TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
BOARD OF PHARMACY
Final Regulation
REGISTRAR'S NOTICE: The Board of Pharmacy is claiming an exemption from Article 2 of the Administrative Process Act in accordance with § 2.2-4006 A 4 a of the Code of Virginia, which excludes regulations that are necessary to conform to changes in Virginia statutory law or the appropriation act where no agency discretion is involved. The board will receive, consider, and respond to petitions by any interested person at any time with respect to reconsideration or revision.
Title of Regulation: 18VAC110-40. Regulations Governing Collaborative Practice Agreements (amending 18VAC110-40-20, 18VAC110-40-50).
Statutory Authority: §§ 54.1-2400 and 54.1-3300.1 of the Code of Virginia.
Effective Date: November 5, 2025.
Agency Contact: Caroline Juran, RPh, Executive Director, Board of Pharmacy, 9960 Mayland Drive, Suite 300, Henrico, VA 23233, telephone (804) 367-4456, fax (804) 527-4472, or email caroline.juran@dhp.virginia.gov.
Summary:
Pursuant to Chapter 117 of the 2025 Acts of Assembly, the amendments adjust collaborative practice agreements to clarify that a pharmacist's participation in a collaborative practice agreement includes prescribing medication.
18VAC110-40-20. Signed authorization for an agreement.
A. The signatories to an agreement shall be a practitioner involved directly in patient care and a pharmacist involved directly in patient care. Within the agreement, the pharmacist may designate alternate pharmacists, provided the alternates are involved directly in patient care at a single physical location where patients receive services.
B. An agreement shall only be implemented for an individual patient pursuant to an order from the practitioner for that patient. A patient who meets the criteria for inclusion in the category of patients whose care is subject to a collaborative agreement and who chooses to not participate in a collaborative procedure shall notify the prescriber practitioner of the patient's refusal to participate in such collaborative procedure.
1. The patient may decline to participate or withdraw from participation at any time.
2. The patient shall be informed by the practitioner or the pharmacist of the collaborative procedures that will be used pursuant to an agreement, and such discussion shall be documented in the patient record.
3. The practitioner and the pharmacist shall provide written disclosure to the patient of any contractual arrangement with any other party or any financial incentive that may impact one of the party's decisions to participate in the agreement.
18VAC110-40-50. Record retention.
A. Signatories to an agreement shall keep a copy of the agreement on file at their primary places of practice.
B. An order for a specific patient from the prescribing practitioner authorizing that authorizes the implementation prescribing of drug therapy management pursuant to the agreement shall be noted in the patient's medical record and kept on file by the pharmacist.
C. The patient's documented informed consent shall be retained by the practitioner in the patient record.
VA.R. Doc. No. R26-8336; Filed September 08, 2025