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53	53	STATE OF OKLAHOMA
54	54
55	55	2nd Session of the 58th Legislature (2022)
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57	57	SENATE BILL 1638 By: Jett
58	58
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63	63	AS INTRODUCED
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65	65	An Act relating to the practice of pharma cy; amending
66	66	59 O.S. 2021, Section 353.20.2 , which relates to
67	67	pharmacist discretion; prohibiting pharmacist from
68	68	refusing to fill valid prescription for specified
69	69	reason; amending 59 O.S. 2021, Section 355.1 , which
70	70	relates to dispensing of d angerous drugs; prohibiting
71	71	licensed practitioner from refusing to dispense drug
72	72	for specified reason ; providing penalties; and
73	73	providing an effective date .
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79	79	BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
80	80	SECTION 1. AMENDATORY 59 O.S. 2 021, Section 353.20.2, is
81	81	amended to read as follows:
82	82	Section 353.20.2. A. Except as provided in subsection C of
83	83	this section, unless the prescriber has specified on the
84	84	prescription that dispensing a prescription for a maintenance
85	85	medication in an initial amount followed by periodic refill s is
86	86	medically necessary, a pharmacist may exercis e his or her
87	87	professional judgment to dis pense varying quantities of medication
88	88	per fill-up to the total number o f dosage units as authorized by the
89	89	prescriber on the original prescription including any ref ills.
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141	141	B. Subsection A of this section shall not a pply to scheduled
142	142	medications or any medi cations for which a report is required under
143	143	the controlled substance da tabase. Dispensing of medication based
144	144	on refills authorized by the physician on the prescri ption shall be
145	145	limited to no more than a ninety -day supply of the medication.
146	146	C. 1. A pharmacist may dispense without a prescription one or
147	147	more devices or medic ations as medically necessary to prevent the
148	148	death of or serious harm to the health of a pati ent if the following
149	149	conditions are met:
150	150	a. the pharmacy which the pharmacist owns or at wh ich the
151	151	pharmacist is employed has a current record of a
152	152	prescription for the medication or device prescribed
153	153	in the name of the patient who is requesting it, but
154	154	the prescription has expired and a refill requires
155	155	authorization from the licensed practition er who
156	156	issued the prescription and neither the patient nor
157	157	the pharmacist was able to obtain the refill after
158	158	reasonable attempts were made to obtain such refill
159	159	and the pharmacist documents such attempts on a form
160	160	prescribed by the State Board of Pharmacy ,
161	161	b. the failure of the pharmacist to dispense the
162	162	medication or device reasonably could result in the
163	163	death of or serious harm to the health of the patient,
164	164
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215	215	c. the device or medication is listed on the formulary
216	216	described in paragraph 4 of this subsection ,
217	217	d. the patient has been on a consistent medication
218	218	therapy as demonstrated by records maintained by the
219	219	pharmacy, and
220	220	e. the amount of the medication or device dis pensed is
221	221	for a reasonable amount of time; provide d, if the
222	222	patient or pharmacist is unable to obtain a refill
223	223	prescription from the patient 's licensed practitione r
224	224	before the amount prescribed to prevent death or
225	225	serious harm to the health of the patient is depleted,
226	226	the pharmacist may dispense an additi onal amount of
227	227	the medication or device n ot more than once in an
228	228	amount consistent with past prescriptions of the
229	229	patient.
230	230	2. The standard of care required of a pharmacist licensed in
231	231	this state who is act ing in accordance with the provisions of this
232	232	subsection shall be the level and type of car e, skill and diligence
233	233	that a reasonably competent and skilled pharmacis t with a similar
234	234	background and in the same or similar locality would have provided
235	235	under the circumstance.
236	236	3. Any pharmacist licensed in this state who in good faith
237	237	dispenses one or more medications or devices to a patient pursuant
238	238	to the provisions of this subsection shall not be liable for any
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290	290	civil damages or subject to criminal prosecution as a result of any
291	291	acts or omissions except for co mmitting gross negligence or willful
292	292	or wanton acts committed in dispensing or failure to dispense the
293	293	medication or device.
294	294	4. The State Board of Pharmacy shall develop and update as
295	295	necessary an inclusio nary formulary of potentially life -saving
296	296	prescription medications and devices, not to incl ude controlled
297	297	dangerous substances, for the purposes of this subsection . Such
298	298	medications and devices shall include but not be limited to:
299	299	a. insulin and any devic es or supplies necessary for the
300	300	administration of insulin,
301	301	b. glucometers and any devices or supplies necessary for
302	302	the operation of the glucometer, and
303	303	c. rescue inhalers.
304	304	5. Dispensing in accordance with this subsection shall be
305	305	deemed dispensing under a legal prescription for purposes of the
306	306	Pharmacy Audit Integrity Act, Section 356 et seq. of this title.
307	307	D. Upon receipt of a valid Schedule II opioid prescript ion
308	308	issued pursuant to the provisions of Section 2 -309I of Title 63 of
309	309	the Oklahoma Statutes, a pharmacist shall fill the prescription to
310	310	the specified dose, and shall not be permitted to fill a different
311	311	dosage than what is prescribed. However, the pharm acist maintains
312	312	the right not to fill the valid opioid prescription.
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364	364	E. A pharmacist shall not refuse to fill a valid prescription
365	365	solely on the grounds that the pharmacist believes the patient
366	366	intends to use the prescribed drug or drugs for o ff-label use. If
367	367	the State Board of Pharmacy finds that a pharmacist is in violation
368	368	of this subsection, the Board shall immediately revoke the license
369	369	of the pharmacist and fine the pharmacist One Hundred Thousand
370	370	Dollars ($100,000.00) per occurrence.
371	371	SECTION 2. AMENDATORY 59 O.S. 2021, Section 355.1, is
372	372	amended to read as follows:
373	373	Section 355.1. A. Except as provided for in Sec tion 353.1 et
374	374	seq. of this title, only a licensed practit ioner may dispense
375	375	dangerous drugs to such practitioner 's patients, and only for the
376	376	expressed purpose of serving the best interests and promoting th e
377	377	welfare of such patients. The dangerous drugs s hall be dispensed in
378	378	an appropriate container to which a label has been affixed. Such
379	379	label shall include the name and office address of the licensed
380	380	practitioner, date dispensed, name of patient, directio ns for
381	381	administration, prescription number, the tr ade or generic name and
382	382	the quantity and strength, not me aning ingredients, of the drug
383	383	therein contained; provided, this requirement shall no t apply to
384	384	compounded medicines. The licensed practitioner shal l keep a
385	385	suitable book, file or record in which sh all be preserved for a
386	386	period of not less than five (5) y ears a record of every dangerous
387	387	drug compounded or dispensed by the licensed practit ioner.
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439	439	B. A prescriber desiring to dispense dangerous drugs pur suant
440	440	to this section shall register annually with the appropriate
441	441	licensing board as a dispenser, through a regulatory procedure
442	442	adopted and prescribed by such licensing board.
443	443	C. A prescriber who dispenses professional samples to patients
444	444	shall be exempt from the requirement of subsection B of this sec tion
445	445	if:
446	446	1. The prescriber furnishes the professional sa mples to the
447	447	patient in the package provided by the manufacturer;
448	448	2. No charge is made to the patient; and
449	449	3. An appropriate record is entered in t he patient's chart.
450	450	D. This section shall not app ly to the services provided
451	451	through the State Department of Health, city/county health
452	452	departments, or the Department of Mental Health and Sub stance Abuse
453	453	Services.
454	454	E. This section shall not apply to organ izations and services
455	455	incorporated as state or fed eral tax-exempt charitable nonprofit
456	456	entities and/or orga nizations and services receiving all or part of
457	457	their operating funds from a local, s tate or federal governmental
458	458	entity; provided, such organization s and services shall comply with
459	459	the labeling and recordkeeping requirements set out in subsection A
460	460	of this section.
461	461	F. A licensed practitioner who dispenses dangerou s drugs shall
462	462	not refuse to dispense a drug solely on the grounds t hat the
463	463
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514	514	practitioner believes the patient intends to use the drug for off-
515	515	label use. If the licensing board of a practitioner finds that the
516	516	practitioner is in violation of this subsection , such board shall,
517	517	in accordance with the rules of such board, immediately revoke the
518	518	license of the practitioner and fine the practitioner One Hundred
519	519	Thousand Dollars ($100,000.00) per occurrence.
520	520	SECTION 3. This act shall become effective November 1, 2022.
521	521
522	522	58-2-3449 DC 1/20/2022 3:29:13 PM

Oklahoma 2022 Regular Session

Oklahoma Senate Bill SB1638 Compare Versions