HF 620 (LSB 2442YH (3) 88)

HOUSE FILE 620

BY  BENNETT and GAINES

A BILL FOR

An Act relating to the dispensing of a refill of a chronic maintenance drug to a patient. 
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 155A.29, Code 2019, is amended to read as follows:
   155A.29  Prescription refills.
   1.  Except as specified in subsection 2 or 3, a prescription for any prescription drug or device which is not a controlled substance shall not be filled or refilled more than eighteen months after the date on which the prescription was issued and a prescription which is authorized to be refilled shall not be refilled more than twelve times.
   2.  A pharmacist may exercise professional judgment by refilling a prescription without prescriber authorization if all of the following are true:
   a.  The pharmacist is unable to contact the prescriber after reasonable effort efforts.
   b.  Failure to refill the prescription might result in an interruption of therapeutic regimen or create patient suffering.
   c.  The pharmacist informs the patient or the patient’s representative at the time of dispensing, and the practitioner at the earliest convenience, that prescriber reauthorization is required.
   3.  d.  Prescriptions may be refilled once pursuant to this subsection 2 for a period of time reasonably necessary for the pharmacist to secure prescriber authorization.
   3.  a.  In addition to the authorization for a pharmacist to refill a prescription without prescriber authorization pursuant to subsection 2, a pharmacist may exercise professional judgment by refilling a prescription for a chronic maintenance drug if all of the following are applicable: 
   (1)  The pharmacist is unable, after reasonable efforts, to obtain authorization from the prescriber or another health care provider responsible for the patient’s care.
   (2)  In the pharmacist’s professional judgment, the refusal to dispense the refill of the chronic maintenance drug will endanger the patient’s life or health or will disrupt essential drug therapy for a chronic condition of the patient.
   b.  The pharmacist may dispense an amount of the chronic maintenance drug not to exceed the amount of the most recent prescription or the standard quantity of the drug dispensed.
   c.  The pharmacist shall dispense the chronic maintenance drug refill in accordance with standard procedures and documentation requirements adopted by rule of the board.
   d.  For the purposes of this subsection, “chronic maintenance drug” means a drug, other than a controlled substance, that is prescribed to a patient to be taken on a recurring basis, and is used as a life-saving rescue drug for a chronic condition or is essential to the continuation of drug therapy for a chronic condition.
   4.  An authorization to refill a prescription drug order shall be transmitted to a pharmacy by a prescriber or the prescriber’s authorized agent pursuant to section 155A.27, except that prescription drug orders for controlled substances shall be transmitted pursuant to section 124.308, and, if not transmitted directly by the practitioner, shall also include the name and title of the practitioner’s agent completing the transmission.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill provides that in addition to existing provisions relating to the refilling of a prescription without prescriber authorization, a pharmacist may exercise professional judgment by refilling a prescription for a chronic maintenance drug if the pharmacist is unable, after reasonable efforts, to obtain authorization from the prescriber or another health care provider responsible for the patient’s care; and if in the pharmacist’s professional judgment, the refusal to dispense the refill of the chronic maintenance drug will endanger the patient’s life or health or will disrupt essential drug therapy for a chronic condition of the patient. The bill authorizes the pharmacist to dispense an amount of the chronic maintenance drug not to exceed the amount of the most recent prescription or the standard quantity of the drug dispensed, and to dispense the chronic maintenance drug refill in accordance with standard procedures and documentation requirements adopted by rules of the board of pharmacy. The bill defines a chronic maintenance drug as a drug, other than a controlled substance, that is prescribed to a patient to be taken on a recurring basis, and is used as a life-saving rescue drug for a chronic condition or is essential to the continuation of drug therapy for a chronic condition.