COMMITTEE ON HEALTH & HUMAN SERVICES
HOUSE OF REPRESENTATIVES AMENDMENTS TO S.B. 1278
(Reference to Senate engrossed bill)
Page 1, line 16, after the first "student" insert ", which may include educating the student about dispensing drugs and devices,"
Between lines 23 and 24, insert:
"Sec. 2. Section 32-1491, Arizona Revised Statutes, is amended to read:
32-1491. Dispensing of drugs and devices; exception; civil penalty; conditions; definition
A. Except as provided in subsection subsections B and F of this section, a doctor of medicine may dispense drugs and devices kept by the doctor if:
1. All drugs are dispensed in packages labeled with the following information:
(a) The dispensing doctor's name, address and telephone number.
(b) The date the drug is dispensed.
(c) The patient's name.
(d) The name and strength of the drug, directions for its use and any cautionary statements.
2. The dispensing doctor enters into the patient's medical record the name and strength of the drug dispensed, the date the drug is dispensed and the therapeutic reason.
3. The dispensing doctor keeps all drugs in a locked cabinet or room, controls access to the cabinet or room by a written procedure and maintains an ongoing inventory of its contents.
4. The doctor registers with the board to dispense drugs and devices and pays the registration fee prescribed by section 32-1436.
C. Except in an emergency situation, a doctor who dispenses drugs without being registered by the board to do so is subject to a civil penalty by the board of not less than three hundred dollars at least $300 and not more than one thousand dollars $1,000 for each transaction and is prohibited from further dispensing for a period of time as prescribed by the board.
D. Before a physician dispenses a drug pursuant to this section, the physician shall give the patient a prescription and inform the patient that the prescription may be filled by the prescribing physician or by a pharmacy of the patient's choice.
E. Except as provided in subsection F of this section, a doctor shall dispense only to the doctor's own patient and only for conditions being treated by that doctor. The doctor shall provide direct supervision of a medical assistant, nurse or attendant involved in the dispensing process. For the purposes of this subsection, "direct supervision" means that a doctor is present and makes the determination as to the legitimacy or the advisability of the drugs or devices to be dispensed.
F. A physician who dispenses not more than a two-day supply of a noncontrolled substance medication that is kept by a health care institution may dispense the noncontrolled substance medication under the dispensing registration of the medical director of the health care institution's emergency department or satellite emergency department and is not required to register to dispense medications pursuant to this section if both of the following apply:
1. The physician dispenses only to patients of the health care institution's emergency department or satellite emergency department for conditions diagnosed or treated at the emergency department or satellite emergency department.
2. The physician works only at the health care institution's emergency department or satellite emergency department.
F. G. This section shall be enforced by the board, which shall establish rules regarding labeling, recordkeeping, storage and packaging of drugs that are consistent with the requirements of chapter 18 of this title. The board may conduct periodic reviews of dispensing practices to ensure compliance with this section and applicable rules.
G. H. For the purposes of this section, "dispense" means the delivery by a doctor of medicine of a prescription drug or device to a patient, except for samples packaged for individual use by licensed manufacturers or repackagers of drugs, and includes the prescribing, administering, packaging, labeling and security necessary to prepare and safeguard the drug or device for delivery."
Renumber to conform
Page 2, line 17, after the first "student" insert ", which may include educating the student about dispensing drugs and devices,"
Between lines 24 and 25, insert:
"Sec. 5. Section 32-1871, Arizona Revised Statutes, is amended to read:
32-1871. Dispensing of drugs and devices; conditions; exception; civil penalty
A. Except as provided in subsection subsections B and F of this section, an osteopathic physician may dispense drugs and devices kept by the physician if:
1. All drugs are dispensed in packages labeled with the following information:
(a) The dispensing physician's name, address and telephone number.
(b) The date the drug is dispensed.
(c) The patient's name.
(d) The name and strength of the drug, directions for its use and any cautionary statements.
2. The dispensing physician enters into the patient's medical record the name and strength of the drug dispensed, the date the drug is dispensed and the therapeutic reason.
3. The dispensing physician keeps all drugs in a locked cabinet or room, controls access to the cabinet or room by a written procedure and maintains an ongoing inventory of its contents.
4. The dispensing physician annually registers with the board to dispense drugs and devices.
5. The dispensing physician pays the registration fee prescribed by the board pursuant to section 32-1826. This paragraph does not apply if the physician is dispensing in a nonprofit practice and neither the patient nor a third party pays or reimburses the physician or the nonprofit practice for the drugs or devices dispensed.
6. The dispensing physician labels dispensed drugs and devices and stores them according to rules adopted by the board.
B. An osteopathic physician may not dispense a schedule II controlled substance that is an opioid, except for an implantable device or an opioid that is for medication-assisted treatment for substance use disorders.
C. Except in an emergency situation, a physician who dispenses drugs without being registered by the board to do so is subject to a civil penalty by the board of not less than three hundred dollars at least $300 and not more than one thousand dollars $1,000 for each transaction and is prohibited from further dispensing for a period of time as prescribed by the board.
D. Before dispensing a drug pursuant to this section, the patient shall be given a written prescription on which appears the following statement in bold type: "This prescription may be filled by the prescribing physician or by a pharmacy of your choice."
E. Except as provided in subsection F of this section, a physician shall dispense only to the physician's patient and only for conditions being treated by that physician.
F. A physician who dispenses not more than a two-day supply of a noncontrolled substance medication that is kept by a health care institution may dispense the noncontrolled substance medication under the dispensing registration of the medical director of the health care institution's emergency department or satellite emergency department and is not required to register to dispense medications pursuant to this section if both of the following apply:
1. The physician dispenses only to patients of the health care institution's emergency department or satellite emergency department for conditions diagnosed or treated at the emergency department or satellite emergency department.
2. The physician works only at the health care institution's emergency department or satellite emergency department.
F. G. The board shall enforce this section and shall establish rules regarding labeling, recordkeeping, storage and packaging of drugs that are consistent with the requirements of chapter 18 of this title. The board may conduct periodic inspections of dispensing practices to ensure compliance with this section and applicable rules.
G. H. If a physician fails to renew a registration to dispense or ceases to dispense for any reason, within thirty days that physician must notify the board in writing of the remaining inventory of drugs and devices and the manner in which they were disposed."
Renumber to conform
Amend title to conform