One-time emergency refills expansion effective Aug. 1

Tuesday, the governor signed into law legislation that would allow pharmacists to dispense a one-time emergency refill of up to a 72-hour supply or the smallest dispensable package size of a prescribed medication. Act No. 2023-231 takes effect Aug. 1.

The new law expands the emergency refill law to apply to injections and other medications not in pill or liquid forms, the Senate sponsor said.

Emergency refills will not be allowed on Schedule I or II drugs nor controlled substances and the pharmacist will have to notify the prescriber with 24 hours of dispensing. Current law allows notification within 72 hours.

Senate yet to consider bill offering pharmacists alternative actions when PBMs reimburse below cost
With three days remaining in the 2023 regular session, the Alabama Senate has not considered legislation that specifies courses of action if a pharmacy benefits manager reimburses a pharmacy or pharmacist at a cost below the pharmacy’s acquisition cost of a specific drug.

After a public hearing May 3, the Senate State Governmental Affairs Committee approved an amended version of SB220. Under the amended bill, a pharmacist who declines to fill a prescription based on reimbursement below a drug’s cost, must instruct the patient to contact the health plan so that the patient can be directed to an in-network pharmacy that will fill the prescription. The pharmacist must also contact the patient’s health plan within 48 hours of declining to fill a prescription.

The pharmacist can discuss alternatives with the covered individual with no restrictions on communications based on payment type. If the pharmacist discusses cost of alternate drugs with the patient, any alternative therapy dispensed must cost the patient either the same amount or less than the originally prescribed medication.

Another amendment to the bill prohibits a health plan from punishing pharmacists or pharmacies for refusing to fill the prescription or taking any of the allowed actions.

A 2019 law regulates pharmacy benefit managers. That law was expanded in 2021 under Act No. 2021-341.

Allowing pharmacists to work remotely effective July 1
Gov. Kay Ivey has signed into law legislation allowing the Alabama Board of Pharmacy to adopt rules related to remote work.

Act No. 2023-60 by Sen. Tom Butler, R-Madison, and Rep. Phillip Rigsby, R-Huntsville, takes effect July 1.

Earlier the House sponsor said the legislation clarifies that individuals are licensed, while entities are permitted. “Currently, a pharmacist is limited to working within the four walls of a pharmacy,” Rigsby said. He said the legislation will allow the board to set the parameters for pharmacists to do certain tasks outside of the pharmacy.

Governor signs bill to make Alabama compliant with the U.S. Drug Supply Chain Security Act
Today, the governor signed into law Act No. 2023-119, which allows the state pharmacy board to require a designated representative be registered with the board for each entity permitted within the drug supply chain. The law takes effect Aug. 1.

Adoption of the legislation was necessary to comply with the federal Drug Supply Chain Security Act, which authorized electronic tracing of certain prescription drugs at the package level. The federal law helps protect consumers from exposure to drugs that may be counterfeit, stolen, contaminated or otherwise harmful.

Legislation to allow pharmacists to prescribe, administer certain vaccines has yet to receive floor debate
The House Health Committee on April 26 approved a substitute version of HB290, which would allow a licensed pharmacist to prescribe flu vaccines to those two or older, COVID-19 vaccines to those 3 or older and other vaccines to those 19 and older. The bill by Rep. Phillip Rigsby, R-Huntsville, does not allow a pharmacist to prescribe any vaccine on the Centers for Disease Control and Prevention’s Immunization Schedule for those 18 or younger.  The House has not yet considered the bill. A similar bill, SB229, never received consideration by the Senate Healthcare Committee.

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