Maryland Expands Prescriber–Pharmacist Agreements And Opens New Opportunities For Opioid Use Disorder Treatment

Beginning July 1, 2026, Maryland pharmacists will have expanded opportunities to participate in collaborative patient care under newly enacted House Bill 838. Signed into law as Chapter 53, the legislation modernizes Maryland’s prescriber–pharmacist agreement framework and creates a pathway for qualified pharmacists to play a more active role in treating opioid use disorder (OUD).

At a time when healthcare systems continue to face provider shortages, increasing patient demand, and an ongoing opioid crisis, Maryland’s legislation reflects a growing national trend toward expanding pharmacists’ clinical responsibilities through collaborative practice models.

Reduced Administrative Burdens for Collaborative Practice Agreements

One of the most immediate changes under HB 838 is the elimination of a longstanding administrative requirement that authorized prescribers submit prescriber–pharmacist agreements to the applicable health occupations board.

While the legislation does not eliminate the need for compliant agreements, it removes an administrative step that many providers viewed as unnecessary. The change should streamline implementation of collaborative practice arrangements and make it easier for healthcare organizations to develop pharmacist-led clinical services.

For physician groups, health systems, accountable care organizations and pharmacies, the revised framework may accelerate the deployment of clinical programs designed to improve access to care and patient outcomes.

Expanded Authority for Opioid Use Disorder Treatment

Perhaps the most significant aspect of HB 838 is its express authorization for pharmacists to participate in opioid use disorder treatment involving controlled dangerous substance drug therapy pursuant to a qualifying prescriber–pharmacist agreement.

Under the new law, pharmacists who satisfy applicable registration, training and protocol requirements may engage in OUD-related drug therapy management under collaborative practice arrangements.

This represents an important evolution in Maryland’s approach to pharmacist-provided patient care. Pharmacists are among the most accessible healthcare professionals in many communities, particularly in rural and underserved areas where behavioral health resources may be limited.

By leveraging pharmacists as part of the treatment team, Maryland policymakers appear to be pursuing greater access to evidence-based treatment while maintaining appropriate safeguards and oversight.

Enhanced Prescription Drug Monitoring Program Requirements

The legislation also strengthens oversight requirements involving controlled substance therapy.

Before initiating or modifying controlled dangerous substance treatment under a collaborative practice arrangement, pharmacists must request and review relevant information from Maryland’s Prescription Drug Monitoring Program (PDMP).

The requirement reflects increasing regulatory emphasis on utilizing PDMP data to identify potential misuse, duplication of therapy, diversion concerns and other patient safety risks.

Healthcare organizations implementing these programs should ensure that participating pharmacists receive appropriate training and that operational workflows incorporate PDMP review requirements before treatment decisions are made.

Operational Considerations for Pharmacies and Health Systems

While HB 838 creates new opportunities, it also presents important compliance considerations.

Organizations seeking to implement or expand prescriber–pharmacist agreements should evaluate:

• Eligibility requirements for participating pharmacists;
• Training and credentialing obligations;
• Controlled substance compliance procedures;
• PDMP access and documentation protocols;
• Agreement drafting and review processes;
• Quality assurance and auditing measures; and
• Risk management policies related to collaborative care services.

Healthcare organizations should also review existing collaborative practice agreements to determine whether updates are needed before the law takes effect.

What This Means for the Future of Pharmacy Practice

Maryland’s enactment of HB 838 continues a broader nationwide movement recognizing pharmacists as essential members of the patient care team. States increasingly are authorizing pharmacists to perform clinical functions that historically fell exclusively within the scope of physicians and advanced practice providers.

The legislation is particularly notable because it intersects two major healthcare priorities: expanding access to care and addressing opioid use disorder.

As implementation approaches, pharmacies, health systems, physician practices and behavioral health providers should evaluate how these expanded authorities may fit within their clinical and operational strategies.

Organizations that proactively assess collaborative practice opportunities now will be best positioned to take advantage of the new framework when the law becomes effective on July 1, 2026.

Key Takeaway

Maryland HB 838 reduces administrative barriers to prescriber–pharmacist agreements while creating new opportunities for qualified pharmacists to participate in opioid use disorder treatment under collaborative practice arrangements. Although the law expands pharmacist involvement in patient care, successful implementation will require careful attention to training requirements, controlled substance compliance obligations and PDMP review procedures.

Healthcare organizations including pharmacies should begin reviewing their collaborative practice programs now to ensure readiness for the July 1, 2026 effective date.

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