Req. No. 1686 Page 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 STATE OF OKLAHOMA 1st Session of the 58th Legislature (2021) COMMITTEE SUBSTITUTE FOR SENATE BILL 638 By: McCortney COMMITTEE SUBSTITUTE An Act relating to pharmacy; amending 59 O.S. 2011, Section 367.2, which relates to definitions us ed in the Utilization of Unused Prescription Medications Act; adding definition; amending 59 O.S. 2011, Section 367.3, as amended by Secti on 45, Chapter 475, O.S.L. 2019 (59 O.S. Supp. 2020 , Section 367.3), which relates to program for utilization of unuse d prescription drugs; deleting procedure for transfer of certain prescription drugs; providing for donation or return of unused prescription medications for credit or reimbursement; excluding certain drugs; amending 59 O.S. 2011, Section 367.4, which relates to criteria for accepting unused prescription drugs; broadening criteria to apply to returned drugs; amending 59 O.S. 2011, Section 367.5, which relates to participation in program ; clarifying inclusion of certain facilities; specifying ability to refuse individual returns; authorizing pharmacy to restock and redistribute returned prescription drugs after credit or reimbursement; amending 59 O.S. 2011, Section 367.6, which relates to l iability of participating organizations and manufacturers; broadening criteria to apply to returned drugs; removing certain pharmacies from program; clarifying inclusion of certain facilities; amending 59 O.S. 2011, Section 367.7, which relates to promulgation of rules; directing promulgation of certain rules; and providing an effective date. BE IT ENACTED BY THE PEOPLE OF TH E STATE OF OKLAHOMA: Req. No. 1686 Page 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 SECTION 1. AMENDATORY 59 O.S. 2011, Section 367.2, is amended to read as follows: Section 367.2. As used in the Utilization of Unused Prescription Medications Act: 1. “Assisted living center ” has the same meaning as such term is defined in Section 1 -890.2 of Title 63 of the Oklahoma Statutes; 2. “Cancer drugs” means any of several drugs that control or kill neoplastic cells, commonly referred to as “cancer-fighting drugs”; and includes, but is not limited to, drugs used in chemotherapy to destroy cancer cells; 3. “Charitable clinic” means a charitable nonpro fit corporation or a facility organized as a not-for-profit organization pursuant to the provisions of the Oklahoma General Corporation Act that: a. holds a valid exemption from federal income taxation issued pursuant to Section 501(a) of the Internal Revenue Code (26 U.S.C., Section 501(a)) , b. is listed as an exempt organization under 501(c) of the Internal Revenue Code (26 U.S.C., Section 501(c)), c. provides on an outpatient basis for a period of less than twenty-four (24) consecutive hours to persons not residing or confined at such faci lity advice, counseling, diagnosis, treatment, surger y, care or services relating to the preservation or maintenance of health, and Req. No. 1686 Page 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 d. has a licensed outpatient pharmacy; 4. “Health care professional ” means any of the following persons licensed and authorized to prescribe and dispense drugs or to provide medical, dental, or other health -related diagnoses, care or treatment within the scope of their professional license: a. a physician holding a current license to practice medicine pursuant to Chapter 11 or Chapter 14 of Title 59 of the Oklahoma Statutes this title, b. an advanced practice nurse licensed pursuant to Chapter 12 of Title 59 of the Oklahoma Statutes this title, c. a physician assistant licensed pursuant to Chapter 11 of Title 59 of the Oklahoma Statutes this title, d. a dentist licensed pursuant to Chapter 7 of Title 59 of the Oklahoma Statutes this title, e. an optometrist licensed pursuant to Chapter 13 of Title 59 of the Oklahoma Statutes this title, and f. a pharmacist licensed pursuant to Chapter 8 of Title 59 of the Oklahoma Statutes this title; 4. 5. “Medically indigent” means a person eligible to receive Medicaid or Medicare or a person who has no health insurance and who otherwise lacks reasonable means to purchase prescribed medications; Req. No. 1686 Page 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 5. “Charitable clinic” means a charitable nonpro fit corporation or a facility organized as a not-for-profit pursuant to the provisions of the Oklahoma General Corporation Act that: a. holds a valid exemption from federal income taxation issued pursuant to Secti on 501(a) of the Internal Revenue Code (26 U.S.C., Section 501(a)), b. is listed as an exempt organization under 501(c) of the Internal Revenue Code (26 U.S.C., Section 501(c)), c. provides on an outpatient basis for a period of less than twenty-four (24) consecutive hours to persons not residing or confined at such facility advice, counseling, diagnosis, treatment, surgery, care or services relating to the preservation or maintenance of health, and d. has a licensed outpatient pharmacy; and 6. “Nursing facility” has the same meaning as such term is defined in Section 1-1902 of Title 63 of the Oklahoma Statutes ; and 7. “Prescription drug” means a drug which may be dispense d only upon prescription by a health care professional authorized by his or her licensing authority and which is approved for saf ety and effectiveness as a prescription drug under Section 505 or 507 of the Federal Food, Drug and Cosmetic Act (52 Stat. 1040 (1938), 21 U.S.C.A., Section 301). Req. No. 1686 Page 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 SECTION 2. AMENDATORY 59 O.S. 2011, Section 367.3, as amended by Section 45, Chapter 475, O.S.L. 2019 (59 O.S. Supp. 2020, Section 367.3), is amended to re ad as follows: Section 367.3. A. The State Board of Pharmacy shall implement statewide a program consistent with public heal th and safety through which unused prescription drugs, other than prescription dr ugs defined as controlled dangerous substances in Section 2-101 of Title 63 of the Oklahoma Statutes , may be transferred from residential care homes, nursing facilities, assis ted living centers, public intermediate care facilities for individuals with inte llectual disabilities (ICFs/IID) or pharmaceutica l manufacturers to pharmacies operated by a county. If no county pharmacy exists, or if a county pharmacy chooses not to part icipate, such unused prescription medications may be transferred to a pharmacy op erated by a city-county health department or a ph armacy under contract with a city-county health department, a pharmacy operated by the Department of Mental Health and Substan ce Abuse Services or: 1. Donated by a residential care home, a nursing facility, an assisted living center, an intermediate care facility for individuals with intellectual disabilities (ICF/IID) or a pharmaceutical manufacturer to a charitable clinic for the purpose of distributing the unused pre scription medications to Oklahoma residents who are medically indigent ; or Req. No. 1686 Page 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 2. Returned by a residential care home, a nursing facility, an assisted living center or an intermediate care facility for individuals with intellectual disabilities (ICF/IID) to the pharmacy where the unused prescription medications were purchased in exchange for credit or reimbursement. Returns under this paragraph shall not be available for drugs purchased by the state Medicaid program. B. The Board of Pharmacy shall promulgate rules and establish procedures necessary to implement the program e stablished by the Utilization of Unused Prescription Medications Act. C. The Board of Pharmacy shall provide technical as sistance to entities who may wish to participate in the program. SECTION 3. AMENDATORY 59 O.S. 2011, Section 367.4, is amended to read as follows: Section 367.4. The following criteria shall be used in accepting unused prescription drugs for use under t he Utilization of Unused Prescription Medi cations Act: 1. Only prescription drug s in their original sealed unit dose packaging or unused injectables shall be accepted and dispensed pursuant to the Utilization of Unused Prescription Medications Act; 2. The packaging must be unopened, except that cancer drugs packaged in single-unit doses may be accepted and dispensed when the outside packaging is opened if the single -unit-dose packaging has not been opened; 3. Expired prescription drugs shall not be accep ted; Req. No. 1686 Page 7 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 4. A prescription drug shall not be accepted or dispensed if the person accepting or dispensing the drug has reason to believe that the drug is adulterated; 5. No controlled dangerous substances shall be accepted; and 6. Subject to the limitation s pecified in this section, unused prescription drugs dispensed for purposes of a m edical assistance program or drug product donation progra m, or unused prescription drugs returned by a facility listed in Section 367.3 of this title in exchange for credit or reimbursement, may be accepted and dispensed under the Utilization of Unused Pre scription Medications Act. SECTION 4. AMENDATORY 59 O.S. 2011, Section 367 .5, is amended to read as follows: Section 367.5. A. Participation in the Utilization of Unused Prescription Medications Act by pharmacies, nursing homes facilities, assisted living centers , intermediate care facilities for individuals with intellectual disabilities (ICF/IID), charitable clinics or prescription dru g manufacturers shall be voluntary. Nothing in the Utilization of Unused Prescription Medicat ions Act shall require any pharmacy, nursing home facility, assisted living center, intermediate care facility for individuals with intellectual disabilities (ICF/IID), charitable clinic or prescription drug manufacturer to participate in the program . Furthermore, a pharmacy Req. No. 1686 Page 8 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 that participates in the program shall have the right to refuse individual returns of unused prescr iption medications. B. A pharmacy or charitable clinic which meets the eligibility requirements established in the Utilization of Unuse d Prescription Medications Act may: 1. Dispense dispense prescription drugs d onated under the Utilization of Unused Prescription Medications Act to persons who are medically indigent residents of Oklahoma as establis hed in rules by the State Board of Pharmacy; and 2. Charge. Such drugs shall not be resold . However, the charitable clinic may charge persons receiving donated prescription drugs a handling fee established by rule by the Board of Pharmacy. C. A pharmacy which meets the eligibility requireme nts established in the Utilization of Unused Prescription Medications Act may restock and redistribute prescription drugs returned to the pharmacy after the pharmacy has issue d the credit or reimbursement to the facility or entity who purchased the prescription drugs. D. A pharmacy or charitable clinic which meets the eligibility requirements established and authorized by the Utilization of Unused Prescription Medications Act which accepts donated prescription drugs shall: 1. Comply with all applicable federal and state laws related to the storage and distribution of dangerous drugs; Req. No. 1686 Page 9 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 2. Inspect all prescription drugs prio r to dispensing the prescription drugs to determine that such drugs are not adulterated; and 3. Dispense prescription drugs only pursuant to a prescription issued by a health care professional . D. Prescription drugs donated under the Utilization of Unuse d Prescription Medications Act shall not be resold. E. For purposes of the Utilization of Unused Prescription Medications Act, reimbursement from governmental agencies to charitable clinics shall not be considered resale of prescription drugs. SECTION 5. AMENDATORY 59 O.S. 2011, Section 367.6, is amended to read as follows: Section 367.6. A. For matters related only to the lawful donation, return, acceptance, or dispensing of prescription drugs under the Utilization of Unused Pr escription Medications Act, the following persons and e ntities, in compliance with the Utilizatio n of Unused Prescription Medications Act, in the absence of bad faith or gross negligence, shall not be subject to criminal or civil liability for injury other than death, or loss to person or property, or professi onal disciplinary action: 1. The State Board of Pharmacy; 2. The Department of Mental Health and Substance Abuse Services; Req. No. 1686 Page 10 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 3. Any prescription drug manufacturer, governmental entity, nursing home facility, or assisted living cent er, intermediate care facility for individuals with intellectual disabilities (ICF/IID) donating or returning prescription drugs under the Utilization of Unused Prescription Medications Act; 4. Any prescription drug manufact urer or its representative that directly donates prescr iption drugs in professional samples to a charitable clinic or a pharmacy under the Utilization of Unused Prescription Medications Act; 5. Any pharmacy, charitable clinic or health care professional that accepts or dispenses prescription drugs under the Utilization of Unused Prescription Medicati ons Act; and 6. Any pharmacy, or charitable clinic, city-county pharmacy or other state-contracted pharmacy that employs a health care professional who accept s or can legally dispense prescription drugs under the Utilization of Unused Prescription Medicat ions Act and the Oklahoma Pharmacy Act. B. For matters related to the donation , return, acceptance, or dispensing of a prescription drug manufactured by the p rescription drug manufacturer that is donated by any en tity under the Utilization of Unused Presc ription Medications Act, a prescription drug manufacturer shall not, in the absence of bad faith or gross negligence, be subject to criminal or civil liability for injury other than for death, or loss to person or property including, but Req. No. 1686 Page 11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 not limited to, liability for failure to transfer or communicate product or consumer information or the expiration date of the donated prescription drug. SECTION 6. AMENDATORY 59 O.S. 2011, Secti on 367.7, is amended to read as follows: Section 367.7. A. The State Board of Pharmacy shall promulgate emergency rules by December 1, 2004, to implement the Utilization of Unused Prescription Medications Act. Permanent rules shall be promulgated pursuant to the A dministrative Procedures Act. Such rules shall include: 1. Eligibility criteria for pharmacies and charitable clinics authorized to receive and dispense donated prescri ption drugs under the Utilization of Unused Prescription Medic ations Act; 2. Establishment of a formulary which shall include a ll prescription drugs app roved by the federal Food and Drug Administration; 3. Standards and procedures for transfer, acceptanc e, safe storage, security, and dispensing of donated prescript ion drugs; 4. A process for seeking input from the State Departme nt of Health in establishing provisions which affect nursing homes facilities and assisted living centers; 5. A process for seeking input from the Department of Mental Health and Substance Abuse Servi ces in establishing provisions which affect mental health and substance abuse clients; Req. No. 1686 Page 12 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 6. Standards and procedures for inspecting donated prescription drugs to ensure that the drugs are in comp liance with the Utilization of Unused Prescription Medications Act and to ensure that, in the professi onal judgment of the pharmacist, the medications meet all federal and state standards for product integrity; 7. Procedures for destruction of medications that are donated which are controlled substances; 8. Procedures for verifying whether the pharmacy a nd responsible pharmacist participating in the prog ram are licensed and in good standing with the Board of Pharmacy; 9. Establishment of standards for ac ceptance of unused prescription medications from assisted livi ng centers; and 10. Procedures for credit and reimbursement for returns of unused prescription medications; and 11. Any other standards and procedures the Board of Pharmacy deems appropriate or necessary to imple ment the provisions of the Utilization of Unused Prescr iption Medications Act. B. In accordance with the rules and procedures of the program established pursuant to this section, a resident of a nursing facility or assisted living cent er, or the represent ative or guardian of a resident may donate unused presc ription medications, other than prescription drugs defined as controlled dange rous Req. No. 1686 Page 13 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 substances by Section 2 -101 of Title 63 of the Oklahoma Statutes, for dispensation to medically in digent persons. SECTION 7. This act shall become effective November 1, 2021. 58-1-1686 DC 2/22/2021 3:40:10 PM