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S.B. 160

             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) (a) except for price discounts [conditional] based upon [volume purchases: (a)]
             117      purchase volumes 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          (b) providing to or receiving from a physician, surgeon, organization, agency, or other
             122      person, either directly or indirectly, any form of compensation for the referral of a patient to a
             123      pharmacy licensed under this chapter, including compensation in the form of a commission,
             124      bonus, rebate, kickback, or split-fee arrangement;
             125          (3) misbranding or adulteration of any drug or device or the sale, distribution, or
             126      dispensing of any outdated, misbranded, or adulterated drug or device;
             127          (4) engaging in the sale or purchase of drugs or devices that are samples or packages
             128      bearing the inscription "sample" or "not for resale" or similar words or phrases;
             129          (5) except as provided in Section 58-17b-503 , accepting back and redistributing of any
             130      unused drug, or a part of it, after it has left the premises of any pharmacy, unless the drug is in
             131      a unit pack, as defined in Section 58-17b-503 , or the manufacturer's sealed container, as
             132      defined in rule;
             133          (6) [being employed as] an act in violation of this chapter committed by a person for
             134      any form of compensation if the act is incidental to the person's professional activities,
             135      including the activities of a pharmacist, pharmacy intern, or pharmacy technician[, or sharing
             136      or receiving compensation in any form arising out of an act incidental to professional activities
             137      in the course of which any person requires him to engage in any aspect of the practice of
             138      pharmacy in violation of this chapter];
             139          (7) violating Federal Title II, P.L. 91, Controlled Substances Act, [or] Title 58, Chapter
             140      37, Utah Controlled Substances Act, or rules [and] or regulations adopted under either act;
             141          (8) requiring or permitting pharmacy interns or technicians to engage in activities
             142      outside the scope of practice for their respective license classifications, as defined in this
             143      chapter and division rules made in collaboration with the board, or beyond [an individual's]
             144      their scope of training and ability;
             145          (9) administering:
             146          (a) without appropriate training, as defined by rule;
             147          (b) without a physician's order, when one is required by law; and
             148          (c) in conflict with a practitioner's written guidelines or written protocol for
             149      administering;
             150          (10) disclosing confidential patient information in violation of the provisions of the
             151      Health Insurance Portability and Accountability Act of 1996 or other applicable law;


             152          (11) engaging in the practice of pharmacy without a licensed pharmacist designated as
             153      the pharmacist-in-charge;
             154          (12) failing to report to the division any adverse action taken by another licensing
             155      jurisdiction, government agency, law enforcement agency, or court for conduct that, in
             156      substance would [constitute grounds for action, as defined in] be considered unprofessional
             157      conduct under this section;
             158          (13) [preparing] as a pharmacist or pharmacy intern, preparing a prescription drug for
             159      sale to another pharmacist or pharmaceutical facility; and
             160          (14) [preparing] as a pharmacist or pharmacy intern, preparing a prescription drug in a
             161      dosage form which is regularly and commonly available from a manufacturer in quantities and
             162      strengths prescribed by a practitioner.
             163          Section 5. Section 58-17b-504 is amended to read:
             164           58-17b-504. Penalty for unlawful or unprofessional conduct -- Fines -- Citations.
             165          (1) Any person who violates any of the unlawful conduct [provision defined in]
             166      provisions of Subsection 58-1-501 (1)(a)(i) and Subsections 58-17b-501 (7) and (11) is guilty of
             167      a third degree felony.
             168          (2) Any person who violates any of the unlawful conduct provisions [defined in] of
             169      Subsection 58-1-501 (1)(a)(ii), Subsections 58-1-501 (1)(b) through (e), and Section
             170      58-17b-501 , except Subsections 58-17b-501 (7) and (11), is guilty of a class A misdemeanor.
             171          (3) (a) Subject to Subsection (5) and in accordance with Section 58-17b-401 , for acts
             172      of unprofessional or unlawful conduct, the division may:
             173          (i) assess administrative penalties [in accordance with the provisions of Section
             174      58-17b-401 for acts of unprofessional or unlawful conduct or]; and
             175          (ii) take any other appropriate administrative action [in accordance with the provisions
             176      of Section 58-17b-401 ].
             177          (b) An administrative penalty imposed pursuant to this section shall be deposited in the
             178      General Fund as a dedicated credit to be used by the division for pharmacy licensee education
             179      and enforcement as provided in Section [ 58-12b-505 ] 58-17b-505 .
             180          (4) If a licensee has been convicted of violating Section 58-17b-501 prior to an
             181      administrative finding of a violation of the same section, the licensee may not be assessed an
             182      administrative fine under this chapter for the same offense for which the conviction was


             183      obtained.
             184          (5) (a) If upon inspection or investigation, the division concludes that a person has
             185      violated the provisions of Section 58-17b-501 [,] or 58-17b-502 , [or] Chapter 37, Utah
             186      Controlled Substances Act, Chapter 1, Division of Occupational and Professional Licensing
             187      Act, or any rule or order issued with respect to these provisions, and that disciplinary action is
             188      appropriate, the director or the director's designee from within the division shall promptly issue
             189      a citation to the person according to this chapter and any pertinent rules, attempt to negotiate a
             190      stipulated settlement, or notify the person to appear before an adjudicative proceeding
             191      conducted under Title 63, Chapter 46b, Administrative Procedures Act.
             192          (b) Any person who is in violation of the provisions of Section 58-17b-501 [,] or
             193      58-17b-502 , [or] Chapter 37, Utah Controlled Substances Act, Chapter 1, Division of
             194      Occupational and Professional Licensing Act, or any rule or order issued with respect to these
             195      provisions, as evidenced by an uncontested citation, a stipulated settlement, or [by] a finding of
             196      violation in an adjudicative proceeding, may be assessed a fine pursuant to this Subsection (5)
             197      of up to $10,000 per single violation or up to $2,000 per day of ongoing violation, whichever is
             198      greater, in accordance with a fine schedule established by rule, and may, in addition to or in
             199      lieu of, be ordered to cease and desist from violating the provisions of Section 58-17b-501 [,] or
             200      58-17b-502 , [or] Chapter 37, Utah Controlled Substances Act, Chapter 1, Division of
             201      Occupational and Professional Licensing Act, or any rule or order issued with respect to these
             202      provisions.
             203          (c) Except for an administrative fine and a cease and desist order, the licensure
             204      sanctions cited in Section 58-17b-401 may not be assessed through a citation.
             205          (d) Each citation shall be in writing and specifically describe with particularity the
             206      nature of the violation, including a reference to the provision of the chapter, rule, or order
             207      alleged to have been violated. The citation shall clearly state that the recipient must notify the
             208      division in writing within 20 calendar days of service of the citation [if the recipient wishes] in
             209      order to contest the citation at a hearing conducted under Title 63, Chapter 46b, Administrative
             210      Procedures Act. The citation shall clearly explain the consequences of failure to timely contest
             211      the citation or to make payment of any fines assessed by the citation within the time specified
             212      in the citation.
             213          (e) Each citation issued under this section, or a copy of each citation, may be served


             214      upon any person upon whom a summons may be served:
             215          (i) in accordance with the Utah Rules of Civil Procedure;
             216          (ii) personally or upon the person's agent by a division investigator or by any person
             217      specially designated by the director; or
             218          (iii) by mail.
             219          (f) If within 20 calendar days from the service of a citation, the person to whom the
             220      citation was issued fails to request a hearing to contest the citation, the citation becomes the
             221      final order of the division and is not subject to further agency review. The period to contest the
             222      citation may be extended by the division for cause.
             223          (g) The division may refuse to issue or renew, suspend, revoke, or place on probation
             224      the license of a licensee who fails to comply with the citation after it becomes final.
             225          (h) The failure of an applicant for licensure to comply with a citation after it becomes
             226      final is a ground for denial of license.
             227          (i) No citation may be issued under this section after the expiration of six months
             228      following the occurrence of any violation.
             229          Section 6. Section 58-17b-602 is amended to read:
             230           58-17b-602. Prescription orders -- Information required -- Alteration -- Labels --
             231      Signatures -- Dispensing in pharmacies.
             232          (1) The minimum information that shall be included in a prescription order, and that
             233      may be defined by rule, is:
             234          (a) the prescriber's name, address, and telephone number, and, if the order is for a
             235      controlled substance, the patient's age and the prescriber's DEA number;
             236          (b) the patient's name and address or, in the case of an animal, the name of the owner
             237      and species of the animal;
             238          (c) the date of issuance;
             239          (d) the name of the medication or device prescribed and dispensing instructions, if
             240      necessary;
             241          (e) the directions, if appropriate, for the use of the prescription[, if appropriate, for] by
             242      the patient or animal[,] and any refill, special labeling, [and] or other instructions;
             243          (f) the prescriber's signature if the prescription order is written;
             244          (g) if the order is an electronically transmitted prescription order, the prescribing


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


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


             307          (a) a permanent closure of the pharmacy facility;
             308          (b) a change of name or ownership of the pharmacy facility;
             309          (c) a change of location of the pharmacy facility;
             310          (d) a sale or transfer of any controlled substance as a result of the permanent closing or
             311      change of ownership of the pharmacy facility;
             312          (e) any matter or occurrence that the board requires by rule to be reported;
             313          (f) a final administrative[,] disciplinary order against the pharmacy license holder by
             314      the regulatory or licensing agency of the state in which the pharmacy is located if the pharmacy
             315      is a class D pharmacy; or
             316          (g) a final order against a pharmacist who is designated as the pharmacist-in-charge of
             317      the pharmacy by the regulatory or licensing agency of the state in which the pharmacy is
             318      located if the pharmacy is a class D pharmacy.
             319          (2) A pharmacy shall report in writing to the division a disaster, accident, or emergency
             320      that may [effect] affect the purity[,] or labeling of a drug, medication, device, or other material
             321      used in the diagnosis or treatment of injury, illness, or disease immediately [on] upon the
             322      occurrence of the disaster, accident, or emergency as defined by rule. [The]
             323          (3) A reporting pharmacy shall maintain a copy of any notification required by this
             324      section for two years and make a copy available for inspection.




Legislative Review Note
    as of 1-19-07 5:05 PM


Office of Legislative Research and General Counsel


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