Bill Text: IA HF555 | 2023-2024 | 90th General Assembly | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: A bill for an act relating to the practice of pharmacy, and providing for administrative penalties. (Formerly HSB 202.) Effective date: 07/01/2024.
Spectrum: Committee Bill
Status: (Passed) 2024-04-19 - Signed by Governor. H.J. 926. [HF555 Detail]
Download: Iowa-2023-HF555-Introduced.html
Bill Title: A bill for an act relating to the practice of pharmacy, and providing for administrative penalties. (Formerly HSB 202.) Effective date: 07/01/2024.
Spectrum: Committee Bill
Status: (Passed) 2024-04-19 - Signed by Governor. H.J. 926. [HF555 Detail]
Download: Iowa-2023-HF555-Introduced.html
House
File
555
-
Introduced
HOUSE
FILE
555
BY
COMMITTEE
ON
HEALTH
AND
HUMAN
SERVICES
(SUCCESSOR
TO
HSB
202)
A
BILL
FOR
An
Act
relating
to
the
practice
of
pharmacy,
and
providing
for
1
administrative
penalties.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
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Section
1.
NEW
SECTION
.
155A.2B
Practice
of
pharmacy
——
1
general
principles.
2
To
evaluate
whether
an
act
by
a
licensee
or
registrant
under
3
this
chapter
violates
the
appropriate
standard
of
care,
a
4
licensee
or
registrant
of
the
board
must
consider
all
of
the
5
following:
6
1.
Whether
performance
of
the
act
is
expressly
prohibited
7
by
a
provision
of
this
chapter.
8
2.
Whether
performance
of
the
act
is
expressly
prohibited
9
by
a
rule
adopted
by
the
board.
10
3.
Whether
performance
of
the
act
is
expressly
prohibited
by
11
another
applicable
state
or
federal
law
or
regulation.
12
4.
Whether
performance
of
the
act
is
consistent
with
13
the
education,
training,
and
experience
of
a
licensee
or
14
registrant.
15
5.
Whether
performance
of
the
act
is
within
the
accepted
16
standard
of
care
that
would
be
provided
in
a
similar
setting
by
17
a
reasonable
and
prudent
licensee
or
registrant
with
similar
18
education,
training,
and
experience.
19
Sec.
2.
Section
155A.3,
subsection
39,
Code
2023,
is
amended
20
to
read
as
follows:
21
39.
“Practitioner”
means
a
physician,
dentist,
podiatric
22
physician,
prescribing
psychologist,
veterinarian,
optometrist,
23
pharmacist,
physician
assistant,
advanced
registered
nurse
24
practitioner,
or
other
person
licensed
or
registered
to
25
prescribe,
distribute,
or
dispense
a
prescription
drug
or
26
device
in
the
course
of
professional
practice
in
this
state
or
27
a
person
licensed
by
another
state
in
a
health
field
in
which,
28
under
Iowa
law,
licensees
in
this
state
may
legally
prescribe
29
drugs.
30
Sec.
3.
Section
155A.3,
Code
2023,
is
amended
by
adding
the
31
following
new
subsection:
32
NEW
SUBSECTION
.
49A.
“Therapeutic
substitution”
means
the
33
replacement
of
a
prescribed
drug
with
an
alternative
molecule
34
with
assumed
equivalent
therapeutic
effect.
The
alternative
35
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drug
may
be
within
the
same
class
or
from
another
class
with
1
assumed
therapeutic
equivalence.
2
Sec.
4.
Section
155A.7,
Code
2023,
is
amended
by
striking
3
the
section
and
inserting
in
lieu
thereof
the
following:
4
155A.7
Pharmacist-intern,
pharmacy
technician,
and
pharmacy
5
support
person
registration.
6
1.
Registration
programs
for
pharmacist-interns,
pharmacy
7
technicians,
and
pharmacy
support
persons
are
established
for
8
the
purposes
of
identification,
tracking,
and
disciplinary
9
action
for
the
violation
of
federal
drug
laws
or
regulations,
10
state
drug
or
pharmacy
laws,
or
rules
of
the
board.
11
2.
A
person
who
is
or
desires
to
be
a
pharmacist-intern,
12
pharmacy
technician,
or
pharmacy
support
person
in
this
state
13
shall
apply
to
the
board
for
registration
on
a
form
prescribed
14
by
the
board.
15
a.
A
pharmacist-intern
shall
be
registered
during
internship
16
training
and
thereafter
pursuant
to
rules
adopted
by
the
board.
17
b.
An
applicant
for
a
new
pharmacy
technician
registration
18
or
for
a
pharmacy
technician
renewal
shall
provide
proof
of
19
current
certification
by
a
national
technician
certification
20
authority
approved
by
the
board.
A
person
who
is
in
the
21
process
of
acquiring
national
certification
as
a
pharmacy
22
technician
and
who
is
in
training
to
become
a
pharmacy
23
technician
shall
register
with
the
board
as
a
pharmacy
24
technician.
25
3.
The
board
shall
adopt
rules
pursuant
to
chapter
17A
on
26
matters
pertaining
to
pharmacist-intern,
pharmacy
technician,
27
and
pharmacy
support
person
registration,
renewals,
fees,
28
training,
national
certification
for
pharmacy
technicians,
29
approval
of
preceptors
for
pharmacist-interns,
and
other
30
relevant
matters.
31
a.
The
board
shall
establish
standards
for
pharmacist-intern
32
registration.
33
b.
The
board
shall
not
adopt
rules
pertaining
to
pharmacy
34
support
person
registration
which
include
any
determination
of
35
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the
competency
of
the
registered
person
and,
notwithstanding
1
section
272C.2,
subsection
1,
shall
not
require
continuing
2
education
for
renewal.
3
4.
The
board
may
deny,
suspend,
or
revoke
the
registration
4
of
a
pharmacist-intern,
pharmacy
technician,
or
pharmacy
5
support
person,
or
otherwise
impose
disciplinary
penalties
upon
6
the
registration
of
a
pharmacy
technician
or
pharmacy
support
7
person,
for
any
violation
of
the
laws
of
this
state,
another
8
state,
or
the
United
States
relating
to
prescription
drugs,
9
controlled
substances,
or
nonprescription
drugs,
or
for
any
10
violation
of
this
chapter
or
chapter
124,
124B,
126,
147,
205,
11
or
272C,
or
any
rule
of
the
board.
The
board
may
deny,
suspend,
12
or
revoke
a
pharmacist-intern
registration
for
failure
to
meet
13
the
standards
prescribed
by
the
board
pursuant
to
subsection
3.
14
5.
Responsibility
for
the
actions
of
a
pharmacist-intern,
15
pharmacy
technician,
or
pharmacy
support
person
working
under
16
a
licensed
pharmacist’s
delegated
functions
and
reasonable
17
professional
oversight
shall
remain
with
the
licensed
18
pharmacist.
19
Sec.
5.
Section
155A.8,
Code
2023,
is
amended
to
read
as
20
follows:
21
155A.8
Requirements
for
pharmacist
Pharmacist
license.
22
1.
A
person
shall
not
engage
in
the
practice
of
pharmacy
in
23
this
state
without
a
license.
The
license
shall
be
identified
24
as
a
pharmacist
license.
25
2.
A
pharmacist
may
dispense,
administer,
monitor,
and
26
issue
prescription
drugs,
biological
products,
and
medication
27
orders
commensurate
with
the
pharmacist’s
training
and
28
education
and
in
accordance
with
the
appropriate
standard
of
29
care.
30
3.
To
qualify
for
a
pharmacist
license,
an
applicant
shall
31
meet
the
following
requirements:
32
1.
a.
Be
a
graduate
of
a
school
or
college
of
pharmacy
33
or
of
a
department
of
pharmacy
of
a
university
recognized
and
34
approved
by
the
board.
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2.
b.
File
proof,
satisfactory
to
the
board,
of
internship
1
for
a
period
of
time
fixed
by
the
board.
2
3.
c.
Pass
an
examination
prescribed
by
the
board.
3
4.
The
board
shall
specify
by
rule
procedures
and
fees
to
4
renew
a
pharmacist
license
and
penalties
for
late
renewal
or
5
failure
to
renew
a
pharmacist
license.
6
Sec.
6.
Section
155A.9,
subsection
2,
Code
2023,
is
amended
7
to
read
as
follows:
8
2.
An
applicant
who
is
a
graduate
of
a
school
or
college
of
9
pharmacy
located
outside
the
United
States
but
who
is
otherwise
10
qualified
to
apply
for
a
pharmacist
license
in
this
state
may
11
be
deemed
to
have
satisfied
the
requirements
of
section
155A.8,
12
subsection
1
section
155A.8,
subsection
3,
paragraph
“a”
,
by
13
verification
to
the
board
of
the
applicant’s
academic
record
14
and
graduation
and
by
meeting
other
requirements
established
15
by
rule
of
the
board.
The
board
may
require
the
applicant
16
to
pass
an
examination
or
examinations
given
or
approved
by
17
the
board
to
establish
proficiency
in
English
and
equivalency
18
of
education
as
a
prerequisite
for
taking
the
licensure
19
examination
required
in
section
155A.8,
subsection
3
.
20
Sec.
7.
Section
155A.12,
subsection
1,
Code
2023,
is
amended
21
to
read
as
follows:
22
1.
Violated
any
provision
of
this
chapter
or
any
rules
of
23
the
board
adopted
under
this
chapter
,
the
pharmacy
or
drug
24
laws
or
rules
of
the
United
States,
or
any
other
state
laws
25
or
rules
of
the
United
States
while
under
the
other
state’s
26
jurisdiction
.
27
Sec.
8.
Section
155A.12,
subsections
8,
9,
and
10,
Code
28
2023,
are
amended
by
striking
the
subsections.
29
Sec.
9.
Section
155A.12,
Code
2023,
is
amended
by
adding
the
30
following
new
subsections:
31
NEW
SUBSECTION
.
11.
Engaged
in
conduct
outside
the
accepted
32
standard
of
care
that
would
be
provided
in
a
similar
setting
by
33
a
reasonable
and
prudent
applicant
or
licensee.
34
NEW
SUBSECTION
.
12.
Displayed
incapacity
of
a
nature
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preventing
engagement
in
the
practice
of
pharmacy
with
1
reasonable
skill,
competence,
and
safety
to
the
public.
2
Sec.
10.
Section
155A.13,
subsection
3,
paragraph
b,
Code
3
2023,
is
amended
by
striking
the
paragraph
and
inserting
in
4
lieu
thereof
the
following:
5
b.
The
board
shall
adopt
rules
for
the
issuance
of
a
special
6
or
limited-use
pharmacy
license
to
a
telepharmacy
site.
7
Sec.
11.
Section
155A.13,
subsection
3,
paragraphs
c,
d,
and
8
e,
Code
2023,
are
amended
by
striking
the
paragraphs.
9
Sec.
12.
Section
155A.13,
subsection
8,
Code
2023,
is
10
amended
by
striking
the
subsection.
11
Sec.
13.
Section
155A.13A,
Code
2023,
is
amended
by
adding
12
the
following
new
subsection:
13
NEW
SUBSECTION
.
6.
Nonresident
pharmacy
license.
The
14
board
shall
specify
by
rule
procedures
and
fees
to
renew
a
15
nonresident
pharmacy
license
and
the
penalties
for
late
renewal
16
or
failure
to
renew
a
nonresident
pharmacy
license.
17
Sec.
14.
Section
155A.18,
Code
2023,
is
amended
to
read
as
18
follows:
19
155A.18
Penalties.
20
1.
The
board
shall
impose
penalties
as
allowed
under
section
21
272C.3
.
In
addition,
civil
penalties
not
to
exceed
twenty-five
22
thousand
dollars,
may
be
imposed.
23
2.
The
board
may
impose
an
administrative
penalty
of
up
to
24
five
hundred
dollars
on
a
licensee
or
registrant
who
does
any
25
of
the
following:
26
a.
Engages
in
a
practice
regulated
by
this
chapter
without
a
27
current
license
or
registration.
28
b.
Employs
a
person
without
a
current
license
or
29
registration
to
engage
in
a
practice
regulated
by
this
chapter.
30
c.
Fails
to
complete
the
continuing
education
required
for
31
renewal
of
a
license
or
registration.
32
d.
Fails
any
component
of
a
routine
inspection
conducted
by
33
the
board.
34
e.
The
assessment
and
payment
of
a
penalty
imposed
pursuant
35
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to
this
subsection
shall
not
be
considered
a
disciplinary
1
action
or
reported
as
discipline
and
shall
be
confidential.
2
Sec.
15.
Section
155A.19,
Code
2023,
is
amended
by
striking
3
the
section
and
inserting
in
lieu
thereof
the
following:
4
155A.19
Notifications
to
board.
5
Individuals
and
businesses
licensed
or
registered
pursuant
6
to
this
chapter
shall
notify
the
board
of
pertinent
changes
7
related
to
activities
performed
pursuant
to
a
license
or
8
registration
issued
under
this
chapter,
pursuant
to
rules
of
9
the
board.
10
Sec.
16.
Section
155A.23,
Code
2023,
is
amended
by
adding
11
the
following
new
subsection:
12
NEW
SUBSECTION
.
4.
a.
A
person
found
in
possession
of
a
13
drug
or
device
limited
to
dispensation
by
prescription,
unless
14
the
drug
or
device
was
so
lawfully
dispensed,
commits
a
serious
15
misdemeanor.
16
b.
Paragraph
“a”
does
not
apply
to
a
licensed
pharmacy,
17
licensed
wholesaler,
physician,
veterinarian,
dentist,
18
podiatric
physician,
optometrist,
advanced
registered
nurse
19
practitioner,
physician
assistant,
pharmacist,
a
nurse
20
acting
under
the
direction
of
a
physician,
staff
acting
21
under
the
direction
of
a
person
licensed
to
prescribe,
or
22
the
board
of
pharmacy,
its
officers,
agents,
inspectors,
23
and
representatives,
or
to
a
common
carrier,
manufacturer’s
24
representative,
or
messenger
when
transporting
the
drug
or
25
device
in
the
same
unbroken
package
in
which
the
drug
or
device
26
was
delivered
to
that
person
for
transportation.
27
Sec.
17.
Section
155A.26,
unnumbered
paragraph
1,
Code
28
2023,
is
amended
to
read
as
follows:
29
The
board,
its
officers,
agents,
inspectors
compliance
30
officers
,
and
representatives,
and
all
peace
officers
31
within
the
state,
and
all
county
attorneys
shall
enforce
32
all
provisions
of
this
chapter
,
except
those
specifically
33
delegated,
and
shall
cooperate
with
all
agencies
charged
34
with
the
enforcement
of
the
laws
of
the
United
States,
of
35
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this
state,
and
of
all
other
states
relating
to
prescription
1
drugs.
Officers,
agents,
inspectors
compliance
officers
,
and
2
representatives
of
the
board
shall
have
the
powers
and
status
3
of
peace
officers
when
enforcing
the
provisions
of
this
chapter
4
and
chapters
124
,
126
,
and
205
.
Officers,
agents,
inspectors
5
compliance
officers
,
and
representatives
of
the
board
of
6
pharmacy
may:
7
Sec.
18.
Section
155A.26,
subsection
3,
Code
2023,
is
8
amended
to
read
as
follows:
9
3.
Conduct
routine
and
unannounced
inspections
of
10
pharmacies,
drug
wholesalers,
and
the
offices
or
business
11
locations
of
all
individuals
and
institutions
authorized
to
12
have
possession
of
prescription
drugs
including
any
entity
13
licensed
by
the
board
or
location
authorized
to
possess
14
controlled
substances
or
prescription
devices,
regardless
of
15
the
location
of
the
office
or
business.
16
Sec.
19.
Section
155A.27,
subsection
2,
paragraph
a,
Code
17
2023,
is
amended
to
read
as
follows:
18
a.
Beginning
January
1,
2020,
every
Every
prescription
19
issued
for
a
prescription
drug
shall
be
transmitted
20
electronically
as
an
electronic
prescription
to
a
pharmacy
by
a
21
prescriber
or
the
prescriber’s
authorized
agent
unless
exempt
22
under
paragraph
“b”
.
23
Sec.
20.
Section
155A.27,
subsection
3,
unnumbered
24
paragraph
1,
Code
2023,
is
amended
to
read
as
follows:
25
For
prescriptions
issued
prior
to
January
1,
2020,
or
26
for
prescriptions
exempt
from
the
electronic
prescription
27
requirement
in
subsection
2
,
paragraph
“b”
,
a
prescriber
or
the
28
prescriber’s
authorized
agent
may
transmit
a
prescription
for
a
29
prescription
drug
to
a
pharmacy
by
any
of
the
following
means:
30
Sec.
21.
Section
155A.27,
Code
2023,
is
amended
by
adding
31
the
following
new
subsections:
32
NEW
SUBSECTION
.
8.
Except
as
specified
in
subsection
9,
a
33
prescription
for
any
prescription
drug
or
device
which
is
not
a
34
controlled
substance
shall
not
be
filled
or
refilled
more
than
35
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eighteen
months
after
the
date
on
which
the
prescription
was
1
issued
and
a
prescription
which
is
authorized
to
be
refilled
2
shall
not
be
refilled
more
than
twelve
times.
3
NEW
SUBSECTION
.
9.
A
pharmacist
may
exercise
professional
4
judgment
by
refilling
a
prescription
drug
order
without
5
prescriber
authorization
in
accordance
with
the
appropriate
6
standard
of
care
and
pursuant
to
rules
established
by
the
7
board.
8
NEW
SUBSECTION
.
10.
An
authorization
to
refill
a
9
prescription
drug
order
shall
be
transmitted
to
a
pharmacy
by
10
a
prescriber
or
the
prescriber’s
authorized
agent
pursuant
11
to
this
section,
except
that
prescription
drug
orders
for
12
controlled
substances
shall
be
transmitted
pursuant
to
section
13
124.308,
and,
if
not
transmitted
directly
by
the
practitioner,
14
shall
also
include
the
name
and
title
of
the
practitioner’s
15
agent
completing
the
transmission.
16
Sec.
22.
Section
155A.32,
Code
2023,
is
amended
by
striking
17
the
section
and
inserting
in
lieu
thereof
the
following:
18
155A.32
Drug
product
selection
——
restrictions.
19
1.
If
an
authorized
practitioner
prescribes
a
drug,
the
20
pharmacist
may
exercise
professional
judgment
in
the
interest
21
of
the
patient
by
providing
a
therapeutic
substitution
for
22
dispensing
and
sale
to
the
patient.
23
2.
The
pharmacist
shall
not
provide
a
therapeutic
24
substitution
if
“dispense
as
written”
is
indicated
on
the
25
prescription.
26
3.
The
board
shall
adopt
rules
on
proper
recording
and
27
notification
when
a
therapeutic
substitution
is
made
under
this
28
section.
29
Sec.
23.
Section
155A.39,
subsection
6,
Code
2023,
is
30
amended
to
read
as
follows:
31
6.
Funds
and
surcharges
collected
under
this
section
shall
32
be
deposited
in
an
account
and
may
be
used
by
the
board
to
33
administer
a
program
authorized
by
this
section
,
but
shall
34
not
be
used
for
costs
incurred
for
a
participant’s
initial
35
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evaluation,
referral
services,
treatment,
or
rehabilitation
1
subsequent
to
intervention
and
to
assist
licensees
and
2
registrants
with
costs
incurred
for
participation
in
the
3
program
.
4
Sec.
24.
Section
155A.40,
subsection
1,
Code
2023,
is
5
amended
to
read
as
follows:
6
1.
The
board
may
request
and
obtain,
notwithstanding
7
section
692.2,
subsection
5
,
criminal
history
data
for
any
8
applicant
for
an
initial
or
renewal
license
or
registration
9
issued
pursuant
to
this
chapter
or
chapter
147
,
any
applicant
10
for
reinstatement
of
a
license
or
registration
issued
pursuant
11
to
this
chapter
or
chapter
147
,
or
any
licensee
or
registrant
12
who
is
being
monitored
as
a
result
of
a
board
order
or
13
agreement
resolving
an
administrative
disciplinary
action,
14
for
the
purpose
of
evaluating
the
applicant’s,
licensee’s,
15
or
registrant’s
eligibility
for
licensure,
registration,
or
16
suitability
for
continued
practice
of
the
profession.
Criminal
17
history
data
may
be
requested
for
all
owners,
managers,
and
18
principal
employees
of
a
pharmacy
,
third-party
logistics
19
provider,
or
drug
wholesaler
wholesale
distributor
licensed
20
pursuant
to
this
chapter
.
The
board
shall
adopt
rules
21
pursuant
to
chapter
17A
to
implement
this
section
.
The
board
22
shall
inform
the
applicant,
licensee,
or
registrant
of
the
23
criminal
history
requirement
and
obtain
a
signed
waiver
from
24
the
applicant,
licensee,
or
registrant
prior
to
submitting
a
25
criminal
history
data
request.
26
Sec.
25.
Section
155A.46,
Code
2023,
is
amended
by
adding
27
the
following
new
subsection:
28
NEW
SUBSECTION
.
01.
A
pharmacist
may,
pursuant
to
29
statewide
protocols
developed
and
approved
by
the
board
in
30
consultation
with
the
department
of
health
and
human
services,
31
order
and
administer
prescription
drugs,
products,
tests,
or
32
treatments.
Each
protocol,
as
established
by
rule,
may
define
33
the
prescription
drugs,
products,
tests,
or
treatments
allowed
34
to
be
ordered
and
administered,
any
training
or
qualification
35
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required
to
implement
the
protocol,
and
any
additional
1
requirements
deemed
appropriate
by
the
board.
2
Sec.
26.
Section
155A.46,
subsection
1,
Code
2023,
is
3
amended
to
read
as
follows:
4
1.
A
pharmacist
may,
pursuant
to
statewide
protocols
5
developed
and
approved
by
the
board
in
consultation
with
6
the
department
of
health
and
human
services
and
consistent
7
with
subsection
2,
order
and
administer
an
immunization
or
8
vaccination.
Each
protocol,
as
established
by
rule,
may
9
define
the
immunization
or
vaccination
allowed
to
be
ordered
10
and
administered,
any
training
or
qualification
required
to
11
implement
the
protocol,
and
any
additional
requirements
deemed
12
appropriate
by
the
board.
13
a.
A
pharmacist
may
,
pursuant
to
statewide
protocols
14
developed
by
the
board
in
consultation
with
the
department
15
of
public
health
and
consistent
with
subsection
2
,
order
and
16
administer
the
following
to
patients
ages
eighteen
years
and
17
older:
18
(1)
Naloxone.
19
(2)
Nicotine
replacement
tobacco
cessation
products.
20
(3)
(1)
An
immunization
or
vaccination
recommended
by
21
the
United
States
centers
for
disease
control
and
prevention
22
advisory
committee
on
immunization
practices
in
its
approved
23
vaccination
schedule
for
adults.
24
(4)
(2)
An
immunization
or
vaccination
recommended
by
the
25
United
States
centers
for
disease
control
and
prevention
for
26
international
travel.
27
(5)
(3)
A
Tdap
(tetanus,
diphtheria,
acellular
pertussis)
28
vaccination
in
a
booster
application.
29
(6)
(4)
Other
emergency
immunizations
or
vaccinations
in
30
response
to
a
public
health
emergency.
31
(7)
(5)
An
immunization
or
vaccination
for
COVID-19
as
32
defined
in
section
686D.2
.
33
b.
A
pharmacist
may
,
pursuant
to
statewide
protocols
34
developed
by
the
board
in
consultation
with
the
department
35
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of
public
health
and
consistent
with
subsection
2
,
order
and
1
administer
the
following
to
patients
ages
six
months
and
older:
2
(1)
A
vaccine
or
An
immunization
or
vaccination
for
3
influenza.
4
(2)
Other
emergency
immunizations
or
vaccines
in
response
5
to
a
public
health
emergency.
6
c.
A
pharmacist
may,
pursuant
to
statewide
protocols
7
developed
by
the
board
in
consultation
with
the
department
8
of
public
health
and
consistent
with
subsection
2
,
order
and
9
administer
the
final
two
doses
in
a
course
of
vaccinations
for
10
HPV
to
patients
ages
eleven
years
and
older.
11
d.
Prior
to
the
ordering
and
administration
of
a
12
vaccination
or
an
immunization
or
vaccination
authorized
by
13
this
subsection
,
pursuant
to
statewide
protocols,
a
licensed
14
pharmacist
shall
consult
and
review
the
statewide
immunization
15
registry
or
health
information
network.
The
board
shall
16
adopt
rules
requiring
the
reporting
of
the
administration
of
17
vaccines
and
immunizations
and
vaccinations
authorized
by
this
18
subsection
to
a
patient’s
primary
health
care
provider,
primary
19
physician,
and
a
statewide
immunization
registry
or
health
20
information
network.
21
e.
A
pharmacist
may,
pursuant
to
statewide
protocols
22
developed
by
the
board
in
consultation
with
the
department
23
of
public
health
and
consistent
with
subsection
2
,
order
and
24
administer
the
following
to
patients
ages
six
years
and
older:
25
(1)
Point-of-care
testing
and
treatment
for
influenza,
26
streptococcus
A,
and
COVID-19
as
defined
in
section
686D.2
at
27
the
point
of
interaction
between
a
pharmacist
and
a
patient.
28
(2)
Point-of-care
testing
at
the
point
of
interaction
29
between
a
pharmacist
and
a
patient
in
response
to
a
public
30
health
emergency.
31
Sec.
27.
Section
155A.46,
subsection
2,
Code
2023,
is
32
amended
by
striking
the
subsection
and
inserting
in
lieu
33
thereof
the
following:
34
2.
Notwithstanding
any
provision
of
law
to
the
contrary,
35
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a
pharmacist
may
develop
policies,
procedures,
and
protocols
1
to
carry
out
the
practices
identified
in
section
155A.8,
2
subsection
2.
3
Sec.
28.
Section
155A.47,
subsection
1,
Code
2023,
is
4
amended
to
read
as
follows:
5
1.
Notwithstanding
any
provision
of
section
147.107,
6
subsection
2
,
or
section
155A.33
this
chapter
to
the
contrary,
7
the
board
may
approve
a
pilot
or
demonstration
research
project
8
of
innovative
applications
in
the
practice
of
pharmacy
to
9
provide
enhanced
patient
care.
10
Sec.
29.
REPEAL.
Sections
155A.6,
155A.6A,
155A.6B,
11
155A.21,
155A.28,
and
155A.29,
Code
2023,
are
repealed.
12
EXPLANATION
13
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
14
the
explanation’s
substance
by
the
members
of
the
general
assembly.
15
This
bill
relates
to
the
practice
of
pharmacy.
The
bill
16
creates
general
principles
that
licensees
and
registrants
of
17
the
board
of
pharmacy
(board)
must
consider
when
determining
18
whether
an
act
violates
the
appropriate
standard
of
care.
The
19
bill
also
reorganizes
Code
chapter
155A
(pharmacy)
by
combining
20
and
repealing
certain
Code
sections,
and
makes
conforming
Code
21
changes.
The
bill
combines
Code
section
155A.21
(unlawful
22
possession
of
prescription
drug
or
device
——
penalty)
into
Code
23
section
155A.23
(prohibited
acts)
and
Code
section
155A.29
24
(prescription
refills)
into
Code
section
155A.27
(requirements
25
for
prescriptions).
26
The
bill
adds
pharmacists
to
the
definition
of
27
“practitioner”
for
the
purposes
of
Code
chapter
155A
and
28
defines
“therapeutic
substitution”
as
the
replacement
of
a
29
prescribed
drug
with
an
alternative
molecule
with
assumed
30
equivalent
therapeutic
effect.
31
The
bill
repeals
and
amends
current
Code
provisions
32
regarding
the
registration
of
pharmacist-interns,
pharmacy
33
technicians,
and
pharmacy
support
persons.
The
bill
requires
34
the
board
to
adopt
rules
regarding
the
registration
and
35
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practice
of
pharmacist-interns,
pharmacy
technicians,
and
1
pharmacy
support
persons.
The
bill
prohibits
the
board
2
from
adopting
rules
pertaining
to
pharmacy
support
person
3
registration
which
include
any
determination
of
the
competency
4
of
the
registered
person
or
requiring
continuing
education.
5
The
bill
allows
the
board
to
deny,
suspend,
or
revoke
a
6
registration
of
a
pharmacist-intern,
pharmacy
technician,
7
or
pharmacy
support
person
based
on
a
violation
of
certain
8
laws
and
regulations.
Responsibility
for
the
actions
of
a
9
pharmacist-intern,
pharmacy
technician,
or
pharmacy
support
10
person
working
under
a
pharmacist
remains
with
the
pharmacist.
11
The
bill
allows
a
pharmacist
to
dispense,
administer,
12
monitor,
and
issue
prescription
drugs,
biological
products,
13
and
medication
orders
according
to
the
pharmacist’s
training
14
and
education
and
in
accordance
with
the
appropriate
standard
15
of
care.
The
bill
requires
the
board
to
specify
by
rule
the
16
procedures
and
fees
to
renew
a
pharmacist
license
and
the
17
penalties
for
late
renewal
or
failure
to
renew
a
pharmacist
18
license.
19
The
bill
allows
the
board
to
discipline
a
pharmacist
or
20
refuse
to
issue
a
pharmacist
license
to
a
person
for
engaging
21
in
conduct
outside
the
accepted
standard
of
care
that
would
22
be
provided
in
a
similar
setting
by
a
reasonable
and
prudent
23
applicant
or
licensee
and
for
displaying
incapacity
of
a
24
nature
preventing
engagement
in
the
practice
of
pharmacy
with
25
reasonable
skill,
competence,
and
safety
to
the
public.
26
The
bill
strikes
provisions
regarding
the
issuance
of
a
27
telepharmacy
license
and
requires
the
board
to
adopt
rules
for
28
the
issuance
of
a
telepharmacy
license.
The
bill
also
strikes
29
a
requirement
that
a
pharmacy
license
be
issued
in
the
name
of
30
the
pharmacist
in
charge
and
not
be
transferable
or
assignable.
31
The
bill
requires
the
board
to
adopt
rules
regarding
the
32
renewal
of
a
nonresident
pharmacy
license
and
the
penalties
33
for
a
late
renewal
or
failure
to
renew
a
nonresident
pharmacy
34
license.
35
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The
bill
allows
the
board
to
impose
an
administrative
1
penalty
of
up
to
$500
on
a
licensee
or
registrant
who
engages
2
in
a
practice
regulated
by
Code
chapter
155A
without
a
current
3
license
or
registration,
employs
a
person
without
a
current
4
license
or
registration
to
engage
in
a
practice
regulated
by
5
Code
chapter
155A,
fails
to
complete
the
continuing
education
6
required
for
renewal
of
a
license
or
registration,
or
fails
any
7
component
of
a
routine
inspection
conducted
by
the
board.
An
8
administrative
penalty
shall
not
be
considered
a
disciplinary
9
action
or
reported
as
discipline
and
shall
be
confidential.
10
Under
current
law,
the
board
can
impose
civil
penalties
not
to
11
exceed
$25,000.
12
The
bill
strikes
current
law
regarding
notifications
13
submitted
by
a
pharmacy
to
the
board
and
requires
the
board
14
to
adopt
rules
for
the
reporting
of
pertinent
changes
related
15
to
activities
performed
pursuant
to
a
license
or
registration
16
issued
under
Code
chapter
155A
to
the
board
by
a
licensed
or
17
registered
person
or
business.
18
The
bill
changes
references
to
“inspectors”
of
the
board
19
to
“compliance
officers”
of
the
board.
The
bill
allows
the
20
board
to
conduct
routine
and
unannounced
inspections
of
any
21
entity
licensed
by
the
board
or
location
authorized
to
possess
22
controlled
substances
or
prescription
devices.
23
The
bill
strikes
provisions
allowing
prescriptions
issued
24
before
January
1,
2020,
to
be
issued
by
nonelectronic
means.
25
The
bill
allows
a
pharmacist
to
exercise
professional
judgment
26
by
refilling
a
prescription
without
prescriber
authorization
in
27
accordance
with
the
appropriate
standard
of
care
and
pursuant
28
to
rules
established
by
the
board.
29
The
bill
allows
a
pharmacist
to
dispense
a
therapeutic
30
substitution
in
lieu
of
a
prescribed
drug
according
to
the
31
professional
judgment
of
the
pharmacist
unless
the
prescription
32
states
“dispense
as
written”.
The
board
shall
adopt
rules
on
33
proper
recording
and
notification
of
therapeutic
substitutions.
34
The
bill
allows
funds
and
surcharges
collected
for
a
35
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program
to
monitor
impaired
pharmacists,
pharmacist-interns,
1
or
pharmacy
technicians
to
be
used
to
assist
licensees
and
2
registrants
with
costs
incurred
for
participation
in
the
3
program.
4
The
bill
allows
the
board
to
request
criminal
history
5
data
for
all
owners,
managers,
and
principal
employees
and
6
third-party
logistics
providers
and
wholesale
distributors.
7
The
bill
amends
current
provisions
regarding
statewide
8
protocols
under
which
a
pharmacist
can
order
and
administer
9
certain
drugs.
The
bill
allows
the
board
to
develop
statewide
10
protocols
for
the
ordering
and
administration
of
prescription
11
drugs,
products,
tests,
treatments,
immunizations,
and
12
vaccinations
in
consultation
with
the
department
of
health
and
13
human
services.
Each
protocol
may
define
the
prescription
14
drugs,
products,
tests,
treatments,
immunizations,
or
15
vaccinations
allowed
to
be
ordered
and
administered,
any
16
training
or
qualification
required
to
implement
the
protocol,
17
and
any
additional
requirements
deemed
appropriate
by
the
18
board.
The
bill
strikes
provisions
allowing
a
pharmacist
to
19
order
and
administer
naloxone
and
nicotine
replacement
tobacco
20
cessation
products
to
patients
ages
18
years
and
older
and
to
21
order
and
administer
certain
forms
of
point-of-care
testing
22
to
patients
ages
6
years
and
older.
The
bill
also
strikes
23
provisions
requiring
a
pharmacist
who
orders
or
administers
24
prescription
drugs,
products,
tests,
or
treatments
to
maintain
25
certain
records,
provide
notice
to
a
patient’s
primary
health
26
care
provider,
and
complete
continuing
education
requirements.
27
The
bill
allows
the
board
to
approve
a
pilot
or
demonstration
28
research
project
of
innovative
applications
in
the
practice
of
29
pharmacy
to
provide
enhanced
patient
care,
notwithstanding
any
30
provision
of
Code
chapter
155A
to
the
contrary.
Current
law
31
allows
the
board
to
approve
such
a
project
notwithstanding
Code
32
section
155A.33
(delegation
of
functions).
33
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