Emergency prescription refill rules: selected state and payer sources

California: Continuity refill when the prescriber is unavailable

Quantity / path

No fixed day-supply cap is stated in §4064 itself. This is not unlimited authority.

Conditions to verify

The pharmacist must judge that not refilling could interrupt ongoing care and significantly harm the patient’s well-being. Inform the patient and notify the prescriber within a reasonable time.

Limits

Apply other prescription and controlled-substance requirements separately. Do not substitute the separate 90-day dispensing provision for this authority.

BPC §4064, version effective January 1, 2026; checked September 5, 2026.

Texas: Ordinary emergency refill

Quantity / path

Up to 72 hours under §562.054(a); Schedule II excluded.

Conditions to verify

Interruption of therapy or patient suffering is a risk, and reasonable contact attempts fail or a disaster prevents contact. Tell the patient that this refill lacks prescriber authorization and future refills require it; inform the prescriber at the earliest reasonable time.

Limits

Keep the required prescription record and label. For a prescription from another pharmacy, verify prior dispensing evidence and the transfer/refill conditions in rule §291.34(b)(8)(D).

Texas Occupations Code §562.054(a) and 22 TAC §291.34(b)(8)(D); checked September 5, 2026.

Texas: Disaster refill with board notification

Quantity / path

Up to 30 days under §562.054(b); Schedule II excluded.

Conditions to verify

The disaster prevents prescriber contact and interruption of therapy or patient suffering is a risk. A governor’s disaster declaration and the board executive director’s notice to pharmacies are both required.

Limits

A declaration alone is insufficient. Tell the patient that future refills need authorization; notify the prescriber promptly. Keep the required record and label, and check other-pharmacy conditions in §291.34(b)(8)(E).

Texas Occupations Code §562.054(b) and 22 TAC §291.34(b)(8)(E); checked September 5, 2026. Verify current declaration and board notice.

Texas: Emergency insulin and related supplies

Quantity / path

Insulin: up to 30 days. Related equipment/supplies: the lesser of 30 days or the smallest available package.

Conditions to verify

After reasonable attempts to reach the practitioner, review documentation of the prior prescription, assess appropriateness, record the visit and evidence, and reasonably attempt to notify the practitioner promptly.

Limits

Insulin pumps are excluded from related supplies. Also follow the community-pharmacy requirements in §291.34(b)(8)(F).

Texas Occupations Code §562.0541 and 22 TAC §291.34(b)(8)(F); checked September 5, 2026.

New York: Emergency insulin under a non-patient-specific regimen

Quantity / path

Up to a 30-day supply, consistent with the prior prescription’s directions.

Conditions to verify

The insulin/supplies prescription must have expired within the last 12 months and have been issued by a New York-licensed physician or New York-certified nurse practitioner. First attempt authorization; it must be unobtainable and the prescriber must not object. Notify the prescriber within 72 hours.

Limits

This is the non-patient-specific insulin regimen in §6801(6), not general permission to refill any prescription. Verify the applicable regimen and all conditions.

New York Education Law §6801(6); checked September 5, 2026.

Florida: One-time emergency refill when authorization cannot readily be obtained

Quantity / path

Section (1): one-time supply up to 72 hours, or emergency insulin and related supplies/equipment up to three nonconsecutive times per calendar year. Section (2): up to 30 days during a governor’s emergency order in affected areas.

Conditions to verify

Refill authorization cannot readily be obtained. For the separate declared-emergency path, verify essential therapy, interruption risk, a signed written order and prescriber notification.

Limits

The Schedule II exclusion appears in the declared-emergency subsection. Check all applicable controlled-substance requirements separately; do not apply this summary as blanket dispensing authority.

Verify the current version of Florida Statutes §465.0275 and any active executive order.

Ohio: Refill from the pharmacy's prior prescription record when authorization cannot be obtained

Quantity / path

Generally 72 hours once. The consistent-therapy noncontrolled path allows a first supply up to 30 days or one standard dispensing unit; later supplies have a seven-day or lowest-package limit.

Conditions to verify

Up to three nonconsecutive uses in 12 months under the extended path. The pharmacy must hold the prior prescription record, be unable to obtain authorization and determine that interruption could harm the patient. Notify the prescriber within 72 hours; keep the required record for one year.

Limits

Schedule II is excluded. Quantity and number of uses depend on §4729.281(B).

Read the full current section, including documentation, notification, and patient-record conditions.

Oregon: Pharmacist-prescribed emergency insulin and related supplies

Quantity / path

Lesser of a 30-day supply or the smallest available package

Conditions to verify

Evidence of a previous prescription; pharmacist assessment, documentation, and reasonable attempt to inform the primary care and prior prescribing providers.

Limits

No more than three emergency refills per calendar year; insulin pump devices are excluded from the defined related supplies.

This is an insulin-specific authority in ORS 689.696, not a general emergency-refill rule.

Washington: Continuity of care during a governor's emergency proclamation

Quantity / path

During the proclamation: up to 30 days of current noncontrolled prescriptions or seven days for current Schedule III–V prescriptions. Expired/no-refill maintenance prescriptions have a separate one-time provision.

Conditions to verify

Emergency event prevents continuity; prescription record or pharmacist professional judgment supports the prior therapy; authorization cannot readily be obtained when expired or out of refills.

Limits

Operates during the proclaimed emergency and includes specific record, labeling, notification, and controlled-substance limits in the full rule.

This is a proclamation-dependent rule, WAC 246-945-332, not a standing vacation-fill benefit.

North Carolina: Insurance coverage for extra prescriptions during a declared emergency or disaster

Quantity / path

A covered plan must provide an early-refill waiver/payment procedure for one remaining authorized refill or an approved replacement prescription when the statute’s disaster conditions apply.

Conditions to verify

Verify the Commissioner’s bulletin, residence in an affected county and a request within 29 days of the triggering bulletin conditions. Extensions require a Commissioner’s order.

Limits

Quantity follows the original prescription; other benefit terms and dispensing authority still apply. This is a coverage rule, not permission to prescribe or dispense without authority.

Keep the coverage rule in G.S. 58-3-228 separate from pharmacy dispensing law and any active bulletin.

CVS Caremark: Plan-dependent vacation supply using Submission Clarification Code 03

Quantity / path

The 2026 provider manual describes SCC 03 for an eligible person reporting eligibility for vacation supply.

Conditions to verify

The plan sponsor must permit early vacation refills. If the returned claim still rejects, the manual directs the provider to the pharmacy help desk.

Limits

This is not a universal override or approval guarantee. Confirm the current plan benefit, valid prescription and returned response.

Plan benefit and live response govern; remaining refills and dispensing authority are separate prerequisites.

Optum Rx: Pharmacy eServices source

Open the responsible authority’s current guidance. This is a navigation link; no quantity or billing instruction has been verified for this entry.

Use the current secure workflow and returned result rather than assuming a universal SCC-only path.

Medi-Cal Rx: Program emergency-fill pathway

Open the responsible authority’s current guidance. This is a navigation link; no quantity or billing instruction has been verified for this entry.

Use current Medi-Cal Rx provider instructions and the live claim; member guidance alone is not a billing instruction.