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H.B. 165

This document includes House Committee Amendments incorporated into the bill on Fri, Mar 2, 2012 at 11:59 AM by lerror. -->              1     

PHARMACY PATIENT COUNSELING AMENDMENTS

             2     
2012 GENERAL SESSION

             3     
STATE OF UTAH

             4     
Chief Sponsor: Marie H. Poulson

             5     
Senate Sponsor: ____________

             6     
             7      LONG TITLE
             8      General Description:
             9          This bill amends the Pharmacy Practice Act.
             10      Highlighted Provisions:
             11          This bill:
             12          .    amends definitions;
             13          .    amends patient counseling provisions; H. [ and ]
             13a          . requires rulemaking; and .H
             14          .    makes technical changes.
             15      Money Appropriated in this Bill:
             16          None
             17      Other Special Clauses:
             18          None
             19      Utah Code Sections Affected:
             20      AMENDS:
             21          58-17b-102, as last amended by Laws of Utah 2010, Chapter 101
             21a           H. 58-17b-309, as last amended by Laws of Utah 2011, Chapter 76 .H
             22          58-17b-613, as enacted by Laws of Utah 2004, Chapter 280
             23     
             24      Be it enacted by the Legislature of the state of Utah:
             25          Section 1. Section 58-17b-102 is amended to read:
             26           58-17b-102. Definitions.
             27          In addition to the definitions in Section 58-1-102 , as used in this chapter:


             28          (1) "Administering" means:
             29          (a) the direct application of a prescription drug or device, whether by injection,
             30      inhalation, ingestion, or by any other means, to the body of a human patient or research subject
             31      by another person; or
             32          (b) the placement by a veterinarian with the owner or caretaker of an animal or group
             33      of animals of a prescription drug for the purpose of injection, inhalation, ingestion, or any other
             34      means directed to the body of the animal by the owner or caretaker in accordance with written
             35      or verbal directions of the veterinarian.
             36          (2) "Adulterated drug or device" means a drug or device considered adulterated under
             37      21 U.S.C.S. Sec. 351 (2003).
             38          (3) (a) "Analytical laboratory" means a facility in possession of prescription drugs for
             39      the purpose of analysis.
             40          (b) "Analytical laboratory" does not include a laboratory possessing prescription drugs
             41      used as standards and controls in performing drug monitoring or drug screening analysis if the
             42      prescription drugs are prediluted in a human or animal body fluid, human or animal body fluid
             43      components, organic solvents, or inorganic buffers at a concentration not exceeding one
             44      milligram per milliliter when labeled or otherwise designated as being for in vitro diagnostic
             45      use.
             46          (4) "Animal euthanasia agency" means an agency performing euthanasia on animals by
             47      the use of prescription drugs.
             48          (5) "Automated pharmacy systems" includes mechanical systems which perform
             49      operations or activities, other than compounding or administration, relative to the storage,
             50      packaging, dispensing, or distribution of medications, and which collect, control, and maintain
             51      all transaction information.
             52          (6) "Beyond use date" means the date determined by a pharmacist and placed on a
             53      prescription label at the time of dispensing that indicates to the patient or caregiver a time
             54      beyond which the contents of the prescription are not recommended to be used.
             55          (7) "Branch pharmacy" means a pharmacy or other facility in a rural or medically
             56      underserved area, used for the storage and dispensing of prescription drugs, which is dependent
             57      upon, stocked by, and supervised by a pharmacist in another licensed pharmacy designated and
             58      approved by the division as the parent pharmacy.


             59          (8) "Board of pharmacy" or "board" means the Utah State Board of Pharmacy created
             60      in Section 58-17b-201 .
             61          (9) "Centralized prescription processing" means the processing by a pharmacy of a
             62      request from another pharmacy to fill or refill a prescription drug order or to perform
             63      processing functions such as dispensing, drug utilization review, claims adjudication, refill
             64      authorizations, and therapeutic interventions.
             65          (10) "Class A pharmacy" means a pharmacy located in Utah that is authorized as a
             66      retail pharmacy to compound or dispense a drug or dispense a device to the public under a
             67      prescription order.
             68          (11) "Class B pharmacy":
             69          (a) means a pharmacy located in Utah:
             70          (i) that is authorized to provide pharmaceutical care for patients in an institutional
             71      setting; and
             72          (ii) whose primary purpose is to provide a physical environment for patients to obtain
             73      health care services; and
             74          (b) (i) includes closed-door, hospital, clinic, nuclear, and branch pharmacies; and
             75          (ii) pharmaceutical administration and sterile product preparation facilities.
             76          (12) "Class C pharmacy" means a pharmacy located in Utah that is authorized to
             77      engage in the manufacture, production, wholesale, or distribution of drugs or devices.
             78          (13) "Class D pharmacy" means a nonresident pharmacy.
             79          (14) "Class E pharmacy" means all other pharmacies.
             80          (15) "Closed-door pharmacy" means a pharmacy that provides pharmaceutical care to a
             81      defined and exclusive group of patients who have access to the services of the pharmacy
             82      because they are treated by or have an affiliation with a specific entity, including a health
             83      maintenance organization or an infusion company, but not including a hospital pharmacy, a
             84      retailer of goods to the general public, or the office of a practitioner.
             85          (16) "Collaborative pharmacy practice" means a practice of pharmacy whereby one or
             86      more pharmacists have jointly agreed, on a voluntary basis, to work in conjunction with one or
             87      more practitioners under protocol whereby the pharmacist may perform certain pharmaceutical
             88      care functions authorized by the practitioner or practitioners under certain specified conditions
             89      or limitations.


             90          (17) "Collaborative pharmacy practice agreement" means a written and signed
             91      agreement between one or more pharmacists and one or more practitioners that provides for
             92      collaborative pharmacy practice for the purpose of drug therapy management of patients and
             93      prevention of disease of human subjects.
             94          (18) (a) "Compounding" means the preparation, mixing, assembling, packaging, or
             95      labeling of a limited quantity drug, sterile product, or device:
             96          (i) as the result of a practitioner's prescription order or initiative based on the
             97      practitioner, patient, or pharmacist relationship in the course of professional practice;
             98          (ii) for the purpose of, or as an incident to, research, teaching, or chemical analysis and
             99      not for sale or dispensing; or
             100          (iii) in anticipation of prescription drug orders based on routine, regularly observed
             101      prescribing patterns.
             102          (b) "Compounding" does not include:
             103          (i) the preparation of prescription drugs by a pharmacist or pharmacy intern for sale to
             104      another pharmacist or pharmaceutical facility;
             105          (ii) the preparation by a pharmacist or pharmacy intern of any prescription drug in a
             106      dosage form which is regularly and commonly available from a manufacturer in quantities and
             107      strengths prescribed by a practitioner; or
             108          (iii) the preparation of a prescription drug, sterile product, or device which has been
             109      withdrawn from the market for safety reasons.
             110          (19) "Confidential information" has the same meaning as "protected health
             111      information" under the Standards for Privacy of Individually Identifiable Health Information,
             112      45 C.F.R. Parts 160 and 164.
             113          (20) "Controlled substance" has the same definition as in Section 58-37-2 .
             114          (21) "Dietary supplement" has the same meaning as Public Law Title 103, Chapter
             115      417, Sec. 3a(ff) which is incorporated by reference.
             116          (22) "Dispense" means the interpretation, evaluation, and implementation of a
             117      prescription drug order or device or nonprescription drug or device under a lawful order of a
             118      practitioner in a suitable container appropriately labeled for subsequent administration to or use
             119      by a patient, research subject, or an animal.
             120          (23) "Distribute" means to deliver a drug or device other than by administering or


             121      dispensing.
             122          (24) (a) "Drug" means:
             123          (i) a substance recognized in the official United States Pharmacopoeia, Official
             124      Homeopathic Pharmacopoeia of the United States, or Official National Formulary, or any
             125      supplement to any of them, intended for use in the diagnosis, cure, mitigation, treatment, or
             126      prevention of disease in humans or animals;
             127          (ii) a substance that is required by any applicable federal or state law or rule to be
             128      dispensed by prescription only or is restricted to administration by practitioners only;
             129          (iii) a substance other than food intended to affect the structure or any function of the
             130      body of humans or other animals; and
             131          (iv) substances intended for use as a component of any substance specified in
             132      Subsections (24)(a)(i), (ii), and (iii)[, and (iv)].
             133          (b) "Drug" does not include dietary supplements.
             134          (25) "Drug product equivalent" means a drug product that is designated as the
             135      therapeutic equivalent of another drug product in the Approved Drug Products with
             136      Therapeutic Equivalence Evaluations prepared by the Center for Drug Evaluation and Research
             137      of the Federal Food and Drug Administration.
             138          (26) "Drug regimen review" includes the following activities:
             139          (a) evaluation of the prescription drug order and patient record for:
             140          (i) known allergies;
             141          (ii) rational therapy-contraindications;
             142          (iii) reasonable dose and route of administration; and
             143          (iv) reasonable directions for use;
             144          (b) evaluation of the prescription drug order and patient record for duplication of
             145      therapy;
             146          (c) evaluation of the prescription drug order and patient record for the following
             147      interactions:
             148          (i) drug-drug;
             149          (ii) drug-food;
             150          (iii) drug-disease; and
             151          (iv) adverse drug reactions; and


             152          (d) evaluation of the prescription drug order and patient record for proper utilization,
             153      including over- or under-utilization, and optimum therapeutic outcomes.
             154          (27) "Drug sample" means a prescription drug packaged in small quantities consistent
             155      with limited dosage therapy of the particular drug, which is marked "sample", is not intended to
             156      be sold, and is intended to be provided to practitioners for the immediate needs of patients for
             157      trial purposes or to provide the drug to the patient until a prescription can be filled by the
             158      patient.
             159          (28) "Electronic signature" means a trusted, verifiable, and secure electronic sound,
             160      symbol, or process attached to or logically associated with a record and executed or adopted by
             161      a person with the intent to sign the record.
             162          (29) "Electronic transmission" means transmission of information in electronic form or
             163      the transmission of the exact visual image of a document by way of electronic equipment.
             164          (30) "Extern" means a college of pharmacy student enrolled in a college coordinated
             165      practical experience program in a health care setting under the supervision of a preceptor, as
             166      defined in this act, and approved by a college of pharmacy.
             167          (31) "Hospital pharmacy" means a pharmacy providing pharmaceutical care to
             168      inpatients of a general acute hospital or specialty hospital licensed by the Department of Health
             169      under Title 26, Chapter 21, Health Care Facility Licensing and Inspection Act.
             170          (32) "Legend drug" has the same meaning as prescription drug.
             171          (33) "Licensed pharmacy technician" means an individual licensed with the division,
             172      that may, under the supervision of a pharmacist, perform the activities involved in the
             173      technician practice of pharmacy.
             174          (34) "Manufacturer" means a person or business physically located in Utah licensed to
             175      be engaged in the manufacturing of drugs or devices.
             176          (35) (a) "Manufacturing" means:
             177          (i) the production, preparation, propagation, conversion, or processing of a drug or
             178      device, either directly or indirectly, by extraction from substances of natural origin or
             179      independently by means of chemical or biological synthesis, or by a combination of extraction
             180      and chemical synthesis, and includes any packaging or repackaging of the substance or labeling
             181      or relabeling of its container; and
             182          (ii) the promotion and marketing of such drugs or devices.


             183          (b) "Manufacturing" includes the preparation and promotion of commercially available
             184      products from bulk compounds for resale by pharmacies, practitioners, or other persons.
             185          (c) "Manufacturing" does not include the preparation or compounding of a drug by a
             186      pharmacist, pharmacy intern, or practitioner for that individual's own use or the preparation,
             187      compounding, packaging, labeling of a drug, or incident to research, teaching, or chemical
             188      analysis.
             189          (36) "Medical order" means a lawful order of a practitioner which may include a
             190      prescription drug order.
             191          (37) "Medication profile" or "profile" means a record system maintained as to drugs or
             192      devices prescribed for a pharmacy patient to enable a pharmacist or pharmacy intern to analyze
             193      the profile to provide pharmaceutical care.
             194          (38) "Misbranded drug or device" means a drug or device considered misbranded under
             195      21 U.S.C.S. Sec. 352 (2003).
             196          (39) (a) "Nonprescription drug" means a drug which:
             197          (i) may be sold without a prescription; and
             198          (ii) is labeled for use by the consumer in accordance with federal law.
             199          (b) "Nonprescription drug" includes homeopathic remedies.
             200          (40) "Nonresident pharmacy" means a pharmacy located outside of Utah that sells to a
             201      person in Utah.
             202          (41) "Nuclear pharmacy" means a pharmacy providing radio-pharmaceutical service.
             203          (42) "Out-of-state mail service pharmacy" means a pharmaceutical facility located
             204      outside the state that is licensed and in good standing in another state, that:
             205          (a) ships, mails, or delivers by any lawful means a dispensed legend drug to a patient in
             206      this state pursuant to a lawfully issued prescription;
             207          (b) provides information to a patient in this state on drugs or devices which may
             208      include, but is not limited to, advice relating to therapeutic values, potential hazards, and uses;
             209      or
             210          (c) counsels pharmacy patients residing in this state concerning adverse and therapeutic
             211      effects of drugs.
             212          (43) "Patient counseling" means [the] written [and] or oral communication by [the] a
             213      pharmacist H. [ or ] , .H pharmacy intern [of information, to the] H. , or other person with
             213a      dispensing authority .H with a patient [or caregiver, in order], or


             214      a patient's agent, to ensure the proper use of [drugs, devices, and dietary supplements] a drug,
             215      device, or dietary supplement.
             216          (44) "Pharmaceutical administration facility" means a facility, agency, or institution in
             217      which:
             218          (a) prescription drugs or devices are held, stored, or are otherwise under the control of
             219      the facility or agency for administration to patients of that facility or agency;
             220          (b) prescription drugs are dispensed to the facility or agency by a licensed pharmacist
             221      or pharmacy intern with whom the facility has established a prescription drug supervising
             222      relationship under which the pharmacist or pharmacy intern provides counseling to the facility
             223      or agency staff as required, and oversees drug control, accounting, and destruction; and
             224          (c) prescription drugs are professionally administered in accordance with the order of a
             225      practitioner by an employee or agent of the facility or agency.
             226          (45) (a) "Pharmaceutical care" means carrying out the following in collaboration with a
             227      prescribing practitioner, and in accordance with division rule:
             228          (i) designing, implementing, and monitoring a therapeutic drug plan intended to
             229      achieve favorable outcomes related to a specific patient for the purpose of curing or preventing
             230      the patient's disease;
             231          (ii) eliminating or reducing a patient's symptoms; or
             232          (iii) arresting or slowing a disease process.
             233          (b) "Pharmaceutical care" does not include prescribing of drugs without consent of a
             234      prescribing practitioner.
             235          (46) "Pharmaceutical facility" means a business engaged in the dispensing, delivering,
             236      distributing, manufacturing, or wholesaling of prescription drugs or devices within or into this
             237      state.
             238          (47) (a) "Pharmaceutical wholesaler or distributor" means a pharmaceutical facility
             239      engaged in the business of wholesale vending or selling of any prescription drug or device to
             240      other than the consumer or user of the prescription drug or device, which the pharmaceutical
             241      facility has not produced, manufactured, compounded, or dispensed.
             242          (b) "Pharmaceutical wholesaler or distributor" does not include a pharmaceutical
             243      facility carrying out the following business activities:
             244          (i) intracompany sales;


             245          (ii) the sale, purchase, or trade of a prescription drug or device, or offer to sell,
             246      purchase or trade a prescription drug or device between hospitals or other health care facilities
             247      that are under common ownership or control of the management and operation of the facilities;
             248          (iii) the sale, purchase, or trade of a prescription drug or device, or offer to sell,
             249      purchase, or trade a prescription drug or device for emergency medical reasons, or to supply
             250      another pharmaceutical facility to alleviate a temporary shortage; or
             251          (iv) the distribution of a prescription drug or device as a sample by representatives of a
             252      manufacturer.
             253          (48) "Pharmacist" means an individual licensed by this state to engage in the practice
             254      of pharmacy.
             255          (49) "Pharmacist-in-charge" means a pharmacist currently licensed in good standing
             256      who accepts responsibility for the operation of a pharmacy in conformance with all laws and
             257      rules pertinent to the practice of pharmacy and the distribution of drugs, and who is personally
             258      in full and actual charge of the pharmacy and all personnel.
             259          (50) "Pharmacist preceptor" means a licensed pharmacist in good standing with two or
             260      more years of licensed experience. The preceptor serves as a teacher, example of professional
             261      conduct, and supervisor of interns in the professional practice of pharmacy.
             262          (51) "Pharmacy" means any place where:
             263          (a) drugs are dispensed;
             264          (b) pharmaceutical care is provided;
             265          (c) drugs are processed or handled for eventual use by a patient; or
             266          (d) drugs are used for the purpose of analysis or research.
             267          (52) "Pharmacy benefits manager or coordinator" means a person or entity that
             268      administers the prescription drug or device portion of a health insurance plan on behalf of a
             269      self-insured employer, insurance company, health maintenance organization, or other plan
             270      sponsor, as defined by rule.
             271          (53) "Pharmacy intern" means an individual licensed by this state to engage in practice
             272      as a pharmacy intern.
             273          (54) "Pharmacy technician training program" means an approved technician training
             274      program providing education for pharmacy technicians.
             275          (55) (a) "Practice as a licensed pharmacy technician" means engaging in practice as a


             276      pharmacy technician under the general supervision of a licensed pharmacist and in accordance
             277      with a scope of practice defined by division rule made in collaboration with the board.
             278          (b) "Practice as a licensed pharmacy technician" does not include:
             279          (i) performing a drug utilization review, prescription drug order clarification from a
             280      prescriber, final review of the prescription and prescribed drug prepared for dispensing,
             281      dispensing of the drug, or counseling a patient with respect to a prescription drug;
             282          (ii) counseling regarding nonprescription drugs and dietary supplements unless
             283      delegated by the supervising pharmacist; or
             284          (iii) receiving new prescription drug orders when communicating telephonically or
             285      electronically unless the original information is recorded so the pharmacist may review the
             286      prescription drug order as transmitted.
             287          (56) "Practice of pharmacy" includes the following:
             288          (a) providing pharmaceutical care;
             289          (b) collaborative pharmacy practice in accordance with a collaborative pharmacy
             290      practice agreement;
             291          (c) compounding, packaging, labeling, dispensing, administering, and the coincident
             292      distribution of prescription drugs or devices, provided that the administration of a prescription
             293      drug or device is:
             294          (i) pursuant to a lawful order of a practitioner when one is required by law; and
             295          (ii) in accordance with written guidelines or protocols:
             296          (A) established by the licensed facility in which the prescription drug or device is to be
             297      administered on an inpatient basis; or
             298          (B) approved by the division, in collaboration with the board and the Physicians
             299      Licensing Board, created in Section 58-67-201 , if the prescription drug or device is to be
             300      administered on an outpatient basis solely by a licensed pharmacist;
             301          (d) participating in drug utilization review;
             302          (e) ensuring proper and safe storage of drugs and devices;
             303          (f) maintaining records of drugs and devices in accordance with state and federal law
             304      and the standards and ethics of the profession;
             305          (g) providing information on drugs or devices, which may include advice relating to
             306      therapeutic values, potential hazards, and uses;


             307          (h) providing drug product equivalents;
             308          (i) supervising pharmacist's supportive personnel, pharmacy interns, and pharmacy
             309      technicians;
             310          (j) providing patient counseling, including adverse and therapeutic effects of drugs;
             311          (k) providing emergency refills as defined by rule;
             312          (l) telepharmacy; and
             313          (m) formulary management intervention.
             314          (57) "Practice of telepharmacy" means the practice of pharmacy through the use of
             315      telecommunications and information technologies.
             316          (58) "Practice of telepharmacy across state lines" means the practice of pharmacy
             317      through the use of telecommunications and information technologies that occurs when the
             318      patient is physically located within one jurisdiction and the pharmacist is located in another
             319      jurisdiction.
             320          (59) "Practitioner" means an individual currently licensed, registered, or otherwise
             321      authorized by the appropriate jurisdiction to prescribe and administer drugs in the course of
             322      professional practice.
             323          (60) "Prescribe" means to issue a prescription:
             324          (a) orally or in writing; or
             325          (b) by telephone, facsimile transmission, computer, or other electronic means of
             326      communication as defined by division rule.
             327          (61) "Prescription" means an order issued:
             328          (a) by a licensed practitioner in the course of that practitioner's professional practice or
             329      by collaborative pharmacy practice agreement; and
             330          (b) for a controlled substance or other prescription drug or device for use by a patient
             331      or an animal.
             332          (62) "Prescription device" means an instrument, apparatus, implement, machine,
             333      contrivance, implant, in vitro reagent, or other similar or related article, and any component
             334      part or accessory, which is required under federal or state law to be prescribed by a practitioner
             335      and dispensed by or through a person or entity licensed under this chapter or exempt from
             336      licensure under this chapter.
             337          (63) "Prescription drug" means a drug that is required by federal or state law or rule to


             338      be dispensed only by prescription or is restricted to administration only by practitioners.
             339          (64) "Retail pharmacy" means a pharmaceutical facility dispensing prescription drugs
             340      and devices to the general public.
             341          (65) "Self-audit" means an internal evaluation of a pharmacy to determine compliance
             342      with this chapter.
             343          (66) "Supervising pharmacist" means a pharmacist who is overseeing the operation of
             344      the pharmacy during a given day or shift.
             345          (67) "Supportive personnel" means unlicensed individuals who:
             346          (a) may assist a pharmacist, pharmacist preceptor, pharmacy intern, or licensed
             347      pharmacy technician in nonjudgmental duties not included in the definition of the practice of
             348      pharmacy, practice of a pharmacy intern, or practice of a licensed pharmacy technician, and as
             349      those duties may be further defined by division rule adopted in collaboration with the board;
             350      and
             351          (b) are supervised by a pharmacist in accordance with rules adopted by the division in
             352      collaboration with the board.
             353          (68) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-17b-501 .
             354          (69) "Unprofessional conduct" is as defined in Sections 58-1-501 and 58-17b-502 and
             355      may be further defined by rule.
             356          (70) "Veterinary pharmaceutical facility" means a pharmaceutical facility that
             357      dispenses drugs intended for use by animals or for sale to veterinarians for the administration
             358      for animals.
             358a      H. Section 2. Section 58-17B-309 is amended to read:
             358b           58-17b-309.   Exemptions from licensure.
             358c          (1) For purposes of this section:
             358d          (a) "Cosmetic drug":
             358e          (i) means a prescription drug that is:
             358f          (A) for the purpose of promoting attractiveness or altering the appearance of an individual;
             358g      and
             358h          (B) listed as a cosmetic drug subject to the exemption under this section by the division by
             358i      administrative rule; and
             358j          (ii) does not include a prescription drug that is:
             358k          (A) a controlled substance;
             358l          (B) compounded by the physician; or
             358m          (C) prescribed or used for the patient for the purpose of diagnosing, curing, mitigating,
             358n      treating, or preventing a disease.
             358o          (b) "Injectable weight loss drug":
             358p           (i) means an injectable prescription drug:
             358q          (A) prescribed to promote weight loss; and .H


             358r          H.(B) listed as an injectable prescription drug subject to exemption under this section by the
             358s      division by administrative rule; and
             358t          (ii) does not include a prescription drug that is a controlled substance.
             358u          (c)    "Patient counseling":
             358v          (i)    is as defined in Section 58-17b-102; and
             358w          (ii)    is limited to in-person face-to-face oral communication or communication by video
             358x      conferencing over a secure data connection.
             358y           [ c ] (d) "Prescribing practitioner" means an individual licensed under:
             358z          (i) Chapter 31b, Nurse Practice Act, as an advanced practice registered nurse with
             358aa      prescriptive practice;
             358ab          (ii) Chapter 67, Utah Medical Practice Act;
             358ac          (iii) Chapter 68, Utah Osteopathic Medical Practice Act; or
             358ad          (iv) Chapter 70a, Physician Assistant Act.
             358ae          (2) In addition to the exemptions from licensure in Section 58-1-307, the following individuals
             358af      may engage in the acts or practices described in this section without being licensed under this chapter:
             358ag          (a) a person selling or providing contact lenses in accordance with Section 58-16a-801;
             358ah          (b) an individual engaging in the practice of pharmacy technician under the direct personal
             358ai      supervision of a pharmacist while making satisfactory progress in an approved program as defined in
             358aj      division rule;
             358ak          (c) a prescribing practitioner who prescribes and dispenses a cosmetic drug or an injectable
             358al      weight loss drug to the prescribing practitioner's patient in accordance with Subsection (4); and
             358am          (d) an optometrist, as defined in Section 58-16a-102, acting within the optometrist's scope of
             358an      practice as defined in Section 58-16a-601, who prescribes and dispenses a cosmetic drug to the
             358ao      optometrist's patient in accordance with Subsection (4).
             358ap          (3) In accordance with Subsection 58-1-303(1)(a), an individual exempt under Subsection
             358aq      (2)(b) must take all examinations as required by division rule following completion of an approved
             358ar      curriculum of education, within the required time frame. This exemption expires immediately upon
             358as      notification of a failing score of an examination, and the individual may not continue working as a
             358at      pharmacy technician even under direct supervision.
             358au          (4) A prescribing practitioner or optometrist is exempt from licensing under the provisions of
             358av      this part if the prescribing practitioner or optometrist:
             358aw          (a) (i) writes a prescription for a drug the prescribing practitioner or optometrist has the
             358ax      authority to dispense under Subsection (4)(b); and
             358ay          (ii) informs the patient:
             358az          (A) that the prescription may be filled at a pharmacy or dispensed in the prescribing
             358ba      practitioner's or optometrist's office;
             358bb           (B) of the directions for appropriate use of the drug;
             358bc          (C) of potential side-effects to the use of the drug; and
             358bd          (D) how to contact the prescribing practitioner or optometrist if the patient has questions or
             358be      concerns regarding the drug; .H


             358bf          H. (b) dispenses a cosmetic drug or injectable weight loss drug only to the prescribing
             358bg      practitioner's patients or for an optometrist, dispenses a cosmetic drug only to the optometrist's
             358bh      patients; and
             358bi          (c) follows labeling, record keeping, patient counseling, and storage requirements established
             358bj      by administrative rule adopted by the division in consultation with the boards listed in Subsection
             358bk      (5)(a).
             358bl          (5) (a) The division, in consultation with the board under this chapter, the Physician Licensing
             358bm      Board, the Osteopathic Physician Licensing Board, the Physician Assistant Licensing Board, the Board
             358bn      of Nursing, and the Optometrist Licensing Board shall adopt administrative rules pursuant to Title
             358bo      63G, Chapter 3, Utah Administrative Rulemaking Act to designate:
             358bp          (i) the prescription drugs that may be dispensed as a cosmetic drug or weight loss drug under
             358bq      this section; and
             358br          (ii) the requirements under Subsection (4)(c).
             358bs          (b) When making a determination under Subsection (1)(a), the division and boards listed in
             358bt      Subsection (5)(a), may consider any federal Food and Drug Administration indications or approval
             358bu      associated with a drug when adopting a rule to designate a prescription drug that may be dispensed
             358bv      under this section.
             358bw          (c) The division may inspect the office of a prescribing practitioner or optometrist who is
             358bx      dispensing under the provisions of this section, in order to determine whether the prescribing
             358by      practitioner or optometrist is in compliance with the provisions of this section. If a prescribing
             358bz      practitioner or optometrist chooses to dispense under the provisions of this section, the prescribing
             358ca      practitioner or optometrist consents to the jurisdiction of the division to inspect the prescribing
             358cb      practitioner's or optometrist's office and determine if the provisions of this section are being met by
             358cc      the prescribing practitioner and optometrist.
             358cd          (d) If a prescribing practitioner or optometrist violates a provision of this section, the
             358ce      prescribing practitioner or optometrist may be subject to discipline under:
             358cf          (i) this chapter; and
             358cg          (ii) (A) Chapter 16a, Utah Optometry Practice Act;
             358ch          (B) Chapter 31b, Nurse Practice Act;
             358ci          (C) Chapter 67, Utah Medical Practice Act;
             358cj          (D) Chapter 68, Utah Osteopathic Medical Practice Act; or
             358ck          (E) Chapter 70a, Physician Assistant Act.
             358cl          (6) Except as provided in Subsection (2)(d), this section does not restrict or limit the scope of
             358cm      practice of an optometrist or optometric physician licensed under Chapter 16a, Utah Optometry
             358cn      Practice Act. .H
             359          Section H. [ 2 ] 3 .H . Section 58-17b-613 is amended to read:
             360           58-17b-613. Patient counseling.
             361          (1) [Every] A class A pharmacy [facility] shall [orally offer to counsel a patient or a
             362      patient's agent in a personal] provide oral patient counseling by in-person face-to-face


             363      [discussion with respect to] communication, or by video conferencing over a secure data
             364      connection, for each prescription drug [dispensed] it dispenses, if the patient or patient's agent[:
             365      (a) delivers the prescription in person to the pharmacist or pharmacy intern; or (b)] receives the
             366      drug [in person] at the pharmacy at the time it is dispensed [at the pharmacy facility].
             367          [(2) A pharmacist or pharmacy intern shall provide counseling to each patient, and
             368      shall provide the patient with a toll-free telephone number by which the patient may contact a


             369      pharmacist at the dispensing pharmacy during normal business hours and receive oral
             370      counseling, with respect to each prescription drug dispensed if the patient provides or the
             371      prescription is otherwise provided to the pharmacy facility by a means other than personal
             372      delivery, and the dispensed prescription drug is mailed or otherwise delivered to the patient
             373      outside of the pharmacy facility.]
             374          (2) A class D pharmacy shall provide oral patient counseling by telephone, or by video
             375      conferencing over a secure data connection, for each prescription drug it dispenses to a patient
             376      in this state.
             377          (3) (a) [The provisions of Subsections (1) and (2) do not apply to] If a class A
             378      pharmacy or a class D pharmacy dispenses a prescription drug for a patient who is incarcerated
             379      [patients or persons] H. [ or otherwise under the jurisdiction of ] by .H the Utah Department of
             379a      Corrections
             380      or a county detention facility[. (b) A] in this state, the pharmacy shall provide patient
             381      counseling for the prescription by written H. or oral .H communication
             381a      [with a person described in
             382      Subsection (3)(a) shall be used by a pharmacist or pharmacy intern] H. [ in lieu of ] .H [a face to
             382a      face or
             383      telephonic communication for the purpose of counseling the patient] H. [ the oral communication
             384      required under Subsection (1) or (2)
] .H
.
             384a      H. (4)This section shall be implemented in accordance with rules made by the division in
             384b      consultation with the Board of pharmacy and in accordance with Title 63G, Chapter 3, Utah
             384c      Administrative Rulemaking Act. .H




Legislative Review Note
    as of 2-7-12 11:21 AM


Office of Legislative Research and General Counsel


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