Bill Text: NY A03849 | 2019-2020 | General Assembly | Introduced
Bill Title: Authorizes physicians and pharmacists to enter into comprehensive medication management protocols for their patients.
Spectrum: Slight Partisan Bill (Democrat 24-10)
Status: (Introduced - Dead) 2020-01-08 - referred to higher education [A03849 Detail]
Download: New_York-2019-A03849-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 3849 2019-2020 Regular Sessions IN ASSEMBLY January 31, 2019 ___________ Introduced by M. of A. McDONALD, MOSLEY, ORTIZ, D'URSO, BENEDETTO, SEAWRIGHT, JOYNER, CROUCH, GIGLIO, NIOU, CAHILL, WRIGHT, LAWRENCE, STECK, JONES, LUPARDO, COLTON, DICKENS, FAHY, LIFTON, RA -- Multi- Sponsored by -- M. of A. ENGLEBRIGHT, HAWLEY -- read once and referred to the Committee on Higher Education AN ACT to amend the public health law and the education law, in relation to comprehensive medication management; and to amend chapter 21 of the laws of 2011 amending the education law relating to authorizing phar- macists to perform collaborative drug therapy management with physi- cians in certain settings, in relation to making the provisions of such chapter permanent The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. The public health law is amended by adding a new article 2 29-H to read as follows: 3 ARTICLE 29-H 4 COMPREHENSIVE MEDICATION MANAGEMENT 5 Section 2999-ee. Comprehensive medication management. 6 § 2999-ee. Comprehensive medication management. 1. Definitions. As 7 used in this article, the following terms shall have the following mean- 8 ings: 9 (a) Qualified pharmacist. The term "qualified pharmacist" shall mean a 10 pharmacist who maintains a current unrestricted license pursuant to 11 article one hundred thirty-seven of the education law, who has a minimum 12 of two years of experience in patient care as a practicing pharmacist 13 within the last five years, and who has demonstrated competency in the 14 medication management of patients with a chronic disease or diseases, 15 including, but not limited to, the completion of one or more programs 16 which are accredited by the accreditation council for pharmacy educa- 17 tion, recognized by the education department and acceptable to the 18 patient's treating physician. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD00591-01-9A. 3849 2 1 (b) Patient care. The term "patient care" shall mean assessing the 2 appropriateness of prescription and non-prescription drugs for individ- 3 ual patients based on an assessment of the patient's medication history, 4 medication experience including beliefs, concerns, understanding and 5 expectations, the clinical goals of therapy, potential drug-to-drug 6 interactions or other medication safety concerns, recommendations for 7 adherence and consulting with a patient or caregiver. 8 (c) Comprehensive medication management. The term "comprehensive medi- 9 cation management" shall mean a program conducted by a qualified pharma- 10 cist that ensures a patient's medications, whether prescription or 11 nonprescription, are individually assessed to determine that each medi- 12 cation is appropriate for the patient, effective for the medical condi- 13 tion, safe given the comorbidities and other medications being taken, 14 and able to be taken by the patient as intended. Comprehensive medica- 15 tion management conducted by a qualified pharmacist shall include shar- 16 ing of applicable patient clinical information with the treating physi- 17 cian as specified in a comprehensive medication management protocol. 18 (d) Comprehensive medication management protocol. The term "comprehen- 19 sive medication management protocol" shall mean a written document 20 pursuant to and consistent with any applicable state and federal 21 requirements, that is entered into voluntarily by a physician licensed 22 pursuant to article one hundred thirty-one of the education law and a 23 qualified pharmacist which addresses a chronic disease or diseases as 24 determined by the treating physician and that describes the nature and 25 scope of the comprehensive medication management services to be 26 performed by the qualified pharmacist, in accordance with the provisions 27 of this article. Comprehensive medication management protocols between 28 licensed physicians and qualified pharmacists shall be made available to 29 the department for review and to ensure compliance with this article, 30 upon request. 31 2. Authorization to establish comprehensive medication management 32 protocols. A physician licensed pursuant to article one hundred thirty- 33 one of the education law shall be authorized to voluntarily establish a 34 comprehensive medication management protocol with a qualified pharmacist 35 to provide comprehensive medication management services for a patient 36 who has not met clinical goals of therapy, is at risk for hospitaliza- 37 tion or for whom the physician deems it is necessary to receive compre- 38 hensive medication management services. Participation by the patient in 39 comprehensive medication management services shall be voluntary. 40 3. Scope of comprehensive medication management protocols. Under a 41 comprehensive medication management protocol, a qualified pharmacist 42 shall be permitted to: 43 (a) adjust or manage a drug regimen of a patient, pursuant to the 44 patient specific order or protocol established by the patient's treating 45 physician, which may include adjusting drug strength, frequency of 46 administration or route of administration. Adjusting the drug regimen 47 shall not include substituting or selecting a different drug which 48 differs from that initially prescribed by the patient's treating physi- 49 cian unless such substitution is expressly authorized in the written 50 order or protocol. The qualified pharmacist shall be required to imme- 51 diately document in the patient's medical record changes made to the 52 patient's drug therapy. The patient's treating physician may prohibit, 53 by written instruction, any adjustment or change in the patient's drug 54 regimen by the qualified pharmacist; 55 (b) evaluate and, only if specifically authorized by the protocol and 56 only to the extent necessary to discharge the responsibilities set forthA. 3849 3 1 in this article, order disease state laboratory tests related to the 2 drug therapy management for the specific chronic disease or diseases 3 specified within the written agreement or protocol; 4 (c) only if specifically authorized by the written order or protocol 5 and only to the extent necessary to discharge the responsibilities set 6 forth in this article, order or perform routine patient monitoring func- 7 tions as may be necessary in the drug therapy management, including the 8 collecting and reviewing of patient histories, and ordering or checking 9 patient vital signs, including pulse, temperature, blood pressure, 10 weight and respiration; and 11 (d) access the complete patient medical record maintained by the 12 treating physician with whom the qualified pharmacist has the comprehen- 13 sive medication management protocol and document any adjustments made 14 pursuant to the protocol in the patient's medical record and shall noti- 15 fy the patient's treating physician of any adjustments in a timely 16 manner electronically or by other means. 17 (e) Under no circumstances, shall the qualified pharmacist be permit- 18 ted to delegate comprehensive medication management services to any 19 other licensed pharmacist or other pharmacy personnel. 20 4. Medication adjustments. Any medication adjustments made by the 21 qualified pharmacist pursuant to the comprehensive medication management 22 protocol including adjustments in drug strength, frequency or route of 23 administration, or initiation of a drug which differs from that initial- 24 ly prescribed and as documented in the patient's medical record shall be 25 deemed an oral prescription authorized by an agent of the patient's 26 treating physician and shall be dispensed consistent with section 27 sixty-eight hundred ten of the education law. For the purposes of this 28 article, a pharmacist who is not an employee of the physician may be 29 authorized to serve as an agent of the physician. 30 5. Referrals. A physician licensed pursuant to article one hundred 31 thirty-one of the education law who has responsibility for the treatment 32 and care of a patient for a chronic disease or diseases as determined by 33 the physician may refer the patient to a qualified pharmacist for 34 comprehensive medication management services, pursuant to the comprehen- 35 sive medication management protocol that the physician has established 36 with the qualified pharmacist. The protocol agreement shall authorize 37 the pharmacist to serve as an agent of the physician as defined by the 38 protocol. Such referral shall be documented in the patient's medical 39 record. 40 6. Patient participation. Participation in comprehensive medication 41 management services shall be voluntary, and no patient, physician or 42 pharmacist shall be required to participate. The referral of a patient 43 for comprehensive medication management services and the patient's right 44 to choose to not participate shall be disclosed to the patient. Compre- 45 hensive medication management services shall not be utilized unless the 46 patient or the patient's authorized representative consents, in writing, 47 to such services. Such consent shall be noted in the patient's medical 48 record. If the patient or the patient's authorized representative who 49 consented chooses to no longer participate in such services, at any 50 time, the services shall be discontinued and it shall be noted in the 51 patient's medical record. 52 § 2. The education law is amended by adding a new section 6801-b to 53 read as follows: 54 § 6801-b. Comprehensive medication management. 1. As used in this 55 section:A. 3849 4 1 (a) "comprehensive medication management" shall mean a program for the 2 management of chronic disease or diseases that ensures a patient's medi- 3 cations, whether prescription or nonprescription, are individually 4 assessed to determine that each medication is appropriate for the 5 patient, effective for the medical condition, safe given the comorbidi- 6 ties and other medications being taken, and able to be taken by the 7 patient as intended; and 8 (b) "comprehensive medication management protocol" shall mean a writ- 9 ten document, pursuant to and consistent with any applicable state or 10 federal requirements, that is entered into voluntarily by a physician 11 licensed pursuant to article one hundred thirty-one of this title and a 12 licensed pharmacist who meets the qualification requirements specified 13 in article twenty-nine-H of the public health law which addresses a 14 chronic disease or diseases as determined by the physician and that 15 describes the nature and scope of the comprehensive medication manage- 16 ment service to be performed by the qualified pharmacist. Comprehensive 17 medication management protocols between licensed physicians and quali- 18 fied pharmacists shall be made available to the department for review 19 and to ensure compliance with this article, upon request. 20 2. A licensed pharmacist qualified pursuant to article twenty-nine-H 21 of the public health law is authorized to serve as an agent of the 22 physician when executing the terms of the written comprehensive medica- 23 tion management protocol as established by the licensed physician for 24 the management of patients with a chronic disease or diseases. 25 § 3. Section 5 of chapter 21 of the laws of 2011, amending the educa- 26 tion law relating to authorizing pharmacists to perform collaborative 27 drug therapy management with physicians in certain settings, as amended 28 by section 5 of part DD of chapter 57 of the laws of 2018, is amended to 29 read as follows: 30 § 5. This act shall take effect on the one hundred twentieth day after 31 it shall have become a law[, provided, however, that the provisions of32sections two, three, and four of this act shall expire and be deemed33repealed July 1, 2020]; provided, however, that the amendments to subdi- 34 vision 1 of section 6801 of the education law made by section one of 35 this act shall be subject to the expiration and reversion of such subdi- 36 vision pursuant to section 8 of chapter 563 of the laws of 2008, when 37 upon such date the provisions of section one-a of this act shall take 38 effect; provided, further, that effective immediately, the addition, 39 amendment and/or repeal of any rule or regulation necessary for the 40 implementation of this act on its effective date are authorized and 41 directed to be made and completed on or before such effective date. 42 § 4. This act shall take effect immediately, provided that sections 43 one and two of this act shall take effect on the one hundred eightieth 44 day after it shall have become a law. Effective immediately, the addi- 45 tion, amendment and/or repeal of any rule or regulation necessary for 46 the implementation of this act on its effective date are authorized and 47 directed to be made and completed on or before such effective date.
