Bill Text: MI SB0155 | 2021-2022 | 101st Legislature | Introduced
Bill Title: Health: pharmaceuticals; emergency dispensing of insulin; provide for under certain circumstances. Amends secs. 17703, 17708, 17751 & 17757 of 1978 PA 368 (MCL 333.17703 et seq.) & adds secs. 17744f.
Spectrum: Partisan Bill (Republican 6-0)
Status: (Passed) 2021-07-15 - Assigned Pa 0036'21 With Immediate Effect [SB0155 Detail]
Download: Michigan-2021-SB0155-Introduced.html
SENATE BILL NO. 155
February 18, 2021, Introduced by Senators
DALEY, LAUWERS, NESBITT, THEIS, HORN and BIZON and referred to the
Committee on Health Policy and Human Services.
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending sections 17703, 17708, 17751, and 17757 (MCL 333.17703, 333.17708, 333.17751, and 333.17757), section 17703 as amended by 2016 PA 528, section 17708 as amended by 2020 PA 4, section 17751 as amended by 2020 PA 136, and section 17757 as amended by 2016 PA 383, and by adding section 17744f.
the people of the state of michigan enact:
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Sec. 17703. (1)
"Deliver" or "delivery" means the actual, constructive, or
attempted transfer of a drug or device from 1
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person to another.
(2) "Device" means an instrument, apparatus, or
contrivance, including its components, parts, and accessories, intended for use
in the diagnosis, cure, mitigation, treatment, or prevention of disease in
human beings or other animals, or to affect the structure or function of the
body of human beings or other animals.
(3) "Dispense" means the preparation, compounding,
packaging, or labeling of a drug pursuant to a prescription or other
authorization issued by a prescriber
or pursuant to section 17744f.
(4) "Dispensing prescriber" means a prescriber,
other than a veterinarian, who dispenses prescription drugs.
(5) Except as otherwise provided in section 17780,
"distribute" or "distribution" means to sell, offer for
sale, deliver, offer to deliver, broker, give away, or transfer a drug, whether
by passage of title or physical movement. The term does not include any of the
following:
(a) Dispensing or administering a drug.
(b) The delivery of a drug, or offering to deliver a drug, by
a common carrier in the usual course of business as a common carrier.
(c) The delivery of a drug via an automated device under
section 17760.
(6) "Drug" means any of the following:
(a) A substance recognized or for which the standards or
specifications are prescribed in the official compendium.
(b) A substance intended for use in the diagnosis, cure,
mitigation, treatment, or prevention of disease in human beings or other
animals.
(c) A substance, other than food, intended to affect the
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structure or a function of the body of human
beings or other animals.
(d) A substance intended for use as a component of a
substance specified in subdivision (a), (b), or (c), but not including a device
or its components, parts, or accessories.
(7) "Electronic signature" means an electronic
sound, symbol, or process attached to or logically associated with a record and
executed or adopted by a person with the intent to sign the record.
(8) "Electronically transmitted prescription" means
the communication of an original prescription or refill authorization by
electronic means including computer to computer, computer to facsimile machine,
or electronic mail transmission that contains the same information it contained
when the prescriber or his or her agent transmitted the prescription.
Electronically transmitted prescription does not include a prescription or
refill authorization transmitted by telephone or facsimile machine.
Sec. 17708. (1)
"Preceptor" means a pharmacist approved by the board to direct the
training of an intern in an approved pharmacy.
(2) "Prescriber" means a licensed dentist, a
licensed doctor of medicine, a licensed doctor of osteopathic medicine and
surgery, a licensed doctor of podiatric medicine and surgery, a licensed
physician's assistant, a licensed optometrist certified under part 174 to
administer and prescribe therapeutic pharmaceutical agents, an advanced
practice registered nurse as that term is defined in section 17201 who meets
the requirements of section 17211a, a licensed veterinarian, or another
licensed health professional acting under the delegation and using, recording,
or otherwise indicating the name of the delegating licensed doctor of medicine
or licensed doctor of osteopathic medicine and surgery.
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(3) "Prescription" means an order by a prescriber
to fill, compound, or dispense a drug or device written and signed; written or
created in an electronic format, signed, and transmitted by facsimile; or
transmitted electronically or by other means of communication. An order
transmitted in other than written or hard-copy form must be electronically
recorded, printed, or written and immediately dated by the pharmacist, and that
record is considered the original prescription. In a health facility or agency
licensed under article 17 or other medical institution, an order for a drug or
device in the patient's chart is considered for the purposes of this definition
the original prescription. For purposes of this part, prescription also
includes a standing order issued under section 17744e. Subject to section
17751(2) and (5), prescription includes, but is not limited to, an order for a
drug, not including a controlled substance except under circumstances described
in section 17763(e), written and signed; written or created in an electronic
format, signed, and transmitted by facsimile; or transmitted electronically or
by other means of communication by a physician prescriber, dentist prescriber,
or veterinarian prescriber who is licensed to practice dentistry, medicine,
osteopathic medicine and surgery, or veterinary medicine in another state.
(4) "Prescription Subject to subsection (5), "prescription drug"
means a drug to which 1 or more of the following apply:
(a) The drug is dispensed pursuant to a prescription.
(b) The drug bears the federal legend "CAUTION: federal
law prohibits dispensing without prescription" or "Rx only".
(c) The drug is designated by the board as a drug that may
only be dispensed pursuant to a prescription.
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(5)
For purposes of this part, prescription drug also includes a drug dispensed
pursuant to section 17744f.
(6)
(5)"Remote
pharmacy" means a pharmacy described in sections 17742a and 17742b.
Sec. 17744f. (1) Subject to subsection
(2), a pharmacist may dispense an emergency supply of insulin to an individual
if the individual has a qualified prescription for insulin in the individual's
name with no remaining authorized refills, the pharmacist completes an
assessment of the individual and determines that dispensing an emergency supply
of insulin is appropriate for the individual, and the individual has previously
had a prescription for insulin dispensed at the pharmacy. A pharmacist who
dispenses an emergency supply of insulin under this section shall comply with
all of the following:
(a)
Before dispensing the emergency supply, make a reasonable effort to communicate
with the prescriber who issued the qualified prescription for insulin regarding
dispensing the emergency supply of insulin and document the efforts made.
(b)
Document all of the following:
(i) The name of the individual receiving
the emergency supply of insulin and the date of the dispensing.
(ii) The reason for dispensing the
emergency supply of insulin.
(iii) Evidence of the individual's
qualified prescription for insulin.
(iv) Information on the individual's
diabetes management.
(v) Any other information required by
the board by rule.
(c)
Within a reasonable period of time, inform the prescriber who issued the
qualified prescription for insulin, in writing, that an emergency supply of
insulin was dispensed under this section.
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(d)
Inform the individual receiving the emergency supply of insulin that the
insulin was dispensed under this section.
(2) An individual shall not receive more than 3 emergency supplies of insulin in 1 calendar year.
(3) A prescriber
or pharmacist is not subject to criminal prosecution, civil liability, or
administrative sanction as a result of the pharmacist dispensing an emergency
supply of insulin under this section.
(4) The board shall promulgate rules to implement this section.
(5) As used in
this section:
(a)
"Emergency supply" means up to a 30-day supply.
(b)
"Qualified prescription for insulin" means a prescription for insulin
that was issued within the 12-month period immediately preceding the date the
individual requests an emergency supply of insulin under this section.
Sec. 17751. (1) A Except
as otherwise provided in section 17744f, a pharmacist shall not
dispense a drug requiring a prescription under the federal act or a law of this
state except under authority of an original prescription or an equivalent
record of an original prescription approved by the board. A pharmacist
described in section 17742b(2) may dispense a drug pursuant to an original
prescription received at a remote pharmacy if the pharmacist receives, reviews,
and verifies an exact digital image of the prescription received at the remote
pharmacy before the drug is dispensed at the remote pharmacy.
(2) Subject to subsections (1) and (5), a pharmacist may
dispense a prescription written and signed; written or created in an electronic
format, signed, and transmitted by facsimile; or
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transmitted electronically or by other means of
communication by a physician prescriber, dentist prescriber, or veterinarian
prescriber in another state, but not including a prescription for a controlled
substance except under circumstances described in section 17763(e), only if the
pharmacist in the exercise of his or her professional judgment determines all
of the following:
(a) Except as otherwise authorized under section 5110,
17744a, or 17744b, if the prescriber is a physician or dentist, that the prescription
was issued pursuant to an existing physician-patient or dentist-patient
relationship.
(b) That the prescription is authentic.
(c) That the prescribed drug is appropriate and necessary for
the treatment of an acute, chronic, or recurrent condition.
(3) A pharmacist or a prescriber shall dispense a
prescription only if the prescription falls within the scope of practice of the
prescriber.
(4) A pharmacist shall not knowingly dispense a prescription
after the death of the prescriber or patient.
(5) A pharmacist shall not dispense a drug or device under a
prescription transmitted by facsimile or created in electronic format and
printed out for use by the patient unless the document is manually signed by
the prescriber. This subsection does not apply to any of the following:
(a) A prescription that is transmitted by a computer to a
facsimile machine if that prescription complies with section 17754 or 17754a.
(b) A prescription that is received by a remote pharmacy and
made available to a pharmacist described in section 17742b(2) for review and
verification in the manner required under subsection
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(1).
(6) After consultation with and agreement from the
prescriber, a pharmacist may add or change a patient's address, a dosage form,
a drug strength, a drug quantity, a direction for use, or an issue date with
regard to a prescription. A pharmacist shall note the details of the
consultation and agreement required under this subsection on the prescription
or, if the drug is dispensed at a remote pharmacy, on the digital image of the
prescription described in subsection (1), and shall maintain that documentation
with the prescription as required in section 17752. A pharmacist shall not
change the patient's name, controlled substance prescribed unless authorized to
dispense a lower cost generically equivalent drug product under section 17755,
or the prescriber's signature with regard to a prescription.
(7) A prescription that is contained within a patient's chart
in a health facility or agency licensed under article 17 or other medical
institution and that is transmitted to a pharmacy under section 17744 is the
original prescription. If all other requirements of this part are met, a
pharmacist shall dispense a drug or device under a prescription described in
this subsection. A pharmacist may dispense a drug or device under a
prescription described in this subsection even if the prescription does not
contain the quantity ordered. If a prescription described in this subsection
does not contain the quantity ordered, the pharmacist shall consult with the
prescriber to determine an agreed-upon quantity. The pharmacist shall record
the quantity dispensed on the prescription and shall maintain that
documentation with the prescription as required in section 17752.
(8) If, after consulting with a patient, a pharmacist
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determines in the exercise of his or her professional
judgment that dispensing additional quantities of a prescription drug is
appropriate for the patient, the pharmacist may dispense, at one time,
additional quantities of the prescription drug up to the total number of dosage
units authorized by the prescriber on the original prescription for the patient
and any refills of the prescription. Except for a controlled substance included
in schedule 5 that does not contain an opioid, this subsection does not apply
to a prescription for a controlled substance.
Sec. 17757. (1) Upon On
receipt of a request made in person or by telephone, a pharmacist
engaged in the business of selling drugs at retail shall provide the current
selling price of a drug dispensed by that pharmacy or comparative current
selling prices of generic and brand name drugs dispensed by that pharmacy. The
information must be provided to the person making the request before a drug is
dispensed to the person. A person that makes a request for price information
under this subsection is not obligated to purchase the drug for which the price
or comparative prices are requested.
(2) A pharmacist engaged in the business of selling drugs at
retail shall conspicuously display the notice described in subsection (3) at
each counter over which prescription drugs are dispensed.
(3) The notice required under subsection (2) must be in
substantially the following form:
NOTICE TO CONSUMERS |
ABOUT PRESCRIPTION DRUGS |
Under Michigan law, you have the right to find out the price
of a prescription drug before the pharmacist fills the
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prescription. You are under no obligation to have
the prescription filled here and may use this price information to shop around
at other pharmacies. You may request price information in person or by
telephone.
Every pharmacy has the current selling prices of both generic
and brand name drugs dispensed by the pharmacy.
Ask your pharmacist if a lower-cost generic drug is available
to fill your prescription. A generic drug contains the same medicine as a brand
name drug and is a suitable substitute in most instances.
A generic drug may not be dispensed by your pharmacist if
your doctor has written "dispense as written" or the initials
"d.a.w." on the prescription.
If you have questions about the drugs that have been
prescribed for you, ask your doctor or pharmacist for more information.
To avoid dangerous drug interactions, let your doctor and
pharmacist know about any other medications you are taking. This is especially
important if you have more than 1 doctor or have prescriptions filled at more
than 1 pharmacy.
(4) The notice required under subsection (2) must also
contain the address and phone number of the board and the department. The text of
the notice must be in at least 32-point bold type and must be printed on paper
at least 11 inches by 17 inches in size. The notice may be printed on multiple
pages.
(5) The department shall provide a copy of the notice
required under subsection (2) to each licensee. The department shall provide
additional copies if needed. A person may duplicate or reproduce the notice if
the duplication or reproduction is a true copy of the
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notice as produced by the department, without any
additions or deletions.
(6) The pharmacist shall furnish to the purchaser of a
prescription drug at the time the drug is delivered to the purchaser a receipt
evidencing the transactions that contains all of the following:
(a) The brand name of the drug, if applicable.
(b) The name of the manufacturer or the supplier of the drug,
if the drug does not have a brand name.
(c) The strength of the drug, if significant.
(d) The quantity dispensed, if applicable.
(e) The name and address of the pharmacy.
(f) The serial number of the prescription, or a reference
to the standing order issued under section 17744e,
or, if the prescription drug was dispensed pursuant to section 17744f, a
reference to section 17744f.
(g) The date the prescription was originally dispensed.
(h) The name of the prescriber or, if prescribed under the
prescriber's delegatory authority, the name of the delegatee. If the prescription drug was dispensed pursuant to section 17744f,
the name of the original prescriber and the pharmacist dispensing the
prescription drug.
(i) Except as otherwise authorized under section 5110,
17744a, 17744b, or 17744e, the name of the patient for whom the drug was
prescribed or dispensed.
(j) The price for which the drug was sold to the purchaser.
(7) The items required under subsection (6)(a), (b), and (c)
may be omitted from a receipt by a pharmacist only if the omission is expressly
required by the prescriber. The pharmacist shall
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retain a copy of each receipt furnished under
subsection (6) for 90 days. The inclusion of the items required under
subsection (6) on the prescription container label is a valid receipt to the
purchaser. Including the items required under subsection (6) on the written
prescription form and retaining the form constitutes retention of a copy of the
receipt.
(8) The department, in consultation with the board, may promulgate rules to implement this section.