Committee hears narrow fix to let physician assistants join pharmacist collaborative agreements

Senator Brian Harden introduced LB955 as a narrow clarification to restore physician assistants’ ability to participate in pharmacist collaborative practice agreements (CPAs) used to manage medication therapy. Harden said a recent Board of Pharmacy interpretation created uncertainty and forced some health systems to remove PAs from these agreements.

Bethany Berg, legislative chair of the Nebraska Academy of PAs, told the committee PAs have long participated in CPAs in primary care, oncology and chronic disease management and that removing PAs created delays and administrative burden. "LB 9 55 restores clarity by explicitly allowing pharmacists to enter collaborative practice agreements with physician assistants who prescribe under existing law," she said.

Carolyn Faylor, a pharmacist testifying for Nebraska Medicine and the Nebraska Hospital Association, described embedded pharmacist teams that receive referrals for chronic disease management and said removing PAs from CPAs created inequities and care delays; she cited approximately 2,500 primary-care referrals to one clinic pharmacist in 2025 as an example of the model’s scale.

Haley Perzborn of the Nebraska Pharmacists Association said enforcement of the Board of Pharmacy interpretation (rather than statutory change) caused the disruption and that the bill restores long-standing practice.

Committee members asked about prescribing authority, whether retail clinics could use CPAs to alter business models, and billing questions. Proponents said the bill does not expand PA or pharmacist scope of practice, that PAs typically prescribe under collaborative authority, and that Medicare/Medicaid coding generally pays for the service regardless of which eligible clinician provides it.

The clerk reported six proponents and no opponents; the committee closed the LB955 hearing.

What’s next: LB955 will be considered in committee; proponents asked for the committee’s support to avoid disruptions to pharmacist-led medication management.