Pharmacy Scope of Practice Expansion - what you need to know
During a three-day special session that concluded on January 23, 2026, the North Dakota Legislative Assembly passed Senate Bill 2402, a landmark piece of legislation that significantly expands the scope of practice for North Dakota pharmacists.
This legislation was part of a larger, four-bill package designed to unlock roughly $199 million in federal funding for the state's Rural Health Transformation Program, with the goal of improving health care access, particularly for residents in remote areas.
NDMA and its partners shared concerns about the scope expansion and the potential patient harms it could cause, and successfully removed some of the most troubling provisions, but concerns remain.
FILING A COMPLAINT: The North Dakota Board of Pharmacy does have a system in place to address complaints. If you or your patient(s) encounter an experience that resulted from pharmacists' prescribing practices, complete the form and return it to the North Dakota Board of Pharmacy.
Key Provisions of the New Pharmacy Law (SB 2402):
- Independent Prescribing: Pharmacists are now authorized to prescribe medications for specific common, uncomplicated conditions—such as strep throat, influenza, COVID-19, lice, cold sores, motion sickness, and hypoglycemia—without a prior doctor's visit.
- Emergency Refills: Pharmacists can now prescribe a 30-day supply of a patient's existing medication if their primary provider is unavailable.
- Therapeutic Substitution: Pharmacists are permitted to substitute prescribed drugs with therapeutically equivalent alternatives if the original is out of stock, provided the prescribing physician does not prohibit it.
- Lab Test Ordering: The law allows pharmacists to order basic laboratory tests necessary to assist in treatment decisions for common conditions.
- Provider Notification: Pharmacists are required to notify the patient's primary care provider of any prescriptions or therapeutic substitutions made.
- Limitations: The legislation does not allow pharmacists to prescribe controlled substances or pain medications.