HF 2602

as introduced - 92nd Legislature (2021 - 2022) Posted on 05/06/2021 03:45pm

A bill for an act
relating to health occupations; expanding licensed pharmacist authority to initiate,
order, and administer vaccines and certain medical and laboratory tests; requiring
coverage under medical assistance; amending Minnesota Statutes 2020, sections
151.01, subdivision 27; 256B.0625, by adding a subdivision.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2020, section 151.01, subdivision 27, is amended to read:

Subd. 27.

Practice of pharmacy.

"Practice of pharmacy" means:

(1) interpretation and evaluation of prescription drug orders;

(2) compounding, labeling, and dispensing drugs and devices (except labeling by a
manufacturer or packager of nonprescription drugs or commercially packaged legend drugs
and devices);

(3) participation in clinical interpretations and monitoring of drug therapy for assurance
of safe and effective use of drugs, including the performance of laboratory tests that are
waived under the federal Clinical Laboratory Improvement Act of 1988, United States Code,
title 42, section 263a et seq., provided that a pharmacist may interpret the results of laboratory
tests but may modify drug therapy only pursuant to a protocol or collaborative practice
agreement;

(4) participation in drug and therapeutic device selection; drug administration for first
dosage and medical emergencies; intramuscular and subcutaneous administration used for
the treatment of alcohol or opioid dependence; drug regimen reviews; and drug or
drug-related research;

(5) drug administration, through intramuscular and subcutaneous administration used
to treat mental illnesses as permitted under the following conditions:

(i) upon the order of a prescriber and the prescriber is notified after administration is
complete; or

(ii) pursuant to a protocol or collaborative practice agreement as defined by section
151.01, subdivisions 27b and 27c, and participation in the initiation, management,
modification, administration, and discontinuation of drug therapy is according to the protocol
or collaborative practice agreement between the pharmacist and a dentist, optometrist,
physician, podiatrist, or veterinarian, or an advanced practice registered nurse authorized
to prescribe, dispense, and administer under section 148.235. Any changes in drug therapy
or medication administration made pursuant to a protocol or collaborative practice agreement
must be documented by the pharmacist in the patient's medical record or reported by the
pharmacist to a practitioner responsible for the patient's care;

(6) deleted text begin participation in administration of influenza vaccines and deleted text end new text begin initiating, ordering, and
administering new text end vaccines approved by the United States Food and Drug Administration deleted text begin related
to COVID-19 or SARS-CoV-2 deleted text end to all eligible individuals deleted text begin six deleted text end new text begin three new text end years of age and older
deleted text begin and all other vaccines to patients 13 years of age and older deleted text end new text begin , according to the federal Advisory
Committee on Immunization Practices schedules, either independently or new text end by written protocol
with a physician licensed under chapter 147, a physician assistant authorized to prescribe
drugs under chapter 147A, or an advanced practice registered nurse authorized to prescribe
drugs under section 148.235 deleted text begin , provided that: deleted text end new text begin . A pharmacist may delegate the authority to
administer vaccines under this clause to a pharmacy technician or pharmacy intern who has
completed training in vaccine administration;
new text end

deleted text begin (i) the protocol includes, at a minimum:
deleted text end

deleted text begin (A) the name, dose, and route of each vaccine that may be given;
deleted text end

deleted text begin (B) the patient population for whom the vaccine may be given;
deleted text end

deleted text begin (C) contraindications and precautions to the vaccine;
deleted text end

deleted text begin (D) the procedure for handling an adverse reaction;
deleted text end

deleted text begin (E) the name, signature, and address of the physician, physician assistant, or advanced
practice registered nurse;
deleted text end

deleted text begin (F) a telephone number at which the physician, physician assistant, or advanced practice
registered nurse can be contacted; and
deleted text end

deleted text begin (G) the date and time period for which the protocol is valid;
deleted text end

deleted text begin (ii) the pharmacist has successfully completed a program approved by the Accreditation
Council for Pharmacy Education specifically for the administration of immunizations or a
program approved by the board;
deleted text end

deleted text begin (iii) the pharmacist utilizes the Minnesota Immunization Information Connection to
assess the immunization status of individuals prior to the administration of vaccines, except
when administering influenza vaccines to individuals age nine and older;
deleted text end

deleted text begin (iv) the pharmacist reports the administration of the immunization to the Minnesota
Immunization Information Connection; and
deleted text end

deleted text begin (v) the pharmacist complies with guidelines for vaccines and immunizations established
by the federal Advisory Committee on Immunization Practices, except that a pharmacist
does not need to comply with those portions of the guidelines that establish immunization
schedules when administering a vaccine pursuant to a valid, patient-specific order issued
by a physician licensed under chapter deleted text end deleted text begin 147 deleted text end deleted text begin , a physician assistant authorized to prescribe
drugs under chapter deleted text end deleted text begin 147A deleted text end deleted text begin , or an advanced practice registered nurse authorized to prescribe
drugs under section 148.235, provided that the order is consistent with the United States
Food and Drug Administration approved labeling of the vaccine;
deleted text end

(7) participation in the initiation, management, modification, and discontinuation of
drug therapy according to a written protocol or collaborative practice agreement between:
(i) one or more pharmacists and one or more dentists, optometrists, physicians, podiatrists,
or veterinarians; or (ii) one or more pharmacists and one or more physician assistants
authorized to prescribe, dispense, and administer under chapter 147A, or advanced practice
registered nurses authorized to prescribe, dispense, and administer under section 148.235.
Any changes in drug therapy made pursuant to a protocol or collaborative practice agreement
must be documented by the pharmacist in the patient's medical record or reported by the
pharmacist to a practitioner responsible for the patient's care;

(8) participation in the storage of drugs and the maintenance of records;

(9) patient counseling on therapeutic values, content, hazards, and uses of drugs and
devices;

(10) offering or performing those acts, services, operations, or transactions necessary
in the conduct, operation, management, and control of a pharmacy;

(11) participation in the initiation, management, modification, and discontinuation of
therapy with opiate antagonists, as defined in section 604A.04, subdivision 1, pursuant to:

(i) a written protocol as allowed under clause (7); or

(ii) a written protocol with a community health board medical consultant or a practitioner
designated by the commissioner of health, as allowed under section 151.37, subdivision 13;
deleted text begin and
deleted text end

(12) prescribing self-administered hormonal contraceptives; nicotine replacement
medications; and opiate antagonists for the treatment of an acute opiate overdose pursuant
to section 151.37, subdivision 14, 15, or 16 deleted text begin . deleted text end new text begin ; and
new text end

new text begin (13) initiating, ordering, and administering medical and laboratory tests, including tests
to detect or diagnose COVID-19, that are waived under the federal Clinical Laboratory
Improvement Amendments of 1988 and authorized by the United States Food and Drug
Administration. A pharmacist may collect specimens, interpret results, notify patients of
results, and refer patients to other health care providers for follow-up care as permitted by
state and federal law. A pharmacist may delegate the authority to administer tests under this
clause to a pharmacy technician or pharmacy intern who has completed training in
administering tests permitted under this clause.
new text end

Sec. 2.

Minnesota Statutes 2020, section 256B.0625, is amended by adding a subdivision
to read:

new text begin Subd. 13k. new text end

new text begin Vaccines and tests conducted by pharmacists. new text end

new text begin (a) Medical assistance
covers vaccines initiated, ordered, or administered by a licensed pharmacist, either
independently or by written protocol, according to the requirements of section 151.01,
subdivision 27, clause (6), at no less than the rate for which the same services are covered
when provided by any other licensed practitioner.
new text end

new text begin (b) Medical assistance covers medical and laboratory tests initiated, ordered, or
administered by a licensed pharmacist according to the requirements of section 151.01,
subdivision 27, clause (13), at no less than the rate for which the same services are covered
when provided by any other licensed practitioner.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later.
new text end