State scrutiny of specialty pharmacies is increasing in response to last fall's deadly meningitis outbreak tied to tainted steroids from the New England Compounding Center. States are considering making pharmacies get special permits to mix sterile drugs, and surprise inspections are being conducted. Virginia and Maryland are among a dozen states considering tighter licensing requirements. New York regulators issued a sales moratorium for one of the nation's biggest compounders, while Iowa's pharmacy board hopes to inspect more than 600 out-of-state compounders that supply medicines to the state.

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