House File 620 - Introduced HOUSE FILE 620 BY BENNETT and GAINES A BILL FOR An Act relating to the dispensing of a refill of a chronic 1 maintenance drug to a patient. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 2442YH (3) 88 pf/rh

H.F. 620 Section 1. Section 155A.29, Code 2019, is amended to read 1 as follows: 2 155A.29 Prescription refills. 3 1. Except as specified in subsection 2 or 3 , a prescription 4 for any prescription drug or device which is not a controlled 5 substance shall not be filled or refilled more than eighteen 6 months after the date on which the prescription was issued and 7 a prescription which is authorized to be refilled shall not be 8 refilled more than twelve times. 9 2. A pharmacist may exercise professional judgment by 10 refilling a prescription without prescriber authorization if 11 all of the following are true: 12 a. The pharmacist is unable to contact the prescriber after 13 reasonable effort efforts . 14 b. Failure to refill the prescription might result in 15 an interruption of therapeutic regimen or create patient 16 suffering. 17 c. The pharmacist informs the patient or the patient’s 18 representative at the time of dispensing, and the practitioner 19 at the earliest convenience , that prescriber reauthorization 20 is required. 21 3. d. Prescriptions may be refilled once pursuant to this 22 subsection 2 for a period of time reasonably necessary for the 23 pharmacist to secure prescriber authorization. 24 3. a. In addition to the authorization for a pharmacist to 25 refill a prescription without prescriber authorization pursuant 26 to subsection 2, a pharmacist may exercise professional 27 judgment by refilling a prescription for a chronic maintenance 28 drug if all of the following are applicable: 29 (1) The pharmacist is unable, after reasonable efforts, to 30 obtain authorization from the prescriber or another health care 31 provider responsible for the patient’s care. 32 (2) In the pharmacist’s professional judgment, the refusal 33 to dispense the refill of the chronic maintenance drug will 34 endanger the patient’s life or health or will disrupt essential 35 -1- LSB 2442YH (3) 88 pf/rh 1/ 3

H.F. 620 drug therapy for a chronic condition of the patient. 1 b. The pharmacist may dispense an amount of the chronic 2 maintenance drug not to exceed the amount of the most recent 3 prescription or the standard quantity of the drug dispensed. 4 c. The pharmacist shall dispense the chronic maintenance 5 drug refill in accordance with standard procedures and 6 documentation requirements adopted by rule of the board. 7 d. For the purposes of this subsection, “chronic maintenance 8 drug” means a drug, other than a controlled substance, that is 9 prescribed to a patient to be taken on a recurring basis, and 10 is used as a life-saving rescue drug for a chronic condition or 11 is essential to the continuation of drug therapy for a chronic 12 condition. 13 4. An authorization to refill a prescription drug order 14 shall be transmitted to a pharmacy by a prescriber or the 15 prescriber’s authorized agent pursuant to section 155A.27 , 16 except that prescription drug orders for controlled substances 17 shall be transmitted pursuant to section 124.308 , and, if not 18 transmitted directly by the practitioner, shall also include 19 the name and title of the practitioner’s agent completing the 20 transmission. 21 EXPLANATION 22 The inclusion of this explanation does not constitute agreement with 23 the explanation’s substance by the members of the general assembly. 24 This bill provides that in addition to existing provisions 25 relating to the refilling of a prescription without prescriber 26 authorization, a pharmacist may exercise professional judgment 27 by refilling a prescription for a chronic maintenance drug 28 if the pharmacist is unable, after reasonable efforts, to 29 obtain authorization from the prescriber or another health care 30 provider responsible for the patient’s care; and if in the 31 pharmacist’s professional judgment, the refusal to dispense 32 the refill of the chronic maintenance drug will endanger the 33 patient’s life or health or will disrupt essential drug therapy 34 for a chronic condition of the patient. The bill authorizes 35 -2- LSB 2442YH (3) 88 pf/rh 2/ 3

H.F. 620 the pharmacist to dispense an amount of the chronic maintenance 1 drug not to exceed the amount of the most recent prescription 2 or the standard quantity of the drug dispensed, and to dispense 3 the chronic maintenance drug refill in accordance with standard 4 procedures and documentation requirements adopted by rules of 5 the board of pharmacy. The bill defines a chronic maintenance 6 drug as a drug, other than a controlled substance, that is 7 prescribed to a patient to be taken on a recurring basis, and 8 is used as a life-saving rescue drug for a chronic condition or 9 is essential to the continuation of drug therapy for a chronic 10 condition. 11 -3- LSB 2442YH (3) 88 pf/rh 3/ 3