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S.B. 160 Enrolled

             1     

PHARMACY PRACTICE ACT AMENDMENTS

             2     
2007 GENERAL SESSION

             3     
STATE OF UTAH

             4     
Chief Sponsor: Peter C. Knudson

             5     
House Sponsor: Scott L Wyatt

             6     
             7      LONG TITLE
             8      General Description:
             9          This bill amends the Pharmacy Practice Act.
             10      Highlighted Provisions:
             11          This bill:
             12          .    deletes archaic language related to the conversion of pharmacy licenses in existence
             13      prior to July 1, 2004;
             14          .    as a condition of licensure, requires a pharmacy intern who has received a degree
             15      from a school or college of pharmacy accredited by the Accreditation Council on
             16      Pharmacy Education to also have completed any intern hours required by division
             17      rule;
             18          .    extends the term of a pharmacy intern license held by a pharmacy student, resident,
             19      or fellow from four years to five years;
             20          .    amends the definition of "unprofessional conduct" as it relates to compensation for
             21      patient referral;
             22          .    amends the definition of "unprofessional conduct" as it relates to compensation for
             23      acts in violation of the Pharmacy Practice Act;
             24          .    adds violations of the Division of Occupational and Professional Licensing Act as a
             25      basis for disciplinary action under the Pharmacy Practice Act;
             26          .    specifies that prescription drugs must be dispensed at licensed pharmacies unless
             27      they are delivered via the United States Postal Service, licensed common carrier, or
             28      supportive personnel;
             29          .    exempts class E pharmacies from the requirement that pharmacies be under the


             30      supervision of a pharmacist-in-charge;
             31          .    changes the deadline for the reporting of various matters by pharmacies to the
             32      Division of Occupational and Professional Licensing;
             33          .    makes clarifying changes; and
             34          .    makes technical corrections.
             35      Monies Appropriated in this Bill:
             36          None
             37      Other Special Clauses:
             38          None
             39      Utah Code Sections Affected:
             40      AMENDS:
             41          58-17b-302, as enacted by Chapter 280, Laws of Utah 2004
             42          58-17b-304, as last amended by Chapter 160, Laws of Utah 2005
             43          58-17b-308, as enacted by Chapter 280, Laws of Utah 2004
             44          58-17b-502, as last amended by Chapter 160, Laws of Utah 2005
             45          58-17b-504, as enacted by Chapter 280, Laws of Utah 2004
             46          58-17b-602, as enacted by Chapter 280, Laws of Utah 2004
             47          58-17b-612, as last amended by Chapter 160, Laws of Utah 2005
             48          58-17b-614, as enacted by Chapter 280, Laws of Utah 2004
             49     
             50      Be it enacted by the Legislature of the state of Utah:
             51          Section 1. Section 58-17b-302 is amended to read:
             52           58-17b-302. License classifications of pharmacy facilities.
             53          (1) A license is required to act as a pharmacy, except as specifically exempted from
             54      licensure under Section 58-1-307 .
             55          (2) The division shall issue a pharmacy license to a facility that qualifies under this
             56      chapter in the classification of a:
             57          (a) class A pharmacy;


             58          (b) class B pharmacy;
             59          (c) class C pharmacy;
             60          (d) class D pharmacy; or
             61          (e) class E pharmacy.
             62          (3) Each place of business shall require a separate license. If multiple pharmacies exist
             63      at the same address, a separate license shall be required for each pharmacy.
             64          (4) The division may further define or supplement the classifications of pharmacies.
             65      The division may impose restrictions upon classifications to protect the public health, safety,
             66      and welfare.
             67          (5) Each pharmacy shall have a pharmacist-in-charge, except as otherwise provided by
             68      rule.
             69          (6) Whenever an applicable statute or rule requires or prohibits action by a pharmacy,
             70      the pharmacist-in-charge and the owner [or owners] of the pharmacy shall be responsible for all
             71      activities of the pharmacy, regardless of the form of the business organization.
             72          [(7) Any facility holding a pharmacy license prior to July 1, 2004, shall be converted
             73      from the classification of license currently held to the appropriate classification established
             74      under this chapter upon their next renewal or reinstatement of licensure, in accordance with a
             75      conversion schedule established by rule.]
             76          Section 2. Section 58-17b-304 is amended to read:
             77           58-17b-304. Qualifications for licensure of pharmacy intern.
             78          Each applicant for licensure as a pharmacy intern shall:
             79          (1) submit an application in a form prescribed by the division;
             80          (2) pay a fee determined by the department under Section 63-38-3.2 ;
             81          (3) produce satisfactory evidence of good moral character as it relates to the applicant's
             82      ability to practice pharmacy;
             83          (4) complete a criminal background check and be free from criminal convictions as
             84      required by Section 58-17b-307 , or as otherwise described in Section 58-1-501 ;
             85          (5) have no physical or mental condition of a nature which prevents the applicant from


             86      engaging in the practice of pharmacy with reasonable skill, competency, and safety to the
             87      public;
             88          (6) meet the preliminary educational qualifications required by division rule made in
             89      collaboration with the board; and
             90          (7) meet one of the following educational criteria:
             91          (a) be a current pharmacy student, a resident, or fellow in a program approved by
             92      division rule made in collaboration with the board;
             93          (b) have graduated and received a pharmacy degree from a school or college of
             94      pharmacy which is accredited by the Accreditation Council on Pharmacy Education but not
             95      completed the internship hours required by division rule for licensure as a pharmacist; or
             96          (c) have graduated from a foreign pharmacy school and received certification of
             97      equivalency from a credentialing agency approved by [the] division rule made in collaboration
             98      with the board.
             99          Section 3. Section 58-17b-308 is amended to read:
             100           58-17b-308. Term of license -- Expiration -- Renewal.
             101          (1) Except as provided in Subsection (2), each license issued under this chapter shall be
             102      issued in accordance with a two-year renewal cycle established by rule. A renewal period may
             103      be extended or shortened by as much as one year to maintain established renewal cycles or to
             104      change an established renewal cycle. Each license automatically expires on the expiration date
             105      shown on the license unless renewed by the licensee in accordance with Section 58-1-308 .
             106          (2) The duration of a pharmacy intern license may be no longer than:
             107          (a) one year for a license issued under Subsection 58-17b-304 (7)(b) or (c); or
             108          (b) [four] five years for a license issued under Subsection 58-17b-304 (7)(a).
             109          (3) A pharmacy intern license issued under this chapter may not be renewed, but may
             110      be extended by the division in collaboration with the board.
             111          Section 4. Section 58-17b-502 is amended to read:
             112           58-17b-502. Unprofessional conduct.
             113          "Unprofessional conduct" includes:


             114          (1) willfully deceiving or attempting to deceive the division, the board, or their agents
             115      as to any relevant matter regarding compliance under this chapter;
             116          [(2) except for price discounts conditional upon volume purchases:]
             117          [(a) paying rebates to practitioners or any other health care providers; and]
             118          [(b) entering into any agreement with a medical practitioner or any other person for the
             119      payment or acceptance of compensation or its economic equivalent for recommending the
             120      professional services of either party;]
             121          (2) (a) except as provided in Subsection (2)(b):
             122          (i) paying or offering rebates to practitioners or any other health care providers, or
             123      receiving or soliciting rebates from practitioners or any other health care provider; or
             124          (ii) paying, offering, receiving, or soliciting compensation in the form of a commission,
             125      bonus, rebate, kickback, or split fee arrangement with practitioners or any other health care
             126      provider, for the purpose of obtaining referrals.
             127          (b) Subsection (2)(a) does not apply to:
             128          (i) giving or receiving price discounts based on purchase volume;
             129          (ii) passing along pharmaceutical manufacturer's rebates; or
             130          (iii) providing compensation for services to a veterinarian.
             131          (3) misbranding or adulteration of any drug or device or the sale, distribution, or
             132      dispensing of any outdated, misbranded, or adulterated drug or device;
             133          (4) engaging in the sale or purchase of drugs or devices that are samples or packages
             134      bearing the inscription "sample" or "not for resale" or similar words or phrases;
             135          (5) except as provided in Section 58-17b-503 , accepting back and redistributing of any
             136      unused drug, or a part of it, after it has left the premises of any pharmacy, unless the drug is in
             137      a unit pack, as defined in Section 58-17b-503 , or the manufacturer's sealed container, as
             138      defined in rule;
             139          (6) [being employed as] an act in violation of this chapter committed by a person for
             140      any form of compensation if the act is incidental to the person's professional activities,
             141      including the activities of a pharmacist, pharmacy intern, or pharmacy technician[, or sharing


             142      or receiving compensation in any form arising out of an act incidental to professional activities
             143      in the course of which any person requires him to engage in any aspect of the practice of
             144      pharmacy in violation of this chapter];
             145          (7) violating Federal Title II, P.L. 91, Controlled Substances Act, [or] Title 58, Chapter
             146      37, Utah Controlled Substances Act, or rules [and] or regulations adopted under either act;
             147          (8) requiring or permitting pharmacy interns or technicians to engage in activities
             148      outside the scope of practice for their respective license classifications, as defined in this
             149      chapter and division rules made in collaboration with the board, or beyond [an individual's]
             150      their scope of training and ability;
             151          (9) administering:
             152          (a) without appropriate training, as defined by rule;
             153          (b) without a physician's order, when one is required by law; and
             154          (c) in conflict with a practitioner's written guidelines or written protocol for
             155      administering;
             156          (10) disclosing confidential patient information in violation of the provisions of the
             157      Health Insurance Portability and Accountability Act of 1996 or other applicable law;
             158          (11) engaging in the practice of pharmacy without a licensed pharmacist designated as
             159      the pharmacist-in-charge;
             160          (12) failing to report to the division any adverse action taken by another licensing
             161      jurisdiction, government agency, law enforcement agency, or court for conduct that, in
             162      substance would [constitute grounds for action, as defined in] be considered unprofessional
             163      conduct under this section;
             164          (13) [preparing] as a pharmacist or pharmacy intern, preparing a prescription drug for
             165      sale to another pharmacist or pharmaceutical facility; and
             166          (14) [preparing] as a pharmacist or pharmacy intern, preparing a prescription drug in a
             167      dosage form which is regularly and commonly available from a manufacturer in quantities and
             168      strengths prescribed by a practitioner.
             169          Section 5. Section 58-17b-504 is amended to read:


             170           58-17b-504. Penalty for unlawful or unprofessional conduct -- Fines -- Citations.
             171          (1) Any person who violates any of the unlawful conduct [provision defined in]
             172      provisions of Subsection 58-1-501 (1)(a)(i) and Subsections 58-17b-501 (7) and (11) is guilty of
             173      a third degree felony.
             174          (2) Any person who violates any of the unlawful conduct provisions [defined in] of
             175      Subsection 58-1-501 (1)(a)(ii), Subsections 58-1-501 (1)(b) through (e), and Section
             176      58-17b-501 , except Subsections 58-17b-501 (7) and (11), is guilty of a class A misdemeanor.
             177          (3) (a) Subject to Subsection (5) and in accordance with Section 58-17b-401 , for acts
             178      of unprofessional or unlawful conduct, the division may:
             179          (i) assess administrative penalties [in accordance with the provisions of Section
             180      58-17b-401 for acts of unprofessional or unlawful conduct or]; and
             181          (ii) take any other appropriate administrative action [in accordance with the provisions
             182      of Section 58-17b-401 ].
             183          (b) An administrative penalty imposed pursuant to this section shall be deposited in the
             184      General Fund as a dedicated credit to be used by the division for pharmacy licensee education
             185      and enforcement as provided in Section [ 58-12b-505 ] 58-17b-505 .
             186          (4) If a licensee has been convicted of violating Section 58-17b-501 prior to an
             187      administrative finding of a violation of the same section, the licensee may not be assessed an
             188      administrative fine under this chapter for the same offense for which the conviction was
             189      obtained.
             190          (5) (a) If upon inspection or investigation, the division concludes that a person has
             191      violated the provisions of Section 58-17b-501 [,] or 58-17b-502 , [or] Chapter 37, Utah
             192      Controlled Substances Act, Chapter 1, Division of Occupational and Professional Licensing
             193      Act, or any rule or order issued with respect to these provisions, and that disciplinary action is
             194      appropriate, the director or the director's designee from within the division shall promptly issue
             195      a citation to the person according to this chapter and any pertinent rules, attempt to negotiate a
             196      stipulated settlement, or notify the person to appear before an adjudicative proceeding
             197      conducted under Title 63, Chapter 46b, Administrative Procedures Act.


             198          (b) Any person who is in violation of the provisions of Section 58-17b-501 [,] or
             199      58-17b-502 , [or] Chapter 37, Utah Controlled Substances Act, Chapter 1, Division of
             200      Occupational and Professional Licensing Act, or any rule or order issued with respect to these
             201      provisions, as evidenced by an uncontested citation, a stipulated settlement, or [by] a finding of
             202      violation in an adjudicative proceeding, may be assessed a fine pursuant to this Subsection (5)
             203      of up to $10,000 per single violation or up to $2,000 per day of ongoing violation, whichever is
             204      greater, in accordance with a fine schedule established by rule, and may, in addition to or in
             205      lieu of, be ordered to cease and desist from violating the provisions of Section 58-17b-501 [,] or
             206      58-17b-502 , [or] Chapter 37, Utah Controlled Substances Act, Chapter 1, Division of
             207      Occupational and Professional Licensing Act, or any rule or order issued with respect to these
             208      provisions.
             209          (c) Except for an administrative fine and a cease and desist order, the licensure
             210      sanctions cited in Section 58-17b-401 may not be assessed through a citation.
             211          (d) Each citation shall be in writing and specifically describe with particularity the
             212      nature of the violation, including a reference to the provision of the chapter, rule, or order
             213      alleged to have been violated. The citation shall clearly state that the recipient must notify the
             214      division in writing within 20 calendar days of service of the citation [if the recipient wishes] in
             215      order to contest the citation at a hearing conducted under Title 63, Chapter 46b, Administrative
             216      Procedures Act. The citation shall clearly explain the consequences of failure to timely contest
             217      the citation or to make payment of any fines assessed by the citation within the time specified
             218      in the citation.
             219          (e) Each citation issued under this section, or a copy of each citation, may be served
             220      upon any person upon whom a summons may be served:
             221          (i) in accordance with the Utah Rules of Civil Procedure;
             222          (ii) personally or upon the person's agent by a division investigator or by any person
             223      specially designated by the director; or
             224          (iii) by mail.
             225          (f) If within 20 calendar days from the service of a citation, the person to whom the


             226      citation was issued fails to request a hearing to contest the citation, the citation becomes the
             227      final order of the division and is not subject to further agency review. The period to contest the
             228      citation may be extended by the division for cause.
             229          (g) The division may refuse to issue or renew, suspend, revoke, or place on probation
             230      the license of a licensee who fails to comply with the citation after it becomes final.
             231          (h) The failure of an applicant for licensure to comply with a citation after it becomes
             232      final is a ground for denial of license.
             233          (i) No citation may be issued under this section after the expiration of six months
             234      following the occurrence of any violation.
             235          Section 6. Section 58-17b-602 is amended to read:
             236           58-17b-602. Prescription orders -- Information required -- Alteration -- Labels --
             237      Signatures -- Dispensing in pharmacies.
             238          (1) The minimum information that shall be included in a prescription order, and that
             239      may be defined by rule, is:
             240          (a) the prescriber's name, address, and telephone number, and, if the order is for a
             241      controlled substance, the patient's age and the prescriber's DEA number;
             242          (b) the patient's name and address or, in the case of an animal, the name of the owner
             243      and species of the animal;
             244          (c) the date of issuance;
             245          (d) the name of the medication or device prescribed and dispensing instructions, if
             246      necessary;
             247          (e) the directions, if appropriate, for the use of the prescription[, if appropriate, for] by
             248      the patient or animal[,] and any refill, special labeling, [and] or other instructions;
             249          (f) the prescriber's signature if the prescription order is written;
             250          (g) if the order is an electronically transmitted prescription order, the prescribing
             251      practitioner's electronic signature; and
             252          (h) if the order is a hard copy prescription order generated from electronic media, the
             253      prescribing practitioner's electronic or manual signature.


             254          (2) The requirement of Subsection (1)(a) does not apply to prescription orders
             255      dispensed for inpatients by hospital pharmacies if the prescriber is a current member of the
             256      hospital staff and the prescription order is on file in the patient's medical record.
             257          (3) [The prescription order, except] Unless it is for a Schedule II controlled substance
             258      [II], a prescription order may be dispensed by pharmacists or pharmacy interns upon an oral
             259      prescription of a practitioner[,] only if the oral prescription is promptly reduced to writing.
             260          (4) (a) [A] Except as provided under Subsection (4)(b), a pharmacist or pharmacy
             261      intern may not dispense or compound any prescription of a practitioner if it shows evidence of
             262      alteration, erasure, or addition by any person other than the person writing the prescription[,
             263      except under Subsection (4)(b)].
             264          (b) A pharmacist or pharmacy intern dispensing or compounding [the] a prescription
             265      may alter or make additions to the prescription after receiving permission of the prescriber[, or]
             266      and may make entries or additions on the prescription required by law or necessitated in the
             267      compounding and dispensing procedures.
             268          (5) Each drug dispensed shall have a label securely affixed to the container indicating
             269      the following minimum information:
             270          (a) the name, address, and telephone number of the pharmacy;
             271          (b) the serial number of the prescription as assigned by the dispensing pharmacy;
             272          (c) the filling date of the prescription or its last dispensing date;
             273          (d) the name of the patient, or in the case of an animal, the name of the owner and
             274      species of the animal;
             275          (e) the name of the prescriber;
             276          (f) the directions for use and cautionary statements, if any, which are contained in the
             277      prescription order or are needed;
             278          (g) except as provided in Subsection (6), the trade, generic, or chemical name, amount
             279      dispensed and the strength of dosage form, but if multiple ingredient products with established
             280      proprietary or nonproprietary names are prescribed, those products' names may be used; and
             281          (h) the beyond use date.


             282          (6) If the prescriber specifically indicates the name of the prescription product should
             283      not appear on the label, then any of the trade, generic, [or] chemical [name and], established
             284      proprietary, and established nonproprietary names and the strength of dosage form may not be
             285      included.
             286          (7) Except when it is delivered to the ultimate user via the United States Postal Service,
             287      licensed common carrier, or supportive personnel, a prescription drug may be dispensed to the
             288      ultimate user or his agent only at a licensed pharmacy.
             289          Section 7. Section 58-17b-612 is amended to read:
             290           58-17b-612. Supervision -- Pharmacist-in-charge.
             291          (1) (a) Any pharmacy, except a wholesaler, distributor, [or] out-of-state mail service
             292      pharmacy, or class E pharmacy, shall be under the general supervision of at least one
             293      pharmacist licensed to practice in Utah. One pharmacist licensed in Utah shall be designated
             294      as the pharmacist-in-charge, whose responsibility it is to oversee the operation of the pharmacy.
             295          (b) Notwithstanding [the provisions of] Subsection 58-17b-102 (64), a supervising
             296      pharmacist does not have to be in the pharmacy or care facility but shall be available via a
             297      telepharmacy system for immediate contact with the supervised pharmacy technician or
             298      pharmacy intern if:
             299          (i) the pharmacy is located in:
             300          (A) a remote rural hospital, as defined in Section 26-21-13.6 ; or
             301          (B) a clinic located in a remote rural county with less than 20 people per square mile;
             302          (ii) the supervising pharmacist described in Subsection (1)(a) is not available; and
             303          (iii) the telepharmacy system maintains records and files quarterly reports as required
             304      by division rule to assure that patient safety is not compromised.
             305          (2) Each out-of-state mail service pharmacy shall designate and identify to the division
             306      a pharmacist holding a current license in good standing issued by the state in which the
             307      pharmacy is located and who serves as the pharmacist-in-charge for all purposes under this
             308      chapter.
             309          Section 8. Section 58-17b-614 is amended to read:


             310           58-17b-614. Notification.
             311          (1) A pharmacy shall report in writing to the division not later than ten business days
             312      [after] before the date of:
             313          (a) a permanent closure of the pharmacy facility;
             314          (b) a change of name or ownership of the pharmacy facility;
             315          (c) a change of location of the pharmacy facility;
             316          (d) a sale or transfer of any controlled substance as a result of the permanent closing or
             317      change of ownership of the pharmacy facility;
             318          (e) any matter or occurrence that the board requires by rule to be reported;
             319          (f) a final administrative[,] disciplinary order against the pharmacy license holder by
             320      the regulatory or licensing agency of the state in which the pharmacy is located if the pharmacy
             321      is a class D pharmacy; or
             322          (g) a final order against a pharmacist who is designated as the pharmacist-in-charge of
             323      the pharmacy by the regulatory or licensing agency of the state in which the pharmacy is
             324      located if the pharmacy is a class D pharmacy.
             325          (2) A pharmacy shall report in writing to the division a disaster, accident, or emergency
             326      that may [effect] affect the purity[,] or labeling of a drug, medication, device, or other material
             327      used in the diagnosis or treatment of injury, illness, or disease immediately [on] upon the
             328      occurrence of the disaster, accident, or emergency as defined by rule. [The]
             329          (3) A reporting pharmacy shall maintain a copy of any notification required by this
             330      section for two years and make a copy available for inspection.


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