SF 4486

Introduction - 94th Legislature (2025 - 2026)

Posted on 03/18/2026 09:19 a.m.

A bill for an act
relating to health occupations; authorizing pharmacists to initiate, prescribe,
administer, and dispense certain drugs for the treatment of opioid use disorder;
modifying grounds for disciplinary action for pharmacists and pharmacist interns;
amending Minnesota Statutes 2024, sections 151.01, subdivision 27; 151.071,
subdivision 2; 151.37, by adding a subdivision; 152.11, subdivision 2; 152.12, by
adding a subdivision; Minnesota Statutes 2025 Supplement, section 151.01,
subdivision 23.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2025 Supplement, section 151.01, subdivision 23, is amended
to read:

Subd. 23.

Practitioner.

"Practitioner" means a licensed doctor of medicine, licensed
doctor of osteopathic medicine duly licensed to practice medicine, licensed doctor of
dentistry, licensed doctor of optometry, licensed podiatrist, licensed veterinarian, licensed
advanced practice registered nurse, licensed certified midwife, or licensed physician assistant.
For purposes of sections 151.15, subdivision 4; 151.211, subdivision 3; 151.252, subdivision
3; 151.37, subdivision 2, paragraph (b); and 151.461, "practitioner" also means a dental
therapist authorized to dispense and administer under chapter 150A. For purposes of sections
151.252, subdivision 3, and 151.461, "practitioner" also means a pharmacist authorized to
prescribe deleted text begin self-administered hormonal contraceptives, nicotine replacement medications, or
opiate antagonists under section 151.37, subdivision 14, 15, or 16, or authorized to prescribe
drugs to prevent the acquisition of human immunodeficiency virus (HIV) under deleted text end new text begin drug therapy
according to subdivision 27 or new text end section 151.37 deleted text begin , subdivision 17 deleted text end .

Sec. 2.

Minnesota Statutes 2024, section 151.01, subdivision 27, is amended to read:

Subd. 27.

Practice of pharmacy.

"Practice of pharmacy" means:

(1) interpretation and evaluation of prescription drug orders;

(2) compounding, labeling, and dispensing drugs and devices (except labeling by a
manufacturer or packager of nonprescription drugs or commercially packaged legend drugs
and devices);

(3) participation in clinical interpretations and monitoring of drug therapy for assurance
of safe and effective use of drugs, including ordering and performing laboratory tests that
are waived under the federal Clinical Laboratory Improvement Act of 1988, United States
Code, title 42, section 263a et seq. A pharmacist may collect specimens, interpret results,
notify the patient of results, and refer the patient to other health care providers for follow-up
care and may initiate, modify, or discontinue drug therapy only pursuant to a protocol or
collaborative practice agreement. A pharmacist may delegate the authority to administer
tests under this clause to a pharmacy technician or pharmacy intern. A pharmacy technician
or pharmacy intern may perform tests authorized under this clause if the technician or intern
is working under the direct supervision of a pharmacist;

(4) participation in drug and therapeutic device selection; drug administration for first
dosage and medical emergencies; intramuscular and subcutaneous drug administration under
a prescription drug order; drug regimen reviews; and drug or drug-related research;

(5) drug administration, through intramuscular and subcutaneous administration used
to treat mental illnesses as permitted under the following conditions:

(i) upon the order of a deleted text begin prescriber deleted text end new text begin practitioner new text end and the deleted text begin prescriber deleted text end new text begin practitioner new text end is notified
after administration is complete; or

(ii) pursuant to a protocol or collaborative practice agreement as defined by section
151.01, subdivisions 27b and 27c, and participation in the initiation, management,
modification, administration, and discontinuation of drug therapy is according to the protocol
or collaborative practice agreement between the pharmacist and a dentist, optometrist,
physician, physician assistant, podiatrist, or veterinarian, or an advanced practice registered
nurse authorized to prescribe, dispense, and administer under section 148.235. Any changes
in drug therapy or medication administration made pursuant to a protocol or collaborative
practice agreement must be documented by the pharmacist in the patient's medical record
or reported by the pharmacist to a practitioner responsible for the patient's care;

(6) initiating, ordering, and administering influenza and COVID-19 or SARS-CoV-2
vaccines authorized or approved by the United States Food and Drug Administration to all
eligible individuals three years of age and older and all other United States Food and Drug
Administration-approved vaccines to patients six years of age and older according to the
federal Advisory Committee on Immunization Practices recommendations. A pharmacist
may delegate the authority to administer vaccines under this clause to a pharmacy technician
or pharmacy intern who has completed training in vaccine administration if:

(i) the pharmacist and the pharmacy technician or pharmacy intern have successfully
completed a program approved by the Accreditation Council for Pharmacy Education
(ACPE) specifically for the administration of immunizations or a program approved by the
board;

(ii) the pharmacist utilizes the Minnesota Immunization Information Connection to
assess the immunization status of individuals prior to the administration of vaccines, except
when administering influenza vaccines to individuals age nine and older;

(iii) the pharmacist reports the administration of the immunization to the Minnesota
Immunization Information Connection;

(iv) if the patient is 18 years of age or younger, the pharmacist, pharmacy technician,
or pharmacy intern informs the patient and any adult caregiver accompanying the patient
of the importance of a well-child visit with a pediatrician or other licensed primary care
provider; and

(v) in the case of a pharmacy technician administering vaccinations while being
supervised by a licensed pharmacist:

(A) the supervision is in-person and must not be done through telehealth as defined
under section 62A.673, subdivision 2;

(B) the pharmacist is readily and immediately available to the immunizing pharmacy
technician;

(C) the pharmacy technician has a current certificate in basic cardiopulmonary
resuscitation;

(D) the pharmacy technician has completed a minimum of two hours of ACPE-approved,
immunization-related continuing pharmacy education as part of the pharmacy technician's
two-year continuing education schedule; and

(E) the pharmacy technician has completed one of two training programs listed under
Minnesota Rules, part 6800.3850, subpart 1h, item B;

(7) participation in the initiation, management, modification, and discontinuation of
drug therapy according to a written protocol or collaborative practice agreement between:
(i) one or more pharmacists and one or more dentists, optometrists, physicians, physician
assistants, podiatrists, or veterinarians; or (ii) one or more pharmacists and one or more
physician assistants authorized to prescribe, dispense, and administer under chapter 147A,
or advanced practice registered nurses authorized to prescribe, dispense, and administer
under section 148.235. Any changes in drug therapy made pursuant to a protocol or
collaborative practice agreement must be documented by the pharmacist in the patient's
medical record or reported by the pharmacist to a practitioner responsible for the patient's
care;

(8) participation in the storage of drugs and the maintenance of records;

(9) patient counseling on therapeutic values, content, hazards, and uses of drugs and
devices;

(10) offering or performing those acts, services, operations, or transactions necessary
in the conduct, operation, management, and control of a pharmacy;

(11) participation in the initiation, management, modification, and discontinuation of
therapy with opiate antagonists, as defined in section 604A.04, subdivision 1, pursuant to:

(i) a written protocol as allowed under clause (7); or

(ii) a written protocol with a community health board medical consultant or a practitioner
designated by the commissioner of health, as allowed under section 151.37, subdivision 13;

(12) prescribing self-administered hormonal contraceptives; nicotine replacement
medications; and opiate antagonists for the treatment of an acute opiate overdose pursuant
to section 151.37, subdivision 14, 15, or 16;

(13) participation in the placement of drug monitoring devices according to a prescription,
protocol, or collaborative practice agreement;

(14) prescribing, dispensing, and administering drugs for preventing the acquisition of
human immunodeficiency virus (HIV) if the pharmacist meets the requirements in section
151.37, subdivision 17; deleted text begin and
deleted text end

(15) ordering, conducting, and interpreting laboratory tests necessary for therapies that
use drugs for preventing the acquisition of HIV, if the pharmacist meets the requirements
in section 151.37, subdivision 17 deleted text begin . deleted text end new text begin ; and
new text end

new text begin (16) initiating, prescribing, dispensing, and administering drugs for the treatment of
opioid use disorder pursuant to section 151.37, subdivision 18.
new text end

Sec. 3.

Minnesota Statutes 2024, section 151.071, subdivision 2, is amended to read:

Subd. 2.

Grounds for disciplinary action.

The following conduct is prohibited and is
grounds for disciplinary action:

(1) failure to demonstrate the qualifications or satisfy the requirements for a license or
registration contained in this chapter or the rules of the board. The burden of proof is on
the applicant to demonstrate such qualifications or satisfaction of such requirements;

(2) obtaining a license by fraud or by misleading the board in any way during the
application process or obtaining a license by cheating, or attempting to subvert the licensing
examination process. Conduct that subverts or attempts to subvert the licensing examination
process includes, but is not limited to: (i) conduct that violates the security of the examination
materials, such as removing examination materials from the examination room or having
unauthorized possession of any portion of a future, current, or previously administered
licensing examination; (ii) conduct that violates the standard of test administration, such as
communicating with another examinee during administration of the examination, copying
another examinee's answers, permitting another examinee to copy one's answers, or
possessing unauthorized materials; or (iii) impersonating an examinee or permitting an
impersonator to take the examination on one's own behalf;

(3) for a pharmacist, pharmacy technician, pharmacist intern, applicant for a pharmacist
or pharmacy license, or applicant for a pharmacy technician or pharmacist intern registration,
conviction of a felony reasonably related to the practice of pharmacy. Conviction as used
in this subdivision includes a conviction of an offense that if committed in this state would
be deemed a felony without regard to its designation elsewhere, or a criminal proceeding
where a finding or verdict of guilt is made or returned but the adjudication of guilt is either
withheld or not entered thereon. The board may delay the issuance of a new license or
registration if the applicant has been charged with a felony until the matter has been
adjudicated;

(4) for a facility, other than a pharmacy, licensed or registered by the board, if an owner
or applicant is convicted of a felony reasonably related to the operation of the facility. The
board may delay the issuance of a new license or registration if the owner or applicant has
been charged with a felony until the matter has been adjudicated;

(5) for a controlled substance researcher, conviction of a felony reasonably related to
controlled substances or to the practice of the researcher's profession. The board may delay
the issuance of a registration if the applicant has been charged with a felony until the matter
has been adjudicated;

(6) disciplinary action taken by another state or by one of this state's health licensing
agencies:

(i) revocation, suspension, restriction, limitation, or other disciplinary action against a
license or registration in another state or jurisdiction, failure to report to the board that
charges or allegations regarding the person's license or registration have been brought in
another state or jurisdiction, or having been refused a license or registration by any other
state or jurisdiction. The board may delay the issuance of a new license or registration if an
investigation or disciplinary action is pending in another state or jurisdiction until the
investigation or action has been dismissed or otherwise resolved; and

(ii) revocation, suspension, restriction, limitation, or other disciplinary action against a
license or registration issued by another of this state's health licensing agencies, failure to
report to the board that charges regarding the person's license or registration have been
brought by another of this state's health licensing agencies, or having been refused a license
or registration by another of this state's health licensing agencies. The board may delay the
issuance of a new license or registration if a disciplinary action is pending before another
of this state's health licensing agencies until the action has been dismissed or otherwise
resolved;

(7) for a pharmacist, pharmacy, pharmacy technician, or pharmacist intern, violation of
any order of the board, of any of the provisions of this chapter or any rules of the board or
violation of any federal, state, or local law or rule reasonably pertaining to the practice of
pharmacy;

(8) for a facility, other than a pharmacy, licensed by the board, violations of any order
of the board, of any of the provisions of this chapter or the rules of the board or violation
of any federal, state, or local law relating to the operation of the facility;

(9) engaging in any unethical conduct; conduct likely to deceive, defraud, or harm the
public, or demonstrating a willful or careless disregard for the health, welfare, or safety of
a patient; or pharmacy practice that is professionally incompetent, in that it may create
unnecessary danger to any patient's life, health, or safety, in any of which cases, proof of
actual injury need not be established;

(10) aiding or abetting an unlicensed person in the practice of pharmacy, except that it
is not a violation of this clause for a pharmacist to supervise a properly registered pharmacy
technician or pharmacist intern if that person is performing duties allowed by this chapter
or the rules of the board;

(11) for an individual licensed or registered by the board, adjudication as mentally ill
or developmentally disabled, or as a chemically dependent person, a person dangerous to
the public, a sexually dangerous person, or a person who has a sexual psychopathic
personality, by a court of competent jurisdiction, within or without this state. Such
adjudication shall automatically suspend a license for the duration thereof unless the board
orders otherwise;

(12) for a pharmacist or pharmacy intern, engaging in unprofessional conduct as specified
in the board's rules. In the case of a pharmacy technician, engaging in conduct specified in
board rules that would be unprofessional if it were engaged in by a pharmacist or pharmacist
intern or performing duties specifically reserved for pharmacists under this chapter or the
rules of the board;

(13) for a pharmacy, operation of the pharmacy without a pharmacist present and on
duty except as allowed by a variance approved by the board;

(14) for a pharmacist, the inability to practice pharmacy with reasonable skill and safety
to patients by reason of illness, use of alcohol, drugs, narcotics, chemicals, or any other type
of material or as a result of any mental or physical condition, including deterioration through
the aging process or loss of motor skills. In the case of registered pharmacy technicians,
pharmacist interns, or controlled substance researchers, the inability to carry out duties
allowed under this chapter or the rules of the board with reasonable skill and safety to
patients by reason of illness, use of alcohol, drugs, narcotics, chemicals, or any other type
of material or as a result of any mental or physical condition, including deterioration through
the aging process or loss of motor skills;

(15) for a pharmacist, pharmacy, pharmacist intern, pharmacy technician, medical gas
dispenser, or controlled substance researcher, revealing a privileged communication from
or relating to a patient except when otherwise required or permitted by law;

(16) for a pharmacist or pharmacy, improper management of patient records, including
failure to maintain adequate patient records, to comply with a patient's request made pursuant
to sections 144.291 to 144.298, or to furnish a patient record or report required by law;

(17) fee splitting, including without limitation:

(i) paying, offering to pay, receiving, or agreeing to receive, a commission, rebate,
kickback, or other form of remuneration, directly or indirectly, for the referral of patients;

(ii) referring a patient to any health care provider as defined in sections 144.291 to
144.298 in which the licensee or registrant has a financial or economic interest as defined
in section 144.6521, subdivision 3, unless the licensee or registrant has disclosed the
licensee's or registrant's financial or economic interest in accordance with section 144.6521;
and

(iii) any arrangement through which a pharmacy, in which the prescribing practitioner
does not have a significant ownership interest, fills a prescription drug order and the
prescribing practitioner is involved in any manner, directly or indirectly, in setting the price
for the filled prescription that is charged to the patient, the patient's insurer or pharmacy
benefit manager, or other person paying for the prescription or, in the case of veterinary
patients, the price for the filled prescription that is charged to the client or other person
paying for the prescription, except that a veterinarian and a pharmacy may enter into such
an arrangement provided that the client or other person paying for the prescription is notified,
in writing and with each prescription dispensed, about the arrangement, unless such
arrangement involves pharmacy services provided for livestock, poultry, and agricultural
production systems, in which case client notification would not be required;

(18) engaging in abusive or fraudulent billing practices, including violations of the
federal Medicare and Medicaid laws or state medical assistance laws or rules;

(19) engaging in conduct with a patient that is sexual or may reasonably be interpreted
by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning
to a patient;

(20) failure to make reports as required by section 151.072 or to cooperate with an
investigation of the board as required by section 151.074;

(21) knowingly providing false or misleading information that is directly related to the
care of a patient unless done for an accepted therapeutic purpose such as the dispensing and
administration of a placebo;

(22) aiding suicide or aiding attempted suicide in violation of section 609.215 as
established by any of the following:

(i) a copy of the record of criminal conviction or plea of guilty for a felony in violation
of section 609.215, subdivision 1 or 2;

(ii) a copy of the record of a judgment of contempt of court for violating an injunction
issued under section 609.215, subdivision 4;

(iii) a copy of the record of a judgment assessing damages under section 609.215,
subdivision 5; or

(iv) a finding by the board that the person violated section 609.215, subdivision 1 or 2.
The board must investigate any complaint of a violation of section 609.215, subdivision 1
or 2;

(23) for a pharmacist, practice of pharmacy under a lapsed or nonrenewed license. For
a pharmacist intern, pharmacy technician, or controlled substance researcher, performing
duties permitted to such individuals by this chapter or the rules of the board under a lapsed
or nonrenewed registration. For a facility required to be licensed under this chapter, operation
of the facility under a lapsed or nonrenewed license or registration;

(24) for a pharmacist, pharmacist intern, or pharmacy technician, termination or discharge
from the health professionals services program for reasons other than the satisfactory
completion of the program; deleted text begin and
deleted text end

(25) for a manufacturer, a violation of section 62J.842 or 62J.845 deleted text begin . deleted text end new text begin ; and
new text end

new text begin (26) for a pharmacist or pharmacist intern, engaging in conduct that departs from or fails
to conform with accepted standards for health care that would be provided in a similar
setting by a reasonable and prudent pharmacist or pharmacist intern.
new text end

Sec. 4.

Minnesota Statutes 2024, section 151.37, is amended by adding a subdivision to
read:

new text begin Subd. 18. new text end

new text begin Treatment of opioid use disorder. new text end

new text begin (a) A pharmacist is authorized to prescribe,
administer, and dispense legend drugs and controlled substances in Schedules III through
V of section 152.02 to treat opioid use disorder if:
new text end

new text begin (1) the pharmacist has determined, based on medically acceptable standards, that treatment
is indicated and necessary; and
new text end

new text begin (2) the pharmacist documents in the patient's health record the assessment, treatment,
response, and monitoring activities performed according to an individual treatment plan.
new text end

new text begin (b) In order to prescribe a drug described in paragraph (a), the pharmacist must first:
new text end

new text begin (1) successfully complete a training program specifically developed for practitioners for
the treatment of substance use disorders, in accordance with United States Code, title 21,
section 823(m); and
new text end

new text begin (2) obtain the appropriate federal Drug Enforcement Administration registration number
required for the schedule in which that drug is included, if the drug to be prescribed is a
controlled substance.
new text end

new text begin (c) Before dispensing a drug described in paragraph (a) that is prescribed by the
pharmacist, the pharmacist must provide counseling to the patient on the proper use of the
drug, the need for follow-up, and any additional information listed in Minnesota Rules, part
6800.0910, subpart 2, that must be provided during patient counseling.
new text end

new text begin (d) A pharmacist is prohibited from delegating the prescribing authority under this
subdivision to any other person. A pharmacist intern registered under section 151.101 may
prepare the prescription, but before the prescription is processed or dispensed, a pharmacist
authorized to prescribe under this subdivision must review, approve, and sign the prescription.
new text end

new text begin (e) Nothing in this subdivision prohibits a pharmacist from participating in the initiation,
management, modification, and discontinuation of drug therapy according to a protocol for
opioid use disorder as authorized in this section and section 151.01, subdivision 27.
new text end

new text begin (f) Nothing in this subdivision prohibits a pharmacist from dispensing or administering
drugs for the treatment of opioid use disorder in accordance with a valid prescription issued
by another practitioner.
new text end

new text begin (g) Nothing in this subdivision prohibits a pharmacist from charging for a service
authorized under this subdivision.
new text end

Sec. 5.

Minnesota Statutes 2024, section 152.11, subdivision 2, is amended to read:

Subd. 2.

Prescription requirements for Schedule III or IV controlled substances.

(a)
Except as provided in paragraph (b), no person may dispense a controlled substance included
in Schedule III or IV of section 152.02 without a prescription issued, as permitted under
subdivision 1, by a doctor of medicine, a doctor of osteopathic medicine licensed to practice
medicine, a doctor of dental surgery, a doctor of dental medicine, a doctor of podiatry, a
doctor of optometry limited to Schedule IV, new text begin a pharmacist limited to Schedule III or IV and
in accordance with section 151.37, new text end or a doctor of veterinary medicine, lawfully licensed to
prescribe in this state or from a practitioner licensed to prescribe controlled substances by
the state in which the prescription is issued, and having a current federal drug enforcement
administration registration number. Such prescription may not be dispensed or refilled
except with the documented consent of the prescriber, and in no event more than six months
after the date on which such prescription was issued and no such prescription may be refilled
more than five times.

(b) This subdivision does not apply to cannabis plants, cannabis flower, cannabis products,
or hemp-derived consumer products sold or transferred in compliance with chapter 342.

Sec. 6.

Minnesota Statutes 2024, section 152.12, is amended by adding a subdivision to
read:

new text begin Subd. 2a. new text end

new text begin Pharmacist. new text end

new text begin A licensed pharmacist, in good faith and in the course of
professional practice only, may prescribe, administer, and dispense a controlled substance
that is included in Schedules III through V of section 152.02 and that the pharmacist is
authorized to prescribe, administer, and dispense under section 151.37, subdivision 18, and
may cause the same to be administered by a pharmacist intern under the direction and
supervision of the pharmacist.
new text end