Enact the Pharmacist Prescribing Authority Act

As Introduced

136th
General Assembly

Regular
Session
H. B. No. 629

2025-2026

Representatives Barhorst, Gross

To
amend sections 339.78, 339.81, 1751.91, 3923.89, 4729.01, and 4729.39
and to enact sections 4729.21 and 4729.211 of the Revised Code
to
authorize pharmacists to treat minor health conditions and to name
this act the Pharmacist Prescribing Authority Act.

BE
IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section
1.
That
sections 339.78, 339.81, 1751.91, 3923.89, 4729.01, and 4729.39 be
amended and sections 4729.21 and 4729.211 of the Revised Code be
enacted to read as follows:

Sec.
339.78.
(A)

As
used in this section, "health care provider" means any of
the following:

(1)
A physician;

(2)
An advanced practice registered nurse licensed under Chapter 4723. of
the Revised Code who is designated as a certified nurse practitioner,
certified nurse-midwife, or clinical nurse specialist;

(3)
A physician assistant licensed under Chapter 4730. of the Revised
Code.

(B)

When
a
physician

health
care provider
completes
diagnostic studies confirming that an individual has tuberculosis,
the
physician

health
care provider
shall
report the confirmed case of tuberculosis to the county or district
tuberculosis control unit. A
physician

health
care provider
shall
make a report to the tuberculosis control unit prior to completion of
diagnostic studies if the signs and symptoms demonstrated by an
individual are sufficient for the
physician

health
care provider
to
suspect that the individual has tuberculosis. At any time it is
determined that an individual's tuberculosis is resistant to one or
more drugs, the
physician

health
care provider
shall
make a report to the unit.

The

physician

health
care provider
attending
an individual with tuberculosis shall document the individual's
adherence to the treatment regimen that the
physician

health
care provider
prescribes
and make a report to the tuberculosis control unit if the individual
does not adhere to the regimen.

In
each report made under this division, the
physician

health
care provider
shall
provide all information that the tuberculosis control unit requests.
The information shall be provided at intervals specified by the
tuberculosis control unit.

(B)
(C)

In addition to accepting reports made by
physicians

health
care providers
under
division
(A)
(B)

of this section, a county or district tuberculosis control unit shall
accept reports made as follows:

(1)
The administrator of a hospital, clinic, or other facility that is
providing services to an individual who is confirmed to have or is
suspected of having tuberculosis shall report the case to the
tuberculosis control unit;

(2)
The administrator of a laboratory that performs tests for
tuberculosis on human specimens shall report to the tuberculosis
control unit each positive tuberculosis test result obtained;

(3)
Any person who suspects that an individual has tuberculosis may
report that suspicion to the tuberculosis control unit.

Sec.
339.81.
Any
information, data, and reports with respect to a case of tuberculosis
that are furnished to, or procured by, a county or district
tuberculosis control unit or the department of health shall be
confidential and used only for statistical, scientific, and medical
research for the purpose of controlling tuberculosis in this state.

No
physician
A
health care provider as defined in section 339.78 of the Revised
Code
,
hospital, or other entity furnishing information, data, or reports
pursuant to this chapter shall
not

by
reason of such furnishing be deemed to have violated any confidential
relationship, be held to answer for willful betrayal of a
professional confidence, or be held liable in damages to any person.

Sec.
1751.91.
A

(A)
Except as provided in division (B) of this section, a
health
insuring corporation may provide payment or reimbursement to a
pharmacist for providing a health care service to a patient if both
of the following are the case:

(A)

(1)

The
pharmacist provided the health care service to the patient in
accordance with Chapter 4729. of the Revised Code, including any of
the following services:

(1)

(a)

Managing
drug therapy under a consult agreement pursuant to section 4729.39 of
the Revised Code;

(2)

(b)

Administering
immunizations in accordance with section 4729.41 of the Revised Code;

(3)

(c)

Administering
drugs in accordance with section 4729.45 of the Revised Code.

(B)

(2)

The
patient's individual or group health insuring corporation policy,
contract, or agreement provides for payment or reimbursement of the
service.

(B)
A health insuring corporation shall provide payment or reimbursement
to a pharmacist for providing a health care service to a patient
pursuant to section 4729.21 or 4729.211 of the Revised Code if the
patient's individual or group health insuring corporation policy,
contract, or agreement provides for payment or reimbursement of the
service when provided by a licensed health professional authorized to
prescribe drugs.

Sec.
3923.89.
A

(A)
Except as provided in division (B) of this section, a
sickness
and accident insurer or public employee benefit plan may provide
payment or reimbursement to a pharmacist for providing a health care
service to a patient if both of the following are the case:

(A)

(1)

The
pharmacist provided the health care service to the patient in
accordance with Chapter 4729. of the Revised Code, including any of
the following services:

(1)

(a)

Managing
drug therapy under a consult agreement pursuant to section 4729.39 of
the Revised Code;

(2)

(b)

Administering
immunizations in accordance with section 4729.41 of the Revised Code;

(3)

(c)

Administering
drugs in accordance with section 4729.45 of the Revised Code.

(B)

(2)

The
patient's individual or group policy of sickness and accident
insurance or public employee benefit plan provides for payment or
reimbursement of the service.

(B)
A sickness and accident insurer or public employee benefit plan shall
provide payment or reimbursement to a pharmacist for providing a
health care service to a patient pursuant to section 4729.21 or
4729.211 of the Revised Code if the patient's individual or group
policy of sickness and accident insurance or public employee benefit
plan provides for payment or reimbursement of the service when
provided by a licensed health professional authorized to prescribe
drugs.

Sec.
4729.01.
As
used in this chapter:

(A)
"Pharmacy," except when used in a context that refers to
the practice of pharmacy, means any area, room, rooms, place of
business, department, or portion of any of the foregoing where the
practice of pharmacy is conducted.

(B)
"Practice of pharmacy" means providing pharmacist care
requiring specialized knowledge, judgment, and skill derived from the
principles of biological, chemical, behavioral, social,
pharmaceutical, and clinical sciences. As used in this division,
"pharmacist care" includes the following:

(1)
Interpreting prescriptions;

(2)
Dispensing drugs and drug therapy related devices;

(3)
Compounding drugs;

(4)
Counseling individuals with regard to their drug therapy,
recommending drug therapy related devices, and assisting in the
selection of drugs and appliances for treatment of common diseases
and injuries and providing instruction in the proper use of the drugs
and appliances;

(5)
Performing drug regimen reviews with individuals by discussing all of
the drugs that the individual is taking and explaining the
interactions of the drugs;

(6)
Performing drug utilization reviews with licensed health
professionals authorized to prescribe drugs when the pharmacist
determines that an individual with a prescription has a drug regimen
that warrants additional discussion with the prescriber;

(7)
Advising an individual and the health care professionals treating an
individual with regard to the individual's drug therapy;

(8)
Acting pursuant to a consult agreement, if an agreement has been
established;

(9)
Engaging in the administration of immunizations to the extent
authorized by section 4729.41 of the Revised Code;

(10)
Engaging in the administration of drugs to the extent authorized by
section 4729.45 of the Revised Code
;

(11)
Prescribing drugs and drug therapy related devices for the treatment
of health conditions as authorized by section 4729.21 of the Revised
Code;

(12)
Prescribing and administering a tuberculin purified protein
derivative product as authorized by section 4729.211 of the Revised
Code
.

(C)
"Compounding" means the preparation, mixing, assembling,
packaging, and labeling of one or more drugs in any of the following
circumstances:

(1)
Pursuant to a prescription issued by a licensed health professional
authorized to prescribe drugs;

(2)
Pursuant to the modification of a prescription made in accordance
with a consult agreement;

(3)
As an incident to research, teaching activities, or chemical
analysis;

(4)
In anticipation of orders for drugs pursuant to prescriptions, based
on routine, regularly observed dispensing patterns;

(5)
Pursuant to a request made by a licensed health professional
authorized to prescribe drugs for a drug that is to be used by the
professional for the purpose of direct administration to patients in
the course of the professional's practice, if all of the following
apply:

(a)
At the time the request is made, the drug is not commercially
available regardless of the reason that the drug is not available,
including the absence of a manufacturer for the drug or the lack of a
readily available supply of the drug from a manufacturer.

(b)
A limited quantity of the drug is compounded and provided to the
professional.

(c)
The drug is compounded and provided to the professional as an
occasional exception to the normal practice of dispensing drugs
pursuant to patient-specific prescriptions.

(D)
"Consult agreement" means an agreement that has been
entered into under section 4729.39 of the Revised Code.

(E)
"Drug" means:

(1)
Any article recognized in the United States pharmacopoeia and
national formulary, or any supplement to them, intended for use in
the diagnosis, cure, mitigation, treatment, or prevention of disease
in humans or animals;

(2)
Any other article intended for use in the diagnosis, cure,
mitigation, treatment, or prevention of disease in humans or animals;

(3)
Any article, other than food, intended to affect the structure or any
function of the body of humans or animals;

(4)
Any article intended for use as a component of any article specified
in division (E)(1), (2), or (3) of this section; but does not include
devices or their components, parts, or accessories.

"Drug"
does not include "hemp" or a "hemp product" as
those terms are defined in section 928.01 of the Revised Code.

(F)
"Dangerous drug" means any of the following:

(1)
Any drug to which either of the following applies:

(a)
Under the "Federal Food, Drug, and Cosmetic Act," 52 Stat.
1040 (1938), 21 U.S.C.A. 301, as amended, the drug is required to
bear a label containing the legend "Caution: Federal law
prohibits dispensing without prescription" or "Caution:
Federal law restricts this drug to use by or on the order of a
licensed veterinarian" or any similar restrictive statement, or
the drug may be dispensed only upon a prescription;

(b)
Under Chapter 3715. or 3719. of the Revised Code, the drug may be
dispensed only upon a prescription.

(2)
Any drug that contains a schedule V controlled substance and that is
exempt from Chapter 3719. of the Revised Code or to which that
chapter does not apply;

(3)
Any drug intended for administration by injection into the human body
other than through a natural orifice of the human body;

(4)
Any drug that is a biological product, as defined in section 3715.01
of the Revised Code.

(G)
"Federal drug abuse control laws" has the same meaning as
in section 3719.01 of the Revised Code.

(H)
"Prescription" means all of the following:

(1)
A written, electronic, or oral order for drugs or combinations or
mixtures of drugs to be used by a particular individual or for
treating a particular animal, issued by a licensed health
professional authorized to prescribe drugs;

(2)
For purposes of sections 4723.4810, 4729.282, 4730.432, and 4731.93
of the Revised Code, a written, electronic, or oral order for a drug
to treat chlamydia, gonorrhea, or trichomoniasis issued to and in the
name of a patient who is not the intended user of the drug but is the
sexual partner of the intended user;

(3)
For purposes of sections 3313.7110, 3313.7111, 3314.143, 3326.28,
3328.29, 4723.483, 4729.88, 4730.433, 4731.96, and 5180.26 of the
Revised Code, a written, electronic, or oral order for an epinephrine
autoinjector issued to and in the name of a school, school district,
or camp;

(4)
For purposes of Chapter 3728. and sections 4723.483, 4729.88,
4730.433, and 4731.96 of the Revised Code, a written, electronic, or
oral order for an epinephrine autoinjector issued to and in the name
of a qualified entity, as defined in section 3728.01 of the Revised
Code;

(5)
For purposes of sections 3313.7115, 3313.7116, 3314.147, 3326.60,
3328.38, 4723.4811, 4730.437, 4731.92, and 5180.262 of the Revised
Code, a written, electronic, or oral order for injectable or nasally
administered glucagon in the name of a school, school district, or
camp.

(I)
"Licensed health professional authorized to prescribe drugs"
or "prescriber" means an individual who is authorized by
law to prescribe drugs or dangerous drugs or drug therapy related
devices in the course of the individual's professional practice,
including only the following:

(1)
A dentist licensed under Chapter 4715. of the Revised Code;

(2)
A clinical nurse specialist, certified nurse-midwife, or certified
nurse practitioner who holds a current, valid license issued under
Chapter 4723. of the Revised Code to practice nursing as an advanced
practice registered nurse;

(3)
A certified registered nurse anesthetist who holds a current, valid
license issued under Chapter 4723. of the Revised Code to practice
nursing as an advanced practice registered nurse, but only to the
extent of the nurse's authority under sections 4723.43 and 4723.434
of the Revised Code;

(4)
An optometrist licensed under Chapter 4725. of the Revised Code to
practice optometry;

(5)
A physician authorized under Chapter 4731. of the Revised Code to
practice medicine and surgery, osteopathic medicine and surgery, or
podiatric medicine and surgery;

(6)
A physician assistant who holds a license to practice as a physician
assistant issued under Chapter 4730. of the Revised Code, holds a
valid prescriber number issued by the state medical board, and has
been granted physician-delegated prescriptive authority;

(7)
A veterinarian licensed under Chapter 4741. of the Revised Code;

(8)
A certified mental health assistant licensed under Chapter 4772. of
the Revised Code who has been granted physician-delegated
prescriptive authority by the physician supervising the certified
mental health assistant
;

(9)
A pharmacist who prescribes drugs or drug therapy related devices
under section 4729.21 of the Revised Code, prescribes a tuberculin
purified protein derivative product under section 4729.211 of the
Revised Code, or adds a drug to a patient's drug therapy under
section 4729.39 of the Revised Code
.

(J)
"Sale" or "sell" includes any transaction made by
any person, whether as principal proprietor, agent, or employee, to
do or offer to do any of the following: deliver, distribute, broker,
exchange, gift or otherwise give away, or transfer, whether the
transfer is by passage of title, physical movement, or both.

(K)
"Wholesale sale" and "sale at wholesale" mean any
sale in which the purpose of the purchaser is to resell the article
purchased or received by the purchaser.

(L)
"Retail sale" and "sale at retail" mean any sale
other than a wholesale sale or sale at wholesale.

(M)
"Retail seller" means any person that sells any dangerous
drug to consumers without assuming control over and responsibility
for its administration. Mere advice or instructions regarding
administration do not constitute control or establish responsibility.

(N)
"Price information" means the price charged for a
prescription for a particular drug product and, in an easily
understandable manner, all of the following:

(1)
The proprietary name of the drug product;

(2)
The established (generic) name of the drug product;

(3)
The strength of the drug product if the product contains a single
active ingredient or if the drug product contains more than one
active ingredient and a relevant strength can be associated with the
product without indicating each active ingredient. The established
name and quantity of each active ingredient are required if such a
relevant strength cannot be so associated with a drug product
containing more than one ingredient.

(4)
The dosage form;

(5)
The price charged for a specific quantity of the drug product. The
stated price shall include all charges to the consumer, including,
but not limited to, the cost of the drug product, professional fees,
handling fees, if any, and a statement identifying professional
services routinely furnished by the pharmacy. Any mailing fees and
delivery fees may be stated separately without repetition. The
information shall not be false or misleading.

(O)
"Wholesale distributor of dangerous drugs" or "wholesale
distributor" means a person engaged in the sale of dangerous
drugs at wholesale and includes any agent or employee of such a
person authorized by the person to engage in the sale of dangerous
drugs at wholesale.

(P)
"Manufacturer of dangerous drugs" or "manufacturer"
means a person, other than a pharmacist or prescriber, who
manufactures dangerous drugs and who is engaged in the sale of those
dangerous drugs.

(Q)
"Terminal distributor of dangerous drugs" or "terminal
distributor" means a person who is engaged in the sale of
dangerous drugs at retail, or any person, other than a manufacturer,
repackager, outsourcing facility, third-party logistics provider,
wholesale distributor, or pharmacist, who has possession, custody, or
control of dangerous drugs for any purpose other than for that
person's own use and consumption. "Terminal distributor"
includes pharmacies, hospitals, nursing homes, and laboratories and
all other persons who procure dangerous drugs for sale or other
distribution by or under the supervision of a pharmacist, licensed
health professional authorized to prescribe drugs, or other person
authorized by the state board of pharmacy.

(R)
"Promote to the public" means disseminating a
representation to the public in any manner or by any means, other
than by labeling, for the purpose of inducing, or that is likely to
induce, directly or indirectly, the purchase of a dangerous drug at
retail.

(S)
"Person" includes any individual, partnership, association,
limited liability company, or corporation, the state, any political
subdivision of the state, and any district, department, or agency of
the state or its political subdivisions.

(T)(1)
"Animal shelter" means a facility operated by a humane
society or any society organized under Chapter 1717. of the Revised
Code or a dog pound operated pursuant to Chapter 955. of the Revised
Code.

(2)
"County dog warden" means a dog warden or deputy dog warden
appointed or employed under section 955.12 of the Revised Code.

(U)
"Food" has the same meaning as in section 3715.01 of the
Revised Code.

(V)
"Pain management clinic" has the same meaning as in section
4731.054 of the Revised Code.

(W)
"Investigational drug or product" means a drug or product
that has successfully completed phase one of the United States food
and drug administration clinical trials and remains under clinical
trial, but has not been approved for general use by the United States
food and drug administration. "Investigational drug or product"
does not include controlled substances in schedule I, as defined in
section 3719.01 of the Revised Code.

(X)
"Product," when used in reference to an investigational
drug or product, means a biological product, other than a drug, that
is made from a natural human, animal, or microorganism source and is
intended to treat a disease or medical condition.

(Y)
"Third-party logistics provider" means a person that
provides or coordinates warehousing or other logistics services
pertaining to dangerous drugs including distribution, on behalf of a
manufacturer, wholesale distributor, or terminal distributor of
dangerous drugs, but does not take ownership of the drugs or have
responsibility to direct the sale or disposition of the drugs.

(Z)
"Repackager of dangerous drugs" or "repackager"
means a person that repacks and relabels dangerous drugs for sale or
distribution.

(AA)
"Outsourcing facility" means a facility that is engaged in
the compounding and sale of sterile drugs and is registered as an
outsourcing facility with the United States food and drug
administration.

(BB)
"Laboratory" means a laboratory licensed under this chapter
as a terminal distributor of dangerous drugs and entrusted to have
custody of any of the following drugs and to use the drugs for
scientific and clinical purposes and for purposes of instruction:
dangerous drugs that are not controlled substances, as defined in
section 3719.01 of the Revised Code; dangerous drugs that are
controlled substances, as defined in that section; and controlled
substances in schedule I, as defined in that section.

(CC)
"Overdose reversal drug" means both of the following:

(1)
Naloxone;

(2)
Any other drug that the state board of pharmacy, through rules
adopted in accordance with Chapter 119. of the Revised Code,
designates as a drug that is approved by the federal food and drug
administration for the reversal of a known or suspected
opioid-related overdose.

Sec.
4729.21.
(A)
As used in this section and sections 4729.211 and 4729.212 of the
Revised Code, "health care provider" means any of the
following:

(1)
A physician authorized under Chapter 4731. of the Revised Code to
practice medicine and surgery or osteopathic medicine and surgery;

(2)
An advanced practice registered nurse licensed under Chapter 4723. of
the Revised Code who is designated as a certified nurse practitioner,
certified nurse-midwife, or clinical nurse specialist;

(3)
A physician assistant licensed under Chapter 4730. of the Revised
Code.

(B)
In accordance with a protocol that meets the requirements of division
(E) of this section, a pharmacist may provide treatment and related
services to individuals who are thirteen years of age or older for
any of the following health conditions by engaging in the activities
described in division (C) of this section:

(1)
Influenza;

(2)
Pharyngitis caused by the bacteria known as "group A
Streptococcus";

(3)
COVID;

(4)
Bronchitis;

(5)
Sinusitis;

(6)
Lice;

(7)
Skin conditions, including ringworm and athlete's foot;

(8)
Urinary tract infections;

(9)
HIV prevention, including pre-exposure and post-exposure prophylaxis;

(10)
Any other minor or generally self-limiting condition specified in the
protocol.

(C)(1)
As part of providing treatment or related services for a health
condition under this section, a pharmacist may do any of the
following:

(a)
Order or perform the laboratory or diagnostic tests or screenings
described in division (D) of this section;

(b)
Evaluate or interpret the results of the tests or screenings that the
pharmacist ordered or performed;

(c)
Subject to division (C)(2) of this section, prescribe drugs and drug
therapy related devices, excluding any controlled substance.

(2)(a)
For the treatment of athlete's foot, a pharmacist may prescribe only
a drug that is to be administered topically.

(b)
Prior to prescribing drugs and drug therapy related devices for the
treatment of pharyngitis, a pharmacist shall order or perform a
diagnostic test described in division (D)(1)(a) of this section.

(D)(1)
A pharmacist may order or perform any of the following tests or
screenings under this section if the pharmacist has received
appropriate training regarding that test or screening according to
rules adopted under this section:

(a)
Any test that may guide clinical decision-making that qualifies for a
waiver under the "Clinical Laboratory Improvement Amendments of
1988," 42 U.S.C. 263a, or the federal regulations adopted
thereunder, as determined by the United States centers for medicare
and medicaid services;

(b)
Any established screening procedure that is specified in rules
adopted under this section.

(2)
Notwithstanding any provision of the Revised Code to the contrary, a
pharmacist may delegate technical and administrative tasks associated
with performing a test described under division (D)(1)(a) of this
section to any of the following who is working under the supervision
of the pharmacist: a pharmacy intern, registered pharmacy technician,
or certified pharmacy technician.

(E)
All of the following apply with respect to the protocol required by
division (B) of this section:

(1)
The protocol shall be established by a health care provider who
practices primarily within the forty-mile radius of the pharmacy
where the protocol will be implemented. Once the protocol is
established, the health care provider may authorize one or more
pharmacists to use the protocol for the purpose of treating health
conditions under this section.

(2)
The protocol shall include particular terms and conditions imposed by
the health care provider regarding the treatment and related services
authorized by this section, including all of the following:

(a)
Specific categories of patients who the pharmacist is authorized to
test or screen;

(b)
The health care provider's instructions for obtaining relevant
patient medical history for the purpose of identifying disqualifying
health conditions, adverse reactions, and contraindications to the
approved course of treatment;

(c)
The health care provider's instructions for treatment based on a
patient's age, symptoms, and test and screening results, including
negative results;

(d)
Requirements related to notifying a patient's primary health care
provider of tests and screenings ordered or performed and treatments
provided;

(e)
A requirement that the pharmacist provide the patient with written
information to advise the patient to seek follow-up care from the
patient's primary health care provider, or, if the patient does not
have a primary health care provider, from the health care provider
who established the protocol required by division (B) of this section
or another primary care provider;

(f)
Any other requirements or limitations established in rules adopted
under this section.

(F)
A pharmacy in which a pharmacist acts in accordance with this section
shall prominently display signage indicating that any patient
receiving treatment or related services under this section is advised
to seek follow-up care from the patient's primary health care
provider, or, if the patient does not have a primary health care
provider, from the health care provider who established the protocol
required by division (B) of this section or another primary health
care provider.

(G)
The state board of pharmacy, in consultation with the state medical
board and board of nursing, shall adopt rules as necessary to
implement this section, including rules regarding training for the
performance of tests and screenings. The rules shall be adopted in
accordance with Chapter 119. of the Revised Code.

(H)
This section is an alternative to the authority granted by sections
4729.39 and 4729.42 of the Revised Code.

Sec.
4729.211.
(A)
Notwithstanding any other provision of the Revised Code to the
contrary, a pharmacist, acting in good faith, may prescribe and
administer a tuberculin purified protein derivative product approved
by the United States food and drug administration to a patient for
the purpose of screening for tuberculosis infection, but only if the
following conditions are met:

(1)
Prior to prescribing and administering a tuberculin purified protein
derivative product, the pharmacist has successfully completed a
course on proper test administration and interpretation of results
from the United States centers for disease control and prevention or
a comparable course from a provider accredited by the accreditation
council for pharmacy education, or a successor organization;

(2)
The pharmacist agrees to follow the recommendations for Mantoux
tuberculin skin testing from the United States centers for disease
control and prevention regarding test administration and
interpretation of results;

(3)
The pharmacist maintains documentation of test results in the records
of the pharmacy and agrees to make a copy of the results available to
the patient upon request.

(B)
If a patient is found to have a positive test result through a test
administered under this section, both of the following apply:

(1)
The pharmacist shall coordinate a timely referral to the patient's
primary health care provider, if applicable, or to a health care
provider or clinic located within a forty-mile radius of the
patient's residence to coordinate further diagnostics and follow-up
care;

(2)
The pharmacist shall report the confirmed case of tuberculosis in the
same manner that a health care provider is required to report under
section 339.78 of the Revised Code.

Sec.
4729.39.
(A)
As used in this section:

(1)
"Certified nurse practitioner," "certified
nurse-midwife," "clinical nurse specialist," and
"standard care arrangement" have the same meanings as in
section 4723.01 of the Revised Code.

(2)
"Collaborating physician" means a physician who has entered
into a standard care arrangement with a clinical nurse specialist,
certified nurse-midwife, or certified nurse practitioner.

(3)
"Physician" means an individual authorized under Chapter
4731. of the Revised Code to practice medicine and surgery or
osteopathic medicine and surgery.

(4)
"Physician assistant" means an individual who is licensed
to practice as a physician assistant under Chapter 4730. of the
Revised Code, holds a valid prescriber number issued by the state
medical board, and has been granted physician-delegated prescriptive
authority.

(5)
"Supervising physician" means a physician who has entered
into a supervision agreement with a physician assistant under section
4730.19 of the Revised Code.

(B)
Subject to division (C) of this section, one or more pharmacists may
enter into a consult agreement with one or more of the following
practitioners:

(1)
Physicians;

(2)
Physician assistants, if entering into a consult agreement is
authorized by one or more supervising physicians;

(3)
Clinical nurse specialists, certified nurse-midwives, or certified
nurse practitioners, if entering into a consult agreement is
authorized by one or more collaborating physicians.

(C)
Before entering into a consult agreement, all of the following
conditions must be met:

(1)
Each practitioner must have an ongoing practitioner-patient
relationship with each patient whose drug therapy is to be managed.

(2)
The diagnosis for which each patient has been prescribed drug therapy
must be within the scope of each practitioner's practice.

(3)
Each pharmacist must have training and experience related to the
particular diagnosis for which drug therapy is to be prescribed.

(D)
With respect to consult agreements, all of the following apply:

(1)
Under a consult agreement, a pharmacist is authorized to do both of
the following, but only to the extent specified in the agreement,
this section, and the rules adopted under this section:

(a)
Manage drug therapy for treatment of specified diagnoses or diseases
for each patient who is subject to the agreement, including all of
the following:

(i)
Changing the duration of treatment for the current drug therapy;

(ii)
Adjusting a drug's strength, dose, dosage form, frequency of
administration, or route of administration;

(iii)
Discontinuing the use of a drug;

(iv)
Administering a drug;

(v)

Notwithstanding
the definition of "licensed health professional authorized to
prescribe drugs" in section 4729.01 of the Revised Code, adding

Adding

a
drug to the patient's drug therapy.

(b)(i)
Order laboratory and diagnostic tests, including blood and urine
tests, that are related to the drug therapy being managed, and
evaluate the results of the tests that are ordered.

(ii)
A pharmacist's authority to evaluate test results under division
(D)(1)(b)(i) of this section does not authorize the pharmacist to
make a diagnosis.

(2)(a)
A consult agreement, or the portion of the agreement that applies to
a particular patient, may be terminated by any of the following:

(i)
A pharmacist who entered into the agreement;

(ii)
A practitioner who entered into the agreement;

(iii)
A patient whose drug therapy is being managed;

(iv)
An individual who consented to the treatment on behalf of a patient
or an individual authorized to act on behalf of a patient.

(b)
The pharmacist or practitioner who receives the notice of a patient's
termination of the agreement shall provide written notice to every
other pharmacist or practitioner who is a party to the agreement. A
pharmacist or practitioner who terminates a consult agreement with
regard to one or more patients shall provide written notice to all
other pharmacists and practitioners who entered into the agreement
and to each individual who consented to treatment under the
agreement. The termination of a consult agreement with regard to one
or more patients shall be recorded by the pharmacist and practitioner
in the medical records of each patient to whom the termination
applies.

(3)
A consult agreement shall be made in writing and shall include all of
the following:

(a)
The diagnoses and diseases being managed under the agreement,
including whether each disease is primary or comorbid;

(b)
A description of the drugs or drug categories the agreement involves;

(c)
A description of the procedures, decision criteria, and plan the
pharmacist is to follow in acting under a consult agreement;

(d)
A description of how the pharmacist is to comply with divisions
(D)(5) and (6) of this section.

(4)
The content of a consult agreement shall be communicated to each
patient whose drug therapy is managed under the agreement.

(5)
A pharmacist acting under a consult agreement shall maintain a record
of each action taken for each patient whose drug therapy is managed
under the agreement.

(6)
Communication between a pharmacist and practitioner acting under a
consult agreement shall take place at regular intervals specified by
the primary practitioner acting under the agreement. The agreement
may include a requirement that a pharmacist send a consult report to
each consulting practitioner.

(7)
A consult agreement is effective for two years and may be renewed if
the conditions specified in division (C) of this section continue to
be met.

(8)
A consult agreement does not permit a pharmacist to manage drug
therapy prescribed by a practitioner who has not entered into the
agreement.

(E)
The state board of pharmacy, state medical board, and board of
nursing shall each adopt rules as follows for its license holders
establishing standards and procedures for entering into a consult
agreement and managing a patient's drug therapy under a consult
agreement:

(1)
The state board of pharmacy, in consultation with the state medical
board and board of nursing, shall adopt rules to be followed by
pharmacists.

(2)
The state medical board, in consultation with the state board of
pharmacy, shall adopt rules to be followed by physicians and rules to
be followed by physician assistants.

(3)
The board of nursing, in consultation with the state board of
pharmacy and state medical board, shall adopt rules to be followed by
clinical nurse specialists, certified nurse-midwives, and certified
nurse practitioners.

The
boards shall specify in the rules any categories of drugs or types of
diseases for which a consult agreement may not be established. Each
board may adopt any other rules it considers necessary for the
implementation and administration of this section. All rules adopted
under this section shall be adopted in accordance with Chapter 119.
of the Revised Code.

(F)(1)
Subject to division (F)(2) of this section, both of the following
apply:

(a)
A pharmacist acting in accordance with a consult agreement regarding
a practitioner's change in a drug for a patient whose drug therapy
the pharmacist is managing under the agreement is not liable in
damages in a tort or other civil action for injury or loss to person
or property allegedly arising from the change.

(b)
A practitioner acting in accordance with a consult agreement
regarding a pharmacist's change in a drug for a patient whose drug
therapy the pharmacist is managing under a consult agreement is not
liable in damages in a tort or other civil action for injury or loss
to person or property allegedly arising from the change unless the
practitioner authorized the specific change.

(2)
Division (F)(1) of this section does not limit a practitioner's or
pharmacist's liability in damages in a tort or other civil action for
injury or loss to person or property allegedly arising from actions
that are not related to the practitioner's or pharmacist's change in
a drug for a patient whose drug therapy is being managed under a
consult agreement.

Section
2.
That
existing sections 339.78, 339.81, 1751.91, 3923.89, 4729.01, and
4729.39 of the Revised Code are hereby repealed.

Section
3.
Sections
1751.91 and 3923.89 of the Revised Code, as amended by this act,
apply to contracts, policies, agreements, and plans that are
delivered, issued for delivery, modified, or renewed on or after the
effective date of this section.

Section
4.
This
act shall be known as the Pharmacist Prescribing Authority Act.