(REPRINTED WITH ADOPTED AMENDMENTS)

 

Assembly Bill No. 415–Assemblyman Lee

 

March 16, 2001

____________

 

Referred to Committee on Commerce and Labor

 

SUMMARY—Revises provisions relating to pharmacy. (BDR 54‑104)

 

FISCAL NOTE:  Effect on Local Government: No.

                             Effect on the State: No.

 

~

 

EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.

 

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:

 

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

1-2  new section to read as follows:

1-3    A pharmacy or insurer may provide to a practitioner a computer or

1-4  any other electronic device, including, without limitation, any software or

1-5  equipment required for the computer or device if the computer or other

1-6  electronic device is capable of transmitting data to any pharmacy in this

1-7  state.

1-8    Sec. 2.  NRS 639.0745 is hereby amended to read as follows:

1-9    639.0745  1.  The board may adopt regulations concerning[:

1-10    (a) The] the transfer of information between pharmacies relating to

1-11  prescriptions.

1-12    [(b)] 2.  The board shall adopt regulations concerning the electronic

1-13  transmission and the transmission by a facsimile machine of a prescription

1-14  from a practitioner to a pharmacist for the dispensing of a drug.

1-15    [2.] The regulations must establish procedures to:

1-16    (a) Ensure the security and confidentiality of the data that is

1-17  transmitted between:

1-18      (1) The practitioner and the pharmacy;

2-1       (2) The practitioner and an insurer of the person for whom the

2-2  prescription is issued; and

2-3       (3) The pharmacy and an insurer of the person for whom the

2-4  prescription is issued.

2-5    (b) Protect the identity of the practitioner to prevent misuse of the

2-6  identity of the practitioner or other fraudulent conduct related to the

2-7  electronic transmission of a prescription.

2-8    (c) Verify the authenticity of a signature that is produced:

2-9       (1) By the computer or other electronic device; or

2-10      (2) Manually by the practitioner.

2-11    (d) Establish requirements for electronic transmission of or

2-12  transmission by facsimile machine of a prescription for a controlled

2-13  substance listed in schedule II if federal law authorizes such a

2-14  prescription to be transmitted in such a manner.

2-15    3.  The board shall adopt regulations governing the exchange of

2-16  information between pharmacists and practitioners relating to prescriptions

2-17  filled by the pharmacists for persons who are suspected of:

2-18    (a) Misusing prescriptions to obtain excessive amounts of drugs.

2-19    (b) Failing to use a drug in conformity with the directions for its use or

2-20  taking a drug in combination with other drugs in a manner that could result

2-21  in injury to that person.

2-22  The pharmacists and practitioners shall maintain the confidentiality of the

2-23  information exchanged pursuant to this subsection.

2-24    Sec. 3.  NRS 639.137 is hereby amended to read as follows:

2-25    639.137  1.  Any person who is not a registered pharmacist, but who is

2-26  employed in this state for the purpose of fulfilling the requirements of

2-27  paragraph (d) of subsection 1 of NRS 639.120 to become eligible for

2-28  registration as a pharmacist, shall register with the board as an intern

2-29  pharmacist. An applicant, to be eligible for registration as an intern

2-30  pharmacist, must [have completed a minimum of 1 year] be enrolled in a

2-31  college of pharmacy or a department of pharmacy of a university approved

2-32  by the board or be a graduate of a foreign school and pass an examination

2-33  for foreign graduates approved by the board. The application must be made

2-34  on a form furnished by the board.

2-35    2.  The secretary of the board, upon approval of the application, shall

2-36  issue a certificate of registration authorizing the applicant to undergo

2-37  practical pharmaceutical training under the direct and immediate

2-38  supervision of a registered pharmacist. The period of validity of the

2-39  certificate of registration, including any renewal, must not exceed 4 years

2-40  after the date of issue. The certificate of registration authorizes the holder,

2-41  if acting under the direct and immediate supervision of a registered

2-42  pharmacist, to perform [the] :

2-43    (a) The duties of a registered pharmacist as authorized by regulation of

2-44  the board; and [to perform other]

2-45    (b) Other activities as authorized by regulation of the board. [The

2-46  period of validity of the certificate of registration, including any renewal,

2-47  must not exceed 4 years after the date of issue.]

2-48    3.  The certificate of registration must be posted as required by

2-49  NRS 639.150.

3-1    4.  Any certificate of registration issued pursuant to the provisions of

3-2  this section may be suspended, terminated or revoked by the board for:

3-3    (a) Any reason set forth in this chapter as grounds for the suspension or

3-4  revocation of any certificate, license or permit; or

3-5    (b) The failure of the registered pharmacist whose name appears on the

3-6  certificate of registration to provide adequate training and supervision for

3-7  the intern pharmacist in compliance with regulations adopted by the board.

3-8    Sec. 4.  NRS 639.2353 is hereby amended to read as follows:

3-9    639.2353  1.  A prescription must be given:

3-10    (a) Directly from the practitioner to a pharmacist;

3-11    (b) Indirectly by means of an order signed by the practitioner;

3-12    (c) By an oral order transmitted by an agent of the practitioner; or

3-13    (d) [By] Except as otherwise provided in subsection 5, by electronic

3-14  transmission or transmission by a facsimile machine, including, without

3-15  limitation, transmissions made from a facsimile machine to another

3-16  facsimile machine, a computer equipped with a facsimile modem to a

3-17  facsimile machine or a computer to another computer, pursuant to the

3-18  regulations of the board.

3-19    2.  A written prescription must contain:

3-20    (a) The name and signature of the practitioner, and his address if not

3-21  immediately available to the pharmacist;

3-22    (b) The classification of his license;

3-23    (c) His registration number assigned by the Drug Enforcement

3-24  Administration if the prescription is for a controlled substance;

3-25    (d) The name of the patient, and his address if not immediately

3-26  available to the pharmacist;

3-27    (e) The name, strength and quantity of the drug or drugs prescribed;

3-28    (f) Directions for use; and

3-29    (g) The date of issue.

3-30    3.  The directions for use must be specific in that they indicate the

3-31  portion of the body to which the medication is to be applied or, if to be

3-32  taken into the body by means other than orally, the orifice or canal of the

3-33  body into which the medication is to be inserted or injected.

3-34    4.  Each written prescription must be written in such a manner that any

3-35  registered pharmacist would be able to dispense it. A prescription must be

3-36  written in Latin or English and may include any character, figure, cipher or

3-37  abbreviation which is generally used by pharmacists and practitioners in

3-38  the writing of prescriptions.

3-39    5.  A prescription for a controlled substance must not be given by

3-40  electronic transmission or transmission by a facsimile machine unless

3-41  authorized by federal law.

3-42    Sec. 5.  NRS 639.255 is hereby amended to read as follows:

3-43    639.255  1.  The holder of any certificate, license or permit issued by

3-44  the board, whose default has been entered or who has been heard by the

3-45  board and found guilty of the violations alleged in the accusation, may be

3-46  disciplined by the board by one or more of the following methods:

3-47    (a) Suspending judgment;

3-48    (b) Placing the certificate, license or permit holder on probation;

4-1    (c) Suspending the right of a certificate holder to practice, or the right to

4-2  use any license or permit, for a period not to exceed 1 year;

4-3    (d) Revoking the certificate, license or permit;

4-4    (e) Public [or private] reprimand;

4-5    (f) Imposition of a fine not to exceed $1,000 for each count of the

4-6  accusation; or

4-7    (g) Requiring the certificate, license or permit holder to pay all costs

4-8  incurred by the board relating to the discipline of the person.

4-9    2.  Such action by the board is final, except that the propriety of such

4-10  action is subject to review upon questions of law by a court of competent

4-11  jurisdiction.

4-12    Sec. 6.  NRS 453.385 is hereby amended to read as follows:

4-13    453.385  1.  Each prescription for a controlled substance listed in

4-14  schedule II must be written on a separate prescription blank or as an order

4-15  on the chart of a patient. The chart of a patient may be used to order

4-16  multiple prescriptions for that patient.

4-17    2.  A prescription for a controlled substance must contain:

4-18    (a) The name of the practitioner, his signature if the prescription was

4-19  not transmitted orally and his address if not immediately available to the

4-20  pharmacist;

4-21    (b) The classification of his license;

4-22    (c) His registration number from the Drug Enforcement Administration

4-23  if it is not immediately available to the pharmacist;

4-24    (d) The name of the patient, and his address if not immediately

4-25  available to the pharmacist;

4-26    (e) The name, strength and quantity of the drug or drugs prescribed;

4-27    (f ) Directions for use; and

4-28    (g) The date of issue.

4-29    3.  A prescription for a controlled substance listed in:

4-30    (a) Schedule III, IV or V must be signed by the practitioner pursuant to

4-31  the regulations of the board and may be preprinted or written by an agent

4-32  of the practitioner, or may be transmitted electronically or by a facsimile

4-33  machine from the practitioner to a pharmacy pursuant to the regulations of

4-34  the board.

4-35    (b) Schedule II must be written and signed entirely by hand by the

4-36  practitioner who issued it, except that:

4-37      (1) The addresses of the patient and the practitioner may be added by

4-38  the pharmacist.

4-39      (2) The name of the practitioner, his address and the classification of

4-40  his license must be preprinted on the prescription form.

4-41      (3) The registration number of the practitioner assigned by the Drug

4-42  Enforcement Administration may be preprinted on the prescription form.

4-43      (4) The prescription may be transmitted by the practitioner or an

4-44  agent of the practitioner to a pharmacy by a facsimile machine if the

4-45  original written prescription is presented to the pharmacist for review

4-46  before the dispensing of the controlled substance, except that:

4-47         (I) If the controlled substance is to be compounded for the direct

4-48  administration to a patient by parenteral, intravenous, intramuscular,

5-1  subcutaneous or intraspinal infusion, the transmission from the facsimile

5-2  machine shall be deemed to be the original written prescription.

5-3         (II) If the controlled substance is prescribed for a resident of a

5-4  facility for long-term care, the transmission from the facsimile machine

5-5  shall be deemed to be the original written prescription and must be

5-6  maintained in accordance with 21 C.F.R. § 1304.04(h).

5-7       (5) If authorized by federal law, a prescription transmitted

5-8  electronically is not required to be written and signed entirely by hand by

5-9  the practitioner who issued the prescription.

5-10    4.  Directions for use must be specific in that they must indicate the

5-11  portion of the body to which the medication is to be applied, or, if to be

5-12  taken into the body by means other than orally, the orifice or canal of the

5-13  body into which the medication is to be inserted or injected.

5-14  Sec. 7.  Chapter 679B of NRS is hereby amended by adding thereto a

5-15  new section to read as follows:

5-16  1.  If a health care plan that provides coverage for prescription drugs

5-17  or devices issues a single identification card or other device to an insured

5-18  that contains information solely needed to process a claim for a

5-19  prescription drug or device, the card or other device must conform to the

5-20  requirements of the National Council for Prescription Drug Programs

5-21  set forth in the NCPDP Pharmacy ID Card Implementation Guide that

5-22  are consistent with applicable regulations adopted pursuant to the Health

5-23  Insurance Portability and Accountability Act of 1996, Public Law

5-24  104‑191, as they may be amended from time to time, or must contain at

5-25  least the following elements:

5-26  (a) The name or logo of the administrator issuing the card or device.

5-27  (b) The insured’s identification number, which must be displayed on

5-28  the front side of the card or device.

5-29  (c) The name and address of the administrator to which prescription

5-30  claims that are not processed electronically or correspondence should be

5-31  sent.

5-32  (d) The telephone number that providers may call for assistance

5-33  concerning pharmacy benefits.

5-34  (e) Complete information concerning routing of electronic

5-35  transactions, including, without limitation, the international

5-36  identification number and, if required by the administrator to process the

5-37  claim, the processing control number and group number.

5-38  The information on the card or device must be arranged in a manner

5-39  that corresponds both in content and form to the content and form

5-40  required by the plan to process the claim.

5-41  2.  The commissioner shall adopt such regulations as are necessary to

5-42  carry out the provisions of this section.

5-43  3.  As used in this section:

5-44  (a) “Administrator” has the meaning ascribed to it in NRS 683A.025,

5-45  and includes a pharmacy benefits manager.

5-46    (b) “Health care plan” has the meaning ascribed to it in

5-47  NRS 679B.520.

5-48  Sec. 8.  The provisions of section 7 of this act do not apply to the

5-49  division of health care financing and policy of the department of human

6-1  resources or a person providing prescription drug benefits in a health care

6-2  program provided by contract with the division until the division becomes

6-3  capable of producing a card or other device that meets the requirements of

6-4  that section. The director of the department of human resources shall issue

6-5  an order requiring compliance with section 7 of this act when the division

6-6  produces such a card or device.

6-7    Sec. 9.  1.  This section becomes effective upon passage and

6-8  approval.

6-9    2.  Sections 1 to 6, inclusive, of this act, become effective on

6-10  October 1, 2001.

6-11  3.  Section 7 of this act becomes effective upon passage and approval

6-12  for the purpose of adopting regulations and on January 1, 2003, for all

6-13  other purposes.

6-14  4.  Section 8 of this act becomes effective on January 1, 2003.

 

6-15  H