71st OREGON LEGISLATIVE ASSEMBLY--2001 Regular Session
NOTE: Matter within { + braces and plus signs + } in an
amended section is new. Matter within { - braces and minus
signs - } is existing law to be omitted. New sections are within
{ + braces and plus signs + } .
LC 1327
A-Engrossed
House Bill 2627
Ordered by the House April 26
Including House Amendments dated April 26
Sponsored by Representative MORRISETTE; Representatives BATES,
GARDNER, HANSEN, HILL, HOPSON, JENSON, KRUSE, LOWE, MONNES
ANDERSON, WITT
SUMMARY
The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure.
Permits practitioners authorized to prescribe drugs to
electronically transmit prescription drug order to pharmacist.
{ + Requires Department of Human Services to seek waiver from
federal Health Care Financing Administration permitting Office of
Medical Assistance Programs to communicate prescription drug
orders by electronic means from prescribing practitioner to
pharmacist. + }
A BILL FOR AN ACT
Relating to electronically transmitted prescriptions; creating
new provisions; and amending ORS 475.005, 475.185, 678.375,
689.005 and 689.515.
Be It Enacted by the People of the State of Oregon:
SECTION 1. { + Section 2 of this 2001 Act is added to and made
a part of ORS 475.005 to 475.285. + }
SECTION 2. { + (1) Prescription drug orders may be transmitted
by electronic means from a practitioner authorized to prescribe
drugs directly to the dispensing pharmacist.
(2) All prescription drug orders communicated by way of
electronic transmission shall:
(a) Be transmitted only by an authorized practitioner;
(b) Be transmitted directly to a pharmacist in a pharmacy of
the patient's choice with no intervening person having access to
the prescription drug order;
(c) Specify the prescribing practitioner's telephone number for
verbal confirmation, the time and date of transmission, the
identity of the pharmacy intended to receive the transmission and
all other information required for a prescription by federal or
state law; and
(d) Be traceable to the prescribing practitioner by an
electronic signature or other secure method of validation.
(3) An electronic transmission of a prescription drug order
shall be stored by electronic means or reduced promptly to
writing, filed by the pharmacy and retained in conformity with
the requirements of ORS 475.165.
(4) The dispensing pharmacist shall exercise professional
judgment regarding the accuracy, validity and authenticity of an
electronically transmitted prescription drug order.
(5) All equipment for transmission, storage or receipt of
electronically transmitted prescription drug orders shall be
maintained to protect against unauthorized access.
(6) A pharmacist, pharmacy or pharmacy department shall not
enter into an agreement with a practitioner or health care
facility concerning the provision of any electronic transmission
equipment or apparatus that would adversely affect a patient's
freedom to select the pharmacy or pharmacy department of the
patient's choice.
(7) A pharmacist, pharmacy or pharmacy department shall not
provide any electronic equipment or apparatus to a practitioner
or health care facility for the purpose of providing an incentive
to the practitioner or health care facility to refer patients to
a particular pharmacy or pharmacy department.
(8) There shall be no additional charge to the patient because
the prescription drug order was electronically transmitted.
(9) Nothing in this section shall be construed as authorizing
the electronic transmission of a prescription drug order when a
written prescription is required under ORS 127.815, 137.473,
169.750, 453.025, 475.185 (1) or 689.535 or section 7, chapter
388, Oregon Laws 1981. + }
SECTION 3. ORS 475.005 is amended to read:
475.005. As used in ORS 475.005 to 475.285 and 475.940 to
475.995, unless the context requires otherwise:
(1) 'Abuse' means the repetitive excessive use of a drug short
of dependence, without legal or medical supervision, which may
have a detrimental effect on the individual or society.
(2) 'Administer' means the direct application of a controlled
substance, whether by injection, inhalation, ingestion or any
other means, to the body of a patient or research subject by:
(a) A practitioner or an authorized agent thereof; or
(b) The patient or research subject at the direction of the
practitioner.
(3) 'Administration' means the Drug Enforcement Administration
of the United States Department of Justice, or its successor
agency.
(4) 'Agent' means an authorized person who acts on behalf of or
at the direction of a manufacturer, distributor or dispenser. It
does not include a common or contract carrier, public
warehouseman or employee of the carrier or warehouseman.
(5) 'Board' means the State Board of Pharmacy.
(6) 'Controlled substance' means a drug or its immediate
precursor classified in Schedules I through V under the federal
Controlled Substances Act, 21 U.S.C. 811 to 812, as modified
under ORS 475.035. The use of the term 'precursor' in this
subsection does not control and is not controlled by the use of
the term ' precursor' in ORS 475.940, 475.950 and 475.955.
(7) 'Counterfeit substance' means a controlled substance or its
container or labeling, which, without authorization, bears the
trademark, trade name, or other identifying mark, imprint, number
or device, or any likeness thereof, of a manufacturer,
distributor or dispenser other than the person who in fact
manufactured, delivered or dispensed the substance.
(8) 'Deliver' or 'delivery' means the actual, constructive or
attempted transfer, other than by administering or dispensing,
from one person to another of a controlled substance, whether or
not there is an agency relationship.
(9) 'Device' means instruments, apparatus or contrivances,
including their components, parts or accessories, intended:
(a) For use in the diagnosis, cure, mitigation, treatment or
prevention of disease in humans or animals; or
(b) To affect the structure of any function of the body of
humans or animals.
(10) 'Dispense' means to deliver a controlled substance to an
ultimate user or research subject by or pursuant to the lawful
order of a practitioner, and includes the prescribing,
administering, packaging, labeling or compounding necessary to
prepare the substance for that delivery.
(11) 'Dispenser' means a practitioner who dispenses.
(12) 'Distributor' means a person who delivers.
(13) 'Drug' means:
(a) Substances recognized as drugs in the official United
States Pharmacopoeia, official Homeopathic Pharmacopoeia of the
United States or official National Formulary, or any supplement
to any of them;
(b) Substances intended for use in the diagnosis, cure,
mitigation, treatment or prevention of disease in humans or
animals;
(c) Substances (other than food) intended to affect the
structure or any function of the body of humans or animals; and
(d) Substances intended for use as a component of any article
specified in paragraph (a), (b) or (c) of this subsection;
however, the term does not include devices or their components,
parts or accessories.
{ + (14) 'Electronically transmitted' or 'electronic
transmission' means a communication sent or received through
technological apparatuses, including computer terminals or other
equipment or mechanisms linked by telephone or microwave relays,
or any similar apparatus having electrical, digital, magnetic,
wireless, optical, electromagnetic or similar capabilities. + }
{ - (14) - } { + (15) + } 'Manufacture' means the
production, preparation, propagation, compounding, conversion or
processing of a controlled substance, either directly or
indirectly by extraction from substances of natural origin, or
independently by means of chemical synthesis, or by a combination
of extraction and chemical synthesis, and includes any packaging
or repackaging of the substance or labeling or relabeling of its
container, except that this term does not include the preparation
or compounding of a controlled substance:
(a) By a practitioner as an incident to administering or
dispensing of a controlled substance in the course of
professional practice; or
(b) By a practitioner, or by an authorized agent under the
practitioner's supervision, for the purpose of, or as an incident
to, research, teaching or chemical analysis and not for sale.
{ - (15) - } { + (16) + } 'Marijuana' means all parts of
the plant Cannabis family Moraceae, whether growing or not; the
resin extracted from any part of the plant; and every compound,
manufacture, salt, derivative, mixture, or preparation of the
plant or its resin. It does not include the mature stalks of the
plant, fiber produced from the stalks, oil or cake made from the
seeds of the plant, any other compound, manufacture, salt,
derivative, mixture, or preparation of the mature stalks (except
the resin extracted therefrom), fiber, oil, or cake, or the
sterilized seed of the plant which is incapable of germination.
{ - (16) - } { + (17) + } 'Person' includes a government
subdivision or agency, business trust, estate, trust or any other
legal entity.
{ - (17) - } { + (18) + } 'Practitioner' means physician,
dentist, veterinarian, scientific investigator, certified nurse
practitioner, physician assistant or other person licensed,
registered or otherwise permitted by law to dispense, conduct
research with respect to or to administer a controlled substance
in the course of professional practice or research in this state
but does not include a pharmacist or a pharmacy.
{ - (18) - } { + (19) + } 'Prescription' means a
written { + , + } { - or - } oral { + or electronically
transmitted + } direction, given by a practitioner for the
preparation and use of a drug. When the context requires, '
prescription' also means the drug prepared under such
written { + , + }
{ - or - } oral { + or electronically transmitted + }
direction. Any label affixed to a drug prepared under
written { + , + } { - or - } oral { + or electronically
transmitted + } direction shall prominently display a warning
that the removal thereof is prohibited by law.
{ - (19) - } { + (20) + } 'Production' includes the
manufacture, planting, cultivation, growing or harvesting of a
controlled substance.
{ - (20) - } { + (21) + } 'Research' means an activity
conducted by the person registered with the federal Drug
Enforcement Administration pursuant to a protocol approved by the
United States Food and Drug Administration.
{ - (21) - } { + (22) + } 'Ultimate user' means a person
who lawfully possesses a controlled substance for the use of the
person or for the use of a member of the household of the person
or for administering to an animal owned by the person or by a
member of the household of the person.
SECTION 4. ORS 475.185 is amended to read:
475.185. (1) Except when dispensed directly by a practitioner
to an ultimate user, no controlled substance in Schedule II may
be dispensed without the written prescription of a practitioner.
(2) In emergency situations, as defined by rule of the State
Board of Pharmacy, Schedule II drugs may be dispensed upon oral
{ + or electronically transmitted + } prescription of a
practitioner, reduced promptly to writing and filed by the
pharmacy. Prescriptions shall be retained in conformity with the
requirements of ORS 475.165. No prescription for a Schedule II
substance may be refilled.
(3) Except when dispensed directly by a practitioner to an
ultimate user, a controlled substance included in Schedule III,
IV or V, which is a prescription drug, shall not be dispensed
without a written { + , + } { - or - } oral { + or
electronically transmitted + } prescription of a practitioner.
The prescription shall not be filled or refilled more than six
months after the date on which it was issued and no prescription
authorized to be refilled may be refilled more than five times.
Additional quantities of the controlled substances listed in
Schedule III, IV or V may only be authorized by a practitioner
through issuance of a new prescription.
(4) A controlled substance shall not be delivered or dispensed
other than for a medical purpose.
(5) Except in good faith and in the course of professional
practice only, a practitioner or a pharmacist may not dispense
controlled substances.
(6) Any oral { + or electronically transmitted
+ }prescription authorized by statute or rule shall be
{ + stored by electronic means or + } reduced promptly to
writing and filed by the pharmacy.
(7) Issuance, preparation, labeling, dispensing, recordkeeping
and filing of prescriptions or medication orders shall be in
conformance with the requirements of the federal law and rules of
the board.
SECTION 5. ORS 678.375 is amended to read:
678.375. (1) The Oregon State Board of Nursing is authorized to
issue certificates of special competency to licensed registered
nurses to practice as nurse practitioners if they meet the
requirements of the board pursuant to ORS 678.380.
(2) No person shall practice as a nurse practitioner or hold
oneself out to the public or to an employer, or use the initials,
name, title, designation or abbreviation as a nurse practitioner
until and unless such person is certified by the board.
(3) A registered nurse, certified as a nurse practitioner, is
authorized to prescribe drugs for the use of and administration
to other persons if approval has been given under ORS 678.390.
The drugs which the nurse practitioner is authorized to prescribe
shall be included within the certified nurse practitioner's scope
of practice as defined by rules of the board subject to ORS
678.385.
(4) The dispensing of certain limited medications prescribed by
a nurse practitioner in accordance with the formulary established
under ORS 678.385 and dispensed by a licensed pharmacist or an
employee thereof may be filled by a pharmacist according to the
terms of the prescription. The filling of such a prescription
shall not constitute evidence of negligence on the part of the
pharmacist if the prescription was dispensed within the
reasonable and prudent practice of pharmacy.
(5) As used in this section:
(a) 'Drug' means medicines and preparations for internal or
external use of human beings which are recognized in the
formulary adopted pursuant to ORS 678.385.
(b) 'Prescribe' means to direct, order or designate the
preparation, use of or manner of using by spoken or written words
{ + or other means + }.
SECTION 6. ORS 689.005 is amended to read:
689.005. As used in this chapter:
(1) 'Administer' means the direct application of a drug or
device whether by injection, inhalation, ingestion, or any other
means, to the body of a patient or research subject by:
(a) A practitioner or the authorized agent thereof; or
(b) The patient or research subject at the direction of the
practitioner.
(2) 'Approved continuing pharmacy education program' means
those seminars, classes, meetings, workshops and other
educational programs on the subject of pharmacy approved by the
board.
(3) 'Board of pharmacy' or 'board' means the State Board of
Pharmacy.
(4) 'Continuing pharmacy education' means professional,
pharmaceutical post-graduate education in the general areas of
socio-economic and legal aspects of health care; the properties
and actions of drugs and dosage forms; and the etiology,
characteristics and therapeutics of the disease state.
(5) 'Continuing pharmacy education unit' means the unit of
measurement of credits for approved continuing education courses
and programs.
(6) 'Deliver' or 'delivery' means the actual, constructive or
attempted transfer of a drug or device other than by
administration from one person to another, whether or not for a
consideration.
(7) 'Device' means an instrument, apparatus, implement,
machine, contrivance, implant, in vitro reagent or other similar
or related article, including any component part or accessory,
which is required under federal or state law to be prescribed by
a practitioner and dispensed by a pharmacist.
(8) 'Dispense' or 'dispensing' means the preparation and
delivery of a prescription drug pursuant to a lawful order of a
practitioner in a suitable container appropriately labeled for
subsequent administration to or use by a patient or other
individual entitled to receive the prescription drug.
(9) 'Distribute' means the delivery of a drug other than by
administering or dispensing.
(10) 'Drug' means:
(a) Articles recognized as drugs in the official United States
Pharmacopoeia, official National Formulary, official Homeopathic
Pharmacopoeia, other drug compendium or any supplement to any of
them;
(b) Articles intended for use in the diagnosis, cure,
mitigation, treatment or prevention of disease in a human or
other animal;
(c) Articles (other than food) intended to affect the structure
or any function of the body of humans or other animals; and
(d) Articles intended for use as a component of any articles
specified in paragraph (a), (b) or (c) of this subsection.
(11) 'Drug order' means a written order, in a hospital or other
inpatient care facility, for an ultimate user of any drug or
device issued and signed by a practitioner, or an order
transmitted by other means of communication from a practitioner,
that is immediately reduced to writing by a pharmacist, licensed
nurse or other practitioner.
(12) 'Drug outlet' means any pharmacy, nursing home, shelter
home, convalescent home, extended care facility, drug abuse
treatment center, penal institution, hospital, family planning
clinic, student health center, retail store, wholesaler,
manufacturer or mail order vendor with facilities located within
or out of this state that is engaged in dispensing, delivery or
distribution of drugs within this state.
(13) 'Drug room' means a secure and lockable location within an
inpatient care facility that does not have a licensed pharmacy.
{ + (14) 'Electronically transmitted' or 'electronic
transmission' means a communication sent or received through
technological apparatuses, including computer terminals or other
equipment or mechanisms linked by telephone or microwave relays,
or any similar apparatus having electrical, digital, magnetic,
wireless, optical, electromagnetic or similar capabilities. + }
{ - (14) - } { + (15) + } ' Institutional drug outlet'
means hospitals and inpatient care facilities where medications
are dispensed to another health care professional for
administration to patients served by the hospitals or facilities.
{ - (15) - } { + (16) + } 'Intern' means any person who has
completed the junior or third academic year of a course of study
at an approved college of pharmacy and is licensed with the board
as an intern.
{ - (16) - } { + (17) + } 'Internship' means a professional
and practical experience program approved by the board under the
supervision of a licensed pharmacist registered with the board as
a preceptor.
{ - (17) - } { + (18) + } 'Itinerant vendor' means all
persons who sell or otherwise distribute nonprescription drugs by
passing from house to house, or by haranguing the people on the
public streets or in public places, or who use the customary
devices for attracting crowds and therewith recommending their
wares and offering them for sale.
{ - (18) - } { + (19) + } 'Labeling' means the process of
preparing and affixing of a label to any drug container
exclusive, however, of the labeling by a manufacturer, packer or
distributor of a nonprescription drug or commercially packaged
legend drug or device. Any such label shall include all
information required by federal and state law or regulation.
{ - (19) - } { + (20) + } 'Manufacture' means the
production, preparation, propagation, compounding, conversion or
processing of a device or a drug, either directly or indirectly
by extraction from substances of natural origin or independently
by means of chemical synthesis or by a combination of extraction
and chemical synthesis and includes any packaging or repackaging
of the substances or labeling or relabeling of its container,
except that this term does not include the preparation or
compounding of a drug by an individual for their own use or the
preparation, compounding, packaging or labeling of a drug:
(a) By a practitioner as an incident to administering or
dispensing of a drug in the course of professional practice; or
(b) By a practitioner or by the practitioner's authorization
under supervision of the practitioner for the purpose of or as an
incident to research, teaching or chemical analysis and not for
sale.
{ - (20) - } { + (21) + } 'Manufacturer' means a person
engaged in the manufacture of drugs.
{ - (21) - } { + (22) + } 'Nonprescription drug outlet'
means shopkeepers and itinerant vendors registered under ORS
689.305.
{ - (22) - } { + (23) + } 'Nonprescription drugs' means
drugs which may be sold without a prescription and which are
prepackaged for use by the consumer and labeled in accordance
with the requirements of the statutes and regulations of this
state and the federal government.
{ - (23) - } { + (24) + } 'Person' means an individual,
corporation, partnership, association or any other legal entity.
{ - (24) - } { + (25) + } 'Pharmacist' means an individual
licensed by this state to engage in the practice of pharmacy.
{ - (25) - } { + (26) + } 'Pharmacy' means a place that
meets the requirements of rules of the board, is licensed and
approved by the board where the practice of pharmacy may lawfully
occur and includes apothecaries, drug stores, dispensaries,
hospital outpatient pharmacies, pharmacy departments and
prescription laboratories but does not include a place used by a
manufacturer or wholesaler.
{ - (26) - } { + (27) + } 'Pharmacy technician' means a
person registered by the State Board of Pharmacy who assists the
pharmacist in the practice of pharmacy pursuant to rules of the
board.
{ - (27) - } { + (28) + } 'Practitioner' means a person
licensed and operating within the scope of such license to
prescribe, dispense, conduct research with respect to or
administer drugs in the course of professional practice or
research:
(a) In this state; or
(b) In another state or territory of the United States not
residing in Oregon and registered under the federal Controlled
Substances Act.
{ - (28) - } { + (29) + } 'Preceptor' means a pharmacist
licensed and in good standing, registered by the board to
supervise the internship training of a licensed intern.
{ - (29) - } { + (30) + } 'Prescription drug' or 'legend
drug' means a drug which is:
(a) Required by federal law, prior to being dispensed or
delivered, to be labeled with either of the following statements:
(A) 'Caution: Federal law prohibits dispensing without
prescription'; or
(B) 'Caution: Federal law restricts this drug to use by or on
the order of a licensed veterinarian'; or
(b) Required by any applicable federal or state law or
regulation to be dispensed on prescription only or is restricted
to use by practitioners only.
{ - (30) - } { + (31) + } 'Prescription' or 'prescription
drug order ' means a written { + , + } { - or - } oral { + or
electronically transmitted + } direction, given by a practitioner
authorized to prescribe drugs, for the preparation and use of a
drug. When the context requires, ' prescription' also means the
drug prepared under such written { + , + }
{ - or - } oral { + or electronically transmitted
+ }direction.
{ - (31) - } { + (32) + } 'Retail drug outlet' means a
place used for the conduct of the retail sale, administering or
dispensing or compounding of drugs or chemicals or for the
administering or dispensing of prescriptions and licensed by the
board as a place wherein the practice of pharmacy may lawfully
occur.
{ - (32) - } { + (33) + } 'Shopkeeper' means a business
establishment, open to the general public, for the sale of
nonlegend drugs, in the original and unbroken package, properly
labeled according to state and federal laws, in conformity with
the rules of the board.
{ - (33) - } { + (34) + } 'Unit dose' means a sealed
single-unit container so designed that the contents are
administered to the patient as a single dose, direct from the
container. Each unit dose container must bear a separate label,
be labeled with the name and strength of the medication, the name
of the manufacturer or distributor, an identifying lot number
and, if applicable, the expiration date of the medication.
{ - (34) - } { + (35) + } 'Wholesale drug outlet' means any
person who imports, stores, distributes or sells for resale any
drugs including legend drugs and nonprescription drugs.
{ - (35) - } { + (36) + } 'Class I wholesaler' means any
person operating or maintaining a wholesale distribution center,
wholesale business or any other business in which drugs,
medicinal chemicals, or poisons are sold, dispensed, stocked,
exposed or offered for sale at wholesale to a pharmacy or other
legally licensed drug outlets or persons.
{ - (36) - } { + (37) + } 'Class II wholesaler' means any
person operating or maintaining a wholesale distribution center,
wholesale business or any other business in which nonprescription
drugs are offered for sale at wholesale to a drug outlet legally
authorized to resell.
SECTION 7. ORS 689.515 is amended to read:
689.515. (1) As used in this section unless the context
requires otherwise:
(a) 'Brand name' means the proprietary or trade name selected
by the manufacturer and placed upon a drug, its container, label
or wrapping at the time of packaging.
(b) 'Dosage form' means the physical formulation or medium in
which the product is intended, manufactured and made available
for use, including but not limited to tablets, capsules, oral
solutions, aerosols, ointments, inhalers and suppositories, and
the particular form of which utilizes a specific technology or
mechanism to control, enhance or direct the release, targeting,
systemic absorption or other delivery of a dosage regimen in the
body.
(c) 'Generic name' means the official title of a drug or drug
ingredients published in the latest edition of the official
Pharmacopoeia, Homeopathic Pharmacopoeia or Formulary.
(d) 'Substitute' means to dispense without the prescriber's
express authorization a different drug product in place of the
drug ordered or prescribed.
(e) 'Therapeutically equivalent' means drugs that are approved
by the United States Food and Drug Administration for interstate
distribution and the Food and Drug Administration has determined
that the drugs will provide essentially the same efficacy and
toxicity when administered to an individual in the same dosage
regimen.
(2) Except as limited by subsections (3) and (5) of this
section, unless the purchaser instructs otherwise, the pharmacist
may substitute as follows:
(a) A drug product with the same generic name in the same
strength, quantity, dose and dosage form as the prescribed drug
which is, in the pharmacist's professional opinion,
therapeutically equivalent.
(b) When the prescriber is not reasonably available for
consultation and the prescribed drug does not utilize a unique
delivery system technology, an oral tablet, capsule or liquid
form of the prescribed drug so long as the form dispensed or
administered has the same strength, dose and dose schedule and is
therapeutically equivalent to the drug prescribed.
(3) A practitioner may specify in writing { + , + }
{ - or - } by a telephonic communication { + or by electronic
transmission + } that there shall be no substitution for the
specified brand name drug in any prescription. The phrase 'no
substitution' or the notation ' N.S.' must be in the
practitioner's handwriting or, if the prohibition was
communicated by telephonic communication { + or electronic
transmission + }, in the pharmacist's handwriting and shall not
be preprinted or stamped or initialed on the prescription form.
(4) Every pharmacy shall post a sign in a location easily seen
by patrons at the counter where prescriptions are dispensed or
administered stating that, 'This pharmacy may be able to
substitute a less expensive drug which is therapeutically
equivalent to the one prescribed by your doctor unless you do not
approve.' The printing on the sign shall be in block letters not
less than one inch in height. If the pharmacist has reasonable
cause to believe that the purchaser cannot read the sign or
comprehend its content, the pharmacist shall endeavor to explain
the meaning of the sign.
(5) A pharmacist shall substitute a drug product under this
section only when there will be a savings in or no increase in
cost to the purchaser.
(6) If the practitioner prescribes a drug by its generic name,
the pharmacist shall, consistent with reasonable professional
judgment, dispense or administer the lowest retail cost,
effective brand which is in stock.
(7) Except as provided in subsection (8) of this section, when
a pharmacist dispenses a substituted drug as authorized by
subsection (2) of this section, the pharmacist must label the
prescription container with the name of the dispensed drug. If
the dispensed drug does not have a brand name, the prescription
label shall indicate the generic name of the drug dispensed along
with the name of the drug manufacturer.
(8) A prescription dispensed by a pharmacist shall bear upon
the label the name of the medication in the container except if
the prescriber writes 'do not label,' or words of similar import,
on the prescription or so designates in an oral { + or
electronic + } transmission of the prescription.
(9) The substitution of any drug by a licensed pharmacist or
the pharmacist's employer pursuant to this section does not
constitute the practice of medicine.
(10) No substitution of drugs made by a pharmacist or the
pharmacist's employer in accordance with this section and any
rules that the State Board of Pharmacy may adopt thereunder shall
constitute evidence of negligence if the substitution was made
within reasonable and prudent practice of pharmacy or if the
substituted drug was accepted in a generally recognized formulary
or government list.
(11) Failure of a practitioner to specify that no substitution
is authorized does not constitute evidence of negligence unless
the practitioner knows that the health condition of the patient
for whom the practitioner is prescribing warrants the use of the
brand name drug product and not the substituted drug.
SECTION 8. { + (1) The Department of Human Services shall seek
a waiver from the federal Health Care Financing Administration to
allow the Office of Medical Assistance Programs to communicate
prescription drug orders by electronic means from a practitioner
authorized to prescribe drugs directly to the dispensing
pharmacist.
(2) The Department of Human Services and the Office of Medical
Assistance Programs shall adopt rules permitting the Office of
Medical Assistance Programs to communicate prescription drug
orders by electronic means from a practitioner authorized to
prescribe drugs directly to the dispensing pharmacist. + }
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