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2019 – 2020 LEGISLATIVE SESSION MAY 2019

Wednesday, June 26, 2019   (0 Comments)
Posted by: SCSHP Advocacy

SCSHP LEGISLATIVE UPDATE

2019 – 2020 LEGISLATIVE SESSION

MAY 2019

 

Bills passed in the 2018 Legislative Session:

 

S136 and H3728 E-prescribing of Controlled Substances and Opioid Antidote Administration

S136 was added as an amendment to H3728. Passed by the Senate and signed by the Governor.

The amended bill will require the health care facility to report the administration of an opioid antidote  within 30 days after a discharge diagnosis of an opioid overdose, will require a practitioner to electronically prescribe any controlled substance included in Schedule II, III, IV and V, but would exempt a practitioner who write a prescription for a controlled substances included in Schedules II through V for a patient who is being discharged from a hospital, emergency department, or urgent care.

This act takes effect January 1, 2021

SECTION    1.    Chapter 130, Title 44 of the 1976 Code is amended by adding:

"Section 44-130-80.    (A)    If a person is administered an opioid antidote in a hospital emergency department or other health care facility and the supervising physician diagnoses the patient as having experienced an opioid overdose, the health care facility, as defined in Section 44-7-130, shall report to the department's Bureau of Drug Control information regarding the opioid antidote administered for inclusion in the prescription monitoring program. The information submitted must include:

(1)    date the opioid antidote was administered; and

(2)    name, address, and date of birth of the person to whom the opioid antidote was administered.

(B)    The health care facility, as defined in Section 44-7-130, shall submit the information required pursuant to subsection (A) electronically or by facsimile to Drug Control within thirty days after a discharge diagnosis of an opioid overdose and administration of an opioid antidote.

SECTION    6.    Section 44-53-360(j) of the 1976 Code, as added by Act 201 of 2018, is amended by adding an appropriately numbered item at the end to read:

"( )(A)    Unless otherwise exempted by this subsection, a practitioner shall electronically prescribe any controlled substance included in Schedules II, III, IV, and V. This subsection does not apply to prescriptions for a controlled substance included in Schedules II through V issued by any of the following:

(i)        a practitioner, other than a pharmacist, who dispenses directly to the ultimate user;

(ii)    a practitioner who orders a controlled substance included in Schedules II through V to be administered in a hospital, nursing home, hospice facility, outpatient dialysis facility, or residential care facility;

(iii)    a practitioner who experiences temporary technological or electrical failure or other extenuating technical circumstances that prevent a prescription from being transmitted electronically; however, the practitioner must document the reason for this exception in the patient's medical record;

(iv)    a practitioner who writes a prescription for a controlled substance included in Schedules II through V to be dispensed by a pharmacy located on federal property; however, the practitioner must document the reason for this exception in the patient's medical record;

(v)    a person licensed to practice veterinary medicine pursuant to Chapter 69, Title 40; or

(vi)    a practitioner who writes a prescription for a controlled substance included in Schedules II through V for a patient who is being discharged from a hospital, emergency department, or urgent care.

 

 S16 – Emergency Refill

The Senate did not concur with House amendment requiring the label to state the refill as an emergency refill, so is in conference committee. If there is no agreement, then the bill is dead for this year and will be carried over until next legislative year

"(P)   If a pharmacist receives a request for a prescription refill and the pharmacist is unable to obtain refill authorization from the prescriber, the pharmacist may dispense, once within a twelve-month period, an emergency refill of up to a ten-day fourteen-day supply of the prescribed medication if:

 (4)    the pharmacist properly records the dispensing and labels the medication package as an emergency refill; and

(5)    the dispensing pharmacist notifies the prescriber of the refill and the amount of the refill, not to exceed a ten-day fourteen-day supply, within a reasonable time, but no later than ten days after the once in twelve months refill dispensing.

In the event that a pharmacist is unable to dispense an emergency refill for the time period specified in this subsection due to the medication's packaging, the pharmacist is permitted to dispense up to a thirty-day quantity of the medication so long as the requirements contained in this subsection are otherwise met."

S463  90 Day Refill

This bill will allow a pharmacist to use their professional judgment to dispense up to a 90 day supply of medications with restrictions.

This bill passed both the House and Senate and was signed into law by the Governor.

SECTION    1.    Section 40-43-86 of the 1976 Code, as last amended by Act 143 of 2018, is further amended by adding an appropriately lettered subsection at the end to read:

"( )(1)    Unless a prescriber has specified on a prescription that dispensing the prescription for a maintenance medication in an initial amount followed by periodic refills is medically necessary, a pharmacist may exercise his professional judgment, in consultation with the patient, to dispense up to a ninety-day supply of medication per refill up to the total number of dosage units as authorized by the prescriber on the original prescription. In consulting with the patient, the pharmacist must utilize readily available, existing mechanisms such as online claim adjudication and inform the patient of any cost changes of the proposed dispensing change. If the pharmacist is presenting the patient with an option to not use an available benefit plan, then the pharmacist must inform the patient that any amounts paid would potentially not apply to the deductibles or other out-of-pocket calculations of his benefit plan.

(2)    Item (1) does not apply to scheduled medications, psychotherapeutic drugs, or any medications for which a report is required under the prescription monitoring program.

(3)    This section shall not be construed to supersede or invalidate any third party payor agreement, in whole or in part, between a third party payor and a retail pharmacy."

 

H3760 South Carolina Medical Malpractice Insurance - Joint Underwriters Association

Section 38-79-110.    As used in this article:

(2)(5)    'Licensed health care providers' means physicians and surgeons, nurses, oral surgeons, dentists, pharmacists, chiropractors, podiatrists, hospitals, nursing homes, or any similar major category of licensed health care providers. The term 'licensed health care provider' also includes blood centers which collect, process, and distribute blood to hospitals and physicians for the care of patients if these blood centers as of July 1, 1997, were insured with the Joint Underwriting Association.

(3)(6)    'Medical malpractice insurance' means medical professional liability insurance or insurance protection against the legal liability of the insured and against loss, damage, or expense incident to a claim arising out of the death or injury of any person as the result of negligence or malpractice in rendering or failing to render professional service by any licensed physician, licensed health care provider, or hospital.

(4)(7)    'Net-direct premiums' means gross direct premiums written on medical malpractice insurance, medical professional liability insurance, hospital professional liability insurance, and any other type of professional liability insurance covering risks of licensed health care providers and facilities as determined and computed by the director or his designee, less return premiums or the unused or unabsorbed portions of premium deposits. The net-direct premium calculation does not include premiums written by the fund.

Section 38-79-220   (1)    All members of the association, excluding companies who have withdrawn from the association pursuant to 38-79-125, must contribute to the elimination of the associations and fund's accumulated deficit. Beginning on January 1, 2020, a uniform assessment of not less than two percent and not more than six percent of net direct written premium must be assessed against each member of the association in order to eliminate the accumulated deficits of the association and the fund.

Section 38-79-230.   Beginning on January 1, 2021, an additional one percent surcharge on premium must be assessed on association policyholders. The premium surcharge must increase by one additional percentage point annually until it reaches ten percent and does not sunset. Surcharges levied under this section are not premium and therefore not subject to premium taxes, fees, or commissions. Surcharges may not be considered when evaluating whether rates are excessive, adequate, or unfairly discriminatory.

 

S132 Physician Assistant

Section 40-47-965.    (A)    If the written scope of practice guidelines authorizes the physician's assistant PA to prescribe drug therapy:

(3)    prescriptions must be signed or electronically submitted by the physician assistant PA and must bear the physician assistant's PA's identification number as assigned by the board and all prescribing numbers required by law. The preprinted prescription form shall include both the physician assistant's PA's and physician's name, address, and phone number, and, if possible, the physician through the electronic system, and shall comply with the provisions of Section 39-24-40;

(6)    the physician assistant PA may authorize prescriptions for an orally administered Schedule II controlled substance, as defined in the federal Controlled Substances Act, pursuant to the following requirements:

(a)    the authorization to prescribe is expressly approved by the supervising physician as set forth in the physician assistant's PA's written scope of practice guidelines;

(b)    the physician assistant PA has directly evaluated the patient, provided, however, that a PA may authorize a prescription if the PA is assigned to take calls for the supervising physician or alternate supervising physician treating the patient;

(c)    the authority to prescribe a Schedule II narcotic controlled substance is limited to an initial prescription and must not to exceed a seventy two hour five-day supply;

(d)    any subsequent prescription authorization for a Schedule II narcotic controlled substance after the initial prescription must be in consultation with and upon patient examination and evaluation by and approved by the supervising physician, and such approval must be documented in the patient's chart; and

(e)    any prescription for continuing drug therapy must include consultation with the supervising physician and must be documented in the patient's chart; 

 

 

Bills carried over to the 2020 Legislative Session:

 

S366 Compassionate Care Act – Marijuana

Senate Tom Davis is working with all interested parties to get agreement with SLED and SCMA.

 

H4348 Marijuana

Section 44-53-361.    Marijuana may only be approved for medical use if first approved as a safe and effective drug as part of a United States Food and Drug Administration drug review process."

 

H4286 Lot Numbers on prescription labels.

This bill would require the lot number of the prescription to be on the label.  This bill resides in the House 3M committee.

SECTION    1.    Section 39-23-50(b)(2) of the 1976 Code is amended to read:

"(2)    Any A drug dispensed by filling or refilling a written or oral prescription of a practitioner licensed by law to administer such the drug shall must be exempt from the requirements of Section 39-23-40, except paragraphs (a), (i)(2) and (3), (k), and the packaging requirements of paragraphs (g) and (h), if the drug bears a label containing the name and address of the dispenser, the serial number and date of the prescription or of its filling, the lot number of the prescription, the name of the prescriber, and if stated in the prescription the name of the patient, and the directions for use and cautionary statements, if any, contained in such the prescription. This exemption shall not apply to any a drug dispensed in the course of the conduct of a business of dispensing drugs pursuant to diagnosis by mail, or to a drug dispensed in violation of paragraph (1) of this subsection."

 

S448 Contraceptives

This bill would allow pharmacists to dispense a self-administered hormonal contraceptive or administer an injectable hormonal contraceptive pursuant to a standing drug order.  This bill resides in the House 3M committee.

Section 44-138-30.    (A)    A person licensed under the South Carolina Pharmacy Practice Act who is acting in good faith and exercising reasonable care as a pharmacist may dispense a self-administered hormonal contraceptive or administer an injectable hormonal contraceptive pursuant to a standing prescription drug order by a prescriber to a patient who is:

(1)    eighteen years of age or older; or

(2)    under eighteen years of age if the person has evidence of a previous prescription from a practitioner for a self-administered hormonal contraceptive or an injectable hormonal contraceptive.

 

H4355 Methadone Dispensing by RNs and LPNs

This bill would allow RNs and LPNs to dispense Methadone in the absence of a pharmacists. Referred to the House 3M committee.

(B)    Methadone or any other opioid agonist treatment medication that is approved by the Food and Drug Administration pursuant to 21 U.S.C. Section 355 for use in the treatment of opioid use disorder must be administered or dispensed only by a practitioner licensed by the State Board of Medical Examiners and registered under state and federal law to administer or dispense opioid drugs, or by an agent of such a practitioner, supervised by or under the order of the licensed practitioner. The agent must be a pharmacist, registered nurse, or licensed practical nurse authorized by federal and state law to administer or dispense opioid drugs and employed by the program, hospital, or pharmacy dispensing the treatment medication."

 

H4532 Sales Tax

This bill would impose a 3% sales tax on medicine, prosthetic devices, diabetic supplies, and disposable medical supplies but would exempt 75% of the gross sales.  In other words the 3% sales tax would apply to 25% of gross sales.

This bill was referred to the House Ways and Means Committee and will be carrier over to the next legislative years.

SECTION    7.    Section 12-36-910(A) and (B) of the 1976 Code are amended to read:

"(A)    A sales tax, equal to five three percent of the gross proceeds of sales, is imposed upon every person engaged or continuing within this State in the business of selling tangible personal property at retail.

"Section 12-36-2120.    Exempted from the taxes imposed by this chapter are the gross proceeds of sales, or sales price of:

(28)(a)    seventy-five percent of the gross proceeds of the sales of medicine and prosthetic devices sold by prescription, prescription medicines used to prevent respiratory syncytial virus, prescription medicines and therapeutic radiopharmaceuticals used in the treatment of rheumatoid arthritis, cancer, lymphoma, leukemia, or related diseases, including prescription medicines used to relieve the effects of any such treatment, free samples of prescription medicine distributed by its manufacturer and any use of these free samples. However, sales of medicine and prosthetic devices, including dental devices, sold by a prescription and specifically written to Medicare or Medicaid beneficiaries are one hundred percent exempt;

(b)    seventy-five percent of the gross proceeds of the sales of hypodermic needles, insulin, alcohol swabs, blood sugar testing strips, monolet lancets, dextrometer supplies, blood glucose meters, and other similar diabetic supplies sold to diabetics under the authorization and direction of a physician. However, such sales made to a diabetic that is a Medicare or Medicaid beneficiary under the authorization and direction of a physician, are one hundred percent exempt;

(c)    seventy-five percent of the gross proceeds of the sales of disposable medical supplies such as bags, tubing, needles, and syringes, which are dispensed by a licensed pharmacist in accordance with an individual prescription written for the use of a human being by a licensed health care provider, which are used for the intravenous administration of a prescription drug or medicine, and which come into direct contact with the prescription drug or medicine. This exemption applies only to supplies used in the treatment of a patient outside of a hospital, skilled nursing facility, or ambulatory surgical treatment center;

(d)    medicine donated by its manufacturer to a public institution of higher education for research or for the treatment of indigent patients;

(e)    seventy-five percent of the gross proceeds of the sales of dental prosthetic devices; and

(f)    prescription drugs dispensed to Medicare Part A patients residing in a nursing home are not considered sales to the nursing home and are not subject to the sales tax;

 


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