Bill Text: NY A06564 | 2023-2024 | General Assembly | Introduced
Bill Title: Authorizes physicians and pharmacists to enter into collaborative practice medication adherence protocols for their patients; makes permanent certain provisions relating to authorizing pharmacists to perform with physicians in certain settings.
Spectrum: Slight Partisan Bill (Democrat 17-6)
Status: (Introduced) 2024-01-03 - referred to higher education [A06564 Detail]
Download: New_York-2023-A06564-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 6564 2023-2024 Regular Sessions IN ASSEMBLY April 19, 2023 ___________ Introduced by M. of A. McDONALD, BENEDETTO, SEAWRIGHT, JOYNER, J. M. GIGLIO, STECK, LUPARDO, JONES, COLTON, DICKENS, FAHY, RA, SAYEGH, MORINELLO, BYRNES, WALLACE, BUTTENSCHON -- Multi-Sponsored by -- M. of A. HAWLEY, TAGUE -- 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 collaborative practice medication adherence; and to amend chapter 21 of the laws of 2011 amending the education law relating to author- izing pharmacists to perform collaborative drug therapy management with physicians 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. This act shall be known and may be cited as the "Collabora- 2 tive Practice Medication Adherence Act". 3 § 2. The public health law is amended by adding a new article 29-H to 4 read as follows: 5 ARTICLE 29-H 6 COLLABORATIVE PRACTICE MEDICATION ADHERENCE ACT 7 Section 2999-ff. Collaborative practice medication adherence. 8 § 2999-ff. Collaborative practice medication adherence. 1. Defi- 9 nitions. As used in this article, the following terms shall have the 10 following meanings: 11 (a) Qualified pharmacist. The term "qualified pharmacist" shall mean a 12 pharmacist who maintains a current unrestricted license pursuant to 13 article one hundred thirty-seven of the education law, who has a minimum 14 of two years of experience in patient care as a practicing pharmacist 15 within the last five years, and who has demonstrated competency in medi- 16 cation adherence of patients with a chronic disease or diseases, includ- 17 ing, but not limited to, the completion of one or more programs which 18 are accredited by the accreditation council for pharmacy education, EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD08609-05-3A. 6564 2 1 recognized by the education department and acceptable to the patient's 2 treating physician. 3 (b) Patient care. The term "patient care" shall mean assessing the 4 appropriateness of prescription and non-prescription drugs for individ- 5 ual patients based on an assessment of the patient's medication history, 6 medication experience including beliefs, concerns, understanding and 7 expectations, the clinical goals of therapy, potential drug-to-drug 8 interactions or other medication safety concerns, recommendations for 9 adherence and consulting with a patient or caregiver. 10 (c) Collaborative practice medication adherence. The term "collabora- 11 tive practice medication adherence" shall mean a program conducted by a 12 qualified pharmacist that ensures a patient's medications, whether 13 prescription or nonprescription, are individually assessed to determine 14 that each medication is appropriate for the patient, effective for the 15 medical condition, safe given the comorbidities and other medications 16 being taken, and able to be taken by the patient as intended. Collabora- 17 tive practice medication adherence protocols conducted by a qualified 18 pharmacist shall include sharing of applicable patient clinical informa- 19 tion with the treating physician as specified in a collaborative prac- 20 tice medication adherence protocol. 21 (d) Collaborative practice medication adherence protocol. The term 22 "collaborative practice medication adherence protocol" shall mean a 23 written document pursuant to and consistent with any applicable state 24 and federal requirements, that is entered into voluntarily by a physi- 25 cian licensed pursuant to article one hundred thirty-one of the educa- 26 tion law and a qualified pharmacist which addresses a chronic disease or 27 diseases as determined by the treating physician and that describes the 28 nature and scope of the collaborative practice medication adherence 29 services to be performed by the qualified pharmacist, in accordance with 30 the provisions of this article. Collaborative practice medication adher- 31 ence protocols between licensed physicians and qualified pharmacists 32 shall be made available to the department for review and to ensure 33 compliance with this article, upon request. 34 2. Authorization to establish collaborative practice medication adher- 35 ence protocols. A physician licensed pursuant to article one hundred 36 thirty-one of the education law shall be authorized to voluntarily 37 establish a collaborative practice medication adherence protocol with a 38 qualified pharmacist to provide collaborative practice medication adher- 39 ence services for a patient who has not met clinical goals of therapy, 40 is at risk for hospitalization or for whom the physician deems it is 41 necessary to receive collaborative practice medication adherence 42 services. Participation by the patient in collaborative practice medi- 43 cation adherence services shall be voluntary. 44 3. Scope of collaborative practice medication adherence protocols. 45 Under a collaborative practice medication adherence protocol, a quali- 46 fied pharmacist shall be permitted to: 47 (a) adjust or manage a drug regimen of a patient, pursuant to the 48 patient specific order or protocol established by the patient's treating 49 physician, which may include adjusting drug strength, frequency of 50 administration or route of administration. Adjusting the drug regimen 51 shall not include substituting or selecting a different drug which 52 differs from that initially prescribed by the patient's treating physi- 53 cian unless such substitution is expressly authorized in the written 54 order or protocol. The qualified pharmacist shall be required to imme- 55 diately document in the patient's medical record changes made to the 56 patient's drug therapy. The patient's treating physician may prohibit,A. 6564 3 1 by written instruction, any adjustment or change in the patient's drug 2 regimen by the qualified pharmacist; 3 (b) evaluate and, only if specifically authorized by the protocol and 4 only to the extent necessary to discharge the responsibilities set forth 5 in this article, order disease state laboratory tests related to the 6 drug therapy management for the specific chronic disease or diseases 7 specified within the written agreement or protocol; 8 (c) only if specifically authorized by the written order or protocol 9 and only to the extent necessary to discharge the responsibilities set 10 forth in this article, order or perform routine patient monitoring func- 11 tions as may be necessary in the drug therapy management, including the 12 collecting and reviewing of patient histories, and ordering or checking 13 patient vital signs, including pulse, temperature, blood pressure, 14 weight and respiration; and 15 (d) access the complete patient medical record maintained by the 16 treating physician with whom the qualified pharmacist has the collabora- 17 tive practice medication adherence protocol and document any adjustments 18 made pursuant to the protocol in the patient's medical record and shall 19 notify the patient's treating physician of any adjustments in a timely 20 manner electronically or by other means. 21 (e) Under no circumstances, shall the qualified pharmacist be permit- 22 ted to delegate collaborative practice medication adherence services to 23 any other licensed pharmacist or other pharmacy personnel. 24 4. Medication adjustments. Any medication adjustments made by the 25 qualified pharmacist pursuant to the collaborative practice medication 26 adherence protocol including adjustments in drug strength, frequency or 27 route of administration, or initiation of a drug which differs from that 28 initially prescribed and as documented in the patient's medical record 29 shall be deemed an oral prescription authorized by an agent of the 30 patient's treating physician and shall be dispensed consistent with 31 section sixty-eight hundred ten of the education law. For the purposes 32 of this article, a pharmacist who is not an employee of the physician 33 may be authorized to serve as an agent of the physician. 34 5. Referrals. A physician licensed pursuant to article one hundred 35 thirty-one of the education law who has responsibility for the treatment 36 and care of a patient for a chronic disease or diseases as determined by 37 the physician may refer the patient to a qualified pharmacist for colla- 38 borative practice medication adherence services, pursuant to the colla- 39 borative practice medication adherence protocol that the physician has 40 established with the qualified pharmacist. The protocol agreement shall 41 authorize the pharmacist to serve as an agent of the physician as 42 defined by the protocol. Such referral shall be documented in the 43 patient's medical record. 44 6. Patient participation. Participation in collaborative practice 45 medication adherence services shall be voluntary, and no patient, physi- 46 cian or pharmacist shall be required to participate. The referral of a 47 patient for collaborative practice medication adherence services and the 48 patient's right to choose to not participate shall be disclosed to the 49 patient. Collaborative practice medication adherence services shall not 50 be utilized unless the patient or the patient's authorized represen- 51 tative consents, in writing, to such services. Such consent shall be 52 noted in the patient's medical record. If the patient or the patient's 53 authorized representative who consented chooses to no longer participate 54 in such services, at any time, the services shall be discontinued and it 55 shall be noted in the patient's medical record.A. 6564 4 1 § 3. The education law is amended by adding a new section 6801-b to 2 read as follows: 3 § 6801-b. Collaborative practice medication adherence. 1. As used in 4 this section: 5 (a) "collaborative practice medication adherence" shall mean a program 6 for the management of chronic disease or diseases that ensures a 7 patient's medications, whether prescription or nonprescription, are 8 individually assessed to determine that each medication is appropriate 9 for the patient, effective for the medical condition, safe given the 10 comorbidities and other medications being taken, and able to be taken by 11 the patient as intended; and 12 (b) "collaborative practice medication adherence protocol" shall mean 13 a written document, pursuant to and consistent with any applicable state 14 or federal requirements, that is entered into voluntarily by a physician 15 licensed pursuant to article one hundred thirty-one of this title and a 16 licensed pharmacist who meets the qualification requirements specified 17 in article twenty-nine-H of the public health law which addresses a 18 chronic disease or diseases as determined by the physician and that 19 describes the nature and scope of the collaborative practice medication 20 adherence service to be performed by the qualified pharmacist. Collabo- 21 rative practice medication adherence protocols between licensed physi- 22 cians and qualified pharmacists shall be made available to the depart- 23 ment for review and to ensure compliance with this article, upon 24 request. 25 2. A licensed pharmacist qualified pursuant to article twenty-nine-H 26 of the public health law is authorized to serve as an agent of the 27 physician when executing the terms of the written collaborative practice 28 medication adherence protocol as established by the licensed physician 29 for the management of patients with a chronic disease or diseases. 30 § 4. Section 5 of chapter 21 of the laws of 2011 amending the educa- 31 tion law relating to authorizing pharmacists to perform collaborative 32 drug therapy management with physicians in certain settings, as amended 33 by section 5 of part CC of chapter 57 of the laws of 2022, is amended to 34 read as follows: 35 § 5. This act shall take effect on the one hundred twentieth day after 36 it shall have become a law[, provided, however, that the provisions of37sections two, three, and four of this act shall expire and be deemed38repealed July 1, 2024]; provided, however, that the amendments to subdi- 39 vision 1 of section 6801 of the education law made by section one of 40 this act shall be subject to the expiration and reversion of such subdi- 41 vision pursuant to section 8 of chapter 563 of the laws of 2008, when 42 upon such date the provisions of section one-a of this act shall take 43 effect; provided, further, that effective immediately, the addition, 44 amendment and/or repeal of any rule or regulation necessary for the 45 implementation of this act on its effective date are authorized and 46 directed to be made and completed on or before such effective date. 47 § 5. This act shall take effect immediately, provided that sections 48 one and two of this act shall take effect on the one hundred eightieth 49 day after it shall have become a law. Effective immediately, the addi- 50 tion, amendment and/or repeal of any rule or regulation necessary for 51 the implementation of this act on its effective date are authorized to 52 be made and completed on or before such effective date.
