What's happening
This bill authorizes qualified pharmacists to provide comprehensive medication management for chronic disease patients under physician-approved protocols, and makes collaborative drug therapy management provisions permanent.
Why it matters
Expands the role of pharmacists in chronic disease management. By allowing qualified pharmacists to adjust medication regimens and order lab tests under physician-written protocols, the bill leverages pharmacists’ expertise to help optimize patients' medication use, potentially improving health outcomes for those with complex, ongoing conditions.
Creates safeguards and maintains physician oversight. The protocols require voluntary agreement from both physician and pharmacist, ensure that any medication changes are documented and communicated to the physician, and prohibit pharmacists from making substitutions unless explicitly authorized—helping maintain coordinated, physician-led care.
Empowers patient choice and rights. Patients must be informed and provide written consent before participating in comprehensive medication management, and may withdraw at any time. This protects patient autonomy and ensures that these services are used only when desired.
Could improve healthcare efficiency and reduce costs. By making collaborative drug therapy management permanent and formally integrating pharmacists into chronic care teams, the bill may help prevent medication errors, reduce hospitalizations, and address therapy gaps—potentially lowering overall healthcare costs and improving system efficiency.
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Who cares
Headline styles
Let Doctors, Pharmacists Manage Meds
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to health
- Referred to health
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Let Doctors, Pharmacists Team Up
In Assembly Committee · Higher Education · Sponsor John T. McDonald III
Full text
4 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
5296
2019-2020 Regular Sessions
IN SENATE
April 23, 2019
Introduced by Sen. BRESLIN -- read twice and ordered printed, and when printed to be committed to the Committee on Health
AN ACT to amend the public health law and the education law, in relation to comprehensive medication management; and to amend chapter 21 of the laws of 2011 amending the education law relating to authorizing pharmacists to perform collaborative drug therapy management with physicians in certain settings, in relation to making the provisions of such chapter permanent
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. The public health law is amended by adding a new article 29-H to read as follows:
ARTICLE 29-H
COMPREHENSIVE MEDICATION MANAGEMENT Section 2999-ee. Comprehensive medication management.
§ 2999-ee. Comprehensive medication management. 1. Definitions. As used in this article, the following terms shall have the following meanings:
(a) Qualified pharmacist. The term "qualified pharmacist" shall mean a pharmacist who maintains a current unrestricted license pursuant to article one hundred thirty-seven of the education law, who has a minimum of two years of experience in patient care as a practicing pharmacist within the last five years, and who has demonstrated competency in the medication management of patients with a chronic disease or diseases, including, but not limited to, the completion of one or more programs which are accredited by the accreditation council for pharmacy education, recognized by the education department and acceptable to the patient's treating physician.
(b) Patient care. The term "patient care" shall mean assessing the appropriateness of prescription and non-prescription drugs for individual patients based on an assessment of the patient's medication history,
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD00591-01-9
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medication experience including beliefs, concerns, understanding and expectations, the clinical goals of therapy, potential drug-to-drug interactions or other medication safety concerns, recommendations for adherence and consulting with a patient or caregiver.
(c) Comprehensive medication management. The term "comprehensive medication management" shall mean a program conducted by a qualified pharmacist that ensures a patient's medications, whether prescription or nonprescription, are individually assessed to determine that each medication is appropriate for the patient, effective for the medical condition, safe given the comorbidities and other medications being taken, and able to be taken by the patient as intended. Comprehensive medication management conducted by a qualified pharmacist shall include sharing of applicable patient clinical information with the treating physician as specified in a comprehensive medication management protocol.
(d) Comprehensive medication management protocol. The term "comprehensive medication management protocol" shall mean a written document pursuant to and consistent with any applicable state and federal requirements, that is entered into voluntarily by a physician licensed pursuant to article one hundred thirty-one of the education law and a qualified pharmacist which addresses a chronic disease or diseases as determined by the treating physician and that describes the nature and scope of the comprehensive medication management services to be performed by the qualified pharmacist, in accordance with the provisions of this article. Comprehensive medication management protocols between licensed physicians and qualified pharmacists shall be made available to the department for review and to ensure compliance with this article, upon request.
2. Authorization to establish comprehensive medication management protocols. A physician licensed pursuant to article one hundred thirtyone of the education law shall be authorized to voluntarily establish a comprehensive medication management protocol with a qualified pharmacist to provide comprehensive medication management services for a patient who has not met clinical goals of therapy, is at risk for hospitalization or for whom the physician deems it is necessary to receive comprehensive medication management services. Participation by the patient in comprehensive medication management services shall be voluntary.
3. Scope of comprehensive medication management protocols. Under a comprehensive medication management protocol, a qualified pharmacist shall be permitted to:
(a) adjust or manage a drug regimen of a patient, pursuant to the patient specific order or protocol established by the patient's treating physician, which may include adjusting drug strength, frequency of administration or route of administration. Adjusting the drug regimen shall not include substituting or selecting a different drug which differs from that initially prescribed by the patient's treating physician unless such substitution is expressly authorized in the written order or protocol. The qualified pharmacist shall be required to immediately document in the patient's medical record changes made to the patient's drug therapy. The patient's treating physician may prohibit, by written instruction, any adjustment or change in the patient's drug regimen by the qualified pharmacist;
(b) evaluate and, only if specifically authorized by the protocol and only to the extent necessary to discharge the responsibilities set forth in this article, order disease state laboratory tests related to the drug therapy management for the specific chronic disease or diseases specified within the written agreement or protocol;
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(c) only if specifically authorized by the written order or protocol and only to the extent necessary to discharge the responsibilities set forth in this article, order or perform routine patient monitoring functions as may be necessary in the drug therapy management, including the collecting and reviewing of patient histories, and ordering or checking patient vital signs, including pulse, temperature, blood pressure, weight and respiration; and
(d) access the complete patient medical record maintained by the treating physician with whom the qualified pharmacist has the comprehensive medication management protocol and document any adjustments made pursuant to the protocol in the patient's medical record and shall notify the patient's treating physician of any adjustments in a timely manner electronically or by other means.
(e) Under no circumstances, shall the qualified pharmacist be permitted to delegate comprehensive medication management services to any other licensed pharmacist or other pharmacy personnel.
4. Medication adjustments. Any medication adjustments made by the qualified pharmacist pursuant to the comprehensive medication management protocol including adjustments in drug strength, frequency or route of administration, or initiation of a drug which differs from that initially prescribed and as documented in the patient's medical record shall be deemed an oral prescription authorized by an agent of the patient's treating physician and shall be dispensed consistent with section sixty-eight hundred ten of the education law. For the purposes of this article, a pharmacist who is not an employee of the physician may be authorized to serve as an agent of the physician.
5. Referrals. A physician licensed pursuant to article one hundred thirty-one of the education law who has responsibility for the treatment and care of a patient for a chronic disease or diseases as determined by the physician may refer the patient to a qualified pharmacist for comprehensive medication management services, pursuant to the comprehensive medication management protocol that the physician has established with the qualified pharmacist. The protocol agreement shall authorize the pharmacist to serve as an agent of the physician as defined by the protocol. Such referral shall be documented in the patient's medical record.
6. Patient participation. Participation in comprehensive medication management services shall be voluntary, and no patient, physician or pharmacist shall be required to participate. The referral of a patient for comprehensive medication management services and the patient's right to choose to not participate shall be disclosed to the patient. Comprehensive medication management services shall not be utilized unless the patient or the patient's authorized representative consents, in writing, to such services. Such consent shall be noted in the patient's medical record. If the patient or the patient's authorized representative who consented chooses to no longer participate in such services, at any time, the services shall be discontinued and it shall be noted in the patient's medical record.
§ 2. The education law is amended by adding a new section 6801-b to read as follows:
§ 6801-b. Comprehensive medication management. 1. As used in this section:
(a) "comprehensive medication management" shall mean a program for the management of chronic disease or diseases that ensures a patient's medications, whether prescription or nonprescription, are individually assessed to determine that each medication is appropriate for the
S. 5296 4
patient, effective for the medical condition, safe given the comorbidities and other medications being taken, and able to be taken by the patient as intended; and
(b) "comprehensive medication management protocol" shall mean a written document, pursuant to and consistent with any applicable state or federal requirements, that is entered into voluntarily by a physician licensed pursuant to article one hundred thirty-one of this title and a licensed pharmacist who meets the qualification requirements specified in article twenty-nine-H of the public health law which addresses a chronic disease or diseases as determined by the physician and that describes the nature and scope of the comprehensive medication management service to be performed by the qualified pharmacist. Comprehensive medication management protocols between licensed physicians and qualified pharmacists shall be made available to the department for review and to ensure compliance with this article, upon request.
2. A licensed pharmacist qualified pursuant to article twenty-nine-H of the public health law is authorized to serve as an agent of the physician when executing the terms of the written comprehensive medication management protocol as established by the licensed physician for the management of patients with a chronic disease or diseases.
§ 3. Section 5 of chapter 21 of the laws of 2011, amending the education law relating to authorizing pharmacists to perform collaborative drug therapy management with physicians in certain settings, as amended by section 5 of part DD of chapter 57 of the laws of 2018, is amended to read as follows:
§ 5. This act shall take effect on the one hundred twentieth day after it shall have become a law[, provided, however, that the provisions of sections two, three, and four of this act shall expire and be deemed repealed July 1, 2020]; provided, however, that the amendments to subdivision 1 of section 6801 of the education law made by section one of this act shall be subject to the expiration and reversion of such subdivision pursuant to section 8 of chapter 563 of the laws of 2008, when upon such date the provisions of section one-a of this act shall take effect; provided, further, that effective immediately, the addition, amendment and/or repeal of any rule or regulation necessary for the implementation of this act on its effective date are authorized and directed to be made and completed on or before such effective date.
§ 4. This act shall take effect immediately, provided that sections one and two of this act shall take effect on the one hundred eightieth day after it shall have become a law. Effective immediately, the addition, amendment and/or repeal of any rule or regulation necessary for the implementation of this act on its effective date are authorized and directed to be made and completed on or before such effective date.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the public health law and the educa- tion law, in relation to comprehensive medication management; and to amend chapter 21 of the laws of 2011 amending the education law relating to authorizing pharmacists to perform collaborative drug therapy manage- ment with physicians in certain settings, in relation to making the provisions of such chapter permanent
Purpose or general idea of bill
Authorizes physicians to refer selected patients to qualified pharma- cists for comprehensive medication management services specified in a written protocol issued by the treating physician
Summary of provisions
Section 1 adds Article 29-H to Public Health Law entitled Comprehensive Medication Management, includes definitions and authorizes a treating physician to refer one or more patients to a qualified pharmacist for comprehensive medication management services specified in the written protocol. Section 1 defines patients eligible for referral by their treating physician as those with a chronic disease or diseases, who have not met the clinical goals of therapy, are at risk for hospitalization, or who are otherwise in need of extra medication-related services as determined by their physician. Section 1 of the bill lists medication- related services. The written protocol applies to an individual named pharmacist and a named physician and is voluntary for all parties including the patient. This section requires sharing of patient data in real-time through a bi-directional interoperable medical records system.
Read the full memo (938 words)
Section 2 amends Section 6801 of the Education Law to create a new para- graph Section 6801-b. This section recognizes comprehensive medication management as a service that can be provided by a qualified pharmacist pursuant to a protocol with a licensed physician, and conforms to chang- es being made in Public Health Law.
Section 3 amend s Section 5 of chapter 21 of the laws of 2011, amending the education law relating to authorizing pharmacists to perform colla- borative drug therapy management with physicians in hospital facilities to remove the sunset and make the law permanent.
Section 4 establishes the effective date.
Difference between original and amended version (if applicable)
Deletion of Section 1 (c) language: but not limited to electronic bidi- rectional. Insert language Section 1(c): as specified in a comprehensive medication management protocol
Justification
Comprehensive Medication Management (CMM) has been accepted by the Health Department as a policy recommendation from a Value-Based Payment stakeholder workgroup. CMM is a professional service provided by quali- fied pharmacists to patients who are referred by their treating physi- cians for extra medication support services. -The service represents a targeted strategy developed to reduce avoidable hospitalizations and healthcare costs resulting from the exacerbation of chronic diseases due to sub-optimal medication use. With expertise in pharmacotherapy and pharmacokinetics, pharmacists are uniquely positioned healthcare provid- ers to address medication-related problems. One key aspect of profes- sional practice is patient counseling which includes an assessment of a patient's understanding of how to use the medication, what side-effects to expect, how to manage them, what side-effects are dangerous and should be reported, etc. Patients are not compliant for many reasons, and pharmacists are well equipped for effective one-to-one discussions that produce positive results. Peer-reviewed studies in published liter- ature consistently document the effectiveness of increasing direct interactions between pharmacists and patients. In fact, the e vidence was so compelling that the Centers for Medicaid and Medicare included Medication Therapy Management as a mandatory element in Medicare Part D Prescription Drug Plans. CMM represents a logical progression. Under CMM, only at-risk patients receive the additional service. Patients are identified by their treating physicians and referred to an individual pharmacist with whom the treating physician has developed a written protocol for a particular patient related to a particular disease or diseases. As Value-Based payment methodologies evolve and quality is increasingly measured by therapeutic outcomes in defined patient popu- lations, the need for Comprehensive Medication Management services by pharmacists will become more and more apparent. In fact, QARR and HEDIS measures currently include many directly concerned with medication adherence, for example: medication management for people with asthma, statin therapy for patients with diabetes, persistence of beta-blocker treatment after a heart attack, antidepressant medication management, and adherence to antipsychotic medications for people with schizophre- nia. Comprehensive Medication Management as described in the bill applies to pharmacists in community settings as well as pat ients with chronic medical conditions and their treating physicians who have relationships with local pharmacists. The protocols envisioned in this proposal will deal with common conditions such as asthma, diabetes, hypertension and hypercholesterolemia. This legislation represents a modest and logical extension to the services that pharmacists in commu- nity practice settings can provide if they meet the additional quali- fications included in the bill. Finally, under current Education Law pharmacists employed in hospitals who meet additional qualification requirements receive a credential from the Education Department author- izing them to enter into collaborative agreements with physicians in hospitals. This bill removes the sunset on this section of law which has been in place since 2011, making it permanent.
Prior legislative history
2017-2018 A.8664-A/S.7682
Fiscal implications for state and local governments
This legislation is expected to result in a savings for the State under Medicaid and other public programs.
Effective date
This act shall take effect immediately, provided that sections one and two of this act shall take effect on the one hundred eightieth day after it shall have become a law provided, that, effective immediately, the addition, amendment and/or repeal of any rule or regulation necessary for the implementation of this act on its effective date is authorized and directed to be made and completed on or before such effective date.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.