On February 1, 2022, the Texas Board of Pharmacy voted to send proposed amendments to its Central Fill Rule under 22 Tex. Admin. Code § 291.125 back to staff for a redraft. As our previous client alert reported, Board staff recently modified their interpretation of the rule, stating that the rule does not permit Class E nonresident pharmacies to utilize central fill services from pharmacies located in Texas. Multiple public comments generally voiced support for the proposed amendment, which expressly added Class E pharmacies to the definition of "outsourcing pharmacy." However, commentors raised concerns regarding the draft's potential for misinterpretation. Namely, commentors raised concerns that a strict reading of the amended rule would impose licensure requirements on any nonresident pharmacy receiving centralized prescription dispensing services from a Texas pharmacy, regardless of whether the nonresident pharmacy serves patients in Texas. Staff made clear on the record that this was not the intent of the amendment. Nevertheless, the Board directed staff to add clarifying language expressly stating that the rule is not intended to trigger additional licensure of nonresident pharmacies engaged in a central fill arrangement and not otherwise serving Texas patients. The revised amendment will likely be heard at the Board's next meeting.