Bill Text: MS SB2418 | 2011 | Regular Session | Introduced


Bill Title: "Mississippi Free Health Clinic Volunteers in Medicine Act"; enact.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Failed) 2011-02-01 - Died In Committee [SB2418 Detail]

Download: Mississippi-2011-SB2418-Introduced.html

MISSISSIPPI LEGISLATURE

2011 Regular Session

To: Public Health and Welfare; Judiciary, Division A

By: Senator(s) Burton

Senate Bill 2418

AN ACT ENTITLED THE "MISSISSIPPI FREE HEALTH CLINIC VOLUNTEERS IN MEDICINE ACT"; TO PROVIDE DEFINITIONS OF HEALTH CARE PROVIDERS AND FREE CLINICS SUBJECT TO THE PROVISIONS OF THIS ACT;  TO PROVIDE FOR CONTRACTS BETWEEN HEALTH CARE PROVIDERS AND FREE CLINICS; TO PROVIDE FOR THE ANNUAL REGISTRATION OF FREE CLINICS WITH THE MISSISSIPPI STATE DEPARTMENT OF HEALTH; TO PROVIDE THAT HEALTH CARE PROVIDERS AND VOLUNTEERS PROVIDING SERVICES TO FREE CLINICS UNDER SUCH CONTRACT SHALL BE DEEMED GOVERNMENTAL EMPLOYEES WITH LIABILITY IMMUNITY PROTECTION UNDER THE MISSISSIPPI TORT CLAIMS ACT; TO REQUIRE NOTIFICATION OF SUCH LIMITATION OF LIABILITY TO PATIENTS AND RECIPIENTS OF SERVICES AT FREE CLINICS; TO PROVIDE THAT FREE CLINICS AND HEALTH CARE PROVIDERS SHALL BE ASSESSED FOR THE COST OF SUCH IMMUNITY UNDER THE TORT CLAIMS ACT; TO REQUIRE CERTAIN REPORTS; TO AMEND SECTIONS 11-46-1 AND 73-25-38, MISSISSIPPI CODE OF 1972, IN CONFORMITY THERETO; TO AMEND SECTIONS 73-15-5 AND 73-25-35, MISSISSIPPI CODE OF 1972, TO AUTHORIZE NURSES AND NURSE PRACTITIONERS TO DISPENSE MEDICATION TO PATIENTS IN A FREE CLINIC SETTING; TO AMEND SECTION 73-21-129, MISSISSIPPI CODE OF 1972, TO AUTHORIZE DRUG MANUFACTURERS TO DONATE DRUGS TO FREE CLINICS UP TO ONE YEAR FOLLOWING THE LABELED EXPIRATION DATE; AND FOR RELATED PURPOSES.

     BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

     SECTION 1.  This act shall be known and may be cited as the "Mississippi Free Health Clinic Volunteers in Medicine Act."

     SECTION 2.  The Legislature finds that a significant proportion of the residents of this state who are uninsured or Medicaid recipients are unable to access needed health care because health care providers fear the increased risk of medical negligence liability.  It is the intent of the Legislature that access to medical care for indigent residents be improved by providing governmental protection to health care providers who offer free quality medical services to underserved populations of the state.  Therefore, it is the intent of the Legislature to ensure that health care professionals who contract to provide such services as agents of the state are provided sovereign immunity.

     SECTION 3.  As used in this act, the term:

          (a)  "Contract" means an agreement executed in compliance with this act between a health care provider and a free clinic.  This contract shall allow the health care provider to deliver health care services to low-income recipients as an agent of the free clinic.  The contract must be for volunteer, uncompensated services.  Payments made to a health care provider from the Mississippi Medicaid program shall not constitute compensation under this act.

          (b)  "Department" means the Mississippi State Department of Health.

          (c)  "Free clinic" or "free health clinic" means a volunteer-based, safety-net health care organization certified by the Mississippi State Department of Health that provides a range of medical, dental, pharmacy and/or behavioral health services to economically disadvantaged individuals who are predominately uninsured or Medicaid recipients.  Free clinics are Section 501(c)(3) tax-exempt organizations, or operate as a program component or affiliate of a Section 501(c)(3) organization.  Entities that otherwise meet the above definition, but charge a nominal fee to patients, may still be considered free clinics provided essential services are delivered regardless of the patient's ability to pay.

          (d)  "Health care provider" or "provider" means:

              (i)  An ambulatory surgical center licensed under Section 41-75-1 et seq.;

              (ii)  A hospital or nursing home licensed under Section 41-9-1 or 43-11-1 et seq.;

              (iii)  A physician or physician assistant licensed under Section 73-25-1 or 73-26-1 et seq.;

              (iv)  An osteopathic physician or osteopathic physician assistant licensed under Section 73-25-1 or 73-26-1 et seq.;

              (v)  A chiropractic physician licensed under Section 73-6-1 et seq.;

              (vi)  A podiatric physician licensed under Section 73-27-1 et seq.;

              (vii)  A physical therapist licensed under Section 73-23-1 et seq.;

              (viii)  A registered nurse, nurse midwife, licensed practical nurse or advanced registered nurse practitioner licensed or registered under Section 73-15-1 et seq. or any facility which employs nurses licensed or registered under Section 73-15-1 et seq. to supply all or part of the care delivered under this act;

              (ix)  A professional association, professional corporation, limited liability company, limited liability partnership or other entity which provides or has members which provide health care services;

              (x)  Any other medical facility the primary purpose of which is to deliver human medical diagnostic services or which delivers nonsurgical human medical treatment and which includes an office maintained by a provider;

              (xi)  A dentist or dental hygienist licensed under Section 73-9-1 et seq.;

              (xii)  A speech-language pathologist or audiologist licensed under Section 73-38-1 et seq.;

              (xiii)  An optometrist certified under Section 73-19-1 et seq.;

              (xiv)  A professional counselor, social worker, or marriage and family therapist licensed under Section 73-30-1 et seq.;

              (xv)  An occupational therapist licensed under Section 73-24-1 et seq.;

              (xvi)  A psychologist licensed under Section 73-31-1;

              (xvii)  A dietitian licensed under Section 73-10-1;

              (xviii)  A pharmacist licensed under Section 73-21-1;

              (xix)  Any other health care professional, practitioner, provider or facility under contract with a free health clinic, including a student enrolled in an accredited program that prepares the student for licensure as any one (1) of the professionals listed in subparagraphs (iii) through (ix) of this paragraph.

     The term includes any nonprofit corporation qualified as exempt from federal income taxation under Section 501(c) of the Internal Revenue Code which delivers health care services provided by licensed professionals listed in this paragraph, any federally funded community health center, and any volunteer corporation or volunteer health care provider that delivers health care services.

          (e)  "Low-income" means:

              (i)  A person who is Medicaid eligible under the laws of this state;

              (ii)  A person:

                   1.  Who is without health insurance; or

                   2.  Who has health insurance that does not cover the injury, illness or condition for which treatment is sought; and

whose family income does not exceed two hundred percent (200%) of the federal poverty level as defined annually by the federal Office of Management and Budget;

              (iii)  A person:

                   1.  Who is without dental insurance; or

                   2.  Who has dental insurance that does not cover the injury, illness or condition for which treatment is sought; and

whose family income does not exceed two hundred percent (200%) of the federal poverty level as defined annually by the federal Office of Management and Budget; or

              (iv)  Any client or beneficiary of the Department of Human Services who voluntarily chooses to participate in a free clinic program and meets the program eligibility guidelines of the Department of Human Services.

          (f)  "Occasional-service volunteer" means a volunteer who provides one-time or occasional volunteer service.

          (g)  "Regular-service volunteer" means a volunteer engaged in specific voluntary service activities on an ongoing or continuous basis.

          (h)  "Volunteer" means any person who, of his or her own free will, provides goods or services in support of or in assistance to any free clinic, with no monetary or material compensation.  This term shall not include a health care provider.

     SECTION 4.  (1)  The department is authorized and directed to certify free clinics to provide for health care services to low-income recipients, and may enter into contracts to effectuate the purposes of this act.  The department shall make reasonable efforts to promote the program to ensure awareness and participation by low-income recipients.  It is the intent of the Legislature that this program be established as soon as is practicable after the effective date of this act and that the program be implemented statewide at the earliest possible date, subject to available funding.

     (2)  A health care provider that executes a contract with a free clinic to deliver health care services on or after July 1, 2011, as an agent of the free clinic shall be considered a state officer or employee for purposes of Section 11-46-1 et seq., while acting within the scope of duties pursuant to the contract, if the contract complies with the requirements of this act and regardless of whether the individual treated is later found to be ineligible.  A health care provider acting under the terms of a contract with a free clinic may not be named as a defendant in any action arising out of the medical care or treatment provided on or after July 1, 2011, pursuant to contracts entered into under this act.  The contract must provide that:

          (a)  The right of dismissal or termination of any health care provider delivering services pursuant to the contract is retained by the free clinic.

          (b)  The free clinic has access to the patient records of patients provided services pursuant to this act of any health care provider delivering services pursuant to the contract.

          (c)  Adverse incidents and information on treatment outcomes must be reported by any health care provider to the free clinic if such incidents and information pertain to a patient treated pursuant to the contract.  If an incident involves a licensed professional or a licensed facility, the free clinic shall submit such incident reports to the appropriate department, agency or board, which shall review each incident and determine whether it involves conduct by the licensee that is subject to disciplinary action.  All patient medical records and any identifying information contained in adverse incident reports and treatment outcomes which are obtained by free clinics pursuant to this paragraph are confidential and exempt from the Open Records Act.

          (d)  The health care provider shall provide services to patients on a walk-in and referral basis, in accordance with the terms of the contract.  The provider must accept all referred patients; provided, however, that the number of patients that must be accepted may be limited under the terms of the contract.

          (e)  The health care provider shall not provide services to a patient unless such patient has received and signed the notice required in Section 5 of this act; provided, however, in cases of emergency care, the patient's legal representative shall be required to receive and sign the notice, or if such individual is unavailable, such patient shall receive and sign the notice within forty-eight (48) hours after the patient has the mental capacity to consent to treatment.

          (f)  Patient care and health care services shall be provided in accordance with the terms of the contract.  Experimental procedures and clinically unproven procedures shall not be provided or performed pursuant to this act.  The free clinic may reserve the right to approve through written protocols any specialty care services and hospitalization, except emergency care as provided for in paragraph (e) of this subsection.

          (g) The provider is subject to supervision and regular inspection by the free clinic.

     (3)  In order to enter into a contract under this section, a health care provider shall:

          (a)  Have a current valid Mississippi health professional license;

          (b)  Not be under probation or suspension by the applicable licensing board or intermediate sanction by the Centers for Medicare and Medicaid Services for Medicare or Medicaid violations; and

          (c)  Submit to a credentialing process to determine acceptability of participation.

     (4)  The provider shall not subcontract for the provision of services under this act.

     (5)  A contract entered into pursuant to this section shall be effective for all services provided by the health care provider pursuant to this act, without regard to when the services are performed.

     SECTION 5.  The free clinic or the health care provider if designated in the contract must provide written notice to each patient or the patient's legal representative, receipt of which must be acknowledged in writing, that the provider is a state employee or officer for purposes of this act and that the exclusive remedy for injury or damage suffered as the result of any act or omission of a provider acting within the scope of duties pursuant to a contract is by commencement of an action pursuant to the provisions of Section 11-46-1 et seq. and that a remedy or remedies for injury or damage suffered as the result of any act or omission of a provider acting outside the scope of duties shall be as provided for under general tort law or other applicable law.

     SECTION 6.  (1)  Every free clinic is authorized to recruit, train and accept the services of volunteers, including regular-service volunteers and occasional-service volunteers in support of or in assistance to the program of health care services provided pursuant to this act to provide services, including, but not limited to, clerical, computer and administrative support.

     (2)  Prior to providing any services, a volunteer shall enter into a written agreement with the free clinic in a form as prescribed by the department.

     (3)  Each free clinic utilizing the services of volunteers pursuant to this section shall:

          (a)  Take such actions as are necessary to ensure that volunteers understand their duties and responsibilities;

          (b)  Take such actions as are necessary to ensure that volunteers are made aware of and follow all applicable health and safety rules, regulations and procedures;

          (c)  Take such actions as are necessary to ensure that volunteers are provided appropriate oversight and guidance in the performance of their volunteer service; and

          (d)  Ensure that each volunteer enters into a written agreement with the free clinic in accordance with subsection (2) of this section.

     (4)  A volunteer shall be considered a state employee or officer for purposes of Section 11-46-1 et seq. while performing services pursuant to and in accordance with this section.

     SECTION 7.  Health care providers and volunteers recruited, trained or accepted under this act shall not be subject to any provisions of the laws of this state relating to state employment, hours of work, rates of compensation, leave time, retirement or employee benefits.  However, all health care providers and volunteers shall comply with applicable department or agency rules and regulations.  Health care providers who are individuals and volunteers shall be considered as unpaid independent volunteers and shall not be entitled to unemployment compensation.

     SECTION 8.  The Tort Claims Board shall annually compile a report of all claims statistics which shall include the number and total of all claims pending and paid, and defense and handling costs associated with all claims brought against contract providers under this act.  This report shall be forwarded to the department and included in the annual report submitted to the Legislature.

     SECTION 9.  Annually, the State Department of Health shall report to the Legislature summarizing the efficacy of access and treatment outcomes with respect to providing health care services for low-income persons pursuant to this act.

     SECTION 10.  The free clinic or the health care provider shall be responsible for and shall pay such amounts or premiums as determined by the Tort Claims Board for liability coverage for the cost of claims and defense against litigation arising out of health care services delivered pursuant to this act.  The free clinic or the health care provider shall be responsible for submitting to the Tort Claims Board underwriting information requested by the Tort Claims Board.  The Tort Claims Board shall annually report to the Legislature the number and type of providers who have entered into a contract pursuant to this act, and may request funding to defray the cost of liability coverage under the Tort Claims Act pursuant to this act.

     SECTION 11.  This act applied to incidents occurring on or after July 1, 2011.

     SECTION 12.  Section 11-46-1, Mississippi Code of 1972, is amended as follows:

     11-46-1.  As used in this chapter, the following terms shall have the meanings herein ascribed unless the context otherwise requires:

          (a)  "Claim" means any demand to recover damages from a governmental entity as compensation for injuries.

          (b)  "Claimant" means any person seeking compensation under the provisions of this chapter, whether by administrative remedy or through the courts.

          (c)  "Board" means the Mississippi Tort Claims Board.

          (d)  "Department" means the Department of Finance and Administration.

          (e)  "Director" means the executive director of the department who is also the executive director of the board.

          (f)  "Employee" means any officer, employee or servant of the State of Mississippi or a political subdivision of the state, including elected or appointed officials and persons acting on behalf of the state or a political subdivision in any official capacity, temporarily or permanently, in the service of the state or a political subdivision whether with or without compensation.  The term "employee" shall not mean a person or other legal entity while acting in the capacity of an independent contractor under contract to the state or a political subdivision; provided, however, that for purposes of the limits of liability provided for in Section 11-46-15, the term "employee" shall include physicians under contract to provide health services with the State Board of Health, the State Board of Mental Health or any county or municipal jail facility while rendering services under such contract.  The term "employee" shall also include any physician, dentist or other health care practitioner employed by the University of Mississippi Medical Center (UMMC) and its departmental practice plans who is a faculty member and provides health care services only for patients at UMMC or its affiliated practice sites.  The term "employee" shall also include any physician, dentist or other health care practitioner employed by any university under the control of the Board of Trustees of State Institutions of Higher Learning who practices only on the campus of any university under the control of the Board of Trustees of State Institutions of Higher Learning.  The term "employee" shall also include any physician, dentist or other health care practitioner employed by the State Veterans Affairs Board and who provides health care services for patients for the State Veterans Affairs Board.  The term "employee" shall also include Mississippi Department of Human Services licensed foster parents for the limited purposes of coverage under the Tort Claims Act as provided in Section 11-46-8.  The term "employee" shall also include any health care provider who is under contract with a free health clinic while in the course of providing care to patients or recipients of care at the free health clinic under such contract, as provided under the provisions of Sections 1 through 11 of this act.

          (g)  "Governmental entity" means and includes the state and political subdivisions as herein defined.

          (h)  "Injury" means death, injury to a person, damage to or loss of property or any other injury that a person may suffer that is actionable at law or in equity.

          (i)  "Political subdivision" means any body politic or body corporate other than the state responsible for governmental activities only in geographic areas smaller than that of the state, including, but not limited to, any county, municipality, school district, community hospital as defined in Section 41-13-10, Mississippi Code of 1972, airport authority or other instrumentality thereof, whether or not such body or instrumentality thereof has the authority to levy taxes or to sue or be sued in its own name.

          (j)  "State" means the State of Mississippi and any office, department, agency, division, bureau, commission, board, institution, hospital, college, university, airport authority or other instrumentality thereof, whether or not such body or instrumentality thereof has the authority to levy taxes or to sue or be sued in its own name.

          (k)  "Law" means all species of law, including, but not limited to, any and all constitutions, statutes, case law, common law, customary law, court order, court rule, court decision, court opinion, court judgment or mandate, administrative rule or regulation, executive order, or principle or rule of equity.

     SECTION 13.  Section 73-25-38, Mississippi Code of 1972, is amended as follows:

     73-25-38.  (1)  Any licensed physician, physician assistant or certified nurse practitioner who voluntarily provides needed medical or health services to any person without the expectation of payment due to the inability of such person to pay for said services shall be immune from liability for any civil action arising out of the provision of such medical or health services provided in good faith on a charitable basis.  This section shall not extend immunity to acts of willful or gross negligence.  Except in cases of rendering emergency care wherein the provisions of Section 73-25-37 apply, immunity under this section shall be extended only if the physician, physician assistant or certified nurse practitioner and patient execute a written waiver in advance of the rendering of such medical services specifying that such services are provided without the expectation of payment and that the licensed physician or certified nurse practitioner shall be immune as provided in this subsection.  The immunity from liability granted by this subsection also shall extend to actions arising from a church-operated outpatient medical clinic that exists solely for the purpose of providing charitable medical services to persons who are unable to pay for such services, provided that the outpatient clinic receives less than Forty Thousand Dollars ($40,000.00) annually in patient payments.

     (2)  Any licensed physician, physician assistant or certified nurse practitioner assisting with emergency management, emergency operations or hazard mitigation in response to any emergency, man-made or natural disaster, who voluntarily provides needed medical or health services to any person without fee or other compensation, shall not be liable for civil damages on the basis of any act or omission if the physician, physician assistant or nurse practitioner was acting in good faith and within the scope of their license, education and training and the acts or omissions were not caused from gross, willful or wanton acts of negligence.

     (3)  Any physician who voluntarily renders any medical service under a special volunteer medical license authorized under Section 73-25-18 without any payment or compensation or the expectation or promise of any payment or compensation shall be immune from liability for any civil action arising out of any act or omission resulting from the rendering of the medical service unless the act or omission was the result of the physician's gross negligence or willful misconduct.  In order for the immunity under this subsection to apply, there must be a written or oral agreement for the physician to provide a voluntary noncompensated medical service before the rendering of the service by the physician.

     (4)  Any physician who is retired from active practice, and who has been previously issued an unrestricted license to practice medicine in any state of the United States or who has been issued a special volunteer medical license under Section 73-25-18, shall be immune from liability for any civil action arising out of any medical care or treatment provided while voluntarily serving as "doctor of the day" for members of the Mississippi State Legislature, legislative or other state employees, or any visitors to the State Capitol on the date of such service.  This subsection shall not extend immunity to acts of willful or gross negligence or misconduct.

     (5)  Any health care provider who provides care or services to patients or recipients at a free health clinic pursuant to contract shall be provided immunity under the Tort Claims Act while performing services under such contract, pursuant to the provisions of Sections 1 through 11 of this act.

     SECTION 14.  Section 73-15-5, Mississippi Code of 1972, is amended as follows:

     73-15-5.  (1)  "Board" means the Mississippi Board of Nursing.

     (2)  The "practice of nursing" by a registered nurse means the performance for compensation of services which requires substantial knowledge of the biological, physical, behavioral, psychological and sociological sciences and of nursing theory as the basis for assessment, diagnosis, planning, intervention and evaluation in the promotion and maintenance of health; management of individuals' responses to illness, injury or infirmity; the restoration of optimum function; or the achievement of a dignified death.  "Nursing practice" includes, but is not limited to, administration, teaching, counseling, delegation and supervision of nursing, and execution of the medical regimen, including the administration of medications and treatments prescribed by any licensed or legally authorized physician or dentist.  The foregoing shall not be deemed to include acts of medical diagnosis or prescriptions of medical, therapeutic or corrective measures, except as may be set forth by rules and regulations promulgated and implemented by the Mississippi Board of Nursing.  "Nursing practice" includes dispensing medication for patients or recipients in a free health clinic setting, pursuant to the provisions of Sections 1 through 11 of this act.

     (3)  "Clinical nurse specialist practice" by a certified clinical nurse specialist means the delivery of advanced practice nursing care to individuals or groups using advanced diagnostic and assessment skills to manage and improve the health status of individuals and families; diagnose human responses to actual or potential health problems; plan for health promotion, disease prevention, and therapeutic intervention in collaboration with the patient or client; implement therapeutic interventions based on the nurse specialist's area of expertise and within the scope of advanced nursing practice, including, but not limited to, direct patient care, counseling, teaching, collaboration with other licensed health care providers; and, coordination of health care as necessary and appropriate and evaluation of the effectiveness of care.

     (4)  "Advanced nursing practice" means, in addition to the practice of professional nursing, the performance of advanced-level nursing approved by the board which, by virtue of graduate education and experience are appropriately performed by an advanced practice registered nurse.  The advanced practice registered nurse may diagnose, treat and manage medical conditions.  This may include prescriptive authority as identified by the board.  Advanced practice registered nurses must practice in a collaborative/consultative relationship with a physician or dentist with an unrestricted license to practice in the State of Mississippi and advanced nursing must be performed within the framework of a standing protocol or practice guidelines, as appropriate.

     (5)  The "practice of nursing" by a licensed practical nurse means the performance for compensation of services requiring basic knowledge of the biological, physical, behavioral, psychological and sociological sciences and of nursing procedures which do not require the substantial skill, judgment and knowledge required of a registered nurse.  These services are performed under the direction of a registered nurse or a licensed physician or licensed dentist and utilize standardized procedures in the observation and care of the ill, injured and infirm; in the maintenance of health; in action to safeguard life and health; and in the administration of medications and treatments prescribed by any licensed physician or licensed dentist authorized by state law to prescribe.  On a selected basis, and within safe limits, the role of the licensed practical nurse shall be expanded by the board under its rule-making authority to more complex procedures and settings commensurate with additional preparation and experience.

     (6)  A "license" means an authorization to practice nursing as a registered nurse or a licensed practical nurse designated herein.

     (7)  A "registered nurse" is a person who is licensed or holds the privilege to practice under the provisions of this article and who practices nursing as defined herein.  "R.N." is the abbreviation for the title of Registered Nurse.

     (8)  A "licensed practical nurse" is a person who is licensed or holds the privilege to practice under this article and who practices practical nursing as defined herein.  "L.P.N." is the abbreviation for the title of Licensed Practical Nurse.

     (9)  A "registered nurse in clinical practice" is one who functions in any health care delivery system which provides nursing services.

     (10)  A "clinical nurse specialist" is a person who is licensed or holds the privilege to practice under this article in this state to practice professional nursing and who in this state practices advanced nursing as defined herein.  "C.N.S." is the abbreviation for the title of Clinical Nurse Specialist.

     (11)  An "advance practice registered nurse" is a person who is licensed or holds the privilege to practice under this article and who is certified in advanced practice registered nurse or specialized nursing practice and includes certified registered nurse midwives, certified registered nurse anesthetists and certified nurse practitioners.  "C.N.M" is the abbreviation for the title of Certified Nurse Midwife, "C.R.N.A." is the abbreviation for the title of Certified Registered Nurse Anesthetist.  "C.N.P." is the abbreviation for the title of Certified Nurse Practitioner.

     (12)  A "nurse educator" is a registered nurse who meets the criteria for faculty as set forth in a state-accredited program of nursing for registered nurses, or a state-approved program of nursing for licensed practical nurses, and who functions as a faculty member.

     (13)  A "consumer representative" is a person representing the interests of the general public, who may use services of a health agency or health professional organization or its members but who is neither a provider of health services, nor employed in the health services field, nor holds a vested interest in the provision of health services at any level, nor has an immediate family member who holds vested interests in the provision of health services at any level.

     (14)  "Privilege to practice" means the authorization to practice nursing in the state as described in the Nurse Licensure Compact provided for in Section 73-15-22.

     (15)  "Licensee" is a person who has been issued a license to practice nursing in the state or who holds the privilege to practice nursing in the state.

     SECTION 15.  Section 73-25-35, Mississippi Code of 1972, is amended as follows:

     73-25-35.  Registered nurses who are licensed and certified by the Mississippi Board of Nursing as nurse practitioners are not prohibited from such nursing practice, but are entitled to engage therein without a physician's license.  Nurse practitioners are entitled to dispense medication to patients or recipients in a free health clinic setting, pursuant to the provisions of Sections 1 through 11 of this act.

     SECTION 16.  Section 73-21-129, Mississippi Code of 1972, is amended as follows:

     73-21-129.  (1)  Each manufacturer whose products are distributed within the State of Mississippi shall make adequate provision for the return of outdated drugs from pharmacies, both full and partial containers, excluding biological, infused or intravenously injected drugs and drugs that are inhaled during surgery, within six (6) months after the labeled expiration date, for prompt full credit or refund.  Outdated drugs may be donated to free health clinics registered pursuant to the provisions of Sections 1 through 11 of this act for a period of time up to one (1) year after the labeled expiration date.

     (2)  Wholesale distributors and reverse distributors that are required to register with the board and have a permit under Section 73-21-105 shall implement and administer the return policies established by the manufacturer.

     (3)  If the board receives information that a manufacturer has failed to comply with this section, the board shall investigate the matter and present any evidence of the manufacturer's failure to comply to a review committee composed of the Dean of the University of Mississippi School of Pharmacy, the Executive Director of the State Board of Pharmacy and the Director of the Pharmacy Bureau of the Division of Medicaid, or the designee of any of those officials.  The committee shall review the evidence of the manufacturer's failure to comply with this section and make a recommendation to the board regarding the discipline of the manufacturer for its failure to comply.  After the board has received the recommendation of the committee, the board may discipline the manufacturer by providing that the manufacturer's products shall be ineligible for use in product selection in any state drug assistance programs.

     (4)  A pharmacist may not dispense a prescription drug or controlled drug unless the pharmacist has satisfactory evidence that the manufacturer of the drug has a procedure for the return of expired drugs.

     (5)  Any manufacturer that had a repurchase program in place on January 1, 2008, shall be exempt from the provisions of this section, provided that the repurchase program makes provision for the repurchase of outdated drugs in either full or partial amounts within six (6) months after the labeled expiration date.

     (6)  As used in this section, the term "biological drug" or "biological product" means a virus, therapeutic serum, toxin, antitoxin, vaccine, blood, blood component or derivative, allergenic product or analogous product, or arsphenamine or derivative of arsphenamine or any other trivalent organic arsenic compound, applicable to the prevention, treatment or cure of a disease or condition of human beings.

     (7)  This section shall stand repealed on July 1, 2012.

     SECTION 17.  This act shall take effect and be in force from and after July 1, 2011.


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