Pharmacist Scope of Practice Keeps Expanding: Four Major Updates from July 2026

Pharmacist scope of practice continues to change rapidly across the country.

Each month, more states are expanding what pharmacists can do, how they can participate in patient care, and whether they can be recognized and reimbursed as medical providers.

July 2026 brought several important developments, but four states stood out: Wyoming, Hawaii, Michigan, and Virginia.

Together, these changes reflect a larger national trend. Pharmacists are increasingly being integrated into the medical system not only as medication experts, but as providers who can assess patients, prescribe treatment, manage chronic conditions, support public health initiatives, and improve access to care.

Wyoming Broadens the Practice of Pharmacy

Wyoming’s SF 121 became effective July 1, 2026 and represents one of the broadest scope-of-practice developments of the month.

The law expands the practice of pharmacy to include patient assessment, pharmacist care services, expanded use of technology, collaborative care, and the prescribing of medications and medical devices under rules established by the Wyoming Board of Pharmacy.

This is important because it moves pharmacist practice beyond a narrow list of individually authorized services. Instead, Wyoming is creating a broader framework that recognizes pharmacists as clinical providers who can use their education and professional judgment to care for patients.

For rural communities, this type of expansion can be especially meaningful. Pharmacists are often among the most accessible healthcare professionals in areas where patients may have limited access to physicians, clinics, or specialists.

The next major question will be whether payer policies and provider networks evolve quickly enough to support the expanded authority.

Hawaii Requires Health Plans to Recognize and Reimburse Pharmacists

Hawaii’s SB 1245, enacted as Act 220, also became effective July 1, 2026.

The law requires participating public and private health plans to recognize registered pharmacists as providers and reimburse covered services performed within the pharmacist’s authorized scope of practice.

This is one of the strongest pharmacist payment developments of 2026.

Many states have passed laws recognizing pharmacists as healthcare providers, but recognition alone does not always result in reimbursement. A pharmacist may legally perform a clinical service and still face barriers when attempting to enroll with a payer, sign a medical provider agreement, or submit a professional medical claim.

Hawaii’s law addresses that gap by connecting provider recognition with payer reimbursement.

Implementation will still require coordination among pharmacies, pharmacists, health plans, credentialing departments, and medical billing systems. However, the law creates a much stronger foundation for pharmacists seeking to participate in medical networks and receive payment for covered clinical services.

Michigan Expands Medicaid Coverage for Pharmacist Services

Michigan’s Medicaid Policy MMP 26-20 became effective July 1, 2026, contingent on federal approval of the related State Plan Amendment.

The policy expands Medicaid coverage for several pharmacist-provided services, including:

• Immunizations

• Related laboratory testing

• Antiviral treatment following certain respiratory tests

• Hormonal contraceptive counseling and prescribing
  

This development is significant because it creates defined service categories that pharmacists may be able to provide and bill through the Medicaid program.

Michigan’s policy also highlights an important lesson for pharmacy owners. Expanded scope of practice is only one piece of the puzzle. Pharmacies must also understand Medicaid enrollment, provider taxonomy, credentialing, claim structure, documentation requirements, covered codes, and managed care organization rules.

The clinical service may be authorized, but the pharmacist and pharmacy still need the correct infrastructure in place to get paid.

Virginia Expands Remote Pharmacy Support for Opioid Treatment Programs

Virginia’s SB 421 became effective July 1, 2026.

The law allows pharmacists to remotely perform verification, counseling, and supervision functions when authorized personnel dispense methadone and other medications used to treat opioid use disorder at federally certified opioid treatment programs.

This change expands access while allowing pharmacist oversight to occur through a remote care model.

Virginia’s legislation is especially important as healthcare systems continue looking for ways to address workforce shortages, improve access to opioid use disorder treatment, and use pharmacists more efficiently across multiple locations.

It also demonstrates that scope-of-practice expansion does not always involve prescribing authority. Telepharmacy, remote verification, clinical supervision, and technology-enabled care are becoming increasingly important parts of modern pharmacy practice.

Scope Expansion Is Only Valuable When Pharmacists Can Get Paid

The developments in Wyoming, Hawaii, Michigan, and Virginia show that states are increasingly recognizing pharmacists as an essential part of the healthcare delivery system.

However, passing legislation is only the beginning.

For pharmacists to successfully provide and bill these services, they may need:

• Individual Type 1 NPIs

• Proper taxonomy enrollment

• CAQH profiles

• Medicaid enrollment

• Commercial and Medicare Advantage contracts

• Medical provider credentialing

• Electronic claims routing

• EFT and ERA enrollment

• Service-specific documentation workflows

• Correct CPT, HCPCS, modifier, diagnosis, and place-of-service coding
  

Without this infrastructure, expanded authority may exist on paper without producing sustainable clinical revenue for the pharmacy.

Provider CSAO is already helping pharmacists become credentialed and contracted with payers in Wyoming, Hawaii, Michigan, and Virginia. Our team works with pharmacies to build the administrative, contracting, enrollment, and billing infrastructure needed to turn pharmacist scope-of-practice authority into actual patient-care opportunities.

As more states expand pharmacist authority and reimbursement, pharmacies that prepare early will be in the best position to participate.

Prepare Your Pharmacy for Medical Billing

Pharmacist scope of practice is changing quickly, and payer enrollment often takes months to complete.

Provider CSAO helps pharmacies navigate medical credentialing, payer contracting, Medicaid enrollment, CAQH management, EFT and ERA setup, and professional medical claim readiness.

Do not wait until a new service becomes reimbursable to begin building your medical billing infrastructure.

Contact Provider CSAO today to learn how your pharmacists can become credentialed, contracted, and prepared to bill medical payers for clinical services. Core changes effective in July

State	Bill or policy	July update	Tracker classification
Hawaii	SB 1245, Act 220	Effective July 1. Public and private plans must recognize participating registered pharmacists as providers and reimburse covered services performed within pharmacist SOP.	Provider status and payment mandate
Wyoming	SF 121, Enrolled Act 65	Effective July 1. Broadens pharmacy practice to include patient assessment, prescribing drugs and devices under Board rules, pharmacist care services, and expanded use of technology and collaborative care.	Broad prescriptive authority and standard of care
Georgia	SB 195, Act 409	Effective July 1. Authorizes trained pharmacists operating under protocol to provide HIV PEP and PrEP, including 30- to 90-day PrEP supplies, long-acting injectable PrEP, and CLIA-waived HIV testing.	HIV prevention and test-and-treat
Maryland	SB 562, Chapter 54	Effective July 1. Allows pharmacists operating under therapy-management agreements to treat opioid use disorder with controlled-substance drug therapy.	Collaborative practice and medication-assisted treatment
Michigan	Medicaid Policy MMP 26-20	Effective July 1, contingent on CMS State Plan Amendment approval. Covers pharmacist-provided immunizations, related laboratory testing, antiviral treatment following certain respiratory tests, and hormonal contraceptive counseling and prescribing.	Medicaid pharmacist payment and test-and-treat
Rhode Island	H 7424 / S 2866	Signed June 30 and effective July 1. Expands collaborative pharmacy practice agreements beyond physicians to other authorized prescribing practitioners.	Collaborative practice expansion
Rhode Island	H 5855A / S 0482A	Effective July 1. Allows pharmacists to substitute therapeutically equivalent drugs without obtaining prior prescriber authorization, subject to notification and patient-choice requirements.	Therapeutic substitution
Virginia	SB 421, Chapter 345	Effective July 1. Allows remote pharmacist verification, counseling, and supervision when authorized personnel dispense methadone and other OUD medications at federally certified opioid treatment programs.	Telepharmacy and OUD access

Pharmacy operational changes effective in July

These should appear in the tracker, but separately from clinical SOP expansion.

State	Update
Indiana	SB 293, Public Law 140, effective July 1. Eliminates the MPJE or separate pharmacy-law examination requirement and replaces it with required education on Indiana and federal pharmacy law. This is a licensing and workforce change, not expanded patient-care authority.
Tennessee	HB 2101 / SB 2323, effective July 1. Changes pseudoephedrine sales requirements, increases the annual quantity limit, and removes the required pharmacist counseling restriction while retaining electronic sales tracking.
California	AB 1503 provisions became effective July 1. Nonresident pharmacies must designate a pharmacist-in-charge who holds an active California pharmacist license and works at the licensed location.
Alabama	Rules 680-X-2-.05 and 680-X-3-.03 became effective July 13, covering pharmacy classifications, permits, and controlled-substance permit renewals. A July 15 proposed technician-rule amendment primarily corrects the rule’s statutory citation and does not materially expand technician duties.

Substantive actions taken during July, with later effective dates

State	July movement
New Hampshire	HB 1735 was signed July 10. It establishes a standard-of-care framework, modernizes pharmacist practice authority, supports remote pharmacy processing, expands qualified technician duties, and modifies collaborative-practice rules. Most substantive provisions become effective September 8, 2026.
Missouri	SB 878 was signed July 13 and becomes effective August 28. It updates vaccine authority, pharmacist medication-therapy authority and Board rulemaking, permits pharmacists to prescribe certain medical devices, and contains additional medication-access provisions.
California	AB 1587 was signed July 13. It changes emergency-refill notification requirements so notification is required when the prescriber can be identified.
California	SB 1094 received July committee and floor movement. The pending bill would allow pharmacists to substitute qualifying biosimilars without limiting substitution to products formally designated as interchangeable, unless the prescriber prohibits substitution.