharmacy or facility in certain primary care models.

• January 2024 — Alabama Expands Practitioner Workforce by Allowing Remote Pharmacy Services. Alabama amended its laws to expand the practitioner workforce by allowing pharmacists to provide remote pharmacy services, enhancing patient care access and safety.

• February 2023 — Role of Technicians Amended: Ratio and Certification Requirements. Amended the Role of Technicians in Pharmacies rule, specifying sufficient ratios of technicians per full-time licensed pharmacist (maximum 4:1, of which two must be certified), including certification requirements by a Board-approved credentialing organization.

• January 2023 — Emergency Dispensing Rule Amended for Institutional Pharmacies. Amended the 680-X-2-.18 Institutional Pharmacies rule to help patients obtain emergency dispensing medications upon discharge. These medications must include specific labeling details for proper storage, handling, safety, and usage.

Arizona

• January/February 2025 — Arizona Passes Senate Bills Related to Opioid Antagonists and CMOs. Arizona enacted legislation addressing opioid antagonist access and Collaborative Management Organizations (CMOs), supporting expanded pharmacist roles in overdose prevention and collaborative patient care agreements.

• June 2024 — Arizona Permits Veterinarian-Client-Patient Relationship Through Electronic Means. Arizona authorized veterinarians to establish a valid VCPR via electronic or telehealth means, enabling remote veterinary prescribing and related pharmacy dispensing.

Arkansas

• April 2025 — Arkansas Signs Law Prohibiting PBMs From Owning Pharmacies. On April 16, 2025, Governor Sarah Huckabee Sanders signed HB 1150 (Act 624), making Arkansas the first state in the nation to prohibit pharmacy benefit managers (PBMs) from acquiring or holding a direct or indirect interest in a pharmacy, effective January 1, 2026. Note: A federal district court issued a preliminary injunction in July 2025 temporarily blocking enforcement while litigation from CVS Health and Express Scripts proceeds.

California

• April/May 2024 — Medication Error Reporting Law. New legislation mandates all licensed community pharmacies to report medication errors to the state board, and provides allowances for increased staffing to prevent fatigue and ensure patient safety.

• January 2023 — Inventory Reconciliation and Controlled Substance Inventory Requirements. Amended California Code of Regulations §1715.65, effective January 1, 2023. The amendment clarifies "inventory reconciliation" and "inventory activities" and specifies inventory requirements for controlled substances. Schedule II controlled substances require reconciliation at least quarterly. Specific Schedule III–V substances (alprazolam, tramadol, promethazine/codeine in specified strengths) require annual reconciliation. All other controlled substances require reconciliation at least every two years or upon discovery of a reportable loss. A written policy and procedure addressing these requirements is required.

Colorado

• June 2024 — HB 24-1045 Grants Pharmacists Prescriptive Authority for FDA-Approved OUD Products. Signed June 6, 2024, this law amends Colorado's pharmacy practice act to include prescriptive authority for any FDA-approved opioid use disorder (OUD) product when authorized through a collaborative pharmacy practice agreement (CPA). Pharmacists must obtain a Pharmacist MOUD authority credential and a DEA license to prescribe buprenorphine. The law also mandates equal reimbursement for pharmacists providing medication-assisted treatment under a CPA.

District of Columbia

• July/August 2024 — DC Enacts Health Professional Licensing Boards Residency Requirement Amendment Act of 2023. Enacted legislation amending the residency requirements for members of health professional licensing boards, affecting the composition and appointment criteria for the DC Board of Pharmacy.

• October 2023 — LinkU DMV Resource Introduced. Introduced LinkU DMV, a resource for finding free and reduced-cost services for patients in the DC/Maryland/Virginia area, including a community needs assessment to help residents find medical care, food, housing, and more.

• 2022 — New Prescription Opioid Labeling Requirements. Prescription opioid drugs must include a statement on the container indicating that the drug is an opioid and has a risk of overdose and addiction.

Florida

• July/August 2025 — Health Care Practitioners Required to Complete Background Screening. Florida issued requirements mandating that health care practitioners, including pharmacists, complete background screening as a condition of licensure compliance, affecting new applicants and certain renewals.

• June 2024 — Drug Importation Program Receives FDA Approval. Florida's Section 804 Drug Importation Program received FDA approval, outlining a system for importing prescription medications from Canada with robust safety and inspection measures.

Georgia

• 2021 — Pharmacist-to-Technician Ratio Amended. Effective July 2021, HB 316 amended the pharmacist-to-technician ratio to 1:4, previously 1:3. Bill includes other updates related to the professional judgment and responsibilities of a pharmacist.

Idaho

• January/February 2026 — Idaho No Longer Requires 'Certification of No Dispensing of Controlled Substances' Form for RDOs, NDOs, and PDOs. The Idaho Division of Occupational and Professional Licenses eliminated the Certification of No Dispensing of Controlled Substances form for Resident Drug Outlets (RDOs), Non-Resident Drug Outlets (NDOs), and Prescriber Drug Outlets (PDOs). With implementation of Idaho's new licensing system (Oasis), specific dispensing questions have been integrated directly into initial and renewal applications, removing the need for the standalone form. Per Idaho Statute 37-2730A(1), all drug outlets dispensing controlled substances in or into Idaho for human patients are still required to report to the Prescription Tracking Program by the end of each business day.

• June 2025 — Idaho Medicaid Accepting Enrollment of Pharmacists as Individual Providers. Idaho Medicaid began accepting enrollment applications from pharmacists as individual providers, enabling pharmacists to directly bill Medicaid for certain clinical services and expanding reimbursement pathways for pharmacist care.

• January/February 2025 — Idaho Provides Opioid Safety Support Resources. The Idaho Board of Pharmacy — recognized as a Dr. Lorna Breen Heroes' Foundation Wellbeing First Champion — distributed resources supporting opioid safety practices, including guidance on naloxone dispensing and overdose prevention.

• October 2023 — HB 162 Expands Telehealth/Virtual Care Access. Passed HB 162 during the 2023 legislative session, expanding the ability of Idaho citizens in rural and underserved areas to access health care from providers not physically present in the patient's geographical area. The bill updates the Idaho Telehealth Access Care Act by changing "telehealth" to "virtual care" and clarifying virtual care practice requirements.

Iowa

• February 2024 — Statewide Protocol Updated for Opioid Antagonist Distribution. Iowa updated its statewide protocol allowing pharmacists to distribute any FDA-approved opioid antagonist for overdose reversal to eligible recipients aged 18 and older, expanding the scope of pharmacists' ability to provide critical care.

• October 2023 — Amended Rules for Vaccine Administration by Registered Nurses. Amended rules in multiple chapters to implement changes from the 2022 Iowa Code, including authorizing registered nurses to assist in the administration of immunizations and vaccinations pursuant to a pharmacist's order.

• January 2023 — New Rules Allow Veterinarians to Dispense From Office Stock. Implemented new rules allowing veterinarians to dispense from office stock in limited circumstances. The product can be dispensed from office stock to the owner of a veterinary patient to treat an immediate medical need when timely access to a patient-specific supply of compounded medication is not available.

• 2021 — Pharmacists Must Review Medication History Before Dispensing Certain CV Medications. Pharmacists must review a patient's medication history prior to dispensing any CV medication that does not require a prescription. Updated PMP requirements: CV medications and cough suppressants with codeine must be reported to the PMP.

Kentucky

• July/August 2025 — SB 188 Regulates PBMs' and Insurers' Pharmacy-Related Practices. Signed April 5, 2024, and effective January 1, 2025, SB 188 requires PBMs to reimburse pharmacies at least the National Average Drug Acquisition Cost (NADAC) plus a dispensing fee of $10.64 (through January 1, 2027, then updated biennially by a joint cost-of-dispensing survey by the Board of Pharmacy and the Department of Insurance). The law prohibits retroactive claim reductions and anti-steering practices favoring PBM-owned pharmacies, and requires pharmacy networks to ensure patient access within 30 miles or 30 minutes. In October 2025, the Kentucky Attorney General issued OAG 25-11 affirming the law's anti-steering provisions are enforceable.

• May 2024 — Hazardous Drugs and Compounding Definitions Updated. Kentucky added definitions related to hazardous drugs and "essential copies" of commercially available products to its compounding regulations to align with USP standards.

Louisiana

• March 2026 — Louisiana Authorizes Pharmacists to Dispense Life-Saving Medications in the Name of a 'Qualified Entity'. Act 657 of the 2024 Louisiana Legislature authorizes pharmacists to dispense life-saving medications (albuterol, epinephrine, and naloxone) in the name of a qualified entity under a statewide standing order issued by the Louisiana Department of Health Secretary or designee. The act defines "qualified entities" to include licensed early learning centers, colleges and universities, restaurants, after-school programs, and others. The Louisiana Surgeon General issued the standing orders on April 1, 2025. Qualified entities may maintain stock supplies of these medications for use during medical emergencies.

• June 2025 — Rules for Obtaining Pharmacy Technician Candidate Registration Amended. Finalized Regulatory Project 2024-05, expanding eligibility criteria for pharmacy technician candidate registration. Adds a new pathway for training under a Louisiana-licensed pharmacist in a non-probationary pharmacy. Minimum age is 18 for most pathways, with a 16-year-old option for students in a Louisiana Department of Education pharmacy technician career program.

• May 2024 — Marijuana Pharmacy Rule Amendments. Louisiana eased marijuana pharmacy regulations, reducing producer testing and packaging requirements, and expanding the number of active marijuana pharmacy permits.

• October 2023 — Board Regulatory and Legislative Activity Updates. Provided updates on the Louisiana Board of Pharmacy's regulatory and legislative activities, including reviews of regulatory proposals on DATA-Waiver registration elimination, health care workplace violence prevention, marijuana pharmacy, pharmacy benefits managers, and more.

• 2022 — BOP Updated Multiple Chapters. The Board of Pharmacy updated several chapters impacting pharmacy administration, pharmacy operation, and tele-pharmacy. See BOP website for complete details.

Maryland

• September 2023 (effective October 1, 2023) — Board Expanded to Include Registered Pharmacy Technician. Expanded the membership of the Maryland Board of Pharmacy to include a registered pharmacy technician. Authorized remote prescription-related data entry and granted administration authority of certain vaccines (COVID-19, influenza, and pneumococcal for patients 18 and older; RSV and herpes zoster for patients 50 and older) to registered pharmacy technicians who complete required ACPE-approved training and maintain current CPR certification.

Massachusetts

• November/December 2025 — New Functionality Introduced in Prescription Monitoring Program. The Massachusetts Prescription Monitoring Program launched new functionality to enhance data access and reporting capabilities for prescribers and pharmacists, supporting efforts to prevent prescription drug misuse.

• January 2024 — Pharmacy Practice and COVID-19 Requirements Updated. Massachusetts updated its pharmacy practice requirements and COVID-19 control measures, adapting to the end of the public health emergency and ongoing staffing challenges.

• February 2023 — Statewide Standing Order for Emergency Contraception Established. Passed Chapter 127 of the Acts of 2022, establishing a statewide standing order for all retail pharmacies to dispense emergency contraception. Training program available through the MGH Institute of Health Professions, also offering continuing education credits.

• 2022 — CII Prescriptions From Non-Resident Practitioners. Pharmacies can fill CII prescriptions from non-resident practitioners who have prescription authority from another state. CII prescriptions from out of state are valid for 5 days from the date they were issued. CII non-narcotic prescriptions can be filled from any state. CII narcotic prescriptions can be filled from states contiguous to Massachusetts or from Maine.

• 2021 — Scope of Practice Updates for Pharmacists, Technicians, and Interns. Updates to the scope of practice regarding vaccine administration and medications specific for mental illness and substance use disorder. Technicians may now perform remote prescription processing and perpetual inventory (restrictions apply; see BOP rules for details).

Michigan

• June 2024 — Removal of MPJE Requirement for Licensure. Michigan eliminated the Multistate Pharmacy Jurisprudence Exam (MPJE) requirement for licensure, which was controversial due to concerns about pharmacists' knowledge of state-specific laws.

Minnesota

• September/October 2025 — List Released of Pharmacies Providing Accessible Drug Container Labels. The Board of Pharmacy published a list of pharmacies offering accessible prescription container labels — including large-print, Braille, and audio options — to support patients with visual impairments as part of state health equity efforts.

• 2021 — Product Labels for Hemp-Derived Cannabinoids. Products containing cannabinoids extracted from hemp can include a QR code or other scannable technology linking directly to the manufacturer's website.

Mississippi

• April 2023 — Pending Status Eliminated for Pharmacy Technician Applications. Mississippi no longer grants a temporary "pending" status to technicians who have submitted all application components except background check results. Technicians must reflect "active" on the licensing verification portal to be allowed in the dispensing area of a pharmacy.

Missouri

• January/February 2026 — Missouri Board Reminds Pharmacists About Filling Veterinary Prescriptions. The Missouri Board of Pharmacy issued a reminder that pharmacists must have procedures in place for adding veterinarians who do not have a Drug Enforcement Administration (DEA) registration number to their computer database. Veterinarians are not required to have a DEA registration to prescribe non-controlled medications. The reminder follows a complaint in which a Missouri-licensed veterinarian alleged a pharmacy refused to fill a non-CS prescription because the veterinarian lacked a DEA number and could not be found in the pharmacy software system.

• 2022 — Prescription Transfer Requests Must Be Completed Within One Business Day. Prescription transfer requests initiated by a patient or caregiver must be completed within one business day.

Nevada

• 2022 — Pharmacists May Dispense Self-Administered Hormonal Contraceptives Without a Prescription. Pharmacists are allowed to dispense self-administered hormonal contraceptives to patients under protocol from the Nevada State Board of Pharmacy without a prescription. Restrictions and limitations apply. All controlled substance prescriptions must be sent via e-prescribing software.

New Jersey

• July/August 2023 — Pilot Program for Anonymous Dispensing of Opioid Antidotes. Approved a pilot program allowing for the dispensing of opioid antidotes at no cost to anonymous recipients at pharmacies with standing orders from the commissioner of health or a New Jersey-licensed physician.

New Mexico

• January/February 2026 — New Mexico Implements Changes to Custodial Care Facilities' Responsibilities. In New Mexico, custodial care facilities can now stock opioid antagonists (rather than naloxone specifically) and epinephrine auto-injectors. Per updates to NMAC 16.19.4.11, a custodial care facility is defined as "any facility which provides care and services on a continuing basis, for two or more in-house residents, not related to the operator, and which maintains custody of the residents' drugs." The updates allow greater flexibility and availability of stock medication in custodial facilities.

• September/October 2025 — SB 122 Expands Prescription Drug Donation Program. SB 122 broadened New Mexico's prescription drug donation program to allow more eligible medications to be donated and redistributed to patients in need, reducing waste and improving medication access.

• March 2025 — Unprofessional or Dishonorable Conduct Definitions Updated. The Board approved updates to 16.19.4 NMAC — Pharmacist. "Standard of care" was added to the definitions in Section 7, and "failure to meet standard of care" was added to the definition of unprofessional or dishonorable conduct in Section 9. Standard of care is defined as care provided within the accepted standard in the same or similar setting by a reasonably competent and prudent licensee with similar education, training, and experience.

• January/February 2025 — Rule for Compounding of Nonsterile Pharmaceuticals Updated. New Mexico finalized updates to its rules governing nonsterile pharmaceutical compounding, aligning state standards with revised USP Chapter <795>.

• May 2024 — Ketamine Joint Advisory Issued. A joint advisory from New Mexico's pharmacy, nursing, and medical boards warns against the off-label use of ketamine, emphasizing patient education and mandatory reporting.

• October 2023 — Practice of Pharmacy Definition Expanded. Amended the practice of pharmacy definition in SB 92 to include prescribing devices or supplies for prescribed drug therapy, and ordering, performing, and interpreting FDA-approved tests.

• January 2023 — Pharmacist Definitions and Controlled Substances Management Updated. Approved rule updates including amendments to the New Mexico Administrative Code related to pharmacist definitions and controlled substances management.

• 2022 — Prescriptive Authority and Technician Vaccine Administration. Board-approved prescriptive authority for pharmacists to prescribe prophylaxis therapy in conjunction with point-of-care testing (certain training required). Technicians are allowed to administer vaccines; training and supervision requirements apply. See BOP law for full details.

North Carolina

• March 2026 — North Carolina Updates Guidance on Dispensing Epinephrine Delivery Systems to Schools and Public Places. A recent legislative change (part of 2025 session legislation) added epinephrine nasal delivery systems to the products that can be prescribed for schools and public places under NCGS §115C-375.2A. North Carolina Board of Pharmacy staff published updated FAQ guidance clarifying that an epinephrine delivery system is "a disposable drug delivery system that is designed for emergency administration of epinephrine to provide rapid, convenient first aid for persons suffering a potentially fatal reaction to anaphylaxis, including nasal sprays and injectors that are approved by the FDA with a premeasured, appropriate weight-based dose of epinephrine."

• November/December 2025 — DHHS Drug Control Unit Launches Dispensation Error Notification Program. The NC DHHS Drug Control Unit launched a formal program for pharmacies to notify the agency of dispensation errors, creating a structured safety reporting mechanism to support quality improvement.

• June 2025 — Amendments to Rules Regarding Registration and Permits Completed. The Board finalized amendments to multiple rules covering pharmacy registration and permit requirements, updating administrative procedures and clarifying obligations for regulated entities.

• March 2025 — Health-System Pharmacy Permits Rule Amended. Amended Rule 21 NCAC 46.1401 to clarify when a health-system satellite pharmacy location requires a separate permit. Separate dispensing areas for inpatient populations may operate under one permit if located in the same building or on contiguous property with the principal permitted location.

• June 2024 — Rule Changes for Licensure Processes. North Carolina updated its licensure requirements, streamlining processes and making changes aimed at improving efficiency in pharmacist licensure.

• March 2024 — Authorization for Direct-to-Patient Dispensing Systems. Authorization for the use of direct-to-patient (DTP) dispensing systems in certain circumstances was completed by the Board of Pharmacy.

• January 2023 — Requirement Revived to Notify Prescribers When Dispensing Interchangeable Biosimilars. Pharmacists must notify prescribers when dispensing an interchangeable biosimilar product, including the product name and manufacturer. This notification must occur within a reasonable time following dispensing and may be made via interoperable electronic medical records system, electronic prescribing technology, pharmacy benefit management system, the NC Health Information Exchange Network, or a pharmacy record electronically accessible by the prescriber. (GS §90-85.28)

• 2021 — Epidiolex® Reclassified as Unscheduled. Epidiolex® is now an unscheduled drug both federally and in North Carolina (previously was CV).

North Dakota

• February 2024 — Regulations Updated to Broaden Use of "Opioid Antagonist." North Dakota proposed changes broadening the use of the term "opioid antagonist" instead of "naloxone," enabling pharmacists to prescribe a wider range of medications within this category.

• 2021 — Pharmacists May Administer Vaccines and Dispense Emergency Fills. Pharmacists can administer vaccines and injectables to patients 3 years and older (restrictions apply). Pharmacists can dispense emergency fills for up to a 30-day supply (previously 72 hours).

Ohio

• November/December 2025 — Ohio Requires All Outpatient Pharmacies to Adopt Electronic Positive Identification by January 2027. Legislation requires all outpatient pharmacies to implement electronic positive identification (e-PID) systems by January 2027, enhancing accountability at the point of dispensing.

• April/May 2025 — Automated Rx Reporting System Begins Alerting Providers to Nonfatal Drug Overdoses. Ohio's OARRS system began issuing real-time alerts to prescribers and dispensers when a patient has experienced a nonfatal drug overdose, enabling proactive clinical intervention.

• March 2025 — Pharmacist Duty-to-Report Rule Takes Effect. Effective March 1, 2025, Ohio Administrative Code 4729:1-4-02 requires pharmacists with direct observation or objective evidence that a Board-licensed individual is practicing while physically or mentally impaired to report that individual to the Board within 10 days. Exceptions apply when knowledge came through protected health information or when the individual is voluntarily seeking treatment without other rule violations. Parallel rules extend obligations to interns (4729:2-4-02) and technicians (4729:3-4-02). Reporter identity is kept confidential.

• June 2024 — Rule Permitting Pharmacist Verification of Prescriber Compounded Medications Takes Effect. Ohio's rule allowing pharmacists to verify that compounded medications have been authorized by a licensed prescriber took effect, streamlining verification processes for compounding pharmacies.

• February 2024 — Ohio Offers Free Fentanyl Test Strips to Pharmacies. Ohio initiated a program to distribute free fentanyl test strips to pharmacies throughout the state to help prevent overdoses. Each licensed pharmacy is eligible to receive up to two boxes.

• January 2024 — COVID-19 Operational Waiver for Pharmacy Technician Trainees. The Ohio Board of Pharmacy implemented a COVID-19 operational waiver allowing pharmacy technician trainees to stock automated pharmacy systems under certain conditions.

• February 2023 — OARRS Check Required Before Dispensing Gabapentin. Amended Ohio Administrative Code to require pharmacists to check the Ohio Automated Rx Reporting System (OARRS) report before dispensing medications containing gabapentin, addressing overutilization concerns.

• 2021 — LTC Entities Allowed to Store and Administer Vaccinations. LTC entities are allowed to store and administer vaccinations and biologics to staff members and patients using the entity's specific dangerous drugs terminal distributor license (restrictions apply; see BOP rules for details).

Oklahoma

• June 2025 — Requirement Takes Effect for Notifying Board of Pharmacy Ownership Change. Under OAC 535:25-3-7, a change of 20% or more of ownership or a change in ownership form requires a new pharmacy license, special inspection, and special inspection fee, with required information reported within 10 days.

• March 2025 — New Pharmacy Responsibility Rules for Closures and PIC Changes. Effective August 11, 2024, OAC 535:15-3-2 requires pharmacies to report pharmacist-in-charge (PIC) changes to the Oklahoma Board within 10 days. A pharmacy closing during normal business hours must notify the Board within 24 hours, providing the license number, name, address, PIC name, closure dates and hours, and reason for the closure.

Oregon

• June 2025 — Pharmacists Reminded of Regulatory Changes for Drug Outlet Pharmacies. The Oregon State Board of Pharmacy issued reminders to pharmacists regarding recent regulatory changes applicable to drug outlet pharmacies, supporting awareness and compliance.

• October 2024 — New Bills on OUD Medications and Prescription Drug Flavoring. Oregon passed bills concerning the dispensing of opioid use disorder (OUD) medications and the flavoring of prescription drugs to improve patient compliance and safety.

• January 2024 — Multiple Bills Passed Affecting Pharmacy Technicians, Nonprescription Drug Outlets, 3PLs, and Wholesale Distributors. Oregon passed several bills affecting pharmacy technicians and drug outlets, including the adoption of temporary licenses for pharmacy technicians and revisions in the definitions for nonprescription drug outlets and wholesale distributors.

• February 2023 — Rules Adopted Requiring Notification of Pharmacy Closures. Adopted permanent rules requiring Retail Drug Outlet pharmacies to notify the public of temporary, emergency, and permanent pharmacy closures, with specific guidelines for notification procedures.

• 2021 — Multiple Bills Approved Affecting Pharmacy Practice. Oregon approved House and Senate bills effective 2022: SB 629 allowing pharmacists to use telepharmacy for specific services; HB 2648 allowing pharmacists and technicians to transfer pseudoephedrine-containing drugs (restrictions apply); HB 2958 allowing pharmacists to prescribe, dispense, and administer pre/post-exposure prophylactic antiretroviral drugs (restrictions apply).

Pennsylvania

• July/August 2025 — DDAP Creates Telehealth-Only License for SUD Treatment Providers. Pennsylvania's Department of Drug and Alcohol Programs established a new telehealth-only license category for substance use disorder treatment providers, creating a formal regulatory pathway for providers exclusively delivering SUD services via telehealth.

South Carolina

• April/May 2025 — Department of Public Health Shares Naloxone Resources. The SC Department of Public Health distributed naloxone access resources and guidance to pharmacies and the public, supporting expanded opioid overdose reversal medication availability statewide.

• January/February 2025 — Act 132 Regarding Compounding Pharmacies Takes Effect. South Carolina Act 132 became effective, establishing new standards and compliance requirements for compounding pharmacies operating in the state.

• January 2024 — Law Enacted Regarding Dispensing Directly to SC Department of Corrections. The South Carolina General Assembly enacted a law that protects the identities of pharmacy staff involved in executing death sentences, allowing pharmacies and pharmacists to dispense directly to the South Carolina Department of Corrections without a prescription.

• May 2023 — Pharmacy Access Act Finalized — Pharmacists May Dispense Hormonal Contraceptives. Finalized the joint protocol for the Pharmacy Access Act. Act 210 allows pharmacists to dispense a self-administered hormonal contraceptive or administer an injectable hormonal contraceptive pursuant to a standing order by a prescriber.

South Dakota

• March 2026 — South Dakota Updates Rules for Emergency Medications and Emergency Kits. The South Dakota Board of Pharmacy reviewed all Board rules and edited multiple sections of the Administrative Rules of South Dakota (ARSD) 20:51. The Board updated ARSD 20:51:15 concerning pharmacies in hospitals, nursing facilities, and related facilities. The language was simplified but also added expectations related to inspections for pharmacies providing emergency medications. The provider pharmacy must ensure that medication stored as emergency medication is inspected monthly and documentation of inspection is maintained at the provider pharmacy. The updated rule also allows for 10 different controlled drugs and no more than 20 doses of any controlled drug to be stored in an emergency kit. Additionally, the Board removed the requirement for licensing automated medication distribution devices being used as an emergency kit or for the supply of first-dose medications as a pharmacy.

• November/December 2025 — PDMP Data Integrity Practices Highlighted. South Dakota published information highlighting the verification processes and quality controls its Prescription Drug Monitoring Program uses to ensure accurate prescription tracking data.

• April/May 2025 — 'Let's Be Clear' Website Expanded to Share SUD Resources. South Dakota's Department of Health and Department of Social Services expanded the "Let's Be Clear" initiative (letsbeclearsd.com), centralizing substance use disorder resources, treatment options, harm reduction information, and a naloxone pharmacy locator for patients, pharmacists, and healthcare providers.

• July/August 2024 — Pharmacy Inspector Audit Project Verifies PDMP Data. South Dakota implemented a pharmacy inspector audit project to verify the accuracy and completeness of data within the state's PDMP database.

• April 2023 — Rules on Donated Prescription Drugs Certified. The South Dakota Interim Rules Review Committee certified that Administrative Rules of South Dakota 20:51:35 could move forward to final form, elaborating on criteria for pharmacies to accept donated prescription drugs.

Tennessee

• March 2024 — Additional Seats Added to Board of Pharmacy. Legislation passed adding additional seats to the Tennessee Board of Pharmacy, including positions for a pharmacist and a pharmacy technician.

• March 2023 — Legislation Related to Pharmacy Technicians and Controlled Substance Monitoring Database. Passed two legislative initiatives related to local county health departments and the Controlled Substance Monitoring Database. Required the Board to review rules impacting pharmacy technicians' scope of practice and collaborative practice agreements for dispensing ivermectin.

• 2022 — Additional Data Points Required in Controlled Substances Monitoring Database. The Board requires additional data points to be populated in the Controlled Substances Monitoring Database and added additional rules outlining the usage of CSMD during the dispensing of CII amphetamines.

Texas

• March 2024 — Amendments for Licensing and Registration of Military Service Members Adopted. Texas adopted and proposed several amendments to its rules, impacting military service members and outlining procedures for licensing and registration.

• March 2023 — Fingerprint Background Check Required for Certain Pharmacist Renewals. Implemented a new statutory requirement for Board-licensed pharmacists registered before June 1, 2015, to undergo an additional fingerprint background check before renewing their Board license.

Utah

• March 2026 — Utah Offers Guidance for Prescribing and Dispensing Fluoride Supplements. Utah enacted House Bill (HB) 81 Fluoride Amendments, which prohibits the addition of fluoride to public water systems, effective May 7, 2025. Under HB 81, pharmacists are now authorized to prescribe fluoride supplements to patients without requiring a prescription from a dental or medical provider. The Utah Department of Health and Human Services and the Utah Department of Commerce Division of Professional Licensing have outlined key changes and guidance for pharmacists and dental professionals regarding fluoride supplements. Pharmacists are required to provide patient counseling on the appropriate use, storage, potential side effects, and risks associated with fluoride supplements.

• January/February 2026 — Utah's New Toolkit Aids Pharmacists in Managing Controlled Substances. The Utah Controlled Substance Database Program released the Utah Controlled Substances Toolkit to aid health care providers in managing controlled substances. The toolkit's platform allows for straightforward navigation to trusted and up-to-date resources, including best practices, patient education materials, prescribing guidelines, and Utah-specific CS laws. The toolkit is available at cstoolkit.utah.gov.

• July/August 2025 — New Regulations Address Pharmaceutical Manufacturers' Interactions With 340B Entities. Utah enacted new regulations governing pharmaceutical manufacturers' practices regarding 340B covered entities, including requirements related to drug pricing and distribution within the 340B program context.

• September/October 2024 — Gabapentin Added as Schedule V Controlled Substance. Utah added gabapentin to its Schedule V controlled substances list, requiring pharmacies to comply with controlled substance dispensing, record-keeping, and reporting requirements when dispensing gabapentin.

• February 2023 — Cybersecurity Affirmative Defense Act Passed. Passed the Cybersecurity Affirmative Defense Act, providing protection to businesses that create, maintain, and comply with industry-recognized cybersecurity regulations.

Virginia

• 2021 — Emergency Regulations Authorizing Pharmacists to Initiate Treatment With Certain Drugs. Emergency regulations became effective January 3, 2021, authorizing pharmacists to initiate treatment for patients 18 years and older with: hormonal contraception and emergency contraception, prenatal vitamins, naloxone, epinephrine, dietary fluoride supplements, and medications for lowering out-of-pocket expenses.

Washington

• March 2026 — Washington Files Rules Adoption Package Pertaining to DSCSA. The Washington State Pharmacy Quality Assurance Commission filed a rules adoption package (CR-103P) under Washington State Register 25-19-024, creating a new section of Washington Administrative Code 246-945-003 Drug Supply Chain Security Act. The rule took effect on October 6, 2025. The Commission is providing an optional self-inspection worksheet and guidance related to the Drug Supply Chain Security Act (DSCSA).

• September/October 2025 — Accessible Labeling Standards Adopted. Adopted January 22, 2025 (WSR 25-04-003), WAC 246-945-027 through -029 require dispensing facilities and practitioners to provide accessible prescription information at no cost to patients with visual impairments, print disabilities, or limited English proficiency (LEP), including large print, audio, Braille, and translated labels. The Commission filed CR-101 in October 2025 to refine implementation requirements based on stakeholder feedback. These changes take effect on January 22, 2027.

• April/May 2025 — Amendments Adopted for Handling Prescription Transfers. Washington adopted rule amendments to WAC 246-945 establishing clear expectations for how pharmacies must handle the transfer of both non-controlled and controlled substance prescriptions between pharmacies.

• March 2025 — Rulemaking Inquiry Filed Regarding Utilization of Pharmacy Ancillary Personnel. The Pharmacy Quality Assurance Commission filed CR-101 Rulemaking Inquiry No. 24-18-032 to consider amending WAC 246-945-001, -315, -317, and -320 and potentially adding a new section to Chapter 246-945 WAC, addressing modern guidelines for pharmacy ancillary personnel, technology use boundaries, and guidance for administration of drugs and devices.

• January/February 2025 — Standing Order to Dispense Naloxone Updated. Washington updated its statewide standing order authorizing pharmacists to dispense naloxone without a patient-specific prescription.

• April/May 2024 — Rulemaking Inquiry Filed Regarding Transfer Practices for Dispensed Prescription Drugs. Washington is considering rules for "white bagging" and "brown bagging" practices, aimed at regulating the transfer of dispensed prescription drugs to protect patient safety.

• February 2024 — Proposed Rulemaking Filed for Remote Dispensing of OUD Medications. Washington State proposed new regulations to establish minimum standards for remote dispensing sites for opioid use disorder (OUD) medications, driven by Substitute Senate Bill 6086, to enhance access to medications essential for treating OUD.

• January 2023 and October 2023 — Rulemaking Inquiries Filed for Prescription Label Accessibility Standards. Washington filed rulemaking inquiries to consider adding or amending rules in Chapter 246-945 WAC, focusing on prescription label accessibility standards for patients with disabilities and limited English proficiency.

• 2022 — Telehealth Training Requirement. Healthcare professionals performing telehealth services must complete specific training before rendering these services.

West Virginia

• March 2024 — Emergency Rules Regarding Prescription Processing and Pharmacy Permits Approved. New emergency rules regarding prescription processing and governing pharmacy permits have been approved, including Regulation 15-1-5 regarding centralized prescription processing.

• 2021 — Controlled Substance Monitoring Program Check Required. West Virginia pharmacists must check the West Virginia Controlled Substance Monitoring Program database when handling prescriptions for specific populations: CII, opioids, and benzodiazepines (restrictions apply; see BOP for details).

Wyoming

• October 2023 — Reminder on License Requirement for Dispensing Antimicrobials. Reminded pharmacies of the need to obtain a license to dispense antimicrobials pursuant to a prescription following FDA's guidance changes.

• 2022 — New 2-Phase Sterile Compounding Inspection Process Implemented.

National / Multi-State

• 2022 — e-Prescribing: As of January 2022, 9 states require e-prescribing for all prescriptions: CA, FL, IA, MI, MN, NV, NY, PA, and WV. Other states have regulations related to e-prescribing specific to controlled substances. Further restrictions apply; check each state Board of Pharmacy for details.

• 2022 — DEA Medication-Assisted Treatment (MAT): DEA allows practitioners in various settings to dispense a 3-day supply of MAT. Prerequisite: practitioners should request an exception from the DEA before performing this action.

• 2021 — DEA Form 222: DEA Form 222 is a single-sheet form only. The triplicate form had a sunset date of October 2021.