SOP Is Changing Rapidly: June Brought Major Movement in 2 States

Scope of practice is changing rapidly across the country. Each month, we are seeing new states introduce, move, or pass legislation that expands how pharmacists can serve patients. Some states are focused on reimbursement. Others are focused on prescribing authority, collaborative practice, PBM reform, telehealth, or pharmacy operations.

Even with the different focuses, the theme is clear: policymakers are increasingly recognizing that pharmacists are one of the most accessible clinical providers in the healthcare system.

Nearly 90% of Americans live within five miles of a community pharmacy, and federal public health sources have repeatedly pointed to pharmacies as a highly accessible healthcare resource, especially in low-income and underserved communities. At the same time, the primary care workforce continues to face serious access pressure, with HRSA projecting a shortage of more than 70,000 primary care physicians by 2038.

That combination matters.

Patients need access. Pharmacists are already embedded in their communities. The missing piece has often been the legal and payment infrastructure that allows pharmacists to practice, bill, and be reimbursed for the clinical work they are trained to provide.

In June, two states stood out: California and Delaware.

California: Reimbursement Remains the Key

California’s AB 2571 is one of the most important reimbursement bills to watch.

The bill advanced through Senate Health in early June, was amended on June 8, and moved to the Senate Appropriations suspense file on June 15.

Why does this matter?

Because scope of practice without reimbursement is only half a win.

California already recognizes pharmacist services as a benefit under Medi-Cal, but AB 2571 focuses on strengthening reimbursement for advanced practice pharmacist services. The bill would require the rate of reimbursement for advanced practice pharmacist services to be tied to the physician fee schedule, including medication therapy management pharmacist services. It would also expand payment pathways for pharmacist services through Medi-Cal, health plans, and insurers when pharmacists are enrolled providers.

For pharmacies, this is the kind of policy movement that can turn clinical authority into a sustainable business model.

A pharmacist may be legally allowed to provide a service, but if the payer infrastructure does not recognize and reimburse that service, pharmacies are left trying to deliver clinical care without a realistic path to payment. AB 2571 is important because it gets closer to the core issue: how pharmacists are paid for patient care.

For Provider CSAO pharmacies, this is exactly the type of bill we track closely. Reimbursement language often creates the foundation for future payer contracting, Medicaid billing, medical claims workflows, and clinical service expansion.

Delaware: A Major Scope of Practice Expansion

Delaware’s SB 320 may be one of the most interesting scope of practice bills of the month.

The bill passed on June 25 and was listed as ready for Governor action. Delaware’s bill page describes SB 320 as a modernization of pharmacy practice laws that would authorize pharmacists to practice to the full extent of their education and training.

The bill would allow pharmacists to independently evaluate patients, identify health conditions, order and prescribe laboratory tests, and prescribe drugs or devices without relying on statewide protocols, formularies, or specified lists of conditions. It also includes controlled-substance limitations, with a specific exception related to medications for opioid use disorder under a standing order from the Division of Public Health.

That is a major shift.

Many pharmacy scope laws still expand authority service by service. One bill may address vaccines. Another may address contraception. Another may address PrEP, PEP, tobacco cessation, or test-and-treat. Delaware’s SB 320 moves closer to a broader professional standard, giving pharmacists more room to practice based on their training rather than waiting for lawmakers to approve each individual service one at a time.

Implementation would be delayed by up to one year to allow the Board of Pharmacy to issue regulations, so this is not an overnight operational change. But strategically, it is a major signal.

Delaware is showing what the next phase of pharmacist scope of practice may look like: less reliance on narrow protocols and more recognition of pharmacists as clinical decision-makers.

Why These Bills Matter for Pharmacies

For independent pharmacies, scope of practice legislation is not just a policy issue. It affects real business strategy.

Expanded scope can create opportunities for:

Patient consultations (first fill, antibiotic, telehealth) Medication therapy management Test-and-treat services Vaccine services Chronic disease support Preventive care Medicaid and commercial medical billing New payer contracting opportunities

But the opportunity only becomes real when pharmacies understand three things:

What the state allows What payers will recognize How to document, submit, and support the claim

That is why Provider CSAO launched the SOP Tracker a few months ago.

Pharmacy laws are moving quickly, and every state is moving differently. Some states are expanding pharmacist authority. Others are working on reimbursement. Others are attacking PBM practices. Some are passing laws, while others are still in committee, on suspense, or waiting for regulations before pharmacies can act.

The SOP Tracker was built to give pharmacies better visibility into the status of their state, including scope of practice, provider status, reimbursement movement, payer opportunity, and legislative updates.

The Bigger Picture

The future of pharmacy is not limited to dispensing.

Pharmacists are already one of the most accessible healthcare providers in the country. Patients walk into pharmacies every day asking clinical questions, requesting vaccines, seeking medication support, and looking for guidance because the pharmacy is often the easiest healthcare setting to reach.

Legislation is beginning to catch up with that reality.

California is pushing the reimbursement conversation forward. Delaware is pushing the scope of practice conversation forward. Other states are moving in similar directions through collaborative practice, PBM reform, remote pharmacy practice, and pharmacist service payment policies.

For pharmacies, the message is simple: this is the time to prepare.

As states expand what pharmacists can do, pharmacies need to be ready with the right contracts, documentation, billing workflows, payer enrollments, and clinical service strategy.

Provider CSAO will continue tracking these changes and helping pharmacies understand how legislative movement connects to real billing opportunities.

We’ll put individual state updates below. If you have any questions or would like to explore what’s available in your state, schedule some time with us to talk through your options. Even in states without state-level recognition, commercial payers will often still reimburse pharmacists for their care. We’d love to get you setup for reimbursements for the care you’re providing.

Full June SOP and Pharmacy Legislative Update

State / Federal	June 2026 Update	Bill / Topic	Why It Matters
California	Advanced in Senate Health on June 3; amended June 8; placed on Senate Appropriations suspense file June 15.	AB 2571, Reimbursement for Pharmacist Services	Strong reimbursement watch item. Would require advanced practice pharmacist services in Medi-Cal to be reimbursed in relation to the physician fee schedule, including MTM pharmacist services, and would expand health plan and insurer reimbursement for advanced practice pharmacist services.
California	Amended and re-referred in June; re-referred to Senate Appropriations June 30.	AB 1990, Pharmacy Law: compounded medications / GLP-1 consumer protection	Pharmacy operations watch item, not a provider-status bill. Would create consumer protection and safety requirements around compounded drugs used for obesity or weight management, including GLP-1/GIP-related compounds.
Delaware	Passed June 25; ready for Governor action.	SB 320, pharmacy practice modernization / pharmacist authority	Major SOP bill. Would authorize pharmacists to practice to the full extent of their education and training, including independently evaluating patients, identifying health conditions, ordering and prescribing lab tests, and prescribing drugs or devices, with controlled-substance limitations. Implementation is delayed up to one year for Board of Pharmacy regulations.
Delaware	Passed Senate June 9; passed House June 24; enrolled.	SB 271, Pharmacy Benefits Managers	PBM reform watch item. Amends Delaware insurance law relating to PBMs. Track as passed both chambers and enrolled, pending final executive action.
Illinois	Governor approved June 1; Public Act 104-0461; effective June 1.	HB 4154, pharmacist application / exam / pharmacy law education	Licensure and regulatory update. Requires pharmacist licensure applicants to complete an approved Illinois pharmacy law program, assessment, or other approved test, updates application expiration rules, and requires 2 of 30 CE hours for pharmacist renewal to be in pharmacy law.
Louisiana	Enrolled June 1; sent to Governor June 4; signed June 12; became Act 913; effective June 12.	HB 1236, PBM reimbursement	Major PBM/payment reform. Provides rules related to PBM reimbursements and pharmacy payment protections. This is one of the bigger June pharmacy payment wins.
New York	Assembly unanimously passed June 5; bill cleared both chambers and awaits Governor action.	Patient Access to Pharmacy Act, PAPA, S5939C / A10030	Major PBM reimbursement reform. Would require PBMs to reimburse pharmacies at no less than NADAC, or pharmacy acquisition cost if NADAC is unavailable, and require a professional dispensing fee at least equal to the New York Medicaid dispensing fee.
Pennsylvania	Public hearing held June 10 in House Health Committee.	HB 2270, single Pharmacy Benefit Administrator model	PBM/payment watch item. Would move Pennsylvania toward a single Pharmacy Benefit Administrator model for state pharmacy benefits. No vote yet, but the June 10 hearing makes it a June movement item.
Rhode Island	House passed June 10; Senate concurrence June 11; transmitted June 18; signed by Governor June 22.	S 3060 / H 8579, Pharmacy Benefit Managers Act	PBM reform. Requires PBMs to obtain a certificate of authority from the Office of the Health Insurance Commissioner and gives the commissioner oversight and penalty authority.
Rhode Island	Senate passed in concurrence June 11; signed by Governor June 22.	H 7424 / S 2866, Collaborative Pharmacy Practice	SOP win. Expands collaborative pharmacy practice beyond physicians to allow other healthcare providers to enter into collaborative practice agreements with pharmacists and removes the collaborative practice committee definition.
South Carolina	Became Act No. 166 on June 2; effective date posted June 5, with Governor signature dated May 18.	S 0449, Collaborative Practice Agreements	SOP win, but implementation depends on regulations. Authorizes pharmacists and physicians to enter collaborative practice agreements and requires the Board of Pharmacy and Board of Medical Examiners to issue regulations before CPAs can be implemented.
Texas	Board rule package proposed at May 5 meeting; May 19 rule update carried into June review.	Texas State Board of Pharmacy proposed rules, including pharmacist telehealth provisions	Regulatory watch item, not a bill. Proposed rule updates included telehealth services provided by a pharmacist, among other pharmacy rule changes.