1     
PHARMACY PRACTICE MODIFICATIONS

2     
2021 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Norman K. Thurston

5     
Senate Sponsor: Curtis S. Bramble

6     

7     LONG TITLE
8     General Description:
9          This bill amends the Pharmacy Practice Act.
10     Highlighted Provisions:
11          This bill:
12          ▸     amends the definition of the practice of pharmacy to include issuing a prescription
13     for certain prescription drugs and devices;
14          ▸     defines the types of prescription drugs and devices that may be prescribed by a
15     pharmacist; and
16          ▸     authorizes the Division of Occupational and Professional Licensing to make rules to
17     implement the provisions of this bill.
18     Money Appropriated in this Bill:
19          None
20     Other Special Clauses:
21          None
22     Utah Code Sections Affected:
23     AMENDS:
24          58-17b-102, as last amended by Laws of Utah 2019, Chapter 343
25     ENACTS:
26          58-17b-627, Utah Code Annotated 1953
27     

28     Be it enacted by the Legislature of the state of Utah:
29          Section 1. Section 58-17b-102 is amended to read:

30          58-17b-102. Definitions.
31          In addition to the definitions in Section 58-1-102, as used in this chapter:
32          (1) "Administering" means:
33          (a) the direct application of a prescription drug or device, whether by injection,
34     inhalation, ingestion, or by any other means, to the body of a human patient or research subject
35     by another person; or
36          (b) the placement by a veterinarian with the owner or caretaker of an animal or group
37     of animals of a prescription drug for the purpose of injection, inhalation, ingestion, or any other
38     means directed to the body of the animal by the owner or caretaker in accordance with written
39     or verbal directions of the veterinarian.
40          (2) "Adulterated drug or device" means a drug or device considered adulterated under
41     21 U.S.C. Sec. 351 (2003).
42          (3) (a) "Analytical laboratory" means a facility in possession of prescription drugs for
43     the purpose of analysis.
44          (b) "Analytical laboratory" does not include a laboratory possessing prescription drugs
45     used as standards and controls in performing drug monitoring or drug screening analysis if the
46     prescription drugs are prediluted in a human or animal body fluid, human or animal body fluid
47     components, organic solvents, or inorganic buffers at a concentration not exceeding one
48     milligram per milliliter when labeled or otherwise designated as being for in vitro diagnostic
49     use.
50          (4) "Animal euthanasia agency" means an agency performing euthanasia on animals by
51     the use of prescription drugs.
52          (5) "Automated pharmacy systems" includes mechanical systems which perform
53     operations or activities, other than compounding or administration, relative to the storage,
54     packaging, dispensing, or distribution of medications, and which collect, control, and maintain
55     all transaction information.
56          (6) "Beyond use date" means the date determined by a pharmacist and placed on a
57     prescription label at the time of dispensing that indicates to the patient or caregiver a time

58     beyond which the contents of the prescription are not recommended to be used.
59          (7) "Board of pharmacy" or "board" means the Utah State Board of Pharmacy created
60     in Section 58-17b-201.
61          (8) "Branch pharmacy" means a pharmacy or other facility in a rural or medically
62     underserved area, used for the storage and dispensing of prescription drugs, which is dependent
63     upon, stocked by, and supervised by a pharmacist in another licensed pharmacy designated and
64     approved by the division as the parent pharmacy.
65          (9) "Centralized prescription processing" means the processing by a pharmacy of a
66     request from another pharmacy to fill or refill a prescription drug order or to perform
67     processing functions such as dispensing, drug utilization review, claims adjudication, refill
68     authorizations, and therapeutic interventions.
69          (10) "Class A pharmacy" means a pharmacy located in Utah that is authorized as a
70     retail pharmacy to compound or dispense a drug or dispense a device to the public under a
71     prescription order.
72          (11) "Class B pharmacy":
73          (a) means a pharmacy located in Utah:
74          (i) that is authorized to provide pharmaceutical care for patients in an institutional
75     setting; and
76          (ii) whose primary purpose is to provide a physical environment for patients to obtain
77     health care services; and
78          (b) (i) includes closed-door, hospital, clinic, nuclear, and branch pharmacies; and
79          (ii) pharmaceutical administration and sterile product preparation facilities.
80          (12) "Class C pharmacy" means a pharmacy that engages in the manufacture,
81     production, wholesale, or distribution of drugs or devices in Utah.
82          (13) "Class D pharmacy" means a nonresident pharmacy.
83          (14) "Class E pharmacy" means all other pharmacies.
84          (15) (a) "Closed-door pharmacy" means a pharmacy that:
85          (i) provides pharmaceutical care to a defined and exclusive group of patients who have

86     access to the services of the pharmacy because they are treated by or have an affiliation with a
87     specific entity, including a health maintenance organization or an infusion company; or
88          (ii) engages exclusively in the practice of telepharmacy and does not serve walk-in
89     retail customers.
90          (b) "Closed-door pharmacy" does not include a hospital pharmacy, a retailer of goods
91     to the general public, or the office of a practitioner.
92          (16) "Collaborative pharmacy practice" means a practice of pharmacy whereby one or
93     more pharmacists have jointly agreed, on a voluntary basis, to work in conjunction with one or
94     more practitioners under protocol whereby the pharmacist may perform certain pharmaceutical
95     care functions authorized by the practitioner or practitioners under certain specified conditions
96     or limitations.
97          (17) "Collaborative pharmacy practice agreement" means a written and signed
98     agreement between one or more pharmacists and one or more practitioners that provides for
99     collaborative pharmacy practice for the purpose of drug therapy management of patients and
100     prevention of disease of human subjects.
101          (18) (a) "Compounding" means the preparation, mixing, assembling, packaging, or
102     labeling of a limited quantity drug, sterile product, or device:
103          (i) as the result of a practitioner's prescription order or initiative based on the
104     practitioner, patient, or pharmacist relationship in the course of professional practice;
105          (ii) for the purpose of, or as an incident to, research, teaching, or chemical analysis and
106     not for sale or dispensing; or
107          (iii) in anticipation of prescription drug orders based on routine, regularly observed
108     prescribing patterns.
109          (b) "Compounding" does not include:
110          (i) the preparation of prescription drugs by a pharmacist or pharmacy intern for sale to
111     another pharmacist or pharmaceutical facility;
112          (ii) the preparation by a pharmacist or pharmacy intern of any prescription drug in a
113     dosage form which is regularly and commonly available from a manufacturer in quantities and

114     strengths prescribed by a practitioner; or
115          (iii) the preparation of a prescription drug, sterile product, or device which has been
116     withdrawn from the market for safety reasons.
117          (19) "Confidential information" has the same meaning as "protected health
118     information" under the Standards for Privacy of Individually Identifiable Health Information,
119     45 C.F.R. Parts 160 and 164.
120          (20) "Controlled substance" means the same as that term is defined in Section 58-37-2.
121          (21) "Dietary supplement" has the same meaning as Public Law Title 103, Chapter
122     417, Sec. 3a(ff) which is incorporated by reference.
123          (22) "Dispense" means the interpretation, evaluation, and implementation of a
124     prescription drug order or device or nonprescription drug or device under a lawful order of a
125     practitioner in a suitable container appropriately labeled for subsequent administration to or use
126     by a patient, research subject, or an animal.
127          (23) "Dispensing medical practitioner" means an individual who is:
128          (a) currently licensed as:
129          (i) a physician and surgeon under Chapter 67, Utah Medical Practice Act;
130          (ii) an osteopathic physician and surgeon under Chapter 68, Utah Osteopathic Medical
131     Practice Act;
132          (iii) a physician assistant under Chapter 70a, Utah Physician Assistant Act;
133          (iv) a nurse practitioner under Chapter 31b, Nurse Practice Act; or
134          (v) an optometrist under Chapter 16a, Utah Optometry Practice Act, if the optometrist
135     is acting within the scope of practice for an optometrist; and
136          (b) licensed by the division under the Pharmacy Practice Act to engage in the practice
137     of a dispensing medical practitioner.
138          (24) "Dispensing medical practitioner clinic pharmacy" means a closed-door pharmacy
139     located within a licensed dispensing medical practitioner's place of practice.
140          (25) "Distribute" means to deliver a drug or device other than by administering or
141     dispensing.

142          (26) (a) "Drug" means:
143          (i) a substance recognized in the official United States Pharmacopoeia, official
144     Homeopathic Pharmacopoeia of the United States, or official National Formulary, or any
145     supplement to any of them, intended for use in the diagnosis, cure, mitigation, treatment, or
146     prevention of disease in humans or animals;
147          (ii) a substance that is required by any applicable federal or state law or rule to be
148     dispensed by prescription only or is restricted to administration by practitioners only;
149          (iii) a substance other than food intended to affect the structure or any function of the
150     body of humans or other animals; and
151          (iv) substances intended for use as a component of any substance specified in
152     Subsections (26)(a)(i), (ii), (iii), and (iv).
153          (b) "Drug" does not include dietary supplements.
154          (27) "Drug regimen review" includes the following activities:
155          (a) evaluation of the prescription drug order and patient record for:
156          (i) known allergies;
157          (ii) rational therapy-contraindications;
158          (iii) reasonable dose and route of administration; and
159          (iv) reasonable directions for use;
160          (b) evaluation of the prescription drug order and patient record for duplication of
161     therapy;
162          (c) evaluation of the prescription drug order and patient record for the following
163     interactions:
164          (i) drug-drug;
165          (ii) drug-food;
166          (iii) drug-disease; and
167          (iv) adverse drug reactions; and
168          (d) evaluation of the prescription drug order and patient record for proper utilization,
169     including over- or under-utilization, and optimum therapeutic outcomes.

170          (28) "Drug sample" means a prescription drug packaged in small quantities consistent
171     with limited dosage therapy of the particular drug, which is marked "sample", is not intended to
172     be sold, and is intended to be provided to practitioners for the immediate needs of patients for
173     trial purposes or to provide the drug to the patient until a prescription can be filled by the
174     patient.
175          (29) "Electronic signature" means a trusted, verifiable, and secure electronic sound,
176     symbol, or process attached to or logically associated with a record and executed or adopted by
177     a person with the intent to sign the record.
178          (30) "Electronic transmission" means transmission of information in electronic form or
179     the transmission of the exact visual image of a document by way of electronic equipment.
180          (31) "Hospital pharmacy" means a pharmacy providing pharmaceutical care to
181     inpatients of a general acute hospital or specialty hospital licensed by the Department of Health
182     under Title 26, Chapter 21, Health Care Facility Licensing and Inspection Act.
183          (32) "Legend drug" has the same meaning as prescription drug.
184          (33) "Licensed pharmacy technician" means an individual licensed with the division,
185     that may, under the supervision of a pharmacist, perform the activities involved in the
186     technician practice of pharmacy.
187          (34) "Manufacturer" means a person or business physically located in Utah licensed to
188     be engaged in the manufacturing of drugs or devices.
189          (35) (a) "Manufacturing" means:
190          (i) the production, preparation, propagation, conversion, or processing of a drug or
191     device, either directly or indirectly, by extraction from substances of natural origin or
192     independently by means of chemical or biological synthesis, or by a combination of extraction
193     and chemical synthesis, and includes any packaging or repackaging of the substance or labeling
194     or relabeling of its container; and
195          (ii) the promotion and marketing of such drugs or devices.
196          (b) "Manufacturing" includes the preparation and promotion of commercially available
197     products from bulk compounds for resale by pharmacies, practitioners, or other persons.

198          (c) "Manufacturing" does not include the preparation or compounding of a drug by a
199     pharmacist, pharmacy intern, or practitioner for that individual's own use or the preparation,
200     compounding, packaging, labeling of a drug, or incident to research, teaching, or chemical
201     analysis.
202          (36) "Medical order" means a lawful order of a practitioner which may include a
203     prescription drug order.
204          (37) "Medication profile" or "profile" means a record system maintained as to drugs or
205     devices prescribed for a pharmacy patient to enable a pharmacist or pharmacy intern to analyze
206     the profile to provide pharmaceutical care.
207          (38) "Misbranded drug or device" means a drug or device considered misbranded under
208     21 U.S.C. Sec. 352 (2003).
209          (39) (a) "Nonprescription drug" means a drug which:
210          (i) may be sold without a prescription; and
211          (ii) is labeled for use by the consumer in accordance with federal law.
212          (b) "Nonprescription drug" includes homeopathic remedies.
213          (40) "Nonresident pharmacy" means a pharmacy located outside of Utah that sells to a
214     person in Utah.
215          (41) "Nuclear pharmacy" means a pharmacy providing radio-pharmaceutical service.
216          (42) "Out-of-state mail service pharmacy" means a pharmaceutical facility located
217     outside the state that is licensed and in good standing in another state, that:
218          (a) ships, mails, or delivers by any lawful means a dispensed legend drug to a patient in
219     this state pursuant to a lawfully issued prescription;
220          (b) provides information to a patient in this state on drugs or devices which may
221     include, but is not limited to, advice relating to therapeutic values, potential hazards, and uses;
222     or
223          (c) counsels pharmacy patients residing in this state concerning adverse and therapeutic
224     effects of drugs.
225          (43) "Patient counseling" means the written and oral communication by the pharmacist

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

254          (b) "Pharmaceutical wholesaler or distributor" does not include a pharmaceutical
255     facility carrying out the following business activities:
256          (i) intracompany sales;
257          (ii) the sale, purchase, or trade of a prescription drug or device, or an offer to sell,
258     purchase, or trade a prescription drug or device, if the activity is carried out between one or
259     more of the following entities under common ownership or common administrative control, as
260     defined by division rule:
261          (A) hospitals;
262          (B) pharmacies;
263          (C) chain pharmacy warehouses, as defined by division rule; or
264          (D) other health care entities, as defined by division rule;
265          (iii) the sale, purchase, or trade of a prescription drug or device, or an offer to sell,
266     purchase, or trade a prescription drug or device, for emergency medical reasons, including
267     supplying another pharmaceutical facility with a limited quantity of a drug, if:
268          (A) the facility is unable to obtain the drug through a normal distribution channel in
269     sufficient time to eliminate the risk of harm to a patient that would result from a delay in
270     obtaining the drug; and
271          (B) the quantity of the drug does not exceed an amount reasonably required for
272     immediate dispensing to eliminate the risk of harm;
273          (iv) the distribution of a prescription drug or device as a sample by representatives of a
274     manufacturer; and
275          (v) the distribution of prescription drugs, if:
276          (A) the facility's total distribution-related sales of prescription drugs does not exceed
277     5% of the facility's total prescription drug sales; and
278          (B) the distribution otherwise complies with 21 C.F.R. Sec. 1307.11.
279          (48) "Pharmacist" means an individual licensed by this state to engage in the practice
280     of pharmacy.
281          (49) "Pharmacist-in-charge" means a pharmacist currently licensed in good standing

282     who accepts responsibility for the operation of a pharmacy in conformance with all laws and
283     rules pertinent to the practice of pharmacy and the distribution of drugs, and who is personally
284     in full and actual charge of the pharmacy and all personnel.
285          (50) "Pharmacist preceptor" means a licensed pharmacist in good standing with one or
286     more years of licensed experience. The preceptor serves as a teacher, example of professional
287     conduct, and supervisor of interns in the professional practice of pharmacy.
288          (51) "Pharmacy" means any place where:
289          (a) drugs are dispensed;
290          (b) pharmaceutical care is provided;
291          (c) drugs are processed or handled for eventual use by a patient; or
292          (d) drugs are used for the purpose of analysis or research.
293          (52) "Pharmacy benefits manager or coordinator" means a person or entity that
294     provides a pharmacy benefits management service as defined in Section 49-20-502 on behalf of
295     a self-insured employer, insurance company, health maintenance organization, or other plan
296     sponsor, as defined by rule.
297          (53) "Pharmacy intern" means an individual licensed by this state to engage in practice
298     as a pharmacy intern.
299          (54) "Pharmacy technician training program" means an approved technician training
300     program providing education for pharmacy technicians.
301          (55) (a) "Practice as a dispensing medical practitioner" means the practice of pharmacy,
302     specifically relating to the dispensing of a prescription drug in accordance with Part 8,
303     Dispensing Medical Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, and
304     division rule adopted after consultation with the Board of pharmacy and the governing boards
305     of the practitioners described in Subsection (23)(a).
306          (b) "Practice as a dispensing medical practitioner" does not include:
307          (i) using a vending type of dispenser as defined by the division by administrative rule;
308     or
309          (ii) except as permitted by Section 58-17b-805, dispensing of a controlled substance as

310     defined in Section 58-37-2.
311          (56) "Practice as a licensed pharmacy technician" means engaging in practice as a
312     pharmacy technician under the general supervision of a licensed pharmacist and in accordance
313     with a scope of practice defined by division rule made in collaboration with the board.
314          (57) "Practice of pharmacy" includes the following:
315          (a) providing pharmaceutical care;
316          (b) collaborative pharmacy practice in accordance with a collaborative pharmacy
317     practice agreement;
318          (c) compounding, packaging, labeling, dispensing, administering, and the coincident
319     distribution of prescription drugs or devices, provided that the administration of a prescription
320     drug or device is:
321          (i) pursuant to a lawful order of a practitioner when one is required by law; and
322          (ii) in accordance with written guidelines or protocols:
323          (A) established by the licensed facility in which the prescription drug or device is to be
324     administered on an inpatient basis; or
325          (B) approved by the division, in collaboration with the board and the Physicians
326     Licensing Board, created in Section 58-67-201, if the prescription drug or device is to be
327     administered on an outpatient basis solely by a licensed pharmacist;
328          (d) participating in drug utilization review;
329          (e) ensuring proper and safe storage of drugs and devices;
330          (f) maintaining records of drugs and devices in accordance with state and federal law
331     and the standards and ethics of the profession;
332          (g) providing information on drugs or devices, which may include advice relating to
333     therapeutic values, potential hazards, and uses;
334          (h) providing drug product equivalents;
335          (i) supervising pharmacist's supportive personnel, pharmacy interns, and pharmacy
336     technicians;
337          (j) providing patient counseling, including adverse and therapeutic effects of drugs;

338          (k) providing emergency refills as defined by rule;
339          (l) telepharmacy;
340          (m) formulary management intervention; [and]
341          (n) prescribing and dispensing a self-administered hormonal contraceptive in
342     accordance with Title 26, Chapter 64, Family Planning Access Act[.]; and
343          (o) issuing a prescription in accordance with Section 58-17b-627.
344          (58) "Practice of telepharmacy" means the practice of pharmacy through the use of
345     telecommunications and information technologies.
346          (59) "Practice of telepharmacy across state lines" means the practice of pharmacy
347     through the use of telecommunications and information technologies that occurs when the
348     patient is physically located within one jurisdiction and the pharmacist is located in another
349     jurisdiction.
350          (60) "Practitioner" means an individual currently licensed, registered, or otherwise
351     authorized by the appropriate jurisdiction to prescribe and administer drugs in the course of
352     professional practice.
353          (61) "Prescribe" means to issue a prescription:
354          (a) orally or in writing; or
355          (b) by telephone, facsimile transmission, computer, or other electronic means of
356     communication as defined by division rule.
357          (62) "Prescription" means an order issued:
358          (a) by a licensed practitioner in the course of that practitioner's professional practice or
359     by collaborative pharmacy practice agreement; and
360          (b) for a controlled substance or other prescription drug or device for use by a patient
361     or an animal.
362          (63) "Prescription device" means an instrument, apparatus, implement, machine,
363     contrivance, implant, in vitro reagent, or other similar or related article, and any component
364     part or accessory, which is required under federal or state law to be prescribed by a practitioner
365     and dispensed by or through a person or entity licensed under this chapter or exempt from

366     licensure under this chapter.
367          (64) "Prescription drug" means a drug that is required by federal or state law or rule to
368     be dispensed only by prescription or is restricted to administration only by practitioners.
369          (65) "Repackage":
370          (a) means changing the container, wrapper, or labeling to further the distribution of a
371     prescription drug; and
372          (b) does not include:
373          (i) Subsection (65)(a) when completed by the pharmacist responsible for dispensing the
374     product to a patient; or
375          (ii) changing or altering a label as necessary for a dispensing practitioner under Part 8,
376     Dispensing Medical Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, for
377     dispensing a product to a patient.
378          (66) "Research using pharmaceuticals" means research:
379          (a) conducted in a research facility, as defined by division rule, that is associated with a
380     university or college in the state accredited by the Northwest Commission on Colleges and
381     Universities;
382          (b) requiring the use of a controlled substance, prescription drug, or prescription
383     device;
384          (c) that uses the controlled substance, prescription drug, or prescription device in
385     accordance with standard research protocols and techniques, including, if required, those
386     approved by an institutional review committee; and
387          (d) that includes any documentation required for the conduct of the research and the
388     handling of the controlled substance, prescription drug, or prescription device.
389          (67) "Retail pharmacy" means a pharmaceutical facility dispensing prescription drugs
390     and devices to the general public.
391          (68) (a) "Self-administered hormonal contraceptive" means a self-administered
392     hormonal contraceptive that is approved by the United States Food and Drug Administration to
393     prevent pregnancy.

394          (b) "Self-administered hormonal contraceptive" includes an oral hormonal
395     contraceptive, a hormonal vaginal ring, and a hormonal contraceptive patch.
396          (c) "Self-administered hormonal contraceptive" does not include any drug intended to
397     induce an abortion, as that term is defined in Section 76-7-301.
398          (69) "Self-audit" means an internal evaluation of a pharmacy to determine compliance
399     with this chapter.
400          (70) "Supervising pharmacist" means a pharmacist who is overseeing the operation of
401     the pharmacy during a given day or shift.
402          (71) "Supportive personnel" means unlicensed individuals who:
403          (a) may assist a pharmacist, pharmacist preceptor, pharmacy intern, or licensed
404     pharmacy technician in nonjudgmental duties not included in the definition of the practice of
405     pharmacy, practice of a pharmacy intern, or practice of a licensed pharmacy technician, and as
406     those duties may be further defined by division rule adopted in collaboration with the board;
407     and
408          (b) are supervised by a pharmacist in accordance with rules adopted by the division in
409     collaboration with the board.
410          (72) "Unlawful conduct" means the same as that term is defined in Sections 58-1-501
411     and 58-17b-501.
412          (73) "Unprofessional conduct" means the same as that term is defined in Sections
413     58-1-501 and 58-17b-502 and may be further defined by rule.
414          (74) "Veterinary pharmaceutical facility" means a pharmaceutical facility that
415     dispenses drugs intended for use by animals or for sale to veterinarians for the administration
416     for animals.
417          Section 2. Section 58-17b-627 is enacted to read:
418          58-17b-627. Prescription of drugs or devices by a pharmacist.
419          (1) Beginning January 1, 2022, a pharmacist may prescribe a prescription drug or
420     device if:
421          (a) prescribing the prescription drug or device is within the scope of the pharmacist's

422     training and experience;
423          (b) the prescription drug or device is designated by the division by rule under
424     Subsection (3)(a); and
425          (c) the prescription drug or device is not a controlled substance that is included in
426     Schedules I, II, III, or IV of:
427          (i) Section 58-37-4; or
428          (ii) the federal Controlled Substances Act, Title II, P.L. 91-513.
429          (2) Nothing in this section requires a pharmacist to issue a prescription for a
430     prescription drug or device.
431          (3) The division shall make rules in accordance with Title 63G, Chapter 3, Utah
432     Administrative Rulemaking Act, to:
433          (a) designate the prescription drugs or devices that may be prescribed by a pharmacist
434     under this section, beginning with prescription drugs or devices that address a public health
435     concern that is designated by the Department of Health, including:
436          (i) post-exposure HIV prophylaxis;
437          (ii) pre-exposure HIV prophylaxis;
438          (iii) self-administered hormonal contraceptives;
439          (iv) smoking cessation; and
440          (v) naloxone;
441          (b) create guidelines that a pharmacist must follow when prescribing a prescription
442     drug or device, including guidelines:
443          (i) for notifying the patient's primary care or other health care provider about the
444     prescription; and
445          (ii) to prevent the over-prescription of drugs or devices including but not limited to
446     antibiotics;
447          (c) address when a pharmacist should refer the patient to an appropriate health care
448     provider or otherwise encourage the patient to seek further medical care; and
449          (d) implement the provisions of this section.

450          (4) The division shall make rules under Subsection (3) in collaboration with:
451          (a) individuals representing pharmacies and pharmacists;
452          (b) individuals representing physicians and advanced practice clinicians; and
453          (c) (i) if the executive director of the Department of Health is a physician, the
454     executive director of the Department of Health;
455          (ii) if the executive director of the Department of Health is not a physician, a deputy
456     director who is a physician in accordance with Subsection 26-1-9(4); or
457          (iii) a designee of the individual described in Subsection (4)(c)(i) or (ii).
458          (5) Before November 1 of each year, the division, in consultation with the individuals
459     described in Subsection (4), shall:
460          (a) develop recommendations for statutory changes to improve patient access to
461     prescribed drugs in the state; and
462          (b) report the recommendations developed under Subsection (5)(a) to the Health and
463     Human Services Interim Committee.