07 LC 33
1816
House
Bill 367
By:
Representatives Carter of the
159th,
Stephens of the
164th,
Parrish of the
156th,
Parham of the
141st,
and Jerguson of the
22nd
A
BILL TO BE ENTITLED
AN ACT
AN ACT
To
amend Article 5 of Chapter 4 of Title 26 of the Official Code of Georgia
Annotated, relating to prescription drugs, so as to eliminate redundant language
relating to what constitutes the practice of medicine; to provide for the
substitution of therapeutically equivalent drugs; to provide for requirements
for therapeutically equivalent substitutions; to provide that a substitution
shall not constitute the practice of medicine; to amend Article 1 of Chapter 24
of Title 33 of the Official Code of Georgia Annotated, relating to insurance
generally, so as to define certain terms; to provide for health insurance
coverage for therapeutically equivalent substitutions under certain
circumstances; to provide for statutory construction; to provide for enforcement
by the Commissioner of Insurance; to provide for related matters; to repeal
conflicting laws; and for other purposes.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION
1.
Article
5 of Chapter 4 of Title 26 of the Official Code of Georgia Annotated, relating
to prescription drugs, is amended by revising Code Section 26-4-81, relating to
substitution of generic drugs for brand name drugs, as follows:
"26-4-81.
(a)
In accordance with this Code section, a pharmacist may substitute a drug with
the same generic name in the same strength, quantity, dose, and dosage form as
the prescribed brand name drug product which is, in the pharmacist´s
reasonable professional opinion, pharmaceutically equivalent.
(b)
If a practitioner of the healing arts prescribes a drug by its generic name, the
pharmacist shall dispense the lowest retail priced drug product which is in
stock and which is, in the pharmacist´s reasonable professional opinion,
pharmaceutically equivalent.
(c)
Substitutions as provided for in subsections (a) and (b) of this Code section
are authorized for the express purpose of making available to the consumer the
lowest retail priced drug product which is in stock and which is, in the
pharmacist´s reasonable professional opinion, both therapeutically
equivalent and pharmaceutically equivalent.
(d)
Whenever a substitution is made, the pharmacist shall record on the original
prescription the fact that there has been a substitution and the identity of the
dispensed drug product and its manufacturer. Such prescription shall be made
available for inspection by the board or its representative in accordance with
the rules of the board.
(e)
The substitution of any drug by a registered pharmacist pursuant to this Code
section does not constitute the practice of medicine.
(f)
A patient for whom a prescription drug order is intended may instruct a
pharmacist not to substitute a generic name drug in lieu of a brand name
drug.
(g)
A practitioner of the healing arts may instruct the pharmacist not to substitute
a generic name drug in lieu of a brand name drug by including the words 'brand
necessary' in the body of the prescription. When a prescription is a hard copy
prescription drug order, such indication of brand necessary must be in the
practitioner´s own handwriting and shall not be printed, applied by rubber
stamp, or any such similar means.
(h)
The substitution of any drug by a registered pharmacist pursuant to this Code
section does not constitute the practice of
medicine."
SECTION
2.
Said
article is further amended by inserting a new Code section to read as
follows:
"26-4-81.1
(a)
In accordance with this Code section, a pharmacist may select a therapeutically
equivalent drug from the patient´s health benefit provider´s pharmacy
and therapeutics committee list of drugs for the specifically prescribed drug
for purposes of formulary adherence to the patient´s insurance company,
carrier, or similar third-party payor plan.
(b)
If a practitioner of the healing arts prescribes a drug but has indicated with
his or her personal signature on the prescription that a therapeutically
equivalent drug may be selected from the patient´s health benefit
provider´s pharmacy and therapeutics committee list of drugs for the
specifically prescribed drug for purposes of formulary adherence to the
patient´s insurance company, carrier, or similar third-party payor plan,
the pharmacist may select a therapeutically equivalent drug and dispense it to
the patient. The board shall be authorized to promulgate regulations to
establish requirements for prescription drug order forms to clearly provide for
such indication.
(c)
The pharmacist shall, within 72 hours of dispensing a therapeutically equivalent
drug selected from the patient´s health provider´s pharmacy and
therapeutics committee list of drugs for the specifically prescribed drug for
purposes of formulary adherence to the patient´s insurance company,
carrier, or similar third-party payor plan, notify the ordering practitioner of
the selection and the name of the therapeutically equivalent drug dispensed.
Further, the pharmacist shall, whenever a selection is made pursuant to this
Code section, record on the original prescription the fact that there has been a
therapeutically equivalent selection made and the identity of the dispensed drug
product and its manufacturer. Such prescription shall be made available for
inspection by the board or its representative in accordance with the rules of
the board. The pharmacist shall also notify and document for the patient at the
time of dispensing that such selection of an alternate drug has taken
place.
(d)
Substitutions made pursuant to this Code section are authorized for the express
purpose of dispensing drugs that are included in the approved formulary of the
pharmacy and therapeutics committee of the patient´s insurance company,
carrier, or similar third-party payor plan.
(e)
The substitution of any drug by a registered pharmacist pursuant to this Code
section does not constitute the practice of medicine."
SECTION
3.
Article
1 of Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating
to insurance generally, is amended by inserting a new Code section to read as
follows:
"33-24-59.13.
(a)
As used in this Code section, the term:
(1)
'Health benefit policy' means any individual or group plan, policy, or contract
for heath care services issued, delivered, issued for delivery, or renewed in
this state by an insurance provider, including, but not limited to, those
policies, plans, or contracts executed by the State of Georgia on behalf of
state employees under Article 1 of Chapter 18 of Title 45.
(2)
'Insurance provider' means an insurance company, carrier, or similar third-party
payor plan.
(b)
Every health benefit policy that is delivered, issued, executed, or renewed in
this state or approved for issuance or renewal in this state by the Commissioner
on or after July 1, 2007, which provides coverage for prescription drugs shall
ensure that if a therapeutically equivalent drug is selected from the
patient´s health benefit policy´s pharmacy and therapeutics committee
list for the specifically prescribed drug for purposes of formulary adherence
with the patient´s health benefit policy by a pharmacist in accordance with
Code Section 26-4-81.1, the insurance provider shall cover such drug
dispensed.
(c)
Nothing in this Code section shall be construed to require any health benefit
policy to include coverage for prescription drugs.
(d)
The Commissioner is authorized to enforce this Code section and, in doing so, to
exercise the powers granted to the Commissioner by Code Section 33-2-24 and any
other provision of this title."
SECTION
4.
All
laws and parts of laws in conflict with this Act are repealed.