Five years after the COVID-19 pandemic placed unprecedented strain on health care systems already experiencing increased demand, workforce and patient access challenges remain pressing concerns for the pharmacy community. At the same time, evolving practice models like telepharmacy, central fill services, and remote medication verification have increased the need for pharmacists to be able to practice in multiple states. While the current licensure framework continues to play a vital role in protecting patients and upholding professional standards, many states have identified a growing need for additional pathways that can expand practice flexibility.
In response to these emerging needs, NABP has been collaborating with state boards of pharmacy to develop a new pharmacist interstate practice privilege model. For states that choose to adopt the model, qualified pharmacists will have the privilege to practice virtually or in person across participating jurisdictions without first obtaining full licensure. Each participating state will maintain its own regulatory authority over the privileged pharmacists’ practice.
Building on the Foundation of Licensure Transfer
For decades, the Electronic Licensure Transfer Program® (eLTP) has been the primary means through which pharmacists have obtained licensure in multiple states. This process enables pharmacists to apply for full licensure in additional states by transferring their existing license. Over the last decade alone, more than 175,000 transfers have been processed through eLTP. Boards of pharmacy continue to rely on eLTP as a trusted mechanism to ensure that they are receiving the information needed to evaluate applicants and uphold their regulatory standards. However, license transfer still requires a pharmacist to secure a full license in each new state. For pharmacists who practice across multiple states or in settings or regions where cross-jurisdictional service is routine, these repeated steps can cause roadblocks.
In response to these needs, NABP and its member boards are developing a new, additional pathway that will allow pharmacists to practice across multiple states without securing a full license in each one. Referred to as the pharmacist interstate practice privilege, this concept will enable pharmacists licensed and in good standing in one participating jurisdiction to seek authorization to provide services in other participating jurisdictions, subject to those states’ laws, regulations, and scope of practice.
Balancing Licensure Flexibility and Oversight
This new interstate practice privilege model is being designed to be voluntary, and each state will determine whether to adopt it. The new model will be built on the existing processes in place for eLTP and NABP Verify®, which was introduced in 2022 to support credential verification for specific temporary practice scenarios, and will serve as a uniform verification authority. When a pharmacist applies for the privilege, NABP will confirm that they hold an active license in at least one participating state, have no unresolved disciplinary actions, and meet any shared eligibility requirements established by participating states, such as passing the uniform version of the Multistate Pharmacy Jurisprudence Examination® (MPJE®) or its equivalent. Verification will be conducted using established NABP systems, such as NABP e-Profile® which already supports licensure transfers and other regulatory processes. Once verified, the pharmacist will be granted a privilege that will be used as the basis for other participating states to permit them to practice physically and remotely in that state.
A pharmacist practicing under this privilege in another state will still be required to follow that state’s laws, rules, and pharmacist’s scope of practice. If a pharmacist violates state pharmacy law, the board in that jurisdiction could take action against the pharmacist, including suspending or revoking the pharmacist’s ability to practice within its state, just as it would for any resident licensee. In this way, the proposed model seeks to enhance mobility without weakening oversight.
NABP Is Well Positioned to Support This New Model
At the 118th NABP Annual Meeting, member boards formally adopted a resolution requiring NABP to evaluate the feasibility of a model supporting multistate practice. In the time since, NABP has convened task forces and work groups to develop a framework that addresses current practice realities, such as cross-border telepharmacy and staffing flexibility. We have created other licensure portability programs and resources since then, allowing us to lead the creation of this new model with prior insights.
For example, during the early months of the COVID-19 pandemic, NABP launched the Emergency Passport Program. This temporary solution allowed states to grant expedited practice authorization to out-of-state pharmacists and technicians. More than 57,000 applications were approved in 2021 alone. The initiative demonstrated that pharmacists could be rapidly and safely mobilized across state lines. The Passport model helped to build tools such as NABP Verify, which now offers an emergency credential.
By supporting a streamlined pathway that retains state oversight, NABP and its member boards aim to reduce barriers to license portability while maintaining robust safeguards.
Interstate Practice Model Development and Next Steps
As of mid-2025, the interstate practice privilege model is still taking shape, with NABP and various board of pharmacy stakeholders refining the details. In early 2025, a dedicated work group helped create a framework for the model. This work is iterative, implementing feedback from experts to ensure that the model addresses as many real-world concerns as possible.
Once the model legislative language and NABP infrastructure are ready, the next step will be state implementation. States will need to enact the model legislation to enable the pharmacist interstate practice privilege model in their states. This new pathway to practice will offer a significant step forward in modernizing licensure portability. By leveraging NABP’s established infrastructure and facilitating streamlined verification, states can adapt the way they authorize pharmacists to practice to fit the pharmacy landscape as it continues to evolve.
This blog was adapted from an article that originally appeared in the June 2025 issue of Innovations.
