All Roll Calls
Yes: 137 • No: 1
North DakotaSB 24022025 Special SessionSenateWALLET
AN ACT to create and enact two new sections to chapter 43-15 and a new subsection to section 43-48-03 of the North Dakota Century Code, relating to the prescriptive authority of pharmacists and therapeutic substitution; to amend and reenact subsection 1 of section 26.1-36.11-01 and section 43-15-01 of the North Dakota Century Code, relating to the scope of practice of pharmacists; to repeal section 43-15-25.3 of the North Dakota Century Code, relating to approved laboratory tests; and to provide an effective date.
Sponsored By: Legislative Management
Became Law
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 2 benefits, 0 costs, 2 mixed.
Devices, travel meds, and care gaps
Pharmacists can prescribe devices like inhalation spacers, nebulizers, diabetes test supplies, pen needles, and auto‑injectors for people with a documented history of severe allergies. They can close guideline care gaps by prescribing a statin for people with diabetes, HIV PEP after nonwork exposure, and a short‑acting asthma inhaler when the patient already has a long‑term control drug and had a prior rescue inhaler. They can also prescribe noncontrolled travel medicines listed by the CDC if they complete an accredited travel‑medicine course and the drug fits your destination. Pharmacists must follow assessment, documentation, and safety rules.
Faster treatment at your pharmacy
Pharmacists in North Dakota can now prescribe for common problems like lice, cold sores, motion sickness, low blood sugar, and simple urinary infections. They can also prescribe after a first positive CLIA‑waived test for flu, strep throat, or COVID‑19, and give antivirals to close contacts when guidelines say so. In an emergency, they can provide a small supply of diphenhydramine, epinephrine, or a short‑acting asthma inhaler until you see a provider. They can prescribe antibiotics to prevent Lyme disease when CDC rules are met. Pharmacists must use patient‑assessment protocols, keep records, consult or refer when needed, and tell your primary doctor within three business days if one is identified.
Pharmacist therapeutic drug substitutions
A pharmacist may substitute a therapeutically equivalent drug to improve cost or access, unless your prescriber blocks it or the drug is excluded. Excluded drugs include antidepressants, antipsychotics, chemotherapy agents, schedule II controlled substances, biologics, and narrow‑therapeutic‑index drugs. Before dispensing, the pharmacist must explain differences in drug and dosing, tell you it is your choice, and decide if the swap helps cost or access. The prescriber must be notified within 24 hours, and is not liable for the pharmacist’s substitution.
Updated pharmacy practice and testing
The law updates the practice of pharmacy to include prescriptive practices and the ordering and performance of CLIA‑waived tests used for pharmacy care. It expands what counts as administration, including vaccines and certain drugs for people age 3 and older, emergency home‑infusion device help when nursing is unavailable, and emergency‑setting drug protocols. It defines comprehensive medication management services like assessments, care plans, counseling, and monitoring, without expanding scope beyond chapter 43‑15. It repeals the prior approved‑laboratory‑tests statute and makes the law effective upon filing with the secretary of state.
Sponsors & Cosponsors
Sponsor
Legislative Management
Affiliation unavailable
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
House vote • 1/23/2026
Second reading, passed, yeas 91 nays 1
Yes: 91 • No: 1
Senate vote • 1/22/2026
Second reading, passed, yeas 46 nays 0
Yes: 46 • No: 0
Actions Timeline
Filed with Secretary Of State 01/23
1/28/2026HouseSigned by Governor 01/23
1/23/2026SenateSent to Governor
1/23/2026SenateSigned by President
1/23/2026SenateSigned by Speaker
1/23/2026HouseReturned to Senate
1/23/2026SenateSecond reading, passed, yeas 91 nays 1
1/23/2026HouseEngrossment placed on calendar 14 0 0
1/22/2026HouseIntroduced, first reading, referred Joint Policy Committee
1/22/2026HouseReceived from Senate
1/22/2026HouseSecond reading, passed, yeas 46 nays 0
1/22/2026SenateAmendment adopted, placed on calendar
1/22/2026SenateReported back amended, do pass, amendment placed on calendar 14 0 0
1/21/2026SenateCommittee Hearing 01:00
1/21/2026SenateIntroduced, first reading, referred Joint Policy Committee
1/21/2026Senate
Bill Text
Adopted by the Senate Joint Policy Committee
Enrollment
FIRST ENGROSSMENT
INTRODUCED
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