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House Study Bill 91 - IntroducedA Bill ForAn Act 1relating to the practice of pharmacy, including
2the prescription and administration of vaccines and
3collaborative pharmacy practice.
4BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. Section 155A.46, Code 2021, is amended to read
2as follows:
3155A.46 Statewide Administration of drugs — statewide
4 protocols.
51. a. A pharmacist may, pursuant to statewide protocols
6developed by the board in consultation with the department of
7public health and consistent with subsection 2 3, order and
8administer the following to patients ages eighteen years and
9older:
10(1) a. Naloxone.
11(2) b. Nicotine replacement tobacco Tobacco cessation
12products.
13c. Point-of-care testing and treatment for influenza,
14streptococcus A, and COVID-19 as defined in section 686D.2 at
15the point of interaction between a pharmacist and a patient.
16d. Point-of-care testing at the point of interaction between
17a pharmacist and a patient in response to a public health
18emergency.
192. a. A pharmacist may prescribe and administer the
20following to patients ages three years and older:
21(3) (1) An immunization or vaccination recommended by
22the United States centers for disease control and prevention
23advisory committee on immunization practices in its approved
24vaccination schedule for adults.
25(4) (2) An immunization or vaccination recommended by the
26United States centers for disease control and prevention for
27international travel.
28(5) A Tdap (tetanus, diphtheria, acellular pertussis)
29vaccination in a booster application.
30(3) Vaccines currently licensed for use in the United
31States on the list issued by the United States food and drug
32administration, including those related to COVID-19.
33(6) (4) Other emergency immunizations or vaccinations in
34response to a public health emergency.
35b. A pharmacist may, pursuant to statewide protocols
-1-1developed by the board in consultation with the department of
2public health and consistent with subsection 2, order prescribe
3 and administer the following to patients ages six months and
4older:
5(1) A vaccine or An immunization or vaccination for
6influenza.
7(2) Other emergency immunizations or vaccines vaccinations
8 in response to a public health emergency.
9c. A pharmacist may, pursuant to statewide protocols
10developed by the board in consultation with the department
11of public health and consistent with subsection 2, order and
12administer the final two doses in a course of vaccinations for
13HPV to patients ages eleven years and older.
14d. c. Prior to the ordering prescribing and administration
15of a vaccination or an immunization or vaccination authorized
16by this subsection, pursuant to statewide protocols, a licensed
17pharmacist shall consult and review the statewide immunization
18registry or health information network. The board shall
19adopt rules requiring the reporting of the administration of
20vaccines and immunizations and vaccinations authorized by this
21subsection to a patient’s primary health care provider, primary
22physician, and a statewide immunization registry or health
23information network.
242. 3. A pharmacist prescribing, ordering, or administering
25a prescription drug, product, test, or treatment pursuant to
26subsection 1 or 2 shall do all of the following:
27a. Maintain a record of all prescription drugs, products,
28tests, and treatments administered pursuant to this section.
29b. Notify the patient’s primary health care provider
30of any prescription drugs, products, tests, or treatments
31administered to the patient, or enter such information in a
32patient record system also used by the primary health care
33provider, as permitted by the primary health care provider. If
34the patient does not have a primary health care provider, the
35pharmacist shall provide the patient with a written record of
-2-1the prescription drugs, products, tests, or treatment provided
2to the patient and shall advise the patient to consult a
3physician.
4c. Complete continuing pharmacy education related to
5statewide protocols and immunizations and vaccinations
6 recognized and approved by the board.
7 Sec. 2. NEW SECTION. 155A.47 Collaborative pharmacy
8practice — agreements — payment.
91. For the purposes of this section:
10a. “Collaborative pharmacy practice” means a practice of
11pharmacy whereby a pharmacist provides patient care and drug
12therapy management services not otherwise permitted to be
13performed by a pharmacist to patients under a collaborative
14pharmacy practice agreement with another pharmacist or
15practitioner which defines the nature, scope, conditions, and
16limitations of the patient care and drug therapy management
17services to be provided by a pharmacist in order to ensure that
18a patient achieves the desired outcomes.
19b. “Health benefit plan” means the same as defined in
20section 514J.102.
21c. “Health carrier” means the same as defined in section
22514J.102.
232. Notwithstanding any provision of law to the contrary, a
24pharmacist may engage in a collaborative pharmacy practice, in
25accordance with rules adopted by the board pursuant to chapter
2617A and under a collaborative pharmacy practice agreement, to
27provide patient care and drug therapy management services to
28a patient.
293. Notwithstanding any provision of a health benefit plan
30to the contrary, whenever a health benefit plan provides for
31payment or reimbursement for a service that is within the
32lawful scope of practice of a practitioner or pharmacist
33and the service is provided by a pharmacist pursuant to a
34collaborative pharmacy practice agreement under this section,
35the health carrier may provide payment or reimbursement for the
-3-1service.
2EXPLANATION
3The inclusion of this explanation does not constitute agreement with
4the explanation’s substance by the members of the general assembly.
5This bill relates to the ordering, prescribing, and
6administration of certain drugs to patients by pharmacists.
7With respect to patients 18 years and older, and pursuant
8to statewide protocols, the bill removes the authority of
9pharmacists to order and administer nicotine replacement
10products and Tdap (tetanus, diphtheria, acellular pertussis)
11vaccinations in a booster application and allows pharmacists
12to order and administer testing and treatment for influenza,
13streptococcus A, and COVID-19 as defined in the bill at the
14point-of-care testing between a pharmacist and a patient. The
15bill also removes the authority of pharmacists to order and
16administer the final two doses in a course of vaccinations for
17HPV (human papilloma virus) to patients 11 years of age and
18older.
19The bill allows a pharmacist to prescribe and administer to
20patients three years of age and older all of the following: 1)
21an immunization or vaccination recommended by the United States
22centers for disease control and prevention advisory committee
23on immunization practices in its approved vaccination schedule,
24including those related to COVID-19, 2) an immunization or
25vaccination recommended by the United States centers for
26disease control and prevention for international travel, 3)
27vaccines currently licensed for use in the United States on the
28list issued by the United States food and drug administration,
29and 4) other emergency immunizations or vaccinations in
30response to a public health emergency. Current law permits
31pharmacists to order and administer such immunizations and
32vaccinations to patients age 18 years and older pursuant to
33statewide protocols.
34The bill allows a pharmacist to prescribe and administer
35a vaccine or immunization for influenza and other emergency
-4-1immunizations or vaccines in response to a public health
2emergency to patients ages six months and older.
3The bill allows a pharmacist to engage in a collaborative
4pharmacy practice under a collaborative pharmacy practice
5agreement to provide patient care and drug therapy management
6services to a patient.
7The bill allows a health carrier to pay for a service
8provided by a pharmacist under a collaborative pharmacy
9practice agreement if the health benefit plan provides for
10payment or reimbursement for a service when the service is
11within the lawful scope of practice of a practitioner or
12pharmacist.
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2the prescription and administration of vaccines and
3collaborative pharmacy practice.
4BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. Section 155A.46, Code 2021, is amended to read
2as follows:
3155A.46 Statewide Administration of drugs — statewide
4 protocols.
51. a. A pharmacist may, pursuant to statewide protocols
6developed by the board in consultation with the department of
7public health and consistent with subsection 2 3, order and
8administer the following to patients ages eighteen years and
9older:
10(1) a. Naloxone.
11(2) b. Nicotine replacement tobacco Tobacco cessation
12products.
13c. Point-of-care testing and treatment for influenza,
14streptococcus A, and COVID-19 as defined in section 686D.2 at
15the point of interaction between a pharmacist and a patient.
16d. Point-of-care testing at the point of interaction between
17a pharmacist and a patient in response to a public health
18emergency.
192. a. A pharmacist may prescribe and administer the
20following to patients ages three years and older:
21(3) (1) An immunization or vaccination recommended by
22the United States centers for disease control and prevention
23advisory committee on immunization practices in its approved
24vaccination schedule for adults.
25(4) (2) An immunization or vaccination recommended by the
26United States centers for disease control and prevention for
27international travel.
28(5) A Tdap (tetanus, diphtheria, acellular pertussis)
29vaccination in a booster application.
30(3) Vaccines currently licensed for use in the United
31States on the list issued by the United States food and drug
32administration, including those related to COVID-19.
33(6) (4) Other emergency immunizations or vaccinations in
34response to a public health emergency.
35b. A pharmacist may, pursuant to statewide protocols
-1-1developed by the board in consultation with the department of
2public health and consistent with subsection 2, order prescribe
3 and administer the following to patients ages six months and
4older:
5(1) A vaccine or An immunization or vaccination for
6influenza.
7(2) Other emergency immunizations or vaccines vaccinations
8 in response to a public health emergency.
9c. A pharmacist may, pursuant to statewide protocols
10developed by the board in consultation with the department
11of public health and consistent with subsection 2, order and
12administer the final two doses in a course of vaccinations for
13HPV to patients ages eleven years and older.
14d. c. Prior to the ordering prescribing and administration
15of a vaccination or an immunization or vaccination authorized
16by this subsection, pursuant to statewide protocols, a licensed
17pharmacist shall consult and review the statewide immunization
18registry or health information network. The board shall
19adopt rules requiring the reporting of the administration of
20vaccines and immunizations and vaccinations authorized by this
21subsection to a patient’s primary health care provider, primary
22physician, and a statewide immunization registry or health
23information network.
242. 3. A pharmacist prescribing, ordering, or administering
25a prescription drug, product, test, or treatment pursuant to
26subsection 1 or 2 shall do all of the following:
27a. Maintain a record of all prescription drugs, products,
28tests, and treatments administered pursuant to this section.
29b. Notify the patient’s primary health care provider
30of any prescription drugs, products, tests, or treatments
31administered to the patient, or enter such information in a
32patient record system also used by the primary health care
33provider, as permitted by the primary health care provider. If
34the patient does not have a primary health care provider, the
35pharmacist shall provide the patient with a written record of
-2-1the prescription drugs, products, tests, or treatment provided
2to the patient and shall advise the patient to consult a
3physician.
4c. Complete continuing pharmacy education related to
5statewide protocols and immunizations and vaccinations
6 recognized and approved by the board.
7 Sec. 2. NEW SECTION. 155A.47 Collaborative pharmacy
8practice — agreements — payment.
91. For the purposes of this section:
10a. “Collaborative pharmacy practice” means a practice of
11pharmacy whereby a pharmacist provides patient care and drug
12therapy management services not otherwise permitted to be
13performed by a pharmacist to patients under a collaborative
14pharmacy practice agreement with another pharmacist or
15practitioner which defines the nature, scope, conditions, and
16limitations of the patient care and drug therapy management
17services to be provided by a pharmacist in order to ensure that
18a patient achieves the desired outcomes.
19b. “Health benefit plan” means the same as defined in
20section 514J.102.
21c. “Health carrier” means the same as defined in section
22514J.102.
232. Notwithstanding any provision of law to the contrary, a
24pharmacist may engage in a collaborative pharmacy practice, in
25accordance with rules adopted by the board pursuant to chapter
2617A and under a collaborative pharmacy practice agreement, to
27provide patient care and drug therapy management services to
28a patient.
293. Notwithstanding any provision of a health benefit plan
30to the contrary, whenever a health benefit plan provides for
31payment or reimbursement for a service that is within the
32lawful scope of practice of a practitioner or pharmacist
33and the service is provided by a pharmacist pursuant to a
34collaborative pharmacy practice agreement under this section,
35the health carrier may provide payment or reimbursement for the
-3-1service.
2EXPLANATION
3The inclusion of this explanation does not constitute agreement with
4the explanation’s substance by the members of the general assembly.
5This bill relates to the ordering, prescribing, and
6administration of certain drugs to patients by pharmacists.
7With respect to patients 18 years and older, and pursuant
8to statewide protocols, the bill removes the authority of
9pharmacists to order and administer nicotine replacement
10products and Tdap (tetanus, diphtheria, acellular pertussis)
11vaccinations in a booster application and allows pharmacists
12to order and administer testing and treatment for influenza,
13streptococcus A, and COVID-19 as defined in the bill at the
14point-of-care testing between a pharmacist and a patient. The
15bill also removes the authority of pharmacists to order and
16administer the final two doses in a course of vaccinations for
17HPV (human papilloma virus) to patients 11 years of age and
18older.
19The bill allows a pharmacist to prescribe and administer to
20patients three years of age and older all of the following: 1)
21an immunization or vaccination recommended by the United States
22centers for disease control and prevention advisory committee
23on immunization practices in its approved vaccination schedule,
24including those related to COVID-19, 2) an immunization or
25vaccination recommended by the United States centers for
26disease control and prevention for international travel, 3)
27vaccines currently licensed for use in the United States on the
28list issued by the United States food and drug administration,
29and 4) other emergency immunizations or vaccinations in
30response to a public health emergency. Current law permits
31pharmacists to order and administer such immunizations and
32vaccinations to patients age 18 years and older pursuant to
33statewide protocols.
34The bill allows a pharmacist to prescribe and administer
35a vaccine or immunization for influenza and other emergency
-4-1immunizations or vaccines in response to a public health
2emergency to patients ages six months and older.
3The bill allows a pharmacist to engage in a collaborative
4pharmacy practice under a collaborative pharmacy practice
5agreement to provide patient care and drug therapy management
6services to a patient.
7The bill allows a health carrier to pay for a service
8provided by a pharmacist under a collaborative pharmacy
9practice agreement if the health benefit plan provides for
10payment or reimbursement for a service when the service is
11within the lawful scope of practice of a practitioner or
12pharmacist.
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