Increase Access to Pharmacy Services

     Under current law, a pharmacist may receive reimbursement under a health benefit plan and under the medical assistance program (medicaid) for health-care services provided pursuant to a collaborative pharmacy practice agreement. If certain conditions are met, the bill requires health benefit plans that provide hospital, surgical, or medical expense insurance to provide coverage for health-care services provided by a pharmacist that are within the pharmacist's scope of practice. Similarly, under medicaid, the bill authorizes reimbursement for services that are within a pharmacist's scope of practice and not duplicative of other pharmacist services or programs reimbursed by medicaid.

     Further, solely on the basis of the type of license or certification, a health benefit plan or health insurance carrier shall not discriminate against a pharmacist who is acting within the scope of the pharmacist's license or certification under state law, with respect to participation, referral, reimbursement of covered services, or indemnification, or prohibit a pharmacist from membership in a provider's network.

     The bill makes changes to the definitions in the pharmacy practice statutes to include a definition for 'final product verification', which is defined as a physical verification process for drug, device, or product orders filled through a pharmacy's electronic system after initial fill by a technician or other automated technology. Final product verification may be delegated by a supervising pharmacist to a certified pharmacy technician or pharmacy intern. The process requires a pharmacy or other outlet to have a continuous quality assessment system in place to periodically verify the accuracy of the final drug, device, or product. A pharmacy intending to implement a final product verification program shall create a plan for final product verification, including how pharmacists' hours will be maintained to provide direct patient care. The state board of pharmacy is required to adopt rules relating to final product verification.

     Under current law, a pharmacist has independent prescriptive authority for drugs that are not controlled substances, drug categories, or devices that are prescribed to patients who are at least 12 years old, if certain conditions are met. The bill also adds to the definition of the 'practice of pharmacy' to include independent prescriptive authority for drugs that are not controlled substances, drug categories, or devices that are prescribed to patients younger than 12 years old for conditions that do not require a new diagnosis, that are minor and self-limiting, or that have a test that guides diagnosis and are not medications that may only be prescribed pursuant to a certified education program and a limited distribution network.
(Note: This summary applies to this bill as introduced.)