AB415_EN

Assembly Bill No. 415–Assemblyman Lee

CHAPTER..........

AN ACT relating to pharmacy; requiring the state board of pharmacy to adopt regulations relating to the electronic transmission or transmission by a facsimile machine of certain prescriptions from a practitioner to a pharmacist for the dispensing of a drug; requiring an applicant for registration as an intern pharmacist to be enrolled in a college of pharmacy or department of pharmacy of a university approved by the board; prohibiting the board from issuing a private reprimand to the holder of a certificate, license or permit issued by the board; providing for the issuance of uniform identification cards and devices to process claims for prescription drugs or devices; and providing other matters properly relating thereto.

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

Section 1. Chapter 639 of NRS is hereby amended by adding thereto a

new section to read as follows:

A pharmacy or insurer may provide to a practitioner a computer or

any other electronic device, including, without limitation, any software

or equipment required for the computer or device if the computer or

other electronic device is capable of transmitting data to any pharmacy

in this state.

Sec. 2. NRS 639.0745 is hereby amended to read as follows:

639.0745 1. The board may adopt regulations concerning[:

(a) The] the transfer of information between pharmacies relating to

prescriptions.

[(b)] 2. The board shall adopt regulations concerning the electronic

transmission and the transmission by a facsimile machine of a prescription

from a practitioner to a pharmacist for the dispensing of a drug.

[2.] The regulations must establish procedures to:

(a) Ensure the security and confidentiality of the data that is

transmitted between:

(1) The practitioner and the pharmacy;

(2) The practitioner and an insurer of the person for whom the

prescription is issued; and

(3) The pharmacy and an insurer of the person for whom the

prescription is issued.

(b) Protect the identity of the practitioner to prevent misuse of the

identity of the practitioner or other fraudulent conduct related to the

electronic transmission of a prescription.

(1) By the computer or other electronic device; or

(2) Manually by the practitioner.

(d) Establish requirements for electronic transmission of or

transmission by facsimile machine of a prescription for a controlled

substance listed in schedule II if federal law authorizes such a

prescription to be transmitted in such a manner.

3. The board shall adopt regulations governing the exchange of

information between pharmacists and practitioners relating to prescriptions

filled by the pharmacists for persons who are suspected of:

(a) Misusing prescriptions to obtain excessive amounts of drugs.

(b) Failing to use a drug in conformity with the directions for its use or

taking a drug in combination with other drugs in a manner that could result

in injury to that person.

The pharmacists and practitioners shall maintain the confidentiality of the

information exchanged pursuant to this subsection.

Sec. 3. NRS 639.137 is hereby amended to read as follows:

639.137 1. Any person who is not a registered pharmacist, but who is

employed in this state for the purpose of fulfilling the requirements of

paragraph (d) of subsection 1 of NRS 639.120 to become eligible for

registration as a pharmacist, shall register with the board as an intern

pharmacist. An applicant, to be eligible for registration as an intern

pharmacist, must [have completed a minimum of 1 year] be enrolled in a

college of pharmacy or a department of pharmacy of a university approved

by the board or be a graduate of a foreign school and pass an examination

for foreign graduates approved by the board. The application must be

made on a form furnished by the board.

2. The secretary of the board, upon approval of the application, shall

issue a certificate of registration authorizing the applicant to undergo

practical pharmaceutical training under the direct and immediate

supervision of a registered pharmacist. The period of validity of the

certificate of registration, including any renewal, must not exceed 4

years after the date of issue. The certificate of registration authorizes the

holder, if acting under the direct and immediate supervision of a registered

pharmacist, to perform [the] :

(a) The duties of a registered pharmacist as authorized by regulation of

the board; and [to perform other]

(b) Other activities as authorized by regulation of the board. [The

period of validity of the certificate of registration, including any renewal,

must not exceed 4 years after the date of issue.]

3. The certificate of registration must be posted as required by

NRS 639.150.

4. Any certificate of registration issued pursuant to the provisions of

this section may be suspended, terminated or revoked by the board for:

(a) Any reason set forth in this chapter as grounds for the suspension or

revocation of any certificate, license or permit; or

(b) The failure of the registered pharmacist whose name appears on the

certificate of registration to provide adequate training and supervision for

the intern pharmacist in compliance with regulations adopted by the board.

Sec. 4. NRS 639.2353 is hereby amended to read as follows:

639.2353 1. A prescription must be given:

(a) Directly from the practitioner to a pharmacist;

(b) Indirectly by means of an order signed by the practitioner;

(d) [By] Except as otherwise provided in subsection 5, by electronic

transmission or transmission by a facsimile machine, including, without

limitation, transmissions made from a facsimile machine to another

facsimile machine, a computer equipped with a facsimile modem to a

facsimile machine or a computer to another computer, pursuant to the

regulations of the board.

2. A written prescription must contain:

(a) The name and signature of the practitioner, and his address if not

immediately available to the pharmacist;

(b) The classification of his license;

Administration if the prescription is for a controlled substance;

(d) The name of the patient, and his address if not immediately

available to the pharmacist;

(e) The name, strength and quantity of the drug or drugs prescribed;

(f) Directions for use; and

(g) The date of issue.

3. The directions for use must be specific in that they indicate the

portion of the body to which the medication is to be applied or, if to be

taken into the body by means other than orally, the orifice or canal of the

body into which the medication is to be inserted or injected.

4. Each written prescription must be written in such a manner that any

registered pharmacist would be able to dispense it. A prescription must be

written in Latin or English and may include any character, figure, cipher

or abbreviation which is generally used by pharmacists and practitioners in

the writing of prescriptions.

5. A prescription for a controlled substance must not be given by

electronic transmission or transmission by a facsimile machine unless

authorized by federal law.

Sec. 5. NRS 639.255 is hereby amended to read as follows:

639.255 1. The holder of any certificate, license or permit issued by

the board, whose default has been entered or who has been heard by the

board and found guilty of the violations alleged in the accusation, may be

disciplined by the board by one or more of the following methods:

(a) Suspending judgment;

(b) Placing the certificate, license or permit holder on probation;

use any license or permit, for a period not to exceed 1 year;

(d) Revoking the certificate, license or permit;

(e) Public [or private] reprimand;

(f) Imposition of a fine not to exceed $1,000 for each count of the

accusation; or

(g) Requiring the certificate, license or permit holder to pay all costs

incurred by the board relating to the discipline of the person.

2. Such action by the board is final, except that the propriety of such

action is subject to review upon questions of law by a court of competent

jurisdiction.

Sec. 6. NRS 453.385 is hereby amended to read as follows:

453.385 1. Each prescription for a controlled substance listed in

schedule II must be written on a separate prescription blank or as an order

on the chart of a patient. The chart of a patient may be used to order

multiple prescriptions for that patient.

2. A prescription for a controlled substance must contain:

(a) The name of the practitioner, his signature if the prescription was

not transmitted orally and his address if not immediately available to the

pharmacist;

(b) The classification of his license;

if it is not immediately available to the pharmacist;

(d) The name of the patient, and his address if not immediately

available to the pharmacist;

(e) The name, strength and quantity of the drug or drugs prescribed;

(f ) Directions for use; and

(g) The date of issue.

3. A prescription for a controlled substance listed in:

(a) Schedule III, IV or V must be signed by the practitioner pursuant to

the regulations of the board and may be preprinted or written by an agent

of the practitioner, or may be transmitted electronically or by a facsimile

machine from the practitioner to a pharmacy pursuant to the regulations of

the board.

(b) Schedule II must be written and signed entirely by hand by the

practitioner who issued it, except that:

(1) The addresses of the patient and the practitioner may be added by

the pharmacist.

(2) The name of the practitioner, his address and the classification of

his license must be preprinted on the prescription form.

(3) The registration number of the practitioner assigned by the Drug

Enforcement Administration may be preprinted on the prescription form.

(4) The prescription may be transmitted by the practitioner or an

agent of the practitioner to a pharmacy by a facsimile machine if the

original written prescription is presented to the pharmacist for review

before the dispensing of the controlled substance, except that:

(I) If the controlled substance is to be compounded for the direct

administration to a patient by parenteral, intravenous, intramuscular,

subcutaneous or intraspinal infusion, the transmission from the facsimile

machine shall be deemed to be the original written prescription.

(II) If the controlled substance is prescribed for a resident of a

facility for long-term care, the transmission from the facsimile machine

shall be deemed to be the original written prescription and must be

maintained in accordance with 21 C.F.R. § 1304.04(h).

(5) If authorized by federal law, a prescription transmitted

electronically is not required to be written and signed entirely by hand by

the practitioner who issued the prescription.

4. Directions for use must be specific in that they must indicate the

portion of the body to which the medication is to be applied, or, if to be

taken into the body by means other than orally, the orifice or canal of the

body into which the medication is to be inserted or injected.

Sec. 7. Chapter 679B of NRS is hereby amended by adding thereto a

new section to read as follows:

1. If a health care plan that provides coverage for prescription drugs

or devices issues a single identification card or other device to an

insured that contains information solely needed to process a claim for a

prescription drug or device, the card or other device must conform to the

requirements of the National Council for Prescription Drug Programs

set forth in the NCPDP Pharmacy ID Card Implementation Guide that

are consistent with applicable regulations adopted pursuant to the

Health Insurance Portability and Accountability Act of 1996, Public

Law

104‑191, as they may be amended from time to time, or must contain at

least the following elements:

(a) The name or logo of the administrator issuing the card or device.

(b) The insured’s identification number, which must be displayed on

the front side of the card or device.

claims that are not processed electronically or correspondence should be

sent.

(d) The telephone number that providers may call for assistance

concerning pharmacy benefits.

(e) Complete information concerning routing of electronic

transactions, including, without limitation, the international

identification number and, if required by the administrator to process

the claim, the processing control number and group number.

The information on the card or device must be arranged in a manner

that corresponds both in content and form to the content and form

required by the plan to process the claim.

2. The commissioner shall adopt such regulations as are necessary to

carry out the provisions of this section.

3. As used in this section:

(a) “Administrator” has the meaning ascribed to it in NRS 683A.025,

and includes a pharmacy benefits manager.

(b) “Health care plan” has the meaning ascribed to it in

NRS 679B.520.

Sec. 8. The provisions of section 7 of this act do not apply to the

division of health care financing and policy of the department of human

resources or a person providing prescription drug benefits in a health care

program provided by contract with the division until the division becomes

capable of producing a card or other device that meets the requirements of

that section. The director of the department of human resources shall issue

an order requiring compliance with section 7 of this act when the division

produces such a card or device.

Sec. 9. 1. This section becomes effective upon passage and

approval.

2. Sections 1 to 6, inclusive, of this act, become effective on

October 1, 2001.

3. Section 7 of this act becomes effective upon passage and approval

for the purpose of adopting regulations and on January 1, 2003, for all

other purposes.

4. Section 8 of this act becomes effective on January 1, 2003.

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