Bill Summary for S 597 (2023-2024)

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Summary date: 

Apr 5 2023

Bill Information:

View NCGA Bill Details2023-2024 Session
Senate Bill 597 (Public) Filed Wednesday, April 5, 2023
Intro. by Hise, Krawiec.

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Bill summary

Amends GS 90-18(c), listing actions that do not constitute practicing medicine or surgery under Article 1, Practice of Medicine. Replaces subdivision (3a) to now exclude the provision of health care services by a licensed pharmacist under a collaborative practice agreement with at least one physician performed pursuant to rules developed by a joint subcommittee of the Medical Board and Board of Pharmacy and approved by both Boards (currently, excludes the provision of drug therapy management by a licensed pharmacist engaged in the practice of pharmacy pursuant to an agreement that is physician, pharmacist, patient, and disease specified when performed pursuant to rules approved by the Boards). Defines health care services as medical tasks, acts, or functions authorized through written agreement by a physician and delegated to a pharmacist for the purpose of providing drug therapy, disease, or population health management for patients. 

Amends GS 90-18.4, which sets limitations on clinical pharmacist practitioners, to eliminate references to drug therapy management. Provides that physicians can authorize clinical pharmacist practitioners to provide health care services so long as the Boards have adopted rules governing the approval of individual practitioners, the practitioner has current approval from both Boards, and the Medical Board has assigned an identification number to the practitioner that is shown on written prescriptions. Eliminates limitations relating to practitioners' prescription substitutions and authority to order medication and tests. Deems orders written by a clinical pharmacist practitioner for medications, tests, or other devices to have been authorized by the supervising physician, with the supervising physician responsible for authorizing the order, and authorizes registered nurses, licensed practical nurses, and pharmacists to perform the order in the same manner as if the order were received from a licensed physician. Authorizes institutional and group practices to implement site-specific, multi-provider collaborative practice agreement for the care of their patients. Requires the institution or group practice to develop an oversight policy and requires evaluation of the practitioners engaged in the agreement by an appointed supervising physician. Lists six requirements that apply to clinical pharmacist practitioners and supervising physicians engaging in collaborative practice, including (1) requiring a clinical pharmacist practitioner to have a site-specific supervising physician, (2) requiring the supervising physician to conduct periodic review and evaluation of the health care services provided by the clinical pharmacist practitioner, (3) allowing a physician to supervise any number of clinical pharmacist technicians as the supervising physician deems can be safely and effectively supervised, (4) requiring delegated health care services to be included in the written agreement between the supervising physician and the clinical pharmacist practitioner, (5) allowing a supervising physician to include a statement of authorization in the written agreement to allow the clinical pharmacist practitioner to conduct drug substitutions as specified, and (6) allowing supervising physicians to add other advanced practice providers that they supervise to the collaborative practice agreement. Allows for the health care settling location of health care services provided by the clinical pharmacist practitioner to be fully or partially embedded for a site-specific practice. Requires the supervising physician to determine the setting location and include the location in the site-specific collaborative practice agreement. 

Amends the definition of clinical pharmacist practitioner in GS 90-85.3 to include authorization to perform medical acts, tasks, and functions for drug therapy, disease, or population health management agreements with physicians pursuant to GS 90-18.4, as amended.

Makes the above provisions effective October 1, 2023. 

Enacts GS 58-50-296 to require health benefit plans offered by insurers to reimburse a pharmacist at the same rate that other advanced practice or mid-level health care providers are reimbursed when providing the same or equivalent heath care services, as defined, or procedures if (1) the service or procedure was performed within the pharmacist's licensed scope of practice, (2) the plan would have provided reimbursement if performed by another health care provider, and (3) the pharmacist provided the service or procedure pursuant to any requirements of the insurer related to the service or procedure. Requires insurers offering a health benefit plan that delegate credentialing agreements to contracted health care facilities to accept credentialing for pharmacists employed or contracted with those facilities. Requires insurers offering health benefit plans to reimburse a contracted health care facility or a contract pharmacist directly for covered services performed by a pharmacist within their lawful scope of practice regardless of network participation. Prohibits participation of a pharmacy in a drug benefit provider network of an insurer offering a health benefit plan from satisfying any requirement that insurers offering health benefit plans include pharmacists in medical benefit provider networks. Includes agents of an insurer offering a health benefit plan, and third-party administrators. Effective October 1, 2023, and applies to contracts entered into, renewed, or amended on or after that date. 

Directs the Boards to adopt temporary implementing rules.