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STATE OF OKLAHOMA
2nd Session of the 58th Legislature (2022)
SENATE BILL 1638 By: Jett
AS INTRODUCED
An Act relating to the practice of pharma cy; amending
59 O.S. 2021, Section 353.20.2 , which relates to
pharmacist discretion; prohibiting pharmacist from
refusing to fill valid prescription for specified
reason; amending 59 O.S. 2021, Section 355.1 , which
relates to dispensing of d angerous drugs; prohibiting
licensed practitioner from refusing to dispense drug
for specified reason ; providing penalties; and
providing an effective date .
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY 59 O.S. 2 021, Section 353.20.2, is
amended to read as follows:
Section 353.20.2. A. Except as provided in subsection C of
this section, unless the prescriber has specified on the
prescription that dispensing a prescription for a maintenance
medication in an initial amount followed by periodic refill s is
medically necessary, a pharmacist may exercis e his or her
professional judgment to dis pense varying quantities of medication
per fill-up to the total number o f dosage units as authorized by the
prescriber on the original prescription including any ref ills.
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B. Subsection A of this section shall not a pply to scheduled
medications or any medi cations for which a report is required under
the controlled substance da tabase. Dispensing of medication based
on refills authorized by the physician on the prescri ption shall be
limited to no more than a ninety -day supply of the medication.
C. 1. A pharmacist may dispense without a prescription one or
more devices or medic ations as medically necessary to prevent the
death of or serious harm to the health of a pati ent if the following
conditions are met:
a. the pharmacy which the pharmacist owns or at wh ich the
pharmacist is employed has a current record of a
prescription for the medication or device prescribed
in the name of the patient who is requesting it, but
the prescription has expired and a refill requires
authorization from the licensed practition er who
issued the prescription and neither the patient nor
the pharmacist was able to obtain the refill after
reasonable attempts were made to obtain such refill
and the pharmacist documents such attempts on a form
prescribed by the State Board of Pharmacy ,
b. the failure of the pharmacist to dispense the
medication or device reasonably could result in the
death of or serious harm to the health of the patient,
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c. the device or medication is listed on the formulary
described in paragraph 4 of this subsection ,
d. the patient has been on a consistent medication
therapy as demonstrated by records maintained by the
pharmacy, and
e. the amount of the medication or device dis pensed is
for a reasonable amount of time; provide d, if the
patient or pharmacist is unable to obtain a refill
prescription from the patient 's licensed practitione r
before the amount prescribed to prevent death or
serious harm to the health of the patient is depleted,
the pharmacist may dispense an additi onal amount of
the medication or device n ot more than once in an
amount consistent with past prescriptions of the
patient.
2. The standard of care required of a pharmacist licensed in
this state who is act ing in accordance with the provisions of this
subsection shall be the level and type of car e, skill and diligence
that a reasonably competent and skilled pharmacis t with a similar
background and in the same or similar locality would have provided
under the circumstance.
3. Any pharmacist licensed in this state who in good faith
dispenses one or more medications or devices to a patient pursuant
to the provisions of this subsection shall not be liable for any
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civil damages or subject to criminal prosecution as a result of any
acts or omissions except for co mmitting gross negligence or willful
or wanton acts committed in dispensing or failure to dispense the
medication or device.
4. The State Board of Pharmacy shall develop and update as
necessary an inclusio nary formulary of potentially life -saving
prescription medications and devices, not to incl ude controlled
dangerous substances, for the purposes of this subsection . Such
medications and devices shall include but not be limited to:
a. insulin and any devic es or supplies necessary for the
administration of insulin,
b. glucometers and any devices or supplies necessary for
the operation of the glucometer, and
c. rescue inhalers.
5. Dispensing in accordance with this subsection shall be
deemed dispensing under a legal prescription for purposes of the
Pharmacy Audit Integrity Act, Section 356 et seq. of this title.
D. Upon receipt of a valid Schedule II opioid prescript ion
issued pursuant to the provisions of Section 2 -309I of Title 63 of
the Oklahoma Statutes, a pharmacist shall fill the prescription to
the specified dose, and shall not be permitted to fill a different
dosage than what is prescribed. However, the pharm acist maintains
the right not to fill the valid opioid prescription.
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E. A pharmacist shall not refuse to fill a valid prescription
solely on the grounds that the pharmacist believes the patient
intends to use the prescribed drug or drugs for o ff-label use. If
the State Board of Pharmacy finds that a pharmacist is in violation
of this subsection, the Board shall immediately revoke the license
of the pharmacist and fine the pharmacist One Hundred Thousand
Dollars ($100,000.00) per occurrence.
SECTION 2. AMENDATORY 59 O.S. 2021, Section 355.1, is
amended to read as follows:
Section 355.1. A. Except as provided for in Sec tion 353.1 et
seq. of this title, only a licensed practit ioner may dispense
dangerous drugs to such practitioner 's patients, and only for the
expressed purpose of serving the best interests and promoting th e
welfare of such patients. The dangerous drugs s hall be dispensed in
an appropriate container to which a label has been affixed. Such
label shall include the name and office address of the licensed
practitioner, date dispensed, name of patient, directio ns for
administration, prescription number, the tr ade or generic name and
the quantity and strength, not me aning ingredients, of the drug
therein contained; provided, this requirement shall no t apply to
compounded medicines. The licensed practitioner shal l keep a
suitable book, file or record in which sh all be preserved for a
period of not less than five (5) y ears a record of every dangerous
drug compounded or dispensed by the licensed practit ioner.
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B. A prescriber desiring to dispense dangerous drugs pur suant
to this section shall register annually with the appropriate
licensing board as a dispenser, through a regulatory procedure
adopted and prescribed by such licensing board.
C. A prescriber who dispenses professional samples to patients
shall be exempt from the requirement of subsection B of this sec tion
if:
1. The prescriber furnishes the professional sa mples to the
patient in the package provided by the manufacturer;
2. No charge is made to the patient; and
3. An appropriate record is entered in t he patient's chart.
D. This section shall not app ly to the services provided
through the State Department of Health, city/county health
departments, or the Department of Mental Health and Sub stance Abuse
Services.
E. This section shall not apply to organ izations and services
incorporated as state or fed eral tax-exempt charitable nonprofit
entities and/or orga nizations and services receiving all or part of
their operating funds from a local, s tate or federal governmental
entity; provided, such organization s and services shall comply with
the labeling and recordkeeping requirements set out in subsection A
of this section.
F. A licensed practitioner who dispenses dangerou s drugs shall
not refuse to dispense a drug solely on the grounds t hat the
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practitioner believes the patient intends to use the drug for off-
label use. If the licensing board of a practitioner finds that the
practitioner is in violation of this subsection , such board shall,
in accordance with the rules of such board, immediately revoke the
license of the practitioner and fine the practitioner One Hundred
Thousand Dollars ($100,000.00) per occurrence.
SECTION 3. This act shall become effective November 1, 2022.
58-2-3449 DC 1/20/2022 3:29:13 PM