First Substitute S.B. 55

This document includes Senate Committee Amendments incorporated into the bill on Thu, Feb 13, 2014 at 9:39 AM by lpoole. --> This document includes Senate 2nd Reading Floor Amendments incorporated into the bill on Tue, Feb 25, 2014 at 2:52 PM by lpoole. -->

Senator Evan J. Vickers proposes the following substitute bill:


             1     
PHARMACEUTICAL DISPENSING AMENDMENTS

             2     
2014 GENERAL SESSION

             3     
STATE OF UTAH

             4     
Chief Sponsor: Evan J. Vickers

             5     
House Sponsor: Stewart Barlow

             6     

             7      LONG TITLE
             8      General Description:
             9          This bill amends the Pharmacy Practice Act to create a dispensing medical practitioner
             10      license and a license classification for a dispensing medical practitioner clinic
             11      pharmacy.
             12      Highlighted Provisions:
             13          This bill:
             14          .    defines terms;
             15          .    establishes the license classification "dispensing medical practitioner" under the
             16      Pharmacy Practice Act for medical practitioners who prescribe and dispense a drug;
             17          .    establishes the pharmacy facility license classification "dispensing medical
             18      practitioner clinic pharmacy" under the Pharmacy Practice Act;
             19          .    creates Part 8, Dispensing Medical Practitioner and Dispensing Medical Practitioner
             20      Clinic Pharmacy;
             21          .    removes the exemption from the Pharmacy Practice Act for medical practitioners
             22      who prescribe and dispense a cosmetic drug, injectable weight loss drug, or a cancer
             23      drug treatment regimen;
             24          .    requires a license as a dispensing medical practitioner for a health care practitioner
             25      to dispense:



Text Box

- 2 -
             26
             .    a cosmetic drug:
             27              .    a cancer drug treatment regimen; or
             28              .    a prepackaged drug at an employer sponsored clinic;
             29          .    requires the Board of Pharmacy to work in conjunction with the affected
             30      practitioner governing boards:
             31              .    for discipline or hearings related to a dispensing medical practitioner; and
             32              .    to develop the administrative rules in the Pharmacy Practice Act related to a
             33      dispensing medical practitioner and a dispensing medical practitioner clinic
             34      pharmacy;
             35          .    establishes that practice as a dispensing medical practitioner does not include:
             36              .    the use of a vending-type dispensing device; or
             37              .    the prescription of controlled substances, except as permitted for cancer drug
             38      treatment regimens;
             39          .    amends the reporting requirements for the controlled substance database;
             40          .    amends unlawful and unprofessional conduct provisions; and
             41          .    makes technical changes.
             42      Money Appropriated in this Bill:
             43          None
             44      Other Special Clauses:
             45          This bill takes effect on July 1, 2014.
             46      Utah Code Sections Affected:
             47      AMENDS:
             48          58-17b-102, as last amended by Laws of Utah 2013, Chapters 52, 166, and 423
             49          58-17b-301, as last amended by Laws of Utah 2013, Chapter 52
             50          58-17b-302, as last amended by Laws of Utah 2013, Chapter 52
             51          58-17b-309, as last amended by Laws of Utah 2013, Chapter 278
             52          58-17b-309.6, as enacted by Laws of Utah 2013, Chapter 52
             53          58-17b-612, as last amended by Laws of Utah 2013, Chapters 52 and 166
             54          58-31b-502, as last amended by Laws of Utah 2012, Chapter 234
             55          58-37f-203, as enacted by Laws of Utah 2010, Chapter 287
             56          58-67-502, as last amended by Laws of Utah 2012, Chapter 234



Text Box

- 3 -
             57
         58-68-502, as last amended by Laws of Utah 2012, Chapter 234
             58          58-70a-502, as last amended by Laws of Utah 2012, Chapter 234
             59          58-70a-503, as last amended by Laws of Utah 2010, Chapter 37
             60          58-83-502, as last amended by Laws of Utah 2012, Chapter 344
             61          63I-1-258, as last amended by Laws of Utah 2013, Chapters 55, 87, 222, 278, and 351
             62      ENACTS:
             63          58-17b-801, Utah Code Annotated 1953
             64          58-17b-802, Utah Code Annotated 1953
             65          58-17b-803, Utah Code Annotated 1953
             66          58-17b-804, Utah Code Annotated 1953
             67          58-17b-805, Utah Code Annotated 1953
             68          58-17b-806, Utah Code Annotated 1953
             69      REPEALS:
             70          58-17b-309.5, as enacted by Laws of Utah 2012, Chapter 234
             71     

             72      Be it enacted by the Legislature of the state of Utah:
             73          Section 1. Section 58-17b-102 is amended to read:
             74           58-17b-102. Definitions.
             75          In addition to the definitions in Section 58-1-102 , as used in this chapter:
             76          (1) "Administering" means:
             77          (a) the direct application of a prescription drug or device, whether by injection,
             78      inhalation, ingestion, or by any other means, to the body of a human patient or research subject
             79      by another person; or
             80          (b) the placement by a veterinarian with the owner or caretaker of an animal or group
             81      of animals of a prescription drug for the purpose of injection, inhalation, ingestion, or any other
             82      means directed to the body of the animal by the owner or caretaker in accordance with written
             83      or verbal directions of the veterinarian.
             84          (2) "Adulterated drug or device" means a drug or device considered adulterated under
             85      21 U.S.C.S. Sec. 351 (2003).
             86          (3) (a) "Analytical laboratory" means a facility in possession of prescription drugs for
             87      the purpose of analysis.



Text Box

- 4 -
             88
         (b) "Analytical laboratory" does not include a laboratory possessing prescription drugs
             89      used as standards and controls in performing drug monitoring or drug screening analysis if the
             90      prescription drugs are prediluted in a human or animal body fluid, human or animal body fluid
             91      components, organic solvents, or inorganic buffers at a concentration not exceeding one
             92      milligram per milliliter when labeled or otherwise designated as being for in vitro diagnostic
             93      use.
             94          (4) "Animal euthanasia agency" means an agency performing euthanasia on animals by
             95      the use of prescription drugs.
             96          (5) "Automated pharmacy systems" includes mechanical systems which perform
             97      operations or activities, other than compounding or administration, relative to the storage,
             98      packaging, dispensing, or distribution of medications, and which collect, control, and maintain
             99      all transaction information.
             100          (6) "Beyond use date" means the date determined by a pharmacist and placed on a
             101      prescription label at the time of dispensing that indicates to the patient or caregiver a time
             102      beyond which the contents of the prescription are not recommended to be used.
             103          (7) "Board of pharmacy" or "board" means the Utah State Board of Pharmacy created
             104      in Section 58-17b-201 .
             105          (8) "Branch pharmacy" means a pharmacy or other facility in a rural or medically
             106      underserved area, used for the storage and dispensing of prescription drugs, which is dependent
             107      upon, stocked by, and supervised by a pharmacist in another licensed pharmacy designated and
             108      approved by the division as the parent pharmacy.
             109          (9) "Centralized prescription processing" means the processing by a pharmacy of a
             110      request from another pharmacy to fill or refill a prescription drug order or to perform
             111      processing functions such as dispensing, drug utilization review, claims adjudication, refill
             112      authorizations, and therapeutic interventions.
             113          (10) "Class A pharmacy" means a pharmacy located in Utah that is authorized as a
             114      retail pharmacy to compound or dispense a drug or dispense a device to the public under a
             115      prescription order.
             116          (11) "Class B pharmacy":
             117          (a) means a pharmacy located in Utah:
             118          (i) that is authorized to provide pharmaceutical care for patients in an institutional



Text Box

- 5 -
             119
     setting; and
             120          (ii) whose primary purpose is to provide a physical environment for patients to obtain
             121      health care services; and
             122          (b) (i) includes closed-door, hospital, clinic, nuclear, and branch pharmacies; and
             123          (ii) pharmaceutical administration and sterile product preparation facilities.
             124          (12) "Class C pharmacy" means a pharmacy located in Utah that is authorized to
             125      engage in the manufacture, production, wholesale, or distribution of drugs or devices.
             126          (13) "Class D pharmacy" means a nonresident pharmacy.
             127          (14) "Class E pharmacy" means all other pharmacies.
             128          (15) "Closed-door pharmacy" means a pharmacy that provides pharmaceutical care to a
             129      defined and exclusive group of patients who have access to the services of the pharmacy
             130      because they are treated by or have an affiliation with a specific entity, including a health
             131      maintenance organization or an infusion company, but not including a hospital pharmacy, a
             132      retailer of goods to the general public, or the office of a practitioner.
             133          (16) "Collaborative pharmacy practice" means a practice of pharmacy whereby one or
             134      more pharmacists have jointly agreed, on a voluntary basis, to work in conjunction with one or
             135      more practitioners under protocol whereby the pharmacist may perform certain pharmaceutical
             136      care functions authorized by the practitioner or practitioners under certain specified conditions
             137      or limitations.
             138          (17) "Collaborative pharmacy practice agreement" means a written and signed
             139      agreement between one or more pharmacists and one or more practitioners that provides for
             140      collaborative pharmacy practice for the purpose of drug therapy management of patients and
             141      prevention of disease of human subjects.
             142          (18) (a) "Compounding" means the preparation, mixing, assembling, packaging, or
             143      labeling of a limited quantity drug, sterile product, or device:
             144          (i) as the result of a practitioner's prescription order or initiative based on the
             145      practitioner, patient, or pharmacist relationship in the course of professional practice;
             146          (ii) for the purpose of, or as an incident to, research, teaching, or chemical analysis and
             147      not for sale or dispensing; or
             148          (iii) in anticipation of prescription drug orders based on routine, regularly observed
             149      prescribing patterns.



Text Box

- 6 -
             150
         (b) "Compounding" does not include:
             151          (i) the preparation of prescription drugs by a pharmacist or pharmacy intern for sale to
             152      another pharmacist or pharmaceutical facility;
             153          (ii) the preparation by a pharmacist or pharmacy intern of any prescription drug in a
             154      dosage form which is regularly and commonly available from a manufacturer in quantities and
             155      strengths prescribed by a practitioner; or
             156          (iii) the preparation of a prescription drug, sterile product, or device which has been
             157      withdrawn from the market for safety reasons.
             158          (19) "Confidential information" has the same meaning as "protected health
             159      information" under the Standards for Privacy of Individually Identifiable Health Information,
             160      45 C.F.R. Parts 160 and 164.
             161          (20) "Controlled substance" has the same definition as in Section 58-37-2 .
             162          (21) "Dietary supplement" has the same meaning as Public Law Title 103, Chapter
             163      417, Sec. 3a(ff) which is incorporated by reference.
             164          (22) "Dispense" means the interpretation, evaluation, and implementation of a
             165      prescription drug order or device or nonprescription drug or device under a lawful order of a
             166      practitioner in a suitable container appropriately labeled for subsequent administration to or use
             167      by a patient, research subject, or an animal.
             168          (23) "Dispensing medical practitioner" means an individual who is:
             169          (a) currently licensed as:
             170          (i) a physician and surgeon under Chapter 67, Utah Medical Practice Act;
             171          (ii) an osteopathic physician and surgeon under Chapter 68, Utah Osteopathic Medical
             172      Practice Act;
             173          (iii) a physician assistant under Chapter 70a, Physician Assistant Act;
             174          (iv) a nurse practitioner under Chapter 31b, Nurse Practice Act; or
             175          (v) an optometrist under Chapter 16a, Utah Optometry Practice Act, if the optometrist
             176      is acting within the scope of practice for an optometrist; and
             177          (b) licensed by the division under the Pharmacy Practice Act to engage in the practice
             178      of a dispensing medical practitioner.
             179          (24) "Dispensing medical practitioner clinic pharmacy" means a closed-door pharmacy
             180      located within a licensed dispensing medical practitioner's place of practice.



Text Box

- 7 -
             181
         [(23)] (25) "Distribute" means to deliver a drug or device other than by administering
             182      or dispensing.
             183          [(24)] (26) (a) "Drug" means:
             184          (i) a substance recognized in the official United States Pharmacopoeia, Official
             185      Homeopathic Pharmacopoeia of the United States, or Official National Formulary, or any
             186      supplement to any of them, intended for use in the diagnosis, cure, mitigation, treatment, or
             187      prevention of disease in humans or animals;
             188          (ii) a substance that is required by any applicable federal or state law or rule to be
             189      dispensed by prescription only or is restricted to administration by practitioners only;
             190          (iii) a substance other than food intended to affect the structure or any function of the
             191      body of humans or other animals; and
             192          (iv) substances intended for use as a component of any substance specified in
             193      Subsections [(24)] (26)(a)(i), (ii), (iii), and (iv).
             194          (b) "Drug" does not include dietary supplements.
             195          [(25)] (27) "Drug regimen review" includes the following activities:
             196          (a) evaluation of the prescription drug order and patient record for:
             197          (i) known allergies;
             198          (ii) rational therapy-contraindications;
             199          (iii) reasonable dose and route of administration; and
             200          (iv) reasonable directions for use;
             201          (b) evaluation of the prescription drug order and patient record for duplication of
             202      therapy;
             203          (c) evaluation of the prescription drug order and patient record for the following
             204      interactions:
             205          (i) drug-drug;
             206          (ii) drug-food;
             207          (iii) drug-disease; and
             208          (iv) adverse drug reactions; and
             209          (d) evaluation of the prescription drug order and patient record for proper utilization,
             210      including over- or under-utilization, and optimum therapeutic outcomes.
             211          [(26)] (28) "Drug sample" means a prescription drug packaged in small quantities



Text Box

- 8 -
             212
     consistent with limited dosage therapy of the particular drug, which is marked "sample", is not
             213      intended to be sold, and is intended to be provided to practitioners for the immediate needs of
             214      patients for trial purposes or to provide the drug to the patient until a prescription can be filled
             215      by the patient.
             216          [(27)] (29) "Electronic signature" means a trusted, verifiable, and secure electronic
             217      sound, symbol, or process attached to or logically associated with a record and executed or
             218      adopted by a person with the intent to sign the record.
             219          [(28)] (30) "Electronic transmission" means transmission of information in electronic
             220      form or the transmission of the exact visual image of a document by way of electronic
             221      equipment.
             222          [(29)] (31) "Hospital pharmacy" means a pharmacy providing pharmaceutical care to
             223      inpatients of a general acute hospital or specialty hospital licensed by the Department of Health
             224      under Title 26, Chapter 21, Health Care Facility Licensing and Inspection Act.
             225          [(30)] (32) "Legend drug" has the same meaning as prescription drug.
             226          [(31)] (33) "Licensed pharmacy technician" means an individual licensed with the
             227      division, that may, under the supervision of a pharmacist, perform the activities involved in the
             228      technician practice of pharmacy.
             229          [(32)] (34) "Manufacturer" means a person or business physically located in Utah
             230      licensed to be engaged in the manufacturing of drugs or devices.
             231          [(33)] (35) (a) "Manufacturing" means:
             232          (i) the production, preparation, propagation, conversion, or processing of a drug or
             233      device, either directly or indirectly, by extraction from substances of natural origin or
             234      independently by means of chemical or biological synthesis, or by a combination of extraction
             235      and chemical synthesis, and includes any packaging or repackaging of the substance or labeling
             236      or relabeling of its container; and
             237          (ii) the promotion and marketing of such drugs or devices.
             238          (b) "Manufacturing" includes the preparation and promotion of commercially available
             239      products from bulk compounds for resale by pharmacies, practitioners, or other persons.
             240          (c) "Manufacturing" does not include the preparation or compounding of a drug by a
             241      pharmacist, pharmacy intern, or practitioner for that individual's own use or the preparation,
             242      compounding, packaging, labeling of a drug, or incident to research, teaching, or chemical



Text Box

- 9 -
             243
     analysis.
             244          [(34)] (36) "Medical order" means a lawful order of a practitioner which may include a
             245      prescription drug order.
             246          [(35)] (37) "Medication profile" or "profile" means a record system maintained as to
             247      drugs or devices prescribed for a pharmacy patient to enable a pharmacist or pharmacy intern to
             248      analyze the profile to provide pharmaceutical care.
             249          [(36)] (38) "Misbranded drug or device" means a drug or device considered
             250      misbranded under 21 U.S.C.S. Sec. 352 (2003).
             251          [(37)] (39) (a) "Nonprescription drug" means a drug which:
             252          (i) may be sold without a prescription; and
             253          (ii) is labeled for use by the consumer in accordance with federal law.
             254          (b) "Nonprescription drug" includes homeopathic remedies.
             255          [(38)] (40) "Nonresident pharmacy" means a pharmacy located outside of Utah that
             256      sells to a person in Utah.
             257          [(39)] (41) "Nuclear pharmacy" means a pharmacy providing radio-pharmaceutical
             258      service.
             259          [(40)] (42) "Out-of-state mail service pharmacy" means a pharmaceutical facility
             260      located outside the state that is licensed and in good standing in another state, that:
             261          (a) ships, mails, or delivers by any lawful means a dispensed legend drug to a patient in
             262      this state pursuant to a lawfully issued prescription;
             263          (b) provides information to a patient in this state on drugs or devices which may
             264      include, but is not limited to, advice relating to therapeutic values, potential hazards, and uses;
             265      or
             266          (c) counsels pharmacy patients residing in this state concerning adverse and therapeutic
             267      effects of drugs.
             268          [(41)] (43) "Patient counseling" means the written and oral communication by the
             269      pharmacist or pharmacy intern of information, to the patient or caregiver, in order to ensure
             270      proper use of drugs, devices, and dietary supplements.
             271          [(42)] (44) "Pharmaceutical administration facility" means a facility, agency, or
             272      institution in which:
             273          (a) prescription drugs or devices are held, stored, or are otherwise under the control of



Text Box

- 10 -
             274
     the facility or agency for administration to patients of that facility or agency;
             275          (b) prescription drugs are dispensed to the facility or agency by a licensed pharmacist
             276      or pharmacy intern with whom the facility has established a prescription drug supervising
             277      relationship under which the pharmacist or pharmacy intern provides counseling to the facility
             278      or agency staff as required, and oversees drug control, accounting, and destruction; and
             279          (c) prescription drugs are professionally administered in accordance with the order of a
             280      practitioner by an employee or agent of the facility or agency.
             281          [(43)] (45) (a) "Pharmaceutical care" means carrying out the following in collaboration
             282      with a prescribing practitioner, and in accordance with division rule:
             283          (i) designing, implementing, and monitoring a therapeutic drug plan intended to
             284      achieve favorable outcomes related to a specific patient for the purpose of curing or preventing
             285      the patient's disease;
             286          (ii) eliminating or reducing a patient's symptoms; or
             287          (iii) arresting or slowing a disease process.
             288          (b) "Pharmaceutical care" does not include prescribing of drugs without consent of a
             289      prescribing practitioner.
             290          [(44)] (46) "Pharmaceutical facility" means a business engaged in the dispensing,
             291      delivering, distributing, manufacturing, or wholesaling of prescription drugs or devices within
             292      or into this state.
             293          [(45)] (47) (a) "Pharmaceutical wholesaler or distributor" means a pharmaceutical
             294      facility engaged in the business of wholesale vending or selling of a prescription drug or device
             295      to other than a consumer or user of the prescription drug or device that the pharmaceutical
             296      facility has not produced, manufactured, compounded, or dispensed.
             297          (b) "Pharmaceutical wholesaler or distributor" does not include a pharmaceutical
             298      facility carrying out the following business activities:
             299          (i) intracompany sales;
             300          (ii) the sale, purchase, or trade of a prescription drug or device, or an offer to sell,
             301      purchase, or trade a prescription drug or device, if the activity is carried out between one or
             302      more of the following entities under common ownership or common administrative control, as
             303      defined by division rule:
             304          (A) hospitals;



Text Box

- 11 -
             305
         (B) pharmacies;
             306          (C) chain pharmacy warehouses, as defined by division rule; or
             307          (D) other health care entities, as defined by division rule;
             308          (iii) the sale, purchase, or trade of a prescription drug or device, or an offer to sell,
             309      purchase, or trade a prescription drug or device, for emergency medical reasons, including
             310      supplying another pharmaceutical facility with a limited quantity of a drug, if:
             311          (A) the facility is unable to obtain the drug through a normal distribution channel in
             312      sufficient time to eliminate the risk of harm to a patient that would result from a delay in
             313      obtaining the drug; and
             314          (B) the quantity of the drug does not exceed an amount reasonably required for
             315      immediate dispensing to eliminate the risk of harm;
             316          (iv) the distribution of a prescription drug or device as a sample by representatives of a
             317      manufacturer; and
             318          (v) the distribution of prescription drugs, if:
             319          (A) the dosage units distributed during a calendar year do not exceed five percent of
             320      the sum of the dosage units distributed by the facility during the calendar year and the dosage
             321      units dispensed by the facility during the calendar year; and
             322          (B) the distribution otherwise complies with 21 C.F.R. Sec. 1307.11.
             323          [(46)] (48) "Pharmacist" means an individual licensed by this state to engage in the
             324      practice of pharmacy.
             325          [(47)] (49) "Pharmacist-in-charge" means a pharmacist currently licensed in good
             326      standing who accepts responsibility for the operation of a pharmacy in conformance with all
             327      laws and rules pertinent to the practice of pharmacy and the distribution of drugs, and who is
             328      personally in full and actual charge of the pharmacy and all personnel.
             329          [(48)] (50) "Pharmacist preceptor" means a licensed pharmacist in good standing with
             330      one or more years of licensed experience. The preceptor serves as a teacher, example of
             331      professional conduct, and supervisor of interns in the professional practice of pharmacy.
             332          [(49)] (51) "Pharmacy" means any place where:
             333          (a) drugs are dispensed;
             334          (b) pharmaceutical care is provided;
             335          (c) drugs are processed or handled for eventual use by a patient; or



Text Box

- 12 -
             336
         (d) drugs are used for the purpose of analysis or research.
             337          [(50)] (52) "Pharmacy benefits manager or coordinator" means a person or entity that
             338      provides pharmacy benefit management services as defined in Section 49-20-502 on behalf of a
             339      self-insured employer, insurance company, health maintenance organization, or other plan
             340      sponsor, as defined by rule.
             341          [(51)] (53) "Pharmacy intern" means an individual licensed by this state to engage in
             342      practice as a pharmacy intern.
             343          [(52)] (54) "Pharmacy technician training program" means an approved technician
             344      training program providing education for pharmacy technicians.
             345          (55) (a) "Practice as a dispensing medical practitioner" means the practice of pharmacy,
             346      specifically relating to the dispensing of a prescription drug in accordance with Part 8,
             347      Dispensing Medical Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, and
             348      division rule adopted after consultation with the Board of Pharmacy and the governing boards
             349      of the practitioners described in Subsection (23)(a).
             350          (b) "Practice as a dispensing medical practitioner" does not include:
             351          (i) using a vending-type of dispenser as defined by the division by administrative rule;
             352      or
             353          (ii) except as permitted by Section 58-17b-805 , dispensing of a controlled substance as
             354      defined in Section 58-37-2 .
             355          [(53)] (56) (a) "Practice as a licensed pharmacy technician" means engaging in practice
             356      as a pharmacy technician under the general supervision of a licensed pharmacist and in
             357      accordance with a scope of practice defined by division rule made in collaboration with the
             358      board.
             359          (b) "Practice as a licensed pharmacy technician" does not include:
             360          (i) performing a drug utilization review, prescription drug order clarification from a
             361      prescriber, final review of the prescription, dispensing of the drug, or counseling a patient with
             362      respect to a prescription drug;
             363          (ii) except as permitted by rules made by the division in consultation with the board,
             364      final review of a prescribed drug prepared for dispensing;
             365          (iii) counseling regarding nonprescription drugs and dietary supplements unless
             366      delegated by the supervising pharmacist; or



Text Box

- 13 -
             367
         (iv) receiving new prescription drug orders when communicating telephonically or
             368      electronically unless the original information is recorded so the pharmacist may review the
             369      prescription drug order as transmitted.
             370          [(54)] (57) "Practice of pharmacy" includes the following:
             371          (a) providing pharmaceutical care;
             372          (b) collaborative pharmacy practice in accordance with a collaborative pharmacy
             373      practice agreement;
             374          (c) compounding, packaging, labeling, dispensing, administering, and the coincident
             375      distribution of prescription drugs or devices, provided that the administration of a prescription
             376      drug or device is:
             377          (i) pursuant to a lawful order of a practitioner when one is required by law; and
             378          (ii) in accordance with written guidelines or protocols:
             379          (A) established by the licensed facility in which the prescription drug or device is to be
             380      administered on an inpatient basis; or
             381          (B) approved by the division, in collaboration with the board and the Physicians
             382      Licensing Board, created in Section 58-67-201 , if the prescription drug or device is to be
             383      administered on an outpatient basis solely by a licensed pharmacist;
             384          (d) participating in drug utilization review;
             385          (e) ensuring proper and safe storage of drugs and devices;
             386          (f) maintaining records of drugs and devices in accordance with state and federal law
             387      and the standards and ethics of the profession;
             388          (g) providing information on drugs or devices, which may include advice relating to
             389      therapeutic values, potential hazards, and uses;
             390          (h) providing drug product equivalents;
             391          (i) supervising pharmacist's supportive personnel, pharmacy interns, and pharmacy
             392      technicians;
             393          (j) providing patient counseling, including adverse and therapeutic effects of drugs;
             394          (k) providing emergency refills as defined by rule;
             395          (l) telepharmacy; and
             396          (m) formulary management intervention.
             397          [(55)] (58) "Practice of telepharmacy" means the practice of pharmacy through the use



Text Box

- 14 -
             398
     of telecommunications and information technologies.
             399          [(56)] (59) "Practice of telepharmacy across state lines" means the practice of
             400      pharmacy through the use of telecommunications and information technologies that occurs
             401      when the patient is physically located within one jurisdiction and the pharmacist is located in
             402      another jurisdiction.
             403          [(57)] (60) "Practitioner" means an individual currently licensed, registered, or
             404      otherwise authorized by the appropriate jurisdiction to prescribe and administer drugs in the
             405      course of professional practice.
             406          [(58)] (61) "Prescribe" means to issue a prescription:
             407          (a) orally or in writing; or
             408          (b) by telephone, facsimile transmission, computer, or other electronic means of
             409      communication as defined by division rule.
             410          [(59)] (62) "Prescription" means an order issued:
             411          (a) by a licensed practitioner in the course of that practitioner's professional practice or
             412      by collaborative pharmacy practice agreement; and
             413          (b) for a controlled substance or other prescription drug or device for use by a patient
             414      or an animal.
             415          [(60)] (63) "Prescription device" means an instrument, apparatus, implement, machine,
             416      contrivance, implant, in vitro reagent, or other similar or related article, and any component
             417      part or accessory, which is required under federal or state law to be prescribed by a practitioner
             418      and dispensed by or through a person or entity licensed under this chapter or exempt from
             419      licensure under this chapter.
             420          [(61)] (64) "Prescription drug" means a drug that is required by federal or state law or
             421      rule to be dispensed only by prescription or is restricted to administration only by practitioners.
             422          [(62)] (65) "Research using pharmaceuticals" means research:
             423          (a) conducted in a research facility, as defined by division rule, that is associated with a
             424      university or college in the state accredited by the Northwest Commission on Colleges and
             425      Universities;
             426          (b) requiring the use of a controlled substance, prescription drug, or prescription
             427      device;
             428          (c) that uses the controlled substance, prescription drug, or prescription device in



Text Box

- 15 -
             429
     accordance with standard research protocols and techniques, including, if required, those
             430      approved by an institutional review committee; and
             431          (d) that includes any documentation required for the conduct of the research and the
             432      handling of the controlled substance, prescription drug, or prescription device.
             433          [(63)] (66) "Retail pharmacy" means a pharmaceutical facility dispensing prescription
             434      drugs and devices to the general public.
             435          [(64)] (67) "Self-audit" means an internal evaluation of a pharmacy to determine
             436      compliance with this chapter.
             437          [(65)] (68) "Supervising pharmacist" means a pharmacist who is overseeing the
             438      operation of the pharmacy during a given day or shift.
             439          [(66)] (69) "Supportive personnel" means unlicensed individuals who:
             440          (a) may assist a pharmacist, pharmacist preceptor, pharmacy intern, or licensed
             441      pharmacy technician in nonjudgmental duties not included in the definition of the practice of
             442      pharmacy, practice of a pharmacy intern, or practice of a licensed pharmacy technician, and as
             443      those duties may be further defined by division rule adopted in collaboration with the board;
             444      and
             445          (b) are supervised by a pharmacist in accordance with rules adopted by the division in
             446      collaboration with the board.
             447          [(67)] (70) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-17b-501 .
             448          [(68)] (71) "Unprofessional conduct" is as defined in Sections 58-1-501 and
             449      58-17b-502 and may be further defined by rule.
             450          [(69)] (72) "Veterinary pharmaceutical facility" means a pharmaceutical facility that
             451      dispenses drugs intended for use by animals or for sale to veterinarians for the administration
             452      for animals.
             453          Section 2. Section 58-17b-301 is amended to read:
             454           58-17b-301. License required -- License classifications for individuals.
             455          (1) A license is required to engage in the practice of pharmacy, telepharmacy, [or the
             456      practice of a] pharmacy technician, or dispensing medical practitioner except as specifically
             457      provided in Section 58-1-307 [,] or 58-17b-309 [, or 58-17-309.6 ].
             458          (2) The division shall issue to an individual who qualifies under this chapter a license
             459      in the classification of:



Text Box

- 16 -
             460
         (a) pharmacist;
             461          (b) pharmacy intern; [or]
             462          (c) pharmacy technician[.]; or
             463          (d) dispensing medical practitioner.
             464          Section 3. Section 58-17b-302 is amended to read:
             465           58-17b-302. License required -- License classifications for pharmacy facilities.
             466          (1) A license is required to act as a pharmacy, except as specifically exempted from
             467      licensure under Section 58-1-307 [or 58-17-309.6 ].
             468          (2) The division shall issue a pharmacy license to a facility that qualifies under this
             469      chapter in the classification of a:
             470          (a) class A pharmacy;
             471          (b) class B pharmacy;
             472          (c) class C pharmacy;
             473          (d) class D pharmacy; [or]
             474          (e) class E pharmacy[.]; or
             475          (f) dispensing medical practitioner clinic pharmacy.
             476          (3) Each place of business shall require a separate license. If multiple pharmacies exist
             477      at the same address, a separate license shall be required for each pharmacy.
             478          (4) The division may further define or supplement the classifications of pharmacies.
             479      The division may impose restrictions upon classifications to protect the public health, safety,
             480      and welfare.
             481          (5) Each pharmacy shall have a pharmacist-in-charge, except as otherwise provided by
             482      rule.
             483          (6) Whenever an applicable statute or rule requires or prohibits action by a pharmacy,
             484      the pharmacist-in-charge and the owner of the pharmacy shall be responsible for all activities
             485      of the pharmacy, regardless of the form of the business organization.
             486          Section 4. Section 58-17b-309 is amended to read:
             487           58-17b-309. Exemptions from licensure.
             488          [(1) For purposes of this section:]
             489          [(a) "Cosmetic drug":]
             490          [(i) means a prescription drug that is:]



Text Box

- 17 -
             491
         [(A) for the purpose of promoting attractiveness or altering the appearance of an
             492      individual; and]
             493          [(B) listed as a cosmetic drug subject to the exemption under this section by the
             494      division by administrative rule or has been expressly approved for online dispensing, whether
             495      or not it is dispensed online or through a physician's office; and]
             496          [(ii) does not include a prescription drug that is:]
             497          [(A) a controlled substance;]
             498          [(B) compounded by the physician; or]
             499          [(C) prescribed or used for the patient for the purpose of diagnosing, curing, or
             500      preventing a disease.]
             501          [(b) "Injectable weight loss drug":]
             502          [(i) means an injectable prescription drug:]
             503          [(A) prescribed to promote weight loss; and]
             504          [(B) listed as an injectable prescription drug subject to exemption under this section by
             505      the division by administrative rule; and]
             506          [(ii) does not include a prescription drug that is a controlled substance.]
             507          [(c) "Prescribing practitioner" means an individual licensed under:]
             508          [(i) Chapter 31b, Nurse Practice Act, as an advanced practice registered nurse with
             509      prescriptive practice;]
             510          [(ii) Chapter 67, Utah Medical Practice Act;]
             511          [(iii) Chapter 68, Utah Osteopathic Medical Practice Act; or]
             512          [(iv) Chapter 70a, Physician Assistant Act.]
             513          [(2)] (1) In addition to the exemptions from licensure in [Sections] Section 58-1-307
             514      [and 58-17b-309.5 ], the following individuals may engage in the acts or practices described in
             515      this section without being licensed under this chapter:
             516          [(a) if the individual is described in Subsections (2)(b), (d), or (e), the individual
             517      notifies the division in writing of the individual's intent to dispense a drug under this
             518      subsection;]
             519          [(b)] (a) a person selling or providing contact lenses in accordance with Section
             520      58-16a-801 ; or
             521          [(c)] (b) an individual engaging in the practice of pharmacy technician under the direct



Text Box

- 18 -
             522
     personal supervision of a pharmacist while making satisfactory progress in an approved
             523      program as defined in division rule[;].
             524          [(d) a prescribing practitioner who prescribes and dispenses a cosmetic drug or an
             525      injectable weight loss drug to the prescribing practitioner's patient in accordance with
             526      Subsection (4); or]
             527          [(e) an optometrist, as defined in Section 58-16a-102 , acting within the optometrist's
             528      scope of practice as defined in Section 58-16a-601 , who prescribes and dispenses a cosmetic
             529      drug to the optometrist's patient in accordance with Subsection (4).]
             530          [(3)] (2) In accordance with Subsection 58-1-303 (1)(a), an individual exempt under
             531      Subsection [(2)(c)] (1)(b) must take all examinations as required by division rule following
             532      completion of an approved curriculum of education, within the required time frame. This
             533      exemption expires immediately upon notification of a failing score of an examination, and the
             534      individual may not continue working as a pharmacy technician even under direct supervision.
             535          [(4) A prescribing practitioner or optometrist is exempt from licensing under the
             536      provisions of this part if the prescribing practitioner or optometrist:]
             537          [(a) (i) writes a prescription for a drug the prescribing practitioner or optometrist has
             538      the authority to dispense under Subsection (4)(b); and]
             539          [(ii) informs the patient:]
             540          [(A) that the prescription may be filled at a pharmacy or dispensed in the prescribing
             541      practitioner's or optometrist's office;]
             542          [(B) of the directions for appropriate use of the drug;]
             543          [(C) of potential side-effects to the use of the drug; and]
             544          [(D) how to contact the prescribing practitioner or optometrist if the patient has
             545      questions or concerns regarding the drug;]
             546          [(b) dispenses a cosmetic drug or injectable weight loss drug only to the prescribing
             547      practitioner's patients or for an optometrist, dispenses a cosmetic drug only to the optometrist's
             548      patients;]
             549          [(c) follows labeling, record keeping, patient counseling, storage, purchasing and
             550      distribution, operating, treatment, and quality of care requirements established by
             551      administrative rule adopted by the division in consultation with the boards listed in Subsection
             552      (5)(a); and]



Text Box

- 19 -
             553
         [(d) follows USP-NF 797 standards for sterile compounding if the drug dispensed to
             554      patients is reconstituted or compounded.]
             555          [(5) (a) The division, in consultation with the board under this chapter and the relevant
             556      professional board, including the Physician Licensing Board, the Osteopathic Physician
             557      Licensing Board, the Physician Assistant Licensing Board, the Board of Nursing, the
             558      Optometrist Licensing Board, or the Online Prescribing, Dispensing, and Facilitation Board,
             559      shall adopt administrative rules pursuant to Title 63G, Chapter 3, Utah Administrative
             560      Rulemaking Act to designate:]
             561          [(i) the prescription drugs that may be dispensed as a cosmetic drug or weight loss drug
             562      under this section; and]
             563          [(ii) the requirements under Subsection (4)(c).]
             564          [(b) When making a determination under Subsection (1)(a), the division and boards
             565      listed in Subsection (5)(a) may consider any federal Food and Drug Administration indications
             566      or approval associated with a drug when adopting a rule to designate a prescription drug that
             567      may be dispensed under this section.]
             568          [(c) The division may inspect the office of a prescribing practitioner or optometrist
             569      who is dispensing under the provisions of this section, in order to determine whether the
             570      prescribing practitioner or optometrist is in compliance with the provisions of this section. If a
             571      prescribing practitioner or optometrist chooses to dispense under the provisions of this section,
             572      the prescribing practitioner or optometrist consents to the jurisdiction of the division to inspect
             573      the prescribing practitioner's or optometrist's office and determine if the provisions of this
             574      section are being met by the prescribing practitioner or optometrist.]
             575          [(d) If a prescribing practitioner or optometrist violates a provision of this section, the
             576      prescribing practitioner or optometrist may be subject to discipline under:]
             577          [(i) this chapter; and]
             578          [(ii) (A) Chapter 16a, Utah Optometry Practice Act;]
             579          [(B) Chapter 31b, Nurse Practice Act;]
             580          [(C) Chapter 67, Utah Medical Practice Act;]
             581          [(D) Chapter 68, Utah Osteopathic Medical Practice Act;]
             582          [(E) Chapter 70a, Physician Assistant Act; or]
             583          [(F) Chapter 83, Online Prescribing, Dispensing, and Facilitation Act.]



Text Box

- 20 -
             584
         [(6) Except as provided in Subsection (2)(e), this section does not restrict or limit the
             585      scope of practice of an optometrist or optometric physician licensed under Chapter 16a, Utah
             586      Optometry Practice Act.]
             587          Section 5. Section 58-17b-309.6 is amended to read:
             588           58-17b-309.6. Exemptions from licensure for research using pharmaceuticals.
             589          Research using pharmaceuticals, as defined in Subsection 58-17b-102 [(64)](65), is
             590      exempt from licensure under Sections 58-17b-301 and 58-17b-302 .
             591          Section 6. Section 58-17b-612 is amended to read:
             592           58-17b-612. Supervision -- Pharmacist-in-charge.
             593          (1) (a) Any pharmacy, except a wholesaler, distributor, out-of-state mail service
             594      pharmacy, or class E pharmacy, shall be under the general supervision of at least one
             595      pharmacist licensed to practice in Utah. One pharmacist licensed in Utah shall be designated
             596      as the pharmacist-in-charge, whose responsibility it is to oversee the operation of the pharmacy.
             597          (b) Notwithstanding Subsection 58-17b-102 [(65)](68), a supervising pharmacist does
             598      not have to be in the pharmacy or care facility but shall be available via a telepharmacy system
             599      for immediate contact with the supervised pharmacy technician or pharmacy intern if:
             600          (i) the pharmacy is located in:
             601          (A) a remote rural hospital, as defined in Section 26-21-13.6 ; or
             602          (B) a clinic located in a remote rural county with less than 20 people per square mile;
             603          (ii) the supervising pharmacist described in Subsection (1)(a) is not available; and
             604          (iii) the telepharmacy system maintains records and files quarterly reports as required
             605      by division rule to assure that patient safety is not compromised.
             606          (2) Each out-of-state mail service pharmacy shall designate and identify to the division
             607      a pharmacist holding a current license in good standing issued by the state in which the
             608      pharmacy is located and who serves as the pharmacist-in-charge for all purposes under this
             609      chapter.
             610          Section 7. Section 58-17b-801 is enacted to read:
             611     
Part 8. Dispensing Medical Practitioner and Dispensing Medical

             612     
Practitioner Clinic Pharmacy

             613          58-17b-801. Title.
             614          This part is known as "Dispensing Medical Practitioner and Dispensing Medical



Text Box

Senate 2nd Reading Amendments 2-25-2014 lp/cjd

- 21 -
Senate Committee Amendments 2-13-2014 lp/cjd
             615
     Practitioner Clinic Pharmacy."
             616          Section 8. Section 58-17b-802 is enacted to read:
             617          58-17b-802. Definitions.
             618          As used in this part:
             619          (1) (a) "Cosmetic drug" means a prescription drug that:
             620          (i) is for the purpose of promoting attractiveness or altering the appearance of an
             621      individual; and
             622          (ii) (A) is listed as a cosmetic drug subject to the exemption under this section by the
             623      division by administrative rule; or
             624          (B) has been expressly approved for online dispensing, whether or not it is dispensed
             625      online or through a physician's office.
             626          (b) "Cosmetic drug" does not include a prescription drug that is:
             627          (i) a controlled substance;
             628          (ii) compounded by the physician; or
             629          (iii) prescribed S. for .S or used S. [ for ] by .S the patient for the purpose of
             629a      diagnosing, curing, or
             630      preventing a disease.
             631          (2) "Employer sponsored clinic" means an entity that S. has a medical director who is
             631a      licensed as a physician as defined in Section 58-67-102 and .S offers health care only to the
             632      employees of an exclusive group of employers and the employees' dependents.
             633          (3) "Health care" is as defined in Section 31A-1-301 S. . .S
             634          (4) (a) "Injectable weight loss drug" means an injectable prescription drug:
             635          (i) prescribed to promote weight loss; and
             636          (ii) listed as an injectable prescription drug subject to exemption under this section by
             637      the division by administrative rule.
             638          (b) "Injectable weight loss drug" does not include a prescription drug that is a
             639      controlled substance.
             640          (5) "Prepackaged drug" means a prescription drug that:
             641          (a) is not listed under federal or state law as a Schedule I, II, III, IV, or V drug; and
             642          (b) is packaged in a fixed quantity per package by:
             643          (i) the drug manufacturer;
             644          (ii) a pharmaceutical wholesaler or distributor; or
             645          (iii) a pharmacy licensed under this title.



Text Box

- 22 -
Senate Committee Amendments 2-13-2014 lp/cjd
             646
         Section 9. Section 58-17b-803 is enacted to read:
             647          58-17b-803. Qualifications for licensure as a dispensing medical practitioner --
             648      Scope of practice.
             649          (1) An applicant for a license as a dispensing medical practitioner shall:
             650          (a) be licensed in good standing under at least one of the chapters listed in Subsection
             651      58-17b-102 (23)(a); and
             652          (b) submit an application for a license as a dispensing medical practitioner in a form
             653      prescribed by the division and pay a fee established by the S. [ department ] division .S .
             654          (2) The division shall accept the licensing in good standing under Subsection (1) in lieu
             655      of requiring an applicant for a license under this part to comply with Sections 58-17b-303 and
             656      58-17b-307 .
             657          (3) A dispensing medical practitioner may dispense, in accordance with this part:
             658          (a) a cosmetic drug and an injectable weight loss drug if:
             659          (i) the drug was prescribed by the dispensing medical practitioner to the dispensing
             660      medical practitioner's patient; and
             661          (ii) the dispensing medical practitioner complies with administrative rules adopted by
             662      the division under Subsection 58-17-802 (1);
             663          (b) a cancer drug treatment regimen if the dispensing medical practitioner complies
             664      with Section 58-17b-805 ; and
             665          (c) a pre-packaged drug to an employee or a dependent of an employee at an employer
             666      sponsored clinic if the dispensing medical practitioner:
             667          (i) treats an employee, or the dependent of an employee, of one of an exclusive group
             668      of employers at an employer sponsored clinic;
             669          (ii) prescribes a prepackaged drug to the employee or the employee's dependent;
             670          (iii) dispenses the prepackaged drug at the employer sponsored clinic; and
             671          (iv) complies with administrative rules adopted by the division in consultation with the
             672      Board of Pharmacy that establish labeling, record keeping, patient counseling, purchasing and
             673      distribution, operating, treatment, quality of care, and storage requirements.
             674          (4) A dispensing medical practitioner:
             675          (a) shall inform the patient:
             676          (i) that the drug dispensed by the practitioner may be obtained from a pharmacy



Text Box

- 23 -
Senate 2nd Reading Amendments 2-25-2014 lp/cjd
             677
     unaffiliated with the practitioner;
             678          (ii) of the directions for appropriate use of the dispensed drug;
             679          (iii) of potential side effects to the use of the dispensed drug; and
             680          (iv) how to contact the dispensing medical practitioner if the patient has questions or
             681      concerns regarding the drug;
             682          (b) shall report to the controlled substance database in the same manner as required in
             683      Section 58-37f-203 ; and
             684          (c) may delegate the dispensing of the drug if the individual to whom the dispensing
             685      was delegated is:
             686          (i) employed by the dispensing medical practitioner or the outpatient clinic setting in
             687      which the dispensing medical practitioner works; and
             688          (ii) acting under the direction of a dispensing medical practitioner who is immediately
             689      available on site for any necessary consultation.
             690          (5) If the chapter that governs the license of a dispensing medical practitioner, as listed
             691      in Subsection 58-17b-102 (23), requires physician supervision in its scope of practice
             692      requirements, the dispensing medical practitioner shall only dispense a drug under the
             693      supervision of an individual licensed under Chapter 67, Utah Medical Practice Act, or Chapter
             694      68, Utah Osteopathic Medical Practice Act S. . .S
             695          Section 10. Section 58-17b-804 is enacted to read:
             696          58-17b-804. Qualifications for licensure as a dispensing medical practitioner clinic
             697      pharmacy.
             698          (1) An applicant for a license as a dispensing medical practitioner clinic pharmacy shall
             699      comply with Section 58-17b-306 .
             700          (2) (a) Notwithstanding Section 58-17b-302 , a pharmacy licensed under this part is not
             701      required to have a pharmacist-in-charge if:
             702          (i) the pharmacy has designated a dispensing medical practitioner as responsible for all
             703      activities of the pharmacy; and
             704          (ii) the pharmacy complies with administrative rules adopted by the division in
             705      consultation with the Board of Pharmacy and the governing bodies of the practitioners
             706      described in Subsection 58-17b-102 (23)(a).
             707          (b) Notwithstanding Subsection 58-17b-306 (1)(e), the division, in consultation with



Text Box

- 24 -
Senate 2nd Reading Amendments 2-25-2014 lp/cjd
             708
     the Board of Pharmacy and the governing boards of the practitioners described in Subsection
             709      58-17b-102 (23)(a), may modify the operating standards for a dispensing medical practitioner
             710      clinic pharmacy.
             711          Section 11. Section 58-17b-805 is enacted to read:
             712          58-17b-805. Dispensing medical practitioner -- Cancer drug treatment regimen.
             713          (1) For purposes of this section:
             714          (a) "Cancer drug treatment regimen" means a prescription drug used to treat cancer,
             715      manage its symptoms, or provide continuity of care for a cancer patient.
             716          (b) "Cancer drug treatment regimen" includes:
             717          (i) a chemotherapy drug administered intravenously, orally, rectally, or by dermal
             718      methods; and
             719          (ii) a drug used to support cancer treatment, including a drug S. used .S to treat,
             719a      alleviate, or
             720      minimize physical and psychological symptoms or pain, S. [ or ] .S to improve patient tolerance
             720a      of
             721      cancer treatments S. , .S or S. to .S prepare a patient for a subsequent course of therapy.
             722          (c) "Cancer drug treatment regimen" does not mean a drug listed under federal law as a
             723      Schedule I, II, or III drug.
             724          (2) An individual may be licensed as a dispensing medical practitioner with a scope of
             725      practice that permits the dispensing medical practitioner to prescribe and dispense a cancer
             726      drug treatment regimen if the individual:
             727          (a) is licensed as described in Subsections 58-17b-102 (23)(a)(i) and (ii); and
             728          (b) is certified or eligible to be certified by the American Board of Internal Medicine in
             729      medical oncology.
             730          (3) A dispensing medical practitioner authorized to prescribe and dispense a cancer
             731      drug treatment regimen under this section may prescribe and dispense a cancer drug treatment
             732      regimen:
             733          (a) to the practitioner's patient who is currently undergoing chemotherapy in an
             734      outpatient clinic setting; and
             735          (b) if the practitioner determines that providing the cancer drug treatment regimen to
             736      the patient in the outpatient clinic setting is in the best interest of the patient or provides better
             737      access to care for the patient.
             738          Section 12. Section 58-17b-806 is enacted to read:



Text Box

- 25 -
Senate Committee Amendments 2-13-2014 lp/cjd
             739
         58-17b-806. Dispensing medical practitioner -- Dispensing medical practitioner
             740      clinic pharmacy -- Unprofessional and Unlawful conduct.
             741          (1) S. (a) .S The division S. [ , in consultation with the board shall:
             742          (a) report a violation of this chapter by a dispensing medical practitioner to
] shall consult

             742a      with .S the
             743      dispensing medical practitioner's appropriate licensing board as designated in Subsection
             744      58-17b-102 (23)(a) S. regarding a violation of this chapter .S ; and
             745          (b) S. the Pharmacy Board shall, if requested by the licensing board of the dispensing
             745a      medical practitioner, .S assist the licensing board for the dispensing medical practitioner with
             745b      reviewing the
             746      violations of the provisions of this chapter.
             747          (2) The division S. [ , in collaboration with the Board of Pharmacy, ] .S may take
             747a      appropriate
             748      action against a dispensing medical practitioner, in accordance with this chapter, if the
             749      licensing board designated in Subsection 58-17b-102 (23)(a) recommends to the division that
             750      action be taken under this chapter.
             751          (3) The division, in consultation with the board is the primary enforcer under this
             752      chapter for a dispensing medical practitioner clinic pharmacy licensed under Section
             753      58-17b-804 .
             754          Section 13. Section 58-31b-502 is amended to read:
             755           58-31b-502. Unprofessional conduct.
             756          "Unprofessional conduct" includes:
             757          (1) failure to safeguard a patient's right to privacy as to the patient's person, condition,
             758      diagnosis, personal effects, or any other matter about which the licensee is privileged to know
             759      because of the licensee's or person with a certification's position or practice as a nurse or
             760      practice as a medication aide certified;
             761          (2) failure to provide nursing service or service as a medication aide certified in a
             762      manner that demonstrates respect for the patient's human dignity and unique personal character
             763      and needs without regard to the patient's race, religion, ethnic background, socioeconomic
             764      status, age, sex, or the nature of the patient's health problem;
             765          (3) engaging in sexual relations with a patient during any:
             766          (a) period when a generally recognized professional relationship exists between the
             767      person licensed or certified under this chapter and patient; or
             768          (b) extended period when a patient has reasonable cause to believe a professional
             769      relationship exists between the person licensed or certified under the provisions of this chapter



Text Box

- 26 -
             770
     and the patient;
             771          (4) (a) as a result of any circumstance under Subsection (3), exploiting or using
             772      information about a patient or exploiting the licensee's or the person with a certification's
             773      professional relationship between the licensee or holder of a certification under this chapter and
             774      the patient; or
             775          (b) exploiting the patient by use of the licensee's or person with a certification's
             776      knowledge of the patient obtained while acting as a nurse or a medication aide certified;
             777          (5) unlawfully obtaining, possessing, or using any prescription drug or illicit drug;
             778          (6) unauthorized taking or personal use of nursing supplies from an employer;
             779          (7) unauthorized taking or personal use of a patient's personal property;
             780          (8) knowingly entering into any medical record any false or misleading information or
             781      altering a medical record in any way for the purpose of concealing an act, omission, or record
             782      of events, medical condition, or any other circumstance related to the patient and the medical or
             783      nursing care provided;
             784          (9) unlawful or inappropriate delegation of nursing care;
             785          (10) failure to exercise appropriate supervision of persons providing patient care
             786      services under supervision of the licensed nurse;
             787          (11) employing or aiding and abetting the employment of an unqualified or unlicensed
             788      person to practice as a nurse;
             789          (12) failure to file or record any medical report as required by law, impeding or
             790      obstructing the filing or recording of such a report, or inducing another to fail to file or record
             791      such a report;
             792          (13) breach of a statutory, common law, regulatory, or ethical requirement of
             793      confidentiality with respect to a person who is a patient, unless ordered by a court;
             794          (14) failure to pay a penalty imposed by the division;
             795          (15) prescribing a schedule II-III controlled substance without a consulting physician or
             796      outside of a consultation and referral plan;
             797          (16) violating Section 58-31b-801 ; and
             798          (17) violating the dispensing requirements of Section 58-17b-309 or [ 58-17b-309.5 ]
             799      Chapter 17b, Part 8, Dispensing Medical Practitioner and Dispensing Medical Practitioner
             800      Clinic Pharmacy, if applicable.



Text Box

- 27 -
             801
         Section 14. Section 58-37f-203 is amended to read:
             802           58-37f-203. Submission, collection, and maintenance of data.
             803          (1) (a) The pharmacist in charge of the drug outlet where a controlled substance is
             804      dispensed shall submit the data described in this section to the division:
             805          [(a)] (i) in accordance with the requirements of this section;
             806          [(b)] (ii) in accordance with the procedures established by the division; and
             807          [(c)] (iii) in the format established by the division.
             808          (b) A dispensing medical practitioner licensed under Chapter 17b, Part 8, Dispensing
             809      Medical Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, shall comply with
             810      the provisions of this section and the dispensing medical practitioner shall assume the duties of
             811      the pharmacist under this chapter.
             812          (2) The pharmacist described in Subsection (1) shall, for each controlled substance
             813      dispensed by a pharmacist under the pharmacist's supervision other than those dispensed for an
             814      inpatient at a health care facility, submit to the division the following information:
             815          (a) the name of the prescribing practitioner;
             816          (b) the date of the prescription;
             817          (c) the date the prescription was filled;
             818          (d) the name of the individual for whom the prescription was written;
             819          (e) positive identification of the individual receiving the prescription, including the
             820      type of identification and any identifying numbers on the identification;
             821          (f) the name of the controlled substance;
             822          (g) the quantity of the controlled substance prescribed;
             823          (h) the strength of the controlled substance;
             824          (i) the quantity of the controlled substance dispensed;
             825          (j) the dosage quantity and frequency as prescribed;
             826          (k) the name of the drug outlet dispensing the controlled substance;
             827          (l) the name of the pharmacist dispensing the controlled substance; and
             828          (m) other relevant information as required by division rule.
             829          (3) (a) The division shall make rules, in accordance with Title 63G, Chapter 3, Utah
             830      Administrative Rulemaking Act, to establish the electronic format in which the information
             831      required under this section shall be submitted to the division.



Text Box

- 28 -
             832
         (b) The division shall ensure that the database system records and maintains for
             833      reference:
             834          (i) the identification of each individual who requests or receives information from the
             835      database;
             836          (ii) the information provided to each individual; and
             837          (iii) the date and time that the information is requested or provided.
             838          Section 15. Section 58-67-502 is amended to read:
             839           58-67-502. Unprofessional conduct.
             840          "Unprofessional conduct" includes, in addition to the definition in Section 58-1-501 :
             841          (1) using or employing the services of any individual to assist a licensee in any manner
             842      not in accordance with the generally recognized practices, standards, or ethics of the
             843      profession, state law, or division rule;
             844          (2) making a material misrepresentation regarding the qualifications for licensure under
             845      Section 58-67-302.7 ; or
             846          (3) violating the dispensing requirements of Section 58-17b-309 or [ 58-17b-309.5 ]
             847      Chapter 17b, Part 8, Dispensing Medical Practitioner and Dispensing Medical Practitioner
             848      Clinic Pharmacy, if applicable.
             849          Section 16. Section 58-68-502 is amended to read:
             850           58-68-502. Unprofessional conduct.
             851          "Unprofessional conduct" includes, in addition to the definition in Section 58-1-501 :
             852          (1) using or employing the services of any individual to assist a licensee in any manner
             853      not in accordance with the generally recognized practices, standards, or ethics of the
             854      profession, state law, or division rule; or
             855          (2) violating the dispensing requirements of Section 58-17b-309 or [ 58-17b-309.5 ]
             856      Chapter 17b, Part 8, Dispensing Medical Practitioner and Dispensing Medical Practitioner
             857      Clinic Pharmacy, if applicable.
             858          Section 17. Section 58-70a-502 is amended to read:
             859           58-70a-502. Unlawful conduct.
             860          "Unlawful conduct" includes[: (1)] engaging in practice as a licensed physician assistant
             861      while not under the supervision of a supervising physician or substitute supervising physician[;
             862      or].



Text Box

- 29 -
             863
         [(2) violating the drug dispensing requirements of Section 58-17b-309 or
             864      58-17b-309.5 , if applicable.]
             865          Section 18. Section 58-70a-503 is amended to read:
             866           58-70a-503. Unprofessional conduct.
             867          "Unprofessional conduct" includes:
             868          (1) violation of a patient confidence to any person who does not have a legal right and
             869      a professional need to know the information concerning the patient;
             870          (2) knowingly prescribing, selling, giving away, or directly or indirectly administering,
             871      or offering to prescribe, sell, furnish, give away, or administer any prescription drug except for
             872      a legitimate medical purpose upon a proper diagnosis indicating use of that drug in the amounts
             873      prescribed or provided;
             874          (3) prescribing prescription drugs for himself or administering prescription drugs to
             875      himself, except those that have been legally prescribed for him by a licensed practitioner and
             876      that are used in accordance with the prescription order for the condition diagnosed;
             877          (4) failure to maintain at the practice site a delegation of services agreement that
             878      accurately reflects current practices;
             879          (5) failure to make the delegation of services agreement available to the division for
             880      review upon request; [and]
             881          (6) in a practice that has physician assistant ownership interests, failure to allow the
             882      supervising physician the independent final decision making authority on patient treatment
             883      decisions, as set forth in the delegation of services agreement or as defined by rule[.]; and
             884          (7) violating the dispensing requirements of Chapter 17b, Part 8, Dispensing Medical
             885      Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if applicable.
             886          Section 19. Section 58-83-502 is amended to read:
             887           58-83-502. Unprofessional conduct.
             888          "Unprofessional conduct" includes, in addition to the definition in Section 58-1-501 and
             889      as may be further defined by administrative rule:
             890          (1) online prescribing, dispensing, or facilitation with respect to a person under the age
             891      of 18 years;
             892          (2) using the name or official seal of the state, the Utah Department of Commerce, or
             893      the Utah Division of Occupational and Professional Licensing, or their boards, in an



Text Box

- 30 -
             894
     unauthorized manner;
             895          (3) failing to respond promptly to a request by the division for information including:
             896          (a) an audit of the website; or
             897          (b) records of the online prescriber, the Internet facilitator, or the online contract
             898      pharmacy;
             899          (4) using an online prescriber, online contract pharmacy, or Internet facilitator without
             900      approval of the division;
             901          (5) failing to inform a patient of the patient's freedom of choice in selecting who will
             902      dispense a prescription in accordance with Subsection 58-83-305 (1)(n);
             903          (6) failing to keep the division informed of the name and contact information of the
             904      Internet facilitator or online contract pharmacy; and
             905          (7) violating the dispensing and labeling requirements of [Section 58-17b-309 ] Chapter
             906      17b, Part 8, Dispensing Medical Practitioner and Dispensing Medical Practitioner Clinic
             907      Pharmacy.
             908          Section 20. Section 63I-1-258 is amended to read:
             909           63I-1-258. Repeal dates, Title 58.
             910          (1) Title 58, Chapter 13, Health Care Providers Immunity from Liability Act, is
             911      repealed July 1, 2016.
             912          (2) Title 58, Chapter 15, Health Facility Administrator Act, is repealed July 1, 2015.
             913          (3) [Section 58-17b-309.5 is repealed July 1, 2015. (4)] Title 58, Chapter 20a,
             914      Environmental Health Scientist Act, is repealed July 1, 2018.
             915          [(5)] (4) Title 58, Chapter 40, Recreational Therapy Practice Act, is repealed July 1,
             916      2023.
             917          [(6)] (5) Title 58, Chapter 41, Speech-Language Pathology and Audiology Licensing
             918      Act, is repealed July 1, 2019.
             919          [(7)] (6) Title 58, Chapter 42a, Occupational Therapy Practice Act, is repealed July 1,
             920      2015.
             921          [(8)] (7) Title 58, Chapter 46a, Hearing Instrument Specialist Licensing Act, is
             922      repealed July 1, 2023.
             923          [(9)] (8) Title 58, Chapter 47b, Massage Therapy Practice Act, is repealed July 1, 2014.
             924          [(10)] (9) Section 58-69-302.5 is repealed on July 1, 2015.



Text Box

- 31 -
             925
         [(11)] (10) Title 58, Chapter 72, Acupuncture Licensing Act, is repealed July 1, 2017.
             926          Section 21. Repealer.
             927          This bill repeals:
             928          Section 58-17b-309.5, Exemption for prescribing practitioner of cancer drug
             929      regimen -- Division study of dispensing practitioners.
             930          Section 22. Effective date.
             931          This bill takes effect on July 1, 2014.


[Bill Documents][Bills Directory]