Under new law, pharmacist scope of practice expands in Tennessee

Governor Bill Lee of Tennessee signed legislation that expands pharmacists’ scope of practice in the state. The law took effect immediately upon the governor’s signature on May 1.

“This law adds to the definition of pharmacy practice, and provides the ability for pharmacists to independently issue prescriptions or medical orders for a select group of medication classes and disease states,” said Anthony Pudlo, MS, PharmD, CEO of the Tennessee Pharmacists Association (TPA).

Pharmacists can use their new independent authority to prescribe antivirals for treatment of influenza or COVID-19, progesterone-only hormonal contraception, naloxone, PEP for non-occupational exposure to HIV, and epinephrine autoinjectors. They can also be listed as the prescriber of record for all adult immunizations for pediatric immunizations against influenza and COVID-19.

“With this law, pharmacists no longer have to undertake the steps to obtain a CPPA [collaborative pharmacy practice agreement] for such activities,” said Pudlo.

For administering vaccinations, that authority was previously granted under a locally signed immunization protocol with another type of prescriber. And for other medications that can now be prescribed, like Tamiflu, PEP, and topical fluoride agents, pharmacists in Tennessee can independently prescribe them now instead of having to be under a formal CPPA.

“Patients will benefit from direct access to health care services and medications for common ailments and improvement in public health,” said Pudlo. “As evidenced by efforts in other states as well as the research published in the medical literature, pharmacists can improve the quality of care delivered in the health care system, especially in our rural and other medically underserved communities.”

The bill was endorsed by the TPA and the Tennessee Medical Association (TMA). Pudlo said TMA testified in support of the legislation. Tennessee legislators also heard from a strong grassroots advocacy push from pharmacists across the state.

In 2017, Tennessee enacted Public Chapter 82, which paved the way for pharmacists to be credentialed and reimbursed as medical providers in commercial health plan medical provider networks. In addition, Tennessee Medicaid and its managed care organizations have pathways for pharmacists to be credentialed and reimbursed as medical providers.

“TPA will continue to guide pharmacists on these pathways so they can be compensated for the services tied to the authorities now granted with the passage of Senate Bill 869/House Bill 282,” said Pudlo.