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                                                       PRINTER'S NO. 901

THE GENERAL ASSEMBLY OF PENNSYLVANIA


SENATE BILL

No. 778 Session of 2007


        INTRODUCED BY ARMSTRONG, ORIE, RAFFERTY, FERLO, COSTA, EARLL,
           RHOADES, WAUGH, MADIGAN, STOUT, WONDERLING AND STACK,
           APRIL 27, 2007

        REFERRED TO PUBLIC HEALTH AND WELFARE, APRIL 27, 2007

                                     AN ACT

     1  Providing for long-term care patient access to pharmaceuticals;
     2     and conferring powers and duties on the State Board of
     3     Pharmacy.

     4     The General Assembly of the Commonwealth of Pennsylvania
     5  hereby enacts as follows:
     6  Section 1. Short title.
     7     This act shall be known and may be cited as the Long-Term
     8  Care Patient Access to Pharmaceuticals Act.
     9  Section 2.  Legislative intent.
    10     The General Assembly finds and declares as follows:
    11         (1)  A mechanism is to be provided whereby patients who
    12     have the ability to acquire lower cost drugs through the
    13     Veterans' Administration have access to those drugs if they
    14     reside in a long-term care facility.
    15         (2)  The mechanism is to be provided by permitting the
    16     pharmacy within the long-term care facility or which has a
    17     contract with the long-term care facility to:
    18             (i)  receive the lower cost drugs directly from the

     1         Veterans' Administration drug benefit program in the
     2         patient's name; and
     3             (ii)  repackage and relabel those drugs so they may
     4         be dispensed in unit doses in compliance with the Food
     5         and Drug Administration, the United States Pharmacopeia
     6         and the long-term care facility's policies and procedures
     7         to patients in a long-term care facility.
     8         (3)  This act shall be interpreted and construed to
     9     effectuate the following purposes:
    10             (i)  To provide for the care, protection and
    11         treatment of patients in long-term care facilities by
    12         allowing them to utilize the drug benefit provided by the
    13         Veterans' Administration.
    14             (ii)  Consistent with the care, protection and
    15         treatment of patients in long-term care facilities, to
    16         provide a means by which a pharmacy in a long-term care
    17         facility or a pharmacy which has a contract with a long-
    18         term care facility may:
    19                 (A)  accept, on behalf of the patient, drugs
    20             received directly from the Veterans' Administration;
    21             and
    22                 (B)  repackage and relabel those drugs so that
    23             the patient may receive them in a unit dose in
    24             compliance with the Food and Drug Administration, the
    25             United States Pharmacopeia and the long-term care
    26             facility's policies and procedures.
    27             (iii)  To provide a means through which the
    28         provisions of this act are executed and enforced and in
    29         which long-term care facilities, pharmacists, drug source
    30         facilities and pharmaceutical providers may implement the
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     1         provisions of this act.
     2  Section 3.  Definitions.
     3     The following words and phrases when used in this act shall
     4  have the meanings given to them in this section unless the
     5  context clearly indicates otherwise:
     6     "Board."  The State Board of Pharmacy.
     7     "Drug source facility."  A facility where drugs are lawfully
     8  manufactured, dispensed or distributed. The term includes a
     9  pharmacy, an entity and a Federal or State agency or
    10  instrumentality.
    11     "Long-term care facility."  A long-term care nursing facility
    12  as defined in section 802.1 of the act of July 19, 1979
    13  (P.L.130, No.48), known as the Health Care Facilities Act.
    14     "Pharmaceutical provider."  An entity that employs a
    15  pharmacist.
    16  Section 4.  State Board of Pharmacy.
    17     The board has the following powers and duties:
    18         (1)  Develop the form required by section 5(b)(3) and
    19     (4).
    20         (2)  Publish a notice in the Pennsylvania Bulletin that
    21     the form has been developed.
    22  Section 5.  Third-party drugs in long-term care facilities.
    23     (a)  Authority.--Notwithstanding any other provision of law,
    24  all of the following may dispense a drug acquired from a drug
    25  source facility outside the long-term care facility to a patient
    26  of a long-term care facility:
    27         (1)  A pharmacist employed by a long-term care facility.
    28         (2)  A pharmacy who contracts with a long-term care
    29     facility to fill prescriptions for patients of the long-term
    30     care facility.
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     1     (b)  Unit dose.--A person authorized under subsection (a) to
     2  dispense a drug shall repackage, relabel and dispense the drug
     3  in a unit dose if all of the following conditions are met:
     4         (1)  The drug is obtained from a drug source facility.
     5         (2)  There is a prescription for the drug.
     6         (3)  The prescriber has signed a form authorizing the
     7     long-term care facility to administer a drug from a drug
     8     source facility outside the long-term care facility.
     9         (4)  The patient has signed a form authorizing the long-
    10     term care facility to administer a drug from a drug source
    11     facility outside the long-term care facility and provided
    12     payment information for payment of the related fees to the
    13     pharmacy. In the case of a minor or a patient who is unable
    14     to sign the form, a parent, a guardian, an agent acting under
    15     a power of attorney or a family member is authorized to sign
    16     the form. The form must explain that a person authorized
    17     under subsection (a) to dispense a drug from a drug source
    18     facility outside the long-term care facility:
    19             (i)  is required to go through the process of
    20         repackaging and relabeling the drug;
    21             (ii)  may charge a fee for repackaging and relabeling
    22         the drug, including the amount of the fee and the
    23         frequency of its assessment; and
    24             (iii)  has immunity from civil liability arising from
    25         dispensation of the drug if the person properly
    26         repackages and relabels the drug as set forth in section
    27         8.
    28         (5)  The nursing facility attending physician has issued
    29     an order continuing the patient's medical regime.
    30         (6)  The drug is not a controlled substance.
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     1         (7)  The repackaging is in compliance with the Food and
     2     Drug Administration, the United States Pharmacopeia and the
     3     long-term care facility's policies and procedures.
     4         (8)  The Veterans' Administration provides the drug
     5     directly to the long-term care pharmacy in the patient's name
     6     and with the following information in preparation for the
     7     repackaging and relabeling:
     8             (i)  The name and address of the dispensing pharmacy.
     9             (ii)  The name of the dispensing pharmacist.
    10             (iii)  The lot number of the drug.
    11             (iv)  A copy of the original prescription.
    12             (v)  The date the drug was dispensed.
    13             (vi)  Directions for use, contraindications and other
    14         materials required by law to be provided to the patient.
    15  Section 6.  Recordkeeping.
    16     For each drug dispensed in accordance with section 5(a), the
    17  person authorized to dispense the drug and the long-term care
    18  facility shall maintain a record for at least two years of all
    19  of the items specified in section 5(b)(8).
    20  Section 7.  Fee.
    21     A person authorized under 5(a) to dispense a drug may charge
    22  a reasonable fee to repackage and relabel the drug. Fees so
    23  charged shall not exceed:
    24         (1)  $20 for up to 90 units per drug;
    25         (2)  $10 additional for half tablets; and
    26         (3)  $10 for each additional 90 units.
    27  Section 8.  Civil liability and unprofessional conduct.
    28     (a)  Repackaging and relabeling.--A person authorized under
    29  section 5(a) to dispense a drug shall be immune from civil
    30  liability arising out of dispensation of the drug if the person
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     1  properly repackages and relabels a drug based on the information
     2  received from the original drug source facility.
     3     (b)  Administration of drug.--A long-term care facility or an
     4  employee or agent of a long-term care facility that properly
     5  administers a drug from a person authorized under section 5(a)
     6  to dispense the drug shall be immune from civil liability
     7  arising out of administration of the drug.
     8     (c)  Unprofessional conduct.--A pharmacist authorized under
     9  section 5(a) to dispense a drug who properly relabels and
    10  repackages the drug shall not be deemed to have engaged in
    11  unprofessional conduct under section 5 of the act of September
    12  27, 1961 (P.L.1700, No.699), known as the Pharmacy Act.
    13  Section 40.  Effective date.
    14     This act shall take effect 90 days following the publication
    15  of the notice in the Pennsylvania Bulletin required under
    16  section 4(2).










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