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To: Public Health and Human
Services
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026
By: Representative Gibbs (72nd)
HOUSE BILL NO. 1434
AN ACT TO AUTHORIZE RESTAURANT OWNERS TO OBTAIN 1
AUTO-INJECTABLE EPINEPHRINE DEVICES FROM THE STATE DEPARTMENT OF 2
HEALTH OR FROM A PHARMACY UNDER A STANDING ORDER ISSUED BY A 3
HEALTH CARE PRACTITIONER; TO REQUIRE RESTAURANTS THAT OBTAIN 4
AUTO-INJECTABLE EPINEPHRINE DEVICES TO REQUIRE AT LEAST ONE 5
EMPLOYEE AT THE RESTAURANT TO RECEIVE TRAINING FROM A PRACTITIONER 6
IN THE ADMINISTRATION OF AUTO-INJECTABLE EPINEPHRINE; TO AUTHORIZE 7
RESTAURANT EMPLOYEES WHO ARE TRAINED IN THE ADMINISTRATION OF 8
AUTO-INJECTABLE EPINEPHRINE, ACTING IN GOOD FAITH AND WITH 9
REASONABLE CARE TO A PERSON IN THE RESTAURANT WHOM THEY BELIEVE TO 10
BE HAVING AN ANAPHYLACTIC REACTION, TO ADMINISTER TO SUCH PERSON 11
AUTO-INJECTABLE EPINEPHRINE THAT WAS OBTAINED AS PROVIDED IN THIS 12
ACT; TO AUTHORIZE THE STATE DEPARTMENT OF HEALTH TO OBTAIN AND 13
DISTRIBUTE AUTO-INJECTABLE EPINEPHRINE DEVICES TO THE OWNER OF A 14
RESTAURANT UPON A REQUEST MADE IN WRITING; TO REQUIRE THE 15
RESTAURANT OWNER TO PAY THE FULL COST OF THE AUTO-INJECTABLE 16
EPINEPHRINE DEVICES OBTAINED FROM THE DEPARTMENT; TO AUTHORIZE 17
PRACTITIONERS TO ISSUE A STANDING ORDER TO ONE OR MORE INDIVIDUAL 18
PHARMACIES THAT AUTHORIZES THE PHARMACY TO DISPENSE 19
AUTO-INJECTABLE EPINEPHRINE DEVICES TO RESTAURANT OWNERS WITHOUT 20
THEM NEEDING TO HAVE AN INDIVIDUAL PRESCRIPTION; TO AUTHORIZE 21
PHARMACISTS TO DISPENSE AUTO-INJECTABLE EPINEPHRINE DEVICES TO 22
RESTAURANT OWNERS UNDER A STANDING ORDER ISSUED BY A PRACTITIONER; 23
TO PROVIDE CIVIL AND CRIMINAL IMMUNITY TO TRAINED RESTAURANT 24
EMPLOYEES WHO ADMINISTER OR ASSIST IN THE ADMINISTRATION OF 25
AUTO-INJECTABLE EPINEPHRINE TO A PERSON IN THE RESTAURANT WHOM 26
THEY BELIEVE TO BE HAVING AN ANAPHYLACTIC REACTION; TO ALSO 27
PROVIDE CIVIL AND CRIMINAL IMMUNITY TO THE RESTAURANT, ANY 28
PRACTITIONER WHO ISSUED THE STANDING ORDER FOR THE DEVICE, ANY 29
PHARMACIST WHO DISPENSED THE DEVICE, ANY EMPLOYEE OF THE STATE 30
DEPARTMENT OF HEALTH WHO DISTRIBUTED THE DEVICE, AND ANY PERSON 31
WHO PROVIDED THE TRAINING IN THE USE OF THE DEVICE; TO AMEND 32
SECTION 73-21-73, MISSISSIPPI CODE OF 1972, TO CONFORM TO THE 33
PRECEDING PROVISIONS; AND FOR RELATED PURPOSES. 34
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 35
SECTION 1. (1) As used in this section, the following terms 36
shall be defined as provided in this subsection: 37
(a) "Auto-injectable epinephrine device" means a 38
medical device for the immediate administration of epinephrine to 39
a person at risk for anaphylaxis. 40
(b) "Practitioner" means a physician licensed to 41
practice medicine in this state or any licensed health care 42
provider who is authorized to prescribe auto-injectable 43
epinephrine devices. 44
(c) "Restaurant" means a restaurant with a food permit 45
from the State Department of Health that has ten (10) or more 46
seats. 47
(2) The owner of a restaurant may obtain one or more 48
auto-injectable epinephrine devices from the State Department of 49
Health or from a pharmacy under a standing order issued by a 50
practitioner as provided in this section. All such 51
auto-injectable epinephrine devices must be kept at the restaurant 52
in a locked, secure and easily accessible location. 53
(3) Each restaurant that obtains auto-injectable epinephrine 54
devices as provided in this section shall require at least one (1) 55
employee at the restaurant to receive training from a practitioner 56
in the administration of auto-injectable epinephrine. 57
(4) An employee of a restaurant who is trained in the 58
administration of auto-injectable epinephrine, acting in good 59
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faith and with reasonable care to a person in the restaurant whom 60
he or she believes to be having an anaphylactic reaction, may 61
administer to such person auto-injectable epinephrine that was 62
obtained from the State Department of Health or obtained from a 63
pharmacy under a standing issued by a practitioner. 64
(5) The State Department of Health may obtain and distribute 65
auto-injectable epinephrine devices to the owner of a restaurant 66
upon a request made in writing by the restaurant owner. The 67
restaurant owner must pay the full cost of the auto-injectable 68
epinephrine devices obtained from the department. 69
(6) A practitioner acting in good faith and in compliance 70
with the standard of care applicable to that practitioner may 71
issue a standing order to one or more individual pharmacies that 72
authorizes the pharmacy to dispense auto-injectable epinephrine 73
devices to the owner of a restaurant, without the owner of the 74
restaurant needing to have an individual prescription. 75
(7) A pharmacist acting in good faith and in compliance with 76
the standard of care applicable to pharmacists may dispense 77
auto-injectable epinephrine devices to the owner of a restaurant 78
under a standing order issued by a practitioner. 79
(8) Any employee of a restaurant who is trained in the 80
administration of auto-injectable epinephrine, acting in good 81
faith and with reasonable care, who administers or assists in the 82
administration of auto-injectable epinephrine to a person in the 83
restaurant whom he or she believes to be having an anaphylactic 84
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reaction, shall be immune from civil and criminal liability for 85
any personal injury as a result of that care or treatment if the 86
employee's actions or failure to act do not amount to willful or 87
wanton misconduct or gross negligence. 88
(9) The immunity from civil and criminal liability for any 89
personal injury provided under subsection (8) of this section also 90
includes: 91
(a) The restaurant that legally obtained the 92
auto-injectable epinephrine device; 93
(b) Any practitioner who issued the standing order for 94
the auto-injectable epinephrine device; 95
(c) Any pharmacy and pharmacist who dispensed the 96
auto-injectable epinephrine device under the standing order; 97
(d) Any employee of the State Department of Health who 98
distributed auto-injectable epinephrine device; and 99
(e) Any person who provided the training in the use of 100
the auto-injectable epinephrine device. 101
SECTION 2. Section 73-21-73, Mississippi Code of 1972, is 102
amended as follows: 103
73-21-73. As used in this chapter, unless the context 104
requires otherwise: 105
(a) "Administer" means the direct application of a 106
prescription drug pursuant to a lawful order of a practitioner to 107
the body of a patient by injection, inhalation, ingestion or any 108
other means. 109
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(b) "Biological product" means the same as that term is 110
defined in 42 USC Section 262. 111
(c) "Board of Pharmacy," "Pharmacy Board," "MSBP" or 112
"board" means the State Board of Pharmacy. 113
(d) "Compounding" means (i) the production, 114
preparation, propagation, conversion or processing of a sterile or 115
nonsterile drug or device either directly or indirectly by 116
extraction from substances of natural origin or independently by 117
means of chemical or biological synthesis or from bulk chemicals 118
or the preparation, mixing, measuring, assembling, packaging or 119
labeling of a drug or device as a result of a practitioner's 120
prescription drug order or initiative based on the 121
practitioner/patient/pharmacist relationship in the course of 122
professional practice, or (ii) for the purpose of, as an incident 123
to, research, teaching or chemical analysis and not for sale or 124
dispensing. Compounding also includes the preparation of drugs or 125
devices in anticipation of prescription drug orders based on 126
routine regularly observed prescribing patterns. 127
(e) "Continuing education unit" means ten (10) clock 128
hours of study or other such activity as may be approved by the 129
board, including, but not limited to, all programs which have been 130
approved by the Accreditation Council for Pharmacy Education. 131
(f) "Deliver" or "delivery" means the actual, 132
constructive or attempted transfer in any manner of a drug or 133
device from one (1) person to another, whether or not for a 134
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consideration, including, but not limited to, delivery by mailing 135
or shipping. 136
(g) "Device" means an instrument, apparatus, implement, 137
machine, contrivance, implant, in vitro reagent or other similar 138
or related article, including any component part or accessory 139
which is required under federal or state law to be prescribed by a 140
practitioner. 141
(h) "Dispense" or "dispensing" means the interpretation 142
of a valid prescription of a practitioner by a pharmacist and the 143
subsequent preparation of the drug or device for administration to 144
or use by a patient or other individual entitled to receive the 145
drug and includes delivery of the drug or device to the patient. 146
(i) "Distribute" means the delivery of a drug or device 147
other than by administering or dispensing to persons other than 148
the ultimate consumer. 149
(j) "Drug" means: 150
(i) Articles recognized as drugs in the official 151
United States Pharmacopeia, official National Formulary, official 152
Homeopathic Pharmacopeia, other drug compendium or any supplement 153
to any of them; 154
(ii) Articles intended for use in the diagnosis, 155
cure, mitigation, treatment or prevention of disease in man or 156
other animals; 157
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(iii) Articles other than food intended to affect 158
the structure or any function of the body of man or other animals; 159
and 160
(iv) Articles intended for use as a component of 161
any articles specified in subparagraph (i), (ii) or (iii) of this 162
paragraph. 163
(k) "Extern" means a student in the professional 164
program of a school of pharmacy accredited by the Accreditation 165
Council for Pharmacy Education who is making normal progress 166
toward completion of a professional degree in pharmacy. 167
(l) "Foreign pharmacy graduate" means a person whose 168
undergraduate pharmacy degree was conferred by a recognized school 169
of pharmacy outside of the United States, the District of Columbia 170
and Puerto Rico. Recognized schools of pharmacy are those 171
colleges and universities listed in the World Health 172
Organization's World Directory of Schools of Pharmacy, or 173
otherwise approved by the Foreign Pharmacy Graduate Examination 174
Committee (FPGEC) certification program as established by the 175
National Association of Boards of Pharmacy. 176
(m) "Generic equivalent drug product" means a drug 177
product which (i) contains the identical active chemical 178
ingredient of the same strength, quantity and dosage form; (ii) is 179
of the same generic drug name as determined by the United States 180
Adoptive Names and accepted by the United States Food and Drug 181
Administration; and (iii) conforms to such rules and regulations 182
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as may be adopted by the board for the protection of the public to 183
assure that such drug product is therapeutically equivalent. 184
(n) "Interchangeable biological product" or "I.B." 185
means a biological product that the federal Food and Drug 186
Administration: 187
(i) Has licensed and determined as meeting the 188
standards for interchangeability under 42 USC Section 262(k)(4); 189
or 190
(ii) Has determined is therapeutically equivalent 191
as set forth in the latest edition of or supplement to the federal 192
Food and Drug Administration's Approved Drug Products with 193
Therapeutic Equivalence Evaluations. 194
(o) "Intern" means a person who has graduated from a 195
school of pharmacy but has not yet become licensed as a 196
pharmacist. 197
(p) "Manufacturer" means a person, business or other 198
entity engaged in the production, preparation, propagation, 199
conversion or processing of a prescription drug or device, if such 200
actions are associated with promotion and marketing of such drugs 201
or devices. 202
(q) "Manufacturer's distributor" means any person or 203
business who is not an employee of a manufacturer, but who 204
distributes sample drugs or devices, and defined under paragraph 205
(i) of this section, under contract or business arrangement for a 206
manufacturer to practitioners. 207
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(r) "Manufacturing" of prescription products means the 208
production, preparation, propagation, conversion or processing of 209
a drug or device, either directly or indirectly, by extraction 210
from substances from natural origin or independently by means of 211
chemical or biological synthesis, or from bulk chemicals and 212
includes any packaging or repackaging of the drug or device or 213
labeling or relabeling of the container of the drug or device for 214
resale by pharmacies, practitioners, business entities or other 215
persons. 216
(s) "Misappropriation of a prescription drug" means to 217
illegally or unlawfully convert a drug, as defined in this 218
section, to one's own use or to the use of another. 219
(t) "Nonprescription drugs" means nonnarcotic medicines 220
or drugs that may be sold without a prescription and are 221
prepackaged and labeled for use by the consumer in accordance with 222
the requirements of the statutes and regulations of this state and 223
the federal government. 224
(u) "Person" means an individual, corporation, 225
partnership, association or any other legal entity. 226
(v) "Pharmacist" means an individual health care 227
provider licensed by this state to engage in the practice of 228
pharmacy. This recognizes a pharmacist as a learned professional 229
who is authorized to provide patient services. 230
(w) "Pharmacy" means any location for which a pharmacy 231
permit is required and in which prescription drugs are maintained, 232
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compounded and dispensed for patients by a pharmacist. This 233
definition includes any location where pharmacy-related services 234
are provided by a pharmacist. 235
(x) "Prepackaging" means the act of placing small 236
precounted quantities of drug products in containers suitable for 237
dispensing or administering in anticipation of prescriptions or 238
orders. 239
(y) "Unlawful or unauthorized possession" means 240
physical holding or control by a pharmacist of a controlled 241
substance outside the usual and lawful course of employment. 242
(z) "Practice of pharmacy" means a health care service 243
that includes, but is not limited to, the compounding, dispensing, 244
and labeling of drugs or devices; interpreting and evaluating 245
prescriptions; administering and distributing drugs and devices; 246
the compounding, dispensing and labeling of drugs and devices; 247
maintaining prescription drug records; advising and consulting 248
concerning therapeutic values, content, hazards and uses of drugs 249
and devices; initiating or modifying of drug therapy in accordance 250
with written guidelines or protocols previously established and 251
approved by the board; selecting drugs; participating in drug 252
utilization reviews; storing prescription drugs and devices; 253
ordering lab work in accordance with written guidelines or 254
protocols as defined in this section; providing 255
pharmacotherapeutic consultations; supervising supportive 256
personnel and such other acts, services, operations or 257
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transactions necessary or incidental to the conduct of the 258
foregoing. 259
(aa) "Practitioner" means a physician, dentist, 260
veterinarian, or other health care provider authorized by law to 261
diagnose and prescribe drugs. 262
(bb) "Prescription" means a written, verbal or 263
electronically transmitted order issued by a practitioner for a 264
drug or device to be dispensed for a patient by a pharmacist. 265
"Prescription" includes a standing order issued by a practitioner 266
to an individual pharmacy that authorizes the pharmacy to dispense 267
an opioid antagonist to certain persons without the person to whom 268
the opioid antagonist is dispensed needing to have an individual 269
prescription, as authorized by Section 41-29-319(3). 270
"Prescription" also includes a standing order issued by a 271
practitioner to one or more individual pharmacies that authorizes 272
the pharmacy to dispense auto-injectable epinephrine devices to 273
certain persons without the person to whom the auto-injectable 274
epinephrine device is dispensed needing to have an individual 275
prescription, as authorized by Section 1 of this act. 276
(cc) "Prescription drug" or "legend drug" means a drug 277
which is required under federal law to be labeled with either of 278
the following statements prior to being dispensed or delivered: 279
(i) "Caution: Federal law prohibits dispensing 280
without prescription," or 281
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(ii) "Caution: Federal law restricts this drug to 282
use by or on the order of a licensed veterinarian"; or a drug 283
which is required by any applicable federal or state law or 284
regulation to be dispensed on prescription only or is restricted 285
to use by practitioners only. 286
(dd) "Product selection" means the dispensing of a 287
generic equivalent drug product or an interchangeable biological 288
product in lieu of the drug product ordered by the prescriber. 289
(ee) "Provider" or "primary health care provider" 290
includes a pharmacist who provides health care services within his 291
or her scope of practice pursuant to state law and regulation. 292
(ff) "Registrant" means a pharmacy or other entity 293
which is registered with the Mississippi State Board of Pharmacy 294
to buy, sell or maintain controlled substances. 295
(gg) "Repackager" means a person registered by the 296
federal Food and Drug Administration as a repackager who removes a 297
prescription drug product from its marketed container and places 298
it into another, usually of smaller size, to be distributed to 299
persons other than the consumer. 300
(hh) "Reverse distributor" means a business operator 301
that is responsible for the receipt and appropriate return or 302
disposal of unwanted, unneeded or outdated stocks of controlled or 303
uncontrolled drugs from a pharmacy. 304
(ii) "Supportive personnel" or "pharmacist technician" 305
means those individuals utilized in pharmacies whose 306
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responsibilities are to provide nonjudgmental technical services 307
concerned with the preparation and distribution of drugs under the 308
direct supervision and responsibility of a pharmacist. 309
(jj) "Written guideline or protocol" means an agreement 310
in which any practitioner authorized to prescribe drugs delegates 311
to a pharmacist authority to conduct specific prescribing 312
functions in an institutional setting, or with the practitioner's 313
individual patients, provided that a specific protocol agreement 314
between the practitioner and the pharmacist is signed and filed as 315
required by law or by rule or regulation of the board. 316
(kk) "Wholesaler" means a person who buys or otherwise 317
acquires prescription drugs or prescription devices for resale or 318
distribution, or for repackaging for resale or distribution, to 319
persons other than consumers. 320
(ll) "Pharmacy benefit manager" has the same meaning as 321
defined in Section 73-21-153. 322
(mm) "Pharmacy services administrative organization" 323
means any entity that contracts with a pharmacy or pharmacist to 324
assist with third-party interactions and that may provide a 325
variety of other administrative services, including, but not 326
limited to, contracting with pharmacy benefit managers on behalf 327
of pharmacies and providing pharmacies with credentialing, 328
billing, audit, general business and analytic support. A covered 329
entity as defined in 42 USC Section 256b, including its pharmacy 330
or the transactions related to the 340B drug discount program of 331
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ST: Auto-injectable epinephrine devices;
authorize restaurants to obtain from Health Dept
or from pharmacies under a standing order.
any pharmacy contracted with the participating covered entity to 332
dispense drugs purchased through the 340B drug discount program, 333
shall not be considered to be a pharmacy services administrative 334
organization. 335
SECTION 3. This act shall take effect and be in force from 336
and after July 1, 2026. 337