SECOND REGULAR SESSION
[PERFECTED]
HOUSE COMMITTEE SUBSTITUTE FOR
94TH GENERAL ASSEMBLY
Reported from the Special Committee on Professional Registration and Licensing March 6, 2008 with recommendation that House Committee Substitute for House Bill No. 2064 Do Pass by Consent. Referred to the Committee on Rules pursuant to Rule 25(21)(f).
Reported from the Committee on Rules March 12, 2008 with recommendation that House Committee Substitute for House Bill No. 2064 Do Pass by Consent with no time limit for debate.
Perfected by Consent March 27, 2008.
D. ADAM CRUMBLISS, Chief Clerk
AN ACT
To repeal sections 334.105, 334.106, 338.013, 338.057, and 338.220, RSMo, and to enact in lieu thereof five new sections relating to the regulation of licensed health care professionals.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Sections 334.105, 334.106, 338.013, 338.057, and 338.220, RSMo, are repealed and five new sections enacted in lieu thereof, to be known as sections 334.105, 334.106, 338.013, 338.146, and 338.220, to read as follows:
334.105. 1. Sections 334.105 to 334.107 shall be known and may be cited as the "[Intractable] Pain Treatment Act".
2. For purposes of sections 334.105 to 334.107, the following terms mean:
(1) "Board", the state board of registration for the healing arts;
(2) ["Intractable pain", a pain state in which the cause of pain cannot be removed or otherwise treated and which in the generally accepted course of medical practice no relief or cure of the cause of the pain is possible or none has been found after reasonable efforts that have been documented in the physician's medical records;
(3)] "Physician", physicians and surgeons licensed pursuant to this chapter by the board;
[(4)] (3) "Therapeutic purpose", the use of controlled substances in acceptable doses with appropriate indication for the treatment of pain. Any other use is nontherapeutic.
334.106. 1. Notwithstanding any other provision of law to the contrary, a physician may prescribe, administer or dispense controlled substances for a therapeutic purpose to a person diagnosed and treated by a physician for a condition resulting in [intractable pain, if such] pain. The diagnosis and treatment [has been] shall be documented in the physician's medical records. No physician shall be subject to disciplinary action by the board solely for prescribing, administering or dispensing controlled substances when prescribed, administered or dispensed for a therapeutic purpose [for a person diagnosed and treated by a physician for a condition resulting in intractable pain, if such diagnosis and treatment has been documented in the physician's medical records].
2. The provisions of subsection 1 of this section shall not apply to those persons being treated by a physician for chemical dependency because of their use of controlled substances not related to the therapeutic purposes of treatment of intractable pain.
3. The provisions of subsection 1 of this section provide no authority to a physician to prescribe, administer or dispense controlled substances to a person the physician knows or should know to be using controlled substances which use is not related to the therapeutic purpose.
4. Drug dependency or the possibility of drug dependency in and of itself is not a reason to withhold or prohibit the prescribing, administering or dispensing of controlled substances for the therapeutic purpose of treatment of a person for [intractable] pain, nor shall dependency relating solely to such prescribing, administering or dispensing subject a physician to disciplinary action by the board.
338.013. 1. Any person desiring to assist a pharmacist in the practice of pharmacy as defined in this chapter shall apply to the board of pharmacy for registration as a pharmacy technician. Such applicant shall be, at a minimum, legal working age and shall forward to the board the appropriate fee and written application on a form provided by the board. Such registration shall be the sole authorization permitted to allow persons to assist licensed pharmacists in the practice of pharmacy as defined in this chapter.
2. The board may refuse to issue a certificate of registration as a pharmacy technician to an applicant that has been adjudicated and found guilty, or has entered a plea of guilty or nolo contendere, of a violation of any state, territory or federal drug law, or to any felony or has violated any provision of subsection 2 of section 338.055. Alternately, the board may issue such person a registration, but may authorize the person to work as a pharmacy technician provided that person adheres to certain terms and conditions imposed by the board. The board shall place on the employment disqualification list the name of an applicant who the board has refused to issue a certificate of registration as a pharmacy technician, or the name of a person who the board has issued a certificate of registration as a pharmacy technician but has authorized to work under certain terms and conditions. The board shall notify the applicant of the applicant's right to file a complaint with the administrative hearing commission as provided by chapter 621, RSMo.
3. If an applicant has submitted the required fee and an application for registration to the board of pharmacy, the applicant for registration as a pharmacy technician may assist a licensed pharmacist in the practice of pharmacy as defined in this chapter [for a period of up to ninety days prior to the issuance of a certificate of registration]. The applicant shall keep a copy of the submitted application on the premises where the applicant is employed. [When] If the board refuses to issue a certificate of registration as a pharmacy technician to an applicant, the applicant shall immediately cease assisting a licensed pharmacist in the practice of pharmacy.
4. A certificate of registration issued by the board shall be conspicuously displayed in the pharmacy or place of business where the registrant is employed.
5. Every pharmacy technician who desires to continue to be registered as provided in this section shall, within thirty days before the registration expiration date, file an application for the renewal, accompanied by the fee prescribed by the board. [No registration as provided in this section shall be valid if the registration has expired and has not been renewed as provided in this subsection] The registration shall lapse and become null and void thirty days following the expiration date.
6. The board shall maintain an employment disqualification list. No person whose name appears on the employment disqualification list shall work as a pharmacy technician, except as otherwise authorized by the board. The board may authorize a person whose name appears on the employment disqualification list to work or continue to work as a pharmacy technician provided the person adheres to certain terms and conditions imposed by the board.
7. The board may place on the employment disqualification list the name of a pharmacy technician who has been adjudicated and found guilty, or has entered a plea of guilty or nolo contendere, of a violation of any state, territory [of] or federal drug law, or to any felony or has violated any provision of subsection 2 of section 338.055.
8. After an investigation and a determination has been made to place a person's name on the employment disqualification list, the board shall notify such person in writing mailed to the person's last known address [that]:
(1) That an allegation has been made against the person, the substance of the allegation and that an investigation has been conducted which tends to substantiate the allegation;
(2) That such person's name has been added in the employment disqualification list of the board;
(3) The consequences to the person of being listed and the length of time the person's name will be on the list; and
(4) The person's right to file a complaint with the administrative hearing commission as provided in chapter 621, RSMo.
9. The length of time a person's name shall remain on the disqualification list shall be determined by the board.
10. No hospital or licensed pharmacy shall knowingly employ any person whose name appears on the employee disqualification list, except that a hospital or licensed pharmacy may employ a person whose name appears on the employment disqualification list but the board has authorized to work under certain terms and conditions. Any hospital or licensed pharmacy shall report to the board any final disciplinary action taken against a pharmacy technician or the voluntary resignation of a pharmacy technician against whom any complaints or reports have been made which might have led to final disciplinary action that can be a cause of action for discipline by the board as provided for in subsection 2 of section 338.055. Compliance with the foregoing sentence may be interposed as an affirmative defense by the employer. Any hospital or licensed pharmacy which reports to the board in good faith shall not be liable for civil damages.
338.146. 1. The board may issue a cease and desist order to stop a person from engaging or offering to engage in an unauthorized practice. The order shall state the reason for its issuance and give notice of the person's right to request a hearing under chapter 621, RSMo. If within fifteen days after service of the order the subject of the order fails to request a hearing in writing, the cease and desist order shall become final.
2. The board may enforce its cease and desist order by applying to the circuit court of Cole County, the county in which the conduct occurred, or the county in which the defendant resides for an order upon any person who fails to obey a cease and desist order to show cause why such cease and desist order should not be enforced. Such order and a copy of the application shall be served upon the person in the same manner as a summons in a civil action. If after a hearing the circuit court determines that the cease and desist order should be sustained and enforced, the court shall proceed to enforce the cease and desist order in the same manner as though the order had been issued by the court.
3. As used in this section, "unauthorized practice" means the practice of pharmacy or wholesale drug distribution by a person or entity who holds no license, certification, registration, or permit from the Missouri board of pharmacy.
338.220. 1. It shall be unlawful for any person, copartnership, association, corporation or any other business entity to open, establish, operate, or maintain any pharmacy as defined by statute without first obtaining a permit or license to do so from the Missouri board of pharmacy. A permit shall not be required for an individual licensed pharmacist to perform nondispensing activities outside of a pharmacy, subject to rules established by the board. The following classes of pharmacy permits or licenses are hereby established:
(1) Class A: Community/ambulatory;
(2) Class B: Hospital outpatient pharmacy;
(3) Class C: Long-term care;
(4) Class D: Nonsterile compounding;
(5) Class E: Radio pharmaceutical;
(6) Class F: Renal dialysis;
(7) Class G: Medical gas;
(8) Class H: Sterile product compounding;
(9) Class I: Consultant services;
(10) Class J: Shared service;
(11) Class K: Internet;
(12) Class L: Veterinary.
2. Application for such permit or license shall be made upon a form furnished to the applicant; shall contain a statement that it is made under oath or affirmation and that its representations are true and correct to the best knowledge and belief of the person signing same, subject to the penalties of making a false affidavit or declaration; and shall be accompanied by a permit or license fee. The permit or license issued shall be renewable upon payment of a renewal fee. Separate applications shall be made and separate permits or licenses required for each pharmacy opened, established, operated, or maintained by the same owner.
3. All permits, licenses or renewal fees collected pursuant to the provisions of sections 338.210 to 338.370 shall be deposited in the state treasury to the credit of the Missouri board of pharmacy fund, to be used by the Missouri board of pharmacy in the enforcement of the provisions of sections 338.210 to 338.370, when appropriated for that purpose by the general assembly.
4. Class L: veterinary permit shall not be construed to prohibit or interfere with any legally registered practitioner of veterinary medicine in the compounding or dispensing of their own prescriptions.
5. Notwithstanding any other law to the contrary, the provisions of this section shall not apply to the sale, dispensing, or filling of a pharmaceutical product or drug used for treating animals.
[338.057. The board of pharmacy shall publish a list of drug products for which substitution as provided in section 338.056 shall not be permitted. The list of drug products to be included on this list shall be based upon a joint determination made by the department of health and senior services, the state board of registration for the healing arts, and the state board of pharmacy. The board of pharmacy shall publish the list not less often than semiannually, and shall publish amendments to the list as required.]
•