Amended in Assembly March 26, 2015

California Legislature—2015–16 Regular Session

Assembly BillNo. 788


Introduced by Assembly Member Chu

February 25, 2015


begin deleteAn act to amend Section 4070 of the Business and Professions Code, relating to healing arts. end deletebegin insertAn act to amend Sections 4040 and 4076 of the Business and Professions Code, relating to pharmacists.end insert

LEGISLATIVE COUNSEL’S DIGEST

AB 788, as amended, Chu. begin deletePharmacy. end deletebegin insertPrescriptions.end insert

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Existing law, the Pharmacy Law, establishes the California State Board of Pharmacy and sets forth its powers and duties, including, but not limited to, the licensing and regulation of pharmacists. Existing law makes a knowing violation of these provisions a crime.

end insert
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Existing law requires every prescription, as defined, to include a legible, clear notice of the condition or purpose for which the drug is prescribed, if requested by the patient. Existing law prohibits a pharmacist from dispensing any prescription unless it is in a specified container that is correctly labeled to include, among other information, the condition or purpose for which the drug was prescribed, if the condition or purpose is indicated on the prescription.

end insert
begin insert

This bill would instead require that every prescription include a legible, clear notice of the condition or purpose for which the drug is prescribed, and would authorize the prescriber or patient to request that this information not be included in the prescription container label. This bill would, similarly, require that every prescription container be correctly labeled to include that information, unless omission of that information has been requested by the prescriber or patient.

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By establishing these additional requirements, the knowing violation of which would be a crime, this bill would impose a state-mandated local program.

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The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

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This bill would provide that no reimbursement is required by this act for a specified reason.

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Existing law, the Pharmacy Law, requires an oral or an electronic data transmission prescription to be reduced to writing by the pharmacist and to be filled by, or under the direction of, the pharmacist. Under existing law, the pharmacist does not need to reduce to writing the address, telephone number, license classification, federal registry number of the prescriber or the address of the patient or patients if the information is readily retrievable in the pharmacy.

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This bill would make nonsubstantive changes to those provisions.

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Vote: majority. Appropriation: no. Fiscal committee: begin deleteno end deletebegin insertyesend insert. State-mandated local program: begin deleteno end deletebegin insertyesend insert.

The people of the State of California do enact as follows:

P2    1begin insert

begin insertSECTION 1.end insert  

end insert

begin insertSection 4040 of the end insertbegin insertBusiness and Professions
2Code
end insert
begin insert is amended to read:end insert

3

4040.  

(a) “Prescription” means an oral, written, or electronic
4transmission order that is both of the following:

5(1) Given individually for the person or persons for whom
6ordered that includes all of the following:

7(A) The name or names and address of the patient or patients.

8(B) The name and quantity of the drug or device prescribed and
9the directions for use.

10(C) The date of issue.

11(D) Either rubber stamped, typed, or printed by hand or typeset,
12the name, address, and telephone number of the prescriber, his or
13 her license classification, and his or her federal registry number,
14if a controlled substance is prescribed.

15(E) A legible, clear notice of the condition or purpose for which
16the drug is beingbegin delete prescribed, if requested by the patient or patients.end delete
17begin insert prescribed. This notice shall indicate that, at the request of the
18prescriber or patient, the information regarding the condition or
P3    1purpose shall be omitted from the container label information
2pursuant to Section 4076.end insert

3(F) If in writing, signed by the prescriber issuing the order, or
4the certified nurse-midwife, nurse practitioner, physician assistant,
5or naturopathic doctor who issues a drug order pursuant to Section
62746.51, 2836.1, 3502.1, or 3640.5, respectively, or the pharmacist
7who issues a drug order pursuant to Section 4052.1, 4052.2, or
84052.6.

9(2) Issued by a physician, dentist, optometrist, podiatrist,
10veterinarian, or naturopathic doctor pursuant to Section 3640.7 or,
11if a drug order is issued pursuant to Section 2746.51, 2836.1,
123502.1, or 3460.5, by a certified nurse-midwife, nurse practitioner,
13physician assistant, or naturopathic doctor licensed in this state,
14or pursuant to Section 4052.1, 4052.2, or 4052.6 by a pharmacist
15licensed in this state.

16(b) Notwithstanding subdivision (a), a written order of the
17prescriber for a dangerous drug, except for any Schedule II
18controlled substance, that contains at least the name and signature
19of the prescriber, the name and address of the patient in a manner
20consistent with paragraph (2) of subdivision (a) of Section 11164
21of the Health and Safety Code, the name and quantity of the drug
22prescribed, directions for use, and the date of issue may be treated
23as a prescription by the dispensing pharmacist as long as any
24additional information required by subdivision (a) is readily
25retrievable in the pharmacy. In the event of a conflict between this
26subdivision and Section 11164 of the Health and Safety Code,
27Section 11164 of the Health and Safety Code shall prevail.

28(c) “Electronic transmission prescription” includes both image
29and data prescriptions. “Electronic image transmission
30prescription” means any prescription order for which a facsimile
31of the order is received by a pharmacy from a licensed prescriber.
32“Electronic data transmission prescription” means any prescription
33order, other than an electronic image transmission prescription,
34that is electronically transmitted from a licensed prescriber to a
35pharmacy.

36(d) The use of commonly used abbreviations shall not invalidate
37an otherwise valid prescription.

38(e) Nothing in the amendments made to this section (formerly
39Section 4036) at the 1969 Regular Session of the Legislature shall
40be construed as expanding or limiting the right that a chiropractor,
P4    1while acting within the scope of his or her license, may have to
2prescribe a device.

3begin insert

begin insertSEC. 2.end insert  

end insert

begin insertSection 4076 of the end insertbegin insertBusiness and Professions Codeend insertbegin insert is
4amended to read:end insert

5

4076.  

(a) A pharmacist shall not dispense any prescription
6except in a container that meets the requirements of state and
7federal law and is correctly labeled with all of the following:

8(1) Except when the prescriber or the certified nurse-midwife
9who functions pursuant to a standardized procedure or protocol
10described in Section 2746.51, the nurse practitioner who functions
11pursuant to a standardized procedure described in Section 2836.1
12or protocol, the physician assistant who functions pursuant to
13Section 3502.1, the naturopathic doctor who functions pursuant
14to a standardized procedure or protocol described in Section
153640.5, or the pharmacist who functions pursuant to a policy,
16procedure, or protocol pursuant to Section 4052.1, 4052.2, or
174052.6 orders otherwise, either the manufacturer’s trade name of
18the drug or the generic name and the name of the manufacturer.
19Commonly used abbreviations may be used. Preparations
20containing two or more active ingredients may be identified by
21the manufacturer’s trade name or the commonly used name or the
22principal active ingredients.

23(2) The directions for the use of the drug.

24(3) The name of the patient or patients.

25(4) The name of the prescriber or, if applicable, the name of the
26certified nurse-midwife who functions pursuant to a standardized
27procedure or protocol described in Section 2746.51, the nurse
28practitioner who functions pursuant to a standardized procedure
29described in Section 2836.1 or protocol, the physician assistant
30who functions pursuant to Section 3502.1, the naturopathic doctor
31who functions pursuant to a standardized procedure or protocol
32described in Section 3640.5, or the pharmacist who functions
33pursuant to a policy, procedure, or protocol pursuant to Section
344052.1, 4052.2, or 4052.6.

35(5) The date of issue.

36(6) The name and address of the pharmacy, and prescription
37number or other means of identifying the prescription.

38(7) The strength of the drug or drugs dispensed.

39(8) The quantity of the drug or drugs dispensed.

P5    1(9) The expiration date of the effectiveness of the drug
2dispensed.

3(10) The condition or purpose for which the drug wasbegin delete prescribed
4if theend delete
begin insert prescribed, unless the patient or prescriber has requested
5that theend insert
condition or purposebegin delete isend deletebegin insert not beend insert indicated on thebegin delete prescription.end delete
6begin insert prescription container label.end insert

7(11) (A) Commencing January 1, 2006, the physical description
8of the dispensed medication, including its color, shape, and any
9identification code that appears on the tablets or capsules, except
10as follows:

11(i) Prescriptions dispensed by a veterinarian.

12(ii) An exemption from the requirements of this paragraph shall
13be granted to a new drug for the first 120 days that the drug is on
14the market and for the 90 days during which the national reference
15file has no description on file.

16(iii) Dispensed medications for which no physical description
17exists in any commercially available database.

18(B) This paragraph applies to outpatient pharmacies only.

19(C) The information required by this paragraph may be printed
20on an auxiliary label that is affixed to the prescription container.

21(D) This paragraph shall not become operative if the board,
22prior to January 1, 2006, adopts regulations that mandate the same
23labeling requirements set forth in this paragraph.

24(b) If a pharmacist dispenses a prescribed drug by means of a
25unit dose medication system, as defined by administrative
26regulation, for a patient in a skilled nursing, intermediate care, or
27other health care facility, the requirements of this section will be
28satisfied if the unit dose medication system contains the
29 aforementioned information or the information is otherwise readily
30available at the time of drug administration.

31(c) If a pharmacist dispenses a dangerous drug or device in a
32facility licensed pursuant to Section 1250 of the Health and Safety
33Code, it is not necessary to include on individual unit dose
34containers for a specific patient, the name of the certified
35nurse-midwife who functions pursuant to a standardized procedure
36or protocol described in Section 2746.51, the nurse practitioner
37who functions pursuant to a standardized procedure described in
38Section 2836.1 or protocol, the physician assistant who functions
39pursuant to Section 3502.1, the naturopathic doctor who functions
40pursuant to a standardized procedure or protocol described in
P6    1Section 3640.5, or the pharmacist who functions pursuant to a
2policy, procedure, or protocol pursuant to Section 4052.1, 4052.2,
3or 4052.6.

4(d) If a pharmacist dispenses a prescription drug for use in a
5facility licensed pursuant to Section 1250 of the Health and Safety
6Code, it is not necessary to include the information required in
7paragraph (11) of subdivision (a) when the prescription drug is
8administered to a patient by a person licensed under the Medical
9Practice Act (Chapter 5 (commencing with Section 2000)), the
10Nursing Practice Act (Chapter 6 (commencing with Section 2700)),
11or the Vocational Nursing Practice Act (Chapter 6.5 (commencing
12with Section 2840)), who is acting within his or her scope of
13practice.

14begin insert

begin insertSEC. 3.end insert  

end insert
begin insert

No reimbursement is required by this act pursuant to
15Section 6 of Article XIII B of the California Constitution because
16the only costs that may be incurred by a local agency or school
17district will be incurred because this act creates a new crime or
18infraction, eliminates a crime or infraction, or changes the penalty
19for a crime or infraction, within the meaning of Section 17556 of
20the Government Code, or changes the definition of a crime within
21the meaning of Section 6 of Article XIII B of the California
22Constitution.

end insert
begin delete
23

SECTION 1.  

Section 4070 of the Business and Professions
24Code
is amended to read:

25

4070.  

(a) Except as provided in Section 4019 and subdivision
26(b), an oral or an electronic data transmission prescription as
27defined in subdivision (c) of Section 4040 shall, as soon as
28practicable, be reduced to writing by the pharmacist and shall be
29filled by, or under the direction of, the pharmacist. The pharmacist
30does not need to reduce to writing the address, telephone number,
31license classification, federal registry number of the prescriber or
32the address of the patient or patients if the information is readily
33retrievable in the pharmacy.

34(b) A pharmacy receiving an electronic transmission prescription
35shall not be required to reduce that prescription to writing or to
36hard copy form if, for three years from the last date of furnishing
37pursuant to that prescription or order, the pharmacy is able, upon
38request by the board, to immediately produce a hard copy report
39that includes for each date of dispensing of a dangerous drug or
40dangerous device pursuant to that prescription or order: (1) all of
P7    1the information described in subparagraphs (A) to (E), inclusive,
2of paragraph (1) of subdivision (a) of Section 4040, and (2) the
3name or identifier of the pharmacist who dispensed the dangerous
4drug or dangerous device. This subdivision shall not apply to
5 prescriptions for controlled substances classified in Schedule II,
6III, IV, or V, except as permitted pursuant to Section 11164.5 of
7the Health and Safety Code.

8(c) If only recorded and stored electronically, on magnetic
9media, or in any other computerized form, the pharmacy’s
10computer system shall not permit the received information or the
11dangerous drug or dangerous device dispensing information
12required by this section to be changed, obliterated, destroyed, or
13disposed of, for the record maintenance period required by law
14once the information has been received by the pharmacy and once
15the dangerous drug or dangerous device has been dispensed. Once
16a dangerous drug or dangerous device has been dispensed, if the
17previously created record is determined to be incorrect, a correcting
18addition may be made only by or with the approval of a pharmacist.
19After a pharmacist enters the change or enters his or her approval
20of the change into the computer, the resulting record shall include
21the correcting addition and the date it was made to the record, the
22identity of the person or pharmacist making the correction, and
23the identity of the pharmacist approving the correction.

24(d) Nothing in this section shall impair the requirement to have
25an electronically transmitted prescription transmitted only to the
26pharmacy of the patient’s choice or to have a written prescription.
27This requirement shall not apply to orders for medications to be
28administered in an acute care hospital.

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