HB-5328, As Passed House, June 16, 2004                                     

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                              SUBSTITUTE FOR                                    

                                                                                

                           HOUSE BILL NO. 5328                                  

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                 A bill to amend 1978 PA 368, entitled                                             

                                                                                

    "Public health code,"                                                       

                                                                                

    by amending sections 17757 and 17757a (MCL 333.17757 and                    

                                                                                

    333.17757a), section 17757 as amended by 1986 PA 304 and section            

                                                                                

    17757a as amended by 1993 PA 305, and by adding section 17753.              

                                                                                

                THE PEOPLE OF THE STATE OF MICHIGAN ENACT:                      

                                                                                

1       Sec. 17753.  (1) Within 1 year after the effective date of                  

                                                                                

2   the amendatory act that added this section, the board, in                   

                                                                                

3   cooperation with the Michigan medication safety coalition and the           

                                                                                

4   Michigan pharmacists association, shall establish a process for             

                                                                                

5   the development and implementation of a quality assurance program           

                                                                                

6   that shall, at a minimum, document, identify, assess, and prevent           

                                                                                

7   prescription medication errors that occur in pharmacies or that             

                                                                                

8   are attributable, in whole or in part, to the pharmacy or its               

                                                                                

9   personnel, a pharmacist, or a dispensing prescriber.  The purpose           

                                                                                


                                                                                

1   of the quality assurance program shall be to assist pharmacies,             

                                                                                

2   pharmacists, and dispensing prescribers to take appropriate                 

                                                                                

3   action to prevent prescription medication errors or to prevent              

                                                                                

4   recurrence.  The quality assurance program may include a peer               

                                                                                

5   review committee appointed by any of the following:                         

                                                                                

6       (a) This state.                                                             

                                                                                

7       (b) An established professional standards review organization               

                                                                                

8   qualified under federal or state law.                                       

                                                                                

9       (c) A foundation, organization, or group of professionals and               

                                                                                

10  experts nominated by the Michigan medication safety coalition and           

                                                                                

11  the Michigan pharmacists association and acting pursuant to the             

                                                                                

12  approval of the board.                                                      

                                                                                

13      (2) A person, organization, or entity may provide                           

                                                                                

14  information, data, or records to a peer review committee under              

                                                                                

15  this program.  Information and records generated for and                    

                                                                                

16  maintained as a component of the quality assurance program are              

                                                                                

17  considered peer review documents, are confidential, and shall be            

                                                                                

18  used only for the purposes of peer review.  In the absence of               

                                                                                

19  malice, a person, organization, or entity is not civilly or                 

                                                                                

20  criminally liable for providing information, data, or records               

                                                                                

21  pursuant to this section or for any act or communication in the             

                                                                                

22  use of the information provided pursuant to this section.                   

                                                                                

23      (3) The department, in consultation with the board and the                  

                                                                                

24  quality assurance program, may promulgate rules establishing                

                                                                                

25  standards, policies, procedures, and requirements for a pharmacy            

                                                                                

26  licensed under this part for the implementation of a quality                

                                                                                

27  assurance program.                                                          


                                                                                

1       (4) A pharmacist shall provide, upon request, to the                        

                                                                                

2   purchaser of a prescription drug information about how to contact           

                                                                                

3   the board or the quality assurance program if he or she has a               

                                                                                

4   complaint regarding the dispensing of his or her prescription or            

                                                                                

5   believes that a prescription medication error may have occurred.            

                                                                                

6       (5) As used in this section, "prescription medication error"                

                                                                                

7   means a preventable event that occurred while the medication is             

                                                                                

8   in control of the health care professional or health facility               

                                                                                

9   that may cause or lead to inappropriate medication use or patient           

                                                                                

10  harm.  A preventable event may be related to any step related to            

                                                                                

11  the health profession and its procedures or systems, including,             

                                                                                

12  but not limited to, the prescribing, compounding, dispensing, or            

                                                                                

13  distribution of a prescription; the ordering or communication of            

                                                                                

14  the prescription to the dispensing prescriber; the labeling,                

                                                                                

15  packaging, or naming of the prescription; the monitoring of the             

                                                                                

16  use of a prescription; and the educating of the patient regarding           

                                                                                

17  the prescription.                                                           

                                                                                

18      Sec. 17757.  (1) Upon a request made in person or by                        

                                                                                

19  telephone, a pharmacist engaged in the business of selling drugs            

                                                                                

20  at retail shall provide the current selling price of a drug                 

                                                                                

21  dispensed by that pharmacy or comparative current selling prices            

                                                                                

22  of generic and brand name drugs dispensed by that pharmacy.  The            

                                                                                

23  information shall be provided to the person making the request              

                                                                                

24  before a drug is dispensed to the person.  A person who makes a             

                                                                                

25  request for price information under this subsection shall not be            

                                                                                

26  obligated to purchase the drug for which the price or comparative           

                                                                                

27  prices are requested.                                                       


                                                                                

1       (2) A pharmacist engaged in the business of selling drugs at                

                                                                                

2   retail shall conspicuously display the notice described in                  

                                                                                

3   subsection (3) at each counter over which prescription drugs are            

                                                                                

4   dispensed.                                                                  

                                                                                

5       (3) The notice required under subsection (2) shall be in                    

                                                                                

6   substantially the following form:                                           

                                                                                

7                          NOTICE TO CONSUMERS                                  

                                                                                

8                        ABOUT PRESCRIPTION DRUGS                               

                                                                                

9       Under Michigan law, you have the right to find out the price                

                                                                                

10  of a prescription drug before the pharmacist fills the                      

                                                                                

11  prescription.  You are under no obligation to have the                      

                                                                                

12  prescription filled here and may use this price information to              

                                                                                

13  shop around at other pharmacies.  You may request price                     

                                                                                

14  information in person or by telephone.                                      

                                                                                

15      Every pharmacy has the current selling prices of both generic               

                                                                                

16  and brand name drugs dispensed by the pharmacy.                             

                                                                                

17      Ask your pharmacist if a lower-cost generic drug is available               

                                                                                

18  to fill your prescription.  A generic drug contains the same                

                                                                                

19  medicine as a brand name drug and is a suitable substitute in               

                                                                                

20  most instances.                                                             

                                                                                

21                                                                               A generic drug may not be dispensed by your pharmacist if                         

                                                                                

22  your doctor has written "dispense as written" or the initials               

                                                                                

23  "d.a.w."  on the prescription.                                              

                                                                                

24                                                                               If you have questions about the drugs which have been                              

                                                                                

25  prescribed for you, ask your doctor or pharmacist for more                  

                                                                                

26  information.                                                                

                                                                                

27                                                                               To avoid dangerous drug interactions, let your doctor and                          


                                                                                

1   pharmacist know about any other medications you are taking.  This           

                                                                                

2   is especially important if you have more than 1 doctor or have              

                                                                                

3   prescriptions filled at more than 1 pharmacy.                               

                                                                                

4                                                                                IF YOU BELIEVE THAT A PRESCRIPTION MEDICATION ERROR MAY HAVE                       

                                                                                

5   OCCURRED IN THE DISPENSING OF YOUR PRESCRIPTION, YOU MAY CONTACT            

                                                                                

6   THE MICHIGAN BOARD OF PHARMACY OR THE QUALITY ASSURANCE PROGRAM.            

                                                                                

7       (4) The notice required under subsection (2) shall also                     

                                                                                

8   contain the address and phone number of the board and the                   

                                                                                

9   department.  The text of the notice shall be in at least 32-point           

                                                                                

10  bold type and shall be printed on paper at least 11 inches by 17            

                                                                                

11  inches in size.  The notice may be printed on multiple pages.               

                                                                                

12      (5) A copy of the notice required under subsection (2) shall                

                                                                                

13  be provided to each licensee by the department.  Additional                 

                                                                                

14  copies shall be available if needed from the department.  A                 

                                                                                

15  person may duplicate or reproduce the notice if the duplication             

                                                                                

16  or reproduction is a true copy of the notice as produced by the             

                                                                                

17  department, without any additions or deletions whatsoever.                  

                                                                                

18      (6) The pharmacist shall furnish to the purchaser of a                      

                                                                                

19  prescription drug at the time the drug is delivered to the                  

                                                                                

20  purchaser a receipt evidencing the transactions, which contains             

                                                                                

21  the following:                                                              

                                                                                

22      (a) The brand name of the drug, if applicable.                              

                                                                                

23      (b) The name of the manufacturer or the supplier of the drug,               

                                                                                

24  if the drug does not have a brand name.                                     

                                                                                

25      (c) The strength of the drug, if significant.                               

                                                                                

26      (d) The quantity dispensed, if applicable.                                  

                                                                                

27      (e) The name and address of the pharmacy.                                   


                                                                                

1       (f) The serial number of the prescription.                                  

                                                                                

2       (g) The date the prescription was originally dispensed.                     

                                                                                

3       (h) The name of the prescriber.                                             

                                                                                

4       (i) The name of patient for whom the drug was prescribed.                   

                                                                                

5       (j) The price for which the drug was sold to the purchaser.                 

                                                                                

6       (7) Subsection (6)(a), (b), and (c) may be omitted by a                     

                                                                                

7   pharmacist only if the omission is expressly required by the                

                                                                                

8   prescriber.  The pharmacist shall retain a copy of each receipt             

                                                                                

9   for 90 days.  The inclusion of subsection (6) on the prescription           

                                                                                

10  container label is a valid receipt to the purchaser.  Including             

                                                                                

11  subsection (6) on the written prescription form and retaining the           

                                                                                

12  form constitutes retention of a copy of the receipt.                        

                                                                                

13      (8) The board may promulgate rules to implement this                        

                                                                                

14  section.                                                                    

                                                                                

15      Sec. 17757a.  (1) Upon a request made in person or by                       

                                                                                

16  telephone, a dispensing prescriber engaged in the business of               

                                                                                

17  selling prescription drugs shall provide the current selling                

                                                                                

18  price of a drug dispensed by that dispensing prescriber or                  

                                                                                

19  comparative current selling prices of generic and brand name                

                                                                                

20  drugs dispensed by that dispensing prescriber.  The information             

                                                                                

21  shall be provided to the person making the request before a                 

                                                                                

22  prescription drug is dispensed to the person.  A person who makes           

                                                                                

23  a request for price information under this subsection is not                

                                                                                

24  obligated to purchase the prescription drug for which the price             

                                                                                

25  or comparative prices are requested.                                        

                                                                                

26      (2) A dispensing prescriber engaged in the business of                      

                                                                                

27  selling prescription drugs shall conspicuously display the notice           


                                                                                

1   described in subsection (3) in the location within the dispensing           

                                                                                

2   prescriber's practice where the dispensing occurs.                          

                                                                                

3       (3) The notice required under subsection (2) shall be in                    

                                                                                

4   substantially the following form:                                           

                                                                                

5              NOTICE TO CONSUMERS ABOUT PRESCRIPTION DRUGS                     

                                                                                

6       Under Michigan law, you have the right to find out the price                

                                                                                

7   of a prescription drug before the doctor provides a prescription            

                                                                                

8   drug directly to you.  You are under no obligation to have the              

                                                                                

9   prescription filled here and may use this price information to              

                                                                                

10  shop around.                                                                

                                                                                

11      You may choose to have the prescription filled by your doctor               

                                                                                

12  or the pharmacy of your choice.  Your doctor may not force you to           

                                                                                

13  have the prescription filled by the doctor.  Your doctor cannot             

                                                                                

14  charge you for medications marked "sample."  Ask your doctor or             

                                                                                

15  pharmacist if a lower-cost generic drug is available to fill your           

                                                                                

16  prescription.  A generic drug contains the same medicine as a               

                                                                                

17  brand name drug and is a suitable substitute in most cases.  If             

                                                                                

18  you have questions about the drugs which have been prescribed for           

                                                                                

19  you, ask your doctor or pharmacist for more information.  To                

                                                                                

20  avoid dangerous drug interactions, let your doctor and pharmacist           

                                                                                

21  know about any other medications you are taking.  This is                   

                                                                                

22  especially important if you have more than 1 doctor or have                 

                                                                                

23  prescriptions filled at more than 1 location.                               

                                                                                

24                                                                               IF YOU BELIEVE THAT A PRESCRIPTION MEDICATION ERROR MAY HAVE                       

                                                                                

25  OCCURRED IN THE DISPENSING OF YOUR PRESCRIPTION, YOU MAY CONTACT            

                                                                                

26  THE MICHIGAN BOARD OF PHARMACY OR THE QUALITY ASSURANCE PROGRAM.            

                                                                                

27      (4) The notice required under subsection (2) shall also                     


                                                                                

1   contain the address and phone number of the board and the                   

                                                                                

2   department.  The text of the notice shall be in at least 32-point           

                                                                                

3   bold type and shall be printed on paper at least 11 inches by 17            

                                                                                

4   inches in size.  The notice may be printed on multiple pages.               

                                                                                

5       (5) A copy of the notice required under subsection (2) shall                

                                                                                

6   be provided to each dispensing prescriber by the department.                

                                                                                

7   Additional copies shall be available if needed from the                     

                                                                                

8   department.  A person may duplicate or reproduce the notice if              

                                                                                

9   the duplication or reproduction is a true copy of the notice as             

                                                                                

10  produced by the department, without any additions or deletions.             

                                                                                

11      Enacting section 1.  Sections 17757 and 17757a of the public                

                                                                                

12  health code, 1978 PA 368, MCL 333.17757 and 333.17757a, as                  

                                                                                

13  amended by this amendatory act, take effect upon the                        

                                                                                

14  implementation of the quality assurance program required under              

                                                                                

15  section 17753 of the public health code, 1978 PA 368, MCL                   

                                                                                

16  333.17753, as added by this amendatory act, and receipt by the              

                                                                                

17  secretary of state of written notice from the Michigan board of             

                                                                                

18  pharmacy that the quality assurance program is operational.