HOUSE BILL NO. 5874

June 18, 2020, Introduced by Reps. Hertel, Hammoud, Kuppa, Hood, Cynthia Johnson, Peterson, Manoogian, Gay-Dagnogo, Camilleri, Garza, Tyrone Carter, Bolden and Stone and referred to the Committee on Health Policy.

"Public health code,"

by amending section 17751 (MCL 333.17751), as amended by 2020 PA 4, and by adding section 17751a.

the people of the state of michigan enact:

Sec. 17751. (1) A pharmacist shall not dispense a drug requiring a prescription under the federal act or a law of this state except under authority of an original prescription or an equivalent record of an original prescription approved by the board. A pharmacist described in section 17742b(2) may dispense a drug pursuant to an original prescription received at a remote pharmacy if the pharmacist receives, reviews, and verifies an exact digital image of the prescription received at the remote pharmacy before the drug is dispensed at the remote pharmacy.

(2) Subject to subsections (1) and (5), a pharmacist may dispense a prescription written and signed; written or created in an electronic format, signed, and transmitted by facsimile; or transmitted electronically or by other means of communication by a physician prescriber, dentist prescriber, or veterinarian prescriber in another state, but not including a prescription for a controlled substance except under circumstances described in section 17763(e), only if the pharmacist in the exercise of his or her professional judgment determines all of the following:

(a) Except as otherwise authorized under section 5110, 17744a, or 17744b, if the prescriber is a physician or dentist, that the prescription was issued pursuant to an existing physician-patient or dentist-patient relationship.

(b) That the prescription is authentic.

(c) That the prescribed drug is appropriate and necessary for the treatment of an acute, chronic, or recurrent condition.

(3) A pharmacist or a prescriber shall dispense a prescription only if the prescription falls within the scope of practice of the prescriber.

(4) A pharmacist shall not knowingly dispense a prescription after the death of the prescriber or patient.

(5) A pharmacist shall not dispense a drug or device under a prescription transmitted by facsimile or created in electronic format and printed out for use by the patient unless the document is manually signed by the prescriber. This subsection does not apply to any of the following:

(a) A prescription that is transmitted by a computer to a facsimile machine if that prescription complies with section 17754.

(b) A prescription that is received by a remote pharmacy and made available to a pharmacist described in section 17742b(2) for review and verification in the manner required under subsection (1).

(6) After consultation with and agreement from the prescriber, a pharmacist may add or change a patient's address, a dosage form, a drug strength, a drug quantity, a direction for use, or an issue date with regard to a prescription. A pharmacist shall note the details of the consultation and agreement required under this subsection on the prescription or, if the drug is dispensed at a remote pharmacy, on the digital image of the prescription described in subsection (1), and shall maintain that documentation with the prescription as required in section 17752. A pharmacist shall not change the patient's name, controlled substance prescribed unless authorized to dispense a lower cost generically equivalent drug product under section 17755, or the prescriber's signature with regard to a prescription.

(7) A prescription that is contained within a patient's chart in a health facility or agency licensed under article 17 or other medical institution and that is transmitted to a pharmacy under section 17744 is the original prescription. If all other requirements of this part are met, a pharmacist shall dispense a drug or device under a prescription described in this subsection. A pharmacist may dispense a drug or device under a prescription described in this subsection even if the prescription does not contain the quantity ordered. If a prescription described in this subsection does not contain the quantity ordered, the pharmacist shall consult with the prescriber to determine an agreed-upon quantity. The pharmacist shall record the quantity dispensed on the prescription and shall maintain that documentation with the prescription as required in section 17752.

(8) If, after consulting with a patient, a pharmacist determines in the exercise of his or her professional judgment that dispensing additional quantities of a prescription drug is appropriate for the patient, the pharmacist may dispense, at one time, additional quantities of the prescription drug up to the total number of dosage units authorized by the prescriber on the original prescription for the patient and any refills of the prescription. Except for a controlled substance included in schedule 5 that does not contain an opioid, this subsection does not apply to a prescription for a controlled substance.

(9) Subsections (6) and (8) are subject to section 17751a.

Sec. 17751a. (1) If the governor issues a qualified executive order, a pharmacist may dispense an emergency refill of up to a 60-day supply of a prescription drug other than a controlled substance for a resident of this state if, in the pharmacist's professional judgment, a failure to refill the prescription might interrupt the patient's ongoing care and have a significant adverse effect on the patient's well-being. All of the following apply for purposes of this section:

(a) The pharmacist shall inform the patient that the prescription was dispensed under this section.

(b) The pharmacist shall inform the prescriber, in writing and within a reasonable period of time, of any refills that the pharmacist dispensed under this section.

(c) Before refilling a prescription under this section, the pharmacist shall make a reasonable effort to communicate with the prescriber regarding refilling the prescription and make a record of the effort made, including the reason for refilling a prescription under this subdivision.

(2) As used in this section, "qualified executive order" means an executive order issued by the governor in which both of the following apply:

(a) The executive order is issued during a declared state of emergency under any of the following:

(i) The emergency management act, 1976 PA 390, MCL 30.401 to 30.421.

(ii) 1945 PA 302, MCL 10.31 to 10.33.

(b) The executive order directs residents of this state to remain in their residences, with limited exceptions, for at least 2 weeks.