Prior authorization reform has become one of the most active areas of pharmacy legislation. Several states have passed laws expanding the pharmacist’s role in the PA process.
What pharmacists can do in PA-reform states
In states with pharmacist PA authority, pharmacists may be able to: initiate PA requests on behalf of prescribers, provide clinical documentation to support PA decisions, dispense under emergency dispensing provisions while PA is pending, and substitute therapeutically equivalent medications when a PA is denied.
States with pharmacist PA legislation
California: AB 1302 gives pharmacists authority to submit PA requests and provide supporting clinical documentation. Pharmacists may also dispense an emergency 30-day supply while PA is pending.
Texas: SB 1399 requires health plans to accept PA requests from pharmacists for medications within their scope of practice.
Virginia, Colorado, Minnesota: Each has passed variations of PA reform giving pharmacists expanded roles in the documentation and submission process.
Federal landscape
The PAEA (Protecting Access to Post-Acute Care Act) and various CMS proposals have addressed PA timelines but not specifically pharmacist authority. Federal action is expected but timing remains uncertain.
Why it matters
For pharmacists practicing at the dispensing level, PA delays are one of the most common points of patient care disruption. Understanding your state’s PA authority helps you act within your scope when prescribers are unavailable.
Verify with your state board
PA reform legislation changes frequently. Verify current authority with your state board and state pharmacy association before acting on PA requests.