] is old law to be omitted. LBD05735-01-5S. 6851 2 1 (b) Patient care. The term "patient care" shall mean assessing the 2 appropriateness of prescription and non-prescription drugs for individ- 3 ual patients based on an assessment of the patient's medication history, 4 medication experience including beliefs, concerns, understanding and 5 expectations, the clinical goals of therapy, potential drug-to-drug 6 interactions or other medication safety concerns, recommendations for 7 adherence and consulting with a patient or caregiver. 8 (c) Collaborative practice medication adherence. The term "collabora- 9 tive practice medication adherence" shall mean a program conducted by a 10 qualified pharmacist that ensures a patient's medications, whether 11 prescription or nonprescription, are individually assessed to determine 12 that each medication is appropriate for the patient, effective for the 13 medical condition, safe given the comorbidities and other medications 14 being taken, and able to be taken by the patient as intended. Collabora- 15 tive practice medication adherence protocols conducted by a qualified 16 pharmacist shall include sharing of applicable patient clinical informa- 17 tion with the treating physician as specified in a collaborative prac- 18 tice medication adherence protocol. 19 (d) Collaborative practice medication adherence protocol. The term 20 "collaborative practice medication adherence protocol" shall mean a 21 written document pursuant to and consistent with any applicable state 22 and federal requirements, that is entered into voluntarily by a physi- 23 cian licensed pursuant to article one hundred thirty-one of the educa- 24 tion law and a qualified pharmacist which addresses a chronic disease or 25 diseases as determined by the treating physician and that describes the 26 nature and scope of the collaborative practice medication adherence 27 services to be performed by the qualified pharmacist, in accordance with 28 the provisions of this article. Collaborative practice medication adher- 29 ence protocols between licensed physicians and qualified pharmacists 30 shall be made available to the department for review and to ensure 31 compliance with this article, upon request. 32 2. Authorization to establish collaborative practice medication adher- 33 ence protocols. A physician licensed pursuant to article one hundred 34 thirty-one of the education law shall be authorized to voluntarily 35 establish a collaborative practice medication adherence protocol with a 36 qualified pharmacist to provide collaborative practice medication adher- 37 ence services for a patient who has not met clinical goals of therapy, 38 is at risk for hospitalization or for whom the physician deems it is 39 necessary to receive collaborative practice medication adherence 40 services. Participation by the patient in collaborative practice medi- 41 cation adherence services shall be voluntary. 42 3. Scope of collaborative practice medication adherence protocols. 43 Under a collaborative practice medication adherence protocol, a quali- 44 fied pharmacist shall be permitted to: 45 (a) adjust or manage a drug regimen of a patient, pursuant to the 46 patient specific order or protocol established by the patient's treating 47 physician, which may include adjusting drug strength, frequency of 48 administration or route of administration. Adjusting the drug regimen 49 shall not include substituting or selecting a different drug which 50 differs from that initially prescribed by the patient's treating physi- 51 cian unless such substitution is expressly authorized in the written 52 order or protocol. The qualified pharmacist shall be required to imme- 53 diately document in the patient's medical record changes made to the 54 patient's drug therapy. The patient's treating physician may prohibit, 55 by written instruction, any adjustment or change in the patient's drug 56 regimen by the qualified pharmacist;S. 6851 3 1 (b) evaluate and, only if specifically authorized by the protocol and 2 only to the extent necessary to discharge the responsibilities set forth 3 in this article, order disease state laboratory tests related to the 4 drug therapy management for the specific chronic disease or diseases 5 specified within the written agreement or protocol; 6 (c) only if specifically authorized by the written order or protocol 7 and only to the extent necessary to discharge the responsibilities set 8 forth in this article, order or perform routine patient monitoring func- 9 tions as may be necessary in the drug therapy management, including the 10 collecting and reviewing of patient histories, and ordering or checking 11 patient vital signs, including pulse, temperature, blood pressure, 12 weight and respiration; and 13 (d) access the complete patient medical record maintained by the 14 treating physician with whom the qualified pharmacist has the collabora- 15 tive practice medication adherence protocol and document any adjustments 16 made pursuant to the protocol in the patient's medical record and shall 17 notify the patient's treating physician of any adjustments in a timely 18 manner electronically or by other means. 19 (e) Under no circumstances, shall the qualified pharmacist be permit- 20 ted to delegate collaborative practice medication adherence services to 21 any other licensed pharmacist or other pharmacy personnel. 22 4. Medication adjustments. Any medication adjustments made by the 23 qualified pharmacist pursuant to the collaborative practice medication 24 adherence protocol including adjustments in drug strength, frequency or 25 route of administration, or initiation of a drug which differs from that 26 initially prescribed and as documented in the patient's medical record 27 shall be deemed an oral prescription authorized by an agent of the 28 patient's treating physician and shall be dispensed consistent with 29 section sixty-eight hundred ten of the education law. For the purposes 30 of this article, a pharmacist who is not an employee of the physician 31 may be authorized to serve as an agent of the physician. 32 5. Referrals. A physician licensed pursuant to article one hundred 33 thirty-one of the education law who has responsibility for the treatment 34 and care of a patient for a chronic disease or diseases as determined by 35 the physician may refer the patient to a qualified pharmacist for colla- 36 borative practice medication adherence services, pursuant to the colla- 37 borative practice medication adherence protocol that the physician has 38 established with the qualified pharmacist. The protocol agreement shall 39 authorize the pharmacist to serve as an agent of the physician as 40 defined by the protocol. Such referral shall be documented in the 41 patient's medical record. 42 6. Patient participation. Participation in collaborative practice 43 medication adherence services shall be voluntary, and no patient, physi- 44 cian or pharmacist shall be required to participate. The referral of a 45 patient for collaborative practice medication adherence services and the 46 patient's right to choose to not participate shall be disclosed to the 47 patient. Collaborative practice medication adherence services shall not 48 be utilized unless the patient or the patient's authorized represen- 49 tative consents, in writing, to such services. Such consent shall be 50 noted in the patient's medical record. If the patient or the patient's 51 authorized representative who consented chooses to no longer participate 52 in such services, at any time, the services shall be discontinued and it 53 shall be noted in the patient's medical record. 54 § 3. The education law is amended by adding a new section 6801-b to 55 read as follows:S. 6851 4 1 § 6801-b. Collaborative practice medication adherence. 1. As used in 2 this section: 3 (a) "collaborative practice medication adherence" shall mean a program 4 for the management of chronic disease or diseases that ensures a 5 patient's medications, whether prescription or nonprescription, are 6 individually assessed to determine that each medication is appropriate 7 for the patient, effective for the medical condition, safe given the 8 comorbidities and other medications being taken, and able to be taken by 9 the patient as intended; and 10 (b) "collaborative practice medication adherence protocol" shall mean 11 a written document, pursuant to and consistent with any applicable state 12 or federal requirements, that is entered into voluntarily by a physician 13 licensed pursuant to article one hundred thirty-one of this title and a 14 licensed pharmacist who meets the qualification requirements specified 15 in article twenty-nine-H of the public health law which addresses a 16 chronic disease or diseases as determined by the physician and that 17 describes the nature and scope of the collaborative practice medication 18 adherence service to be performed by the qualified pharmacist. Collabo- 19 rative practice medication adherence protocols between licensed physi- 20 cians and qualified pharmacists shall be made available to the depart- 21 ment for review and to ensure compliance with this article, upon 22 request. 23 2. A licensed pharmacist qualified pursuant to article twenty-nine-H 24 of the public health law is authorized to serve as an agent of the 25 physician when executing the terms of the written collaborative practice 26 medication adherence protocol as established by the licensed physician 27 for the management of patients with a chronic disease or diseases. 28 § 4. Section 5 of chapter 21 of the laws of 2011 amending the educa- 29 tion law relating to authorizing pharmacists to perform collaborative 30 drug therapy management with physicians in certain settings, as amended 31 by section 2 of part P of chapter 57 of the laws of 2024, is amended to 32 read as follows: 33 § 5. This act shall take effect on the one hundred twentieth day after 34 it shall have become a law, [provided, however, that the provisions of35sections two, three, and four of this act shall expire and be deemed36repealed July 1, 2026]; provided, however, that the amendments to subdi- 37 vision 1 of section 6801 of the education law made by section one of 38 this act shall be subject to the expiration and reversion of such subdi- 39 vision pursuant to section 8 of chapter 563 of the laws of 2008, when 40 upon such date the provisions of section one-a of this act shall take 41 effect; provided, further, that effective immediately, the addition, 42 amendment and/or repeal of any rule or regulation necessary for the 43 implementation of this act on its effective date are authorized and 44 directed to be made and completed on or before such effective date. 45 § 5. This act shall take effect immediately, provided that sections 46 one and two of this act shall take effect on the one hundred eightieth 47 day after it shall have become a law. Effective immediately, the addi- 48 tion, amendment and/or repeal of any rule or regulation necessary for 49 the implementation of this act on its effective date are authorized to 50 be made and completed on or before such effective date.