Missouri HB 1188: Creates provisions relating to pharmacists' authority to dispense insulin

Bill Text

FIRST REGULAR SESSION
HOUSE BILL NO. 1188
103RD GENERAL ASSEMBLY
INTRODUCED BY REPRESENTATIVE HEWKIN.
2703H.01I JOSEPH ENGLER, Chief Clerk
AN ACT
Torepealsection338.010,RSMo,andtoenactinlieuthereoftwonewsectionsrelatingtothe
dispensing of insulin.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Section 338.010, RSMo, is repealed and two new sections enacted in lieu
2 thereof, to be known as sections 338.010 and 338.740, to read as follows:
338.010. 1. The "practice of pharmacy" includes:
2 (1) Theinterpretation,implementation,andevaluationofmedicalprescriptionorders,
3 including any legend drugs under 21 U.S.C. Section 353, and the receipt, transmission, or
4 handling of such orders or facilitating the dispensing of such orders;
5 (2) The designing, initiating, implementing, and monitoring of a medication
6 therapeutic plan in accordance with the provisions of this section;
7 (3) The compounding, dispensing, labeling, and administration of drugs and devices
8 pursuant to medical prescription orders;
9 (4) The ordering and administration of vaccines approved or authorized by the U.S.
10 Food and Drug Administration, excluding vaccines for cholera, monkeypox, Japanese
11 encephalitis, typhoid, rabies, yellow fever, tick-borne encephalitis, anthrax, tuberculosis,
12 dengue, Hib, polio, rotavirus, smallpox, and any vaccine approved after January 1, 2023, to
13 persons at least seven years of age or the age recommended by the Centers for Disease
14 Control and Prevention, whichever is older, pursuant to joint promulgation of rules
15 established by the board of pharmacy and the state board of registration for the healing arts
16 unless rules are established under a state of emergency as described in section 44.100;
EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is
intended to be omitted from the law. Matter in bold-face type in the above bill is proposed language.

17 (5) Theparticipationindrugselectionaccordingtostatelawandparticipationindrug
18 utilization reviews;
19 (6) The proper and safe storage of drugs and devices and the maintenance of proper
20 records thereof;
21 (7) Consultation with patients and other health care practitioners, and veterinarians
22 and their clients about legend drugs, about the safe and effective use of drugs and devices;
23 (8) Theprescribinganddispensingofanynicotinereplacementtherapyproductunder
24 section 338.665;
25 (9) The dispensing of HIV postexposure prophylaxis pursuant to section 338.730;
26 [and]
27 (10) The dispensing of an emergency supply of insulin under section 338.740;
28 and
29 (11) The offering or performing of those acts, services, operations, or transactions
30 necessary in the conduct, operation, management and control of a pharmacy.
31 2. No person shall engage in the practice of pharmacy unless he or she is licensed
32 under the provisions of this chapter.
33 3. This chapter shall not be construed to prohibit the use of auxiliary personnel under
34 thedirectsupervisionofapharmacistfromassistingthepharmacistinanyofhisorherduties.
35 Thisassistance in no way is intended to relieve the pharmacist fromhis or herresponsibilities
36 for compliance with this chapter and he or she will be responsible for the actions of the
37 auxiliary personnel acting in his or her assistance.
38 4. This chapter shall not be construed to prohibit or interfere with any legally
39 registered practitioner of medicine, dentistry, or podiatry, or veterinary medicine only for use
40 in animals, or the practice of optometry in accordance with and as provided in sections
41 195.070 and 336.220 in the compounding, administering, prescribing, or dispensing of his or
42 her own prescriptions.
43 5. A pharmacist with a certificate of medication therapeutic plan authority may
44 provide medication therapy services pursuant to a written protocol from a physician licensed
45 under chapter 334 to patients who have established a physician-patient relationship, as
46 described in subdivision (1) of subsection 1 of section 191.1146, with the protocol physician.
47 The written protocol authorized by this section shall come only from the physician and shall
48 not come from a nurse engaged in a collaborative practice arrangement under section
49 334.104, or from a physician assistant engaged in a collaborative practice arrangement under
50 section 334.735.
51 6. Nothing in this section shall be construed as to prevent any person, firm or
52 corporation from owning a pharmacy regulated by sections 338.210 to 338.315, provided that
53 a licensed pharmacist is in charge of such pharmacy.
HB 1188 2

54 7. Nothing in this section shall be construed to apply to or interfere with the sale of
55 nonprescription drugs and the ordinary household remedies and such drugs or medicines as
56 are normally sold by those engaged in the sale of general merchandise.
57 8. No health carrier as defined in chapter 376 shall require any