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  • Can a pharmacist order and evaluate laboratory results under a collaborative practice agreement (CPA)?

    Again, as with prescribing and administering buprenorphine under a CPA, the content of laws/regulations governing CPAs provides a state’s upfront answer. While there remains a lack of specificity in some states about whether ordering or evaluating lab tests falls under the scope of practice under CPAs, more states expressly address testing under CPAs than expressly address either prescribing or administering drugs and medications.

  • Can a pharmacist order and evaluate laboratory results under a collaborative practice agreement (CPA)?

    • 10 states where the answer is “yes” as to both ordering and evaluating the results of lab tests in general; Colorado, Florida, Maine, Massachusetts, Missouri, New Mexico, New York, Ohio, Rhode Island, and Utah.

    • 15 states and the District of Columbia where the answer is “yes,” but the laws/regulations only expressly address ordering tests and do not refer to evaluating or interpreting tests; Arizona, Connecticut, District of Columbia, Kentucky, Maryland, Mississippi, Montana, Nevada, New Hampshire, North Dakota, Oregon, Pennsylvania, Tennessee, Texas, Virginia, and West Virginia.

    • Four states where the answer is “yes,” but only as to limited forms of tests that may not cover the types of tests necessary for patients undergoing treatment with buprenorphine; Alabama, Louisiana, Minnesota, and New Jersey. Typically, the provision allows a pharmacist to order CLIA-waived tests and/or tests related to specified illnesses/diseases that do not include OUD;

    • 20 states and Puerto Rico where laws/regulations governing CPAs do not clearly address whether scope of practice under CPAs includes ordering or evaluating lab tests and thus the answer is “unclear.”

      • In 16 of the 20 states, the information LAPPA obtained to answer the question “Can a pharmacist order and/or evaluate the results of lab tests without entering a CPA?” indicates that outside of a CPA a pharmacist:

        • (1) has authority to order and evaluate lab tests in general (three states); California, Idaho, and Washington.

        • (2) has authority with respect to limited types of tests only (12 states); Arkansas, Delaware, Georgia, Hawaii, Illinois, Iowa, Michigan, North Dakota, South Carolina, South Dakota, Vermont, and Wyoming. or

        • (3) has no authority to order or evaluate lab tests (one state); Oklahoma.

        • In the other four states and Puerto Rico with the upfront answer “unclear,” (Alaska, Kansas, Nebraska, Puerto Rico, and Wisconsin) the answer to the question “Can a pharmacist order and/or evaluate the results of lab tests without entering a CPA?” does not assist; and

    • One state where the answer is “no,” because the list of authorized activities under a CPA does not reference ordering or evaluating lab tests; Indiana.

    More details about each state’s laws and regulations can be found in the individual state charts.