Bill Text: NY S07682 | 2017-2018 | General Assembly | Introduced
Bill Title: Authorizes physicians and pharmacists to enter into comprehensive medication management protocols for their patients.
Sponsorship: Moderate Partisan Bill (Republican 4-1)
Status: (Introduced - Dead) 2018-02-07 - REFERRED TO HEALTH [S07682 Detail]
Download: New_York-2017-S07682-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 7682 IN SENATE February 7, 2018 ___________ Introduced by Sen. LAVALLE -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT to amend the public health law and the education law, in relation to comprehensive medication management; and to amend chapter 21 of the laws of 2011 amending the education law relating to authorizing phar- macists to perform collaborative drug therapy management with physi- cians in certain settings, in relation to making the provisions of such chapter permanent The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. The public health law is amended by adding a new article 2 29-H to read as follows: 3 ARTICLE 29-H 4 COMPREHENSIVE MEDICATION MANAGEMENT 5 Section 2999-ee. Comprehensive medication management. 6 § 2999-ee. Comprehensive medication management. 1. Definitions. As 7 used in this article, the following terms shall have the following mean- 8 ings: 9 (a) Qualified pharmacist. The term "qualified pharmacist" shall mean a 10 pharmacist who maintains a current unrestricted license pursuant to 11 article one hundred thirty-seven of the education law, who has a minimum 12 of two years of experience in patient care as a practicing pharmacist 13 within the last five years, and who has demonstrated competency in the 14 medication management of patients with a chronic disease or diseases, 15 including, but not limited to, the completion of one or more programs 16 which are accredited by the accreditation council for pharmacy educa- 17 tion, recognized by the education department and acceptable to the 18 patient's treating physician. 19 (b) Patient care. The term "patient care" shall mean assessing the 20 appropriateness of prescription and non-prescription drugs for individ- 21 ual patients based on an assessment of the patient's medication history, 22 medication experience including beliefs, concerns, understanding and 23 expectations, the clinical goals of therapy, potential drug-to-drug EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD13456-05-8S. 7682 2 1 interactions or other medication safety concerns, recommendations for 2 adherence and consulting with a patient or caregiver. 3 (c) Comprehensive medication management. The term "comprehensive medi- 4 cation management" shall mean a program conducted by a qualified pharma- 5 cist that ensures a patient's medications, whether prescription or 6 nonprescription, are individually assessed to determine that each medi- 7 cation is appropriate for the patient, effective for the medical condi- 8 tion, safe given the comorbidities and other medications being taken, 9 and able to be taken by the patient as intended. Comprehensive medica- 10 tion management conducted by a qualified pharmacist shall include shar- 11 ing of applicable patient clinical information with the treating physi- 12 cian as specified in a comprehensive medication management protocol. 13 (d) Comprehensive medication management protocol. The term "comprehen- 14 sive medication management protocol" shall mean a written document 15 pursuant to and consistent with any applicable state and federal 16 requirements, that is entered into voluntarily by a physician licensed 17 pursuant to article one hundred thirty-one of the education law and a 18 qualified pharmacist which addresses a chronic disease or diseases as 19 determined by the treating physician and that describes the nature and 20 scope of the comprehensive medication management services to be 21 performed by the qualified pharmacist, in accordance with the provisions 22 of this article. Comprehensive medication management protocols between 23 licensed physicians and qualified pharmacists shall be made available to 24 the department for review and to ensure compliance with this article, 25 upon request. 26 2. Authorization to establish comprehensive medication management 27 protocols. A physician licensed pursuant to article one hundred thirty- 28 one of the education law shall be authorized to voluntarily establish a 29 comprehensive medication management protocol with a qualified pharmacist 30 to provide comprehensive medication management services for a patient 31 who has not met clinical goals of therapy, is at risk for hospitaliza- 32 tion or for whom the physician deems it is necessary to receive compre- 33 hensive medication management services. Participation by the patient in 34 comprehensive medication management services shall be voluntary. 35 3. Scope of comprehensive medication management protocols. Under a 36 comprehensive medication management protocol, a qualified pharmacist 37 shall be permitted to: 38 (a) adjust or manage a drug regimen of a patient, pursuant to the 39 patient specific order or protocol established by the patient's treating 40 physician, which may include adjusting drug strength, frequency of 41 administration or route of administration. Adjusting the drug regimen 42 shall not include substituting or selecting a different drug which 43 differs from that initially prescribed by the patient's treating physi- 44 cian unless such substitution is expressly authorized in the written 45 order or protocol. The qualified pharmacist shall be required to imme- 46 diately document in the patient's medical record changes made to the 47 patient's drug therapy. The patient's treating physician may prohibit, 48 by written instruction, any adjustment or change in the patient's drug 49 regimen by the qualified pharmacist; 50 (b) evaluate and, only if specifically authorized by the protocol and 51 only to the extent necessary to discharge the responsibilities set forth 52 in this article, order disease state laboratory tests related to the 53 drug therapy management for the specific chronic disease or diseases 54 specified within the written agreement or protocol; 55 (c) only if specifically authorized by the written order or protocol 56 and only to the extent necessary to discharge the responsibilities setS. 7682 3 1 forth in this article, order or perform routine patient monitoring func- 2 tions as may be necessary in the drug therapy management, including the 3 collecting and reviewing of patient histories, and ordering or checking 4 patient vital signs, including pulse, temperature, blood pressure, 5 weight and respiration; and 6 (d) access the complete patient medical record maintained by the 7 treating physician with whom the qualified pharmacist has the comprehen- 8 sive medication management protocol and document any adjustments made 9 pursuant to the protocol in the patient's medical record and shall noti- 10 fy the patient's treating physician of any adjustments in a timely 11 manner electronically or by other means. 12 (e) Under no circumstances, shall the qualified pharmacist be permit- 13 ted to delegate comprehensive medication management services to any 14 other licensed pharmacist or other pharmacy personnel. 15 4. Medication adjustments. Any medication adjustments made by the 16 qualified pharmacist pursuant to the comprehensive medication management 17 protocol including adjustments in drug strength, frequency or route of 18 administration, or initiation of a drug which differs from that initial- 19 ly prescribed and as documented in the patient's medical record shall be 20 deemed an oral prescription authorized by an agent of the patient's 21 treating physician and shall be dispensed consistent with section 22 sixty-eight hundred ten of the education law. For the purposes of this 23 article, a pharmacist who is not an employee of the physician may be 24 authorized to serve as an agent of the physician. 25 5. Referrals. A physician licensed pursuant to article one hundred 26 thirty-one of the education law who has responsibility for the treatment 27 and care of a patient for a chronic disease or diseases as determined by 28 the physician may refer the patient to a qualified pharmacist for 29 comprehensive medication management services, pursuant to the comprehen- 30 sive medication management protocol that the physician has established 31 with the qualified pharmacist. The protocol agreement shall authorize 32 the pharmacist to serve as an agent of the physician as defined by the 33 protocol. Such referral shall be documented in the patient's medical 34 record. 35 6. Patient participation. Participation in comprehensive medication 36 management services shall be voluntary, and no patient, physician or 37 pharmacist shall be required to participate. The referral of a patient 38 for comprehensive medication management services and the patient's right 39 to choose to not participate shall be disclosed to the patient. Compre- 40 hensive medication management services shall not be utilized unless the 41 patient or the patient's authorized representative consents, in writing, 42 to such services. Such consent shall be noted in the patient's medical 43 record. If the patient or the patient's authorized representative who 44 consented chooses to no longer participate in such services, at any 45 time, the services shall be discontinued and it shall be noted in the 46 patient's medical record. 47 § 2. The education law is amended by adding a new section 6801-b to 48 read as follows: 49 § 6801-b. Comprehensive medication management. 1. As used in this 50 section: 51 (a) "comprehensive medication management" shall mean a program for the 52 management of chronic disease or diseases that ensures a patient's medi- 53 cations, whether prescription or nonprescription, are individually 54 assessed to determine that each medication is appropriate for the 55 patient, effective for the medical condition, safe given the comorbidi-S. 7682 4 1 ties and other medications being taken, and able to be taken by the 2 patient as intended; and 3 (b) "comprehensive medication management protocol" shall mean a writ- 4 ten document, pursuant to and consistent with any applicable state or 5 federal requirements, that is entered into voluntarily by a physician 6 licensed pursuant to article one hundred thirty-one of this title and a 7 licensed pharmacist who meets the qualification requirements specified 8 in article twenty-nine-H of the public health law which addresses a 9 chronic disease or diseases as determined by the physician and that 10 describes the nature and scope of the comprehensive medication manage- 11 ment service to be performed by the qualified pharmacist. Comprehensive 12 medication management protocols between licensed physicians and quali- 13 fied pharmacists shall be made available to the department for review 14 and to ensure compliance with this article, upon request. 15 2. A licensed pharmacist qualified pursuant to article twenty-nine-H 16 of the public health law is authorized to serve as an agent of the 17 physician when executing the terms of the written comprehensive medica- 18 tion management protocol as established by the licensed physician for 19 the management of patients with a chronic disease or diseases. 20 § 3. Section 5 of chapter 21 of the laws of 2011, amending the educa- 21 tion law relating to authorizing pharmacists to perform collaborative 22 drug therapy management with physicians in certain settings, as amended 23 by chapter 238 of the laws of 2015, is amended to read as follows: 24 § 5. This act shall take effect on the one hundred twentieth day after 25 it shall have become a law [and shall expire 7 years after such effec-26tive date when upon such date the provisions of this act shall be deemed27repealed]; provided, however, that the amendments to subdivision 1 of 28 section 6801 of the education law made by section one of this act shall 29 be subject to the expiration and reversion of such subdivision pursuant 30 to section 8 of chapter 563 of the laws of 2008, when upon such date the 31 provisions of section one-a of this act shall take effect; provided, 32 further, that effective immediately, the addition, amendment and/or 33 repeal of any rule or regulation necessary for the implementation of 34 this act on its effective date is authorized and directed to be made and 35 completed on or before such effective date. 36 § 4. This act shall take effect immediately, provided that sections 37 one and two of this act shall take effect on the one hundred eightieth 38 day after it shall have become a law, provided that, effective imme- 39 diately, the addition, amendment and/or repeal of any rule or regulation 40 necessary for the implementation of this act on its effective date are 41 authorized and directed to be made and completed on or before such 42 effective date.
