S T A T E O F N E W Y O R K
________________________________________________________________________
7592
2023-2024 Regular Sessions
I N A S S E M B L Y
May 25, 2023
___________
Introduced by M. of A. McDONALD -- read once and referred to the Commit-
tee on Higher Education
AN ACT to amend the education law, in relation to establishing the prac-
tice of telepharmacy
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Section 6802 of the education law is amended by adding five
new subdivisions 30, 31, 32, 33 and 34 to read as follows:
30. "CENTRAL PHARMACY" MEANS A REGISTERED PHARMACY THAT PROVIDES PHAR-
MACY SERVICES TO A REMOTE SITE PHARMACY VIA A COMPUTER LINK, VIDEO LINK
AND AUDIO LINK, OR OTHER FUNCTIONALLY EQUIVALENT TELECOMMUNICATIONS
EQUIPMENT.
31. "REMOTE SITE PHARMACY" MEANS A REGISTERED PHARMACY WHERE DRUGS AND
DEVICES ARE STORED AND DISPENSED, AND IS STAFFED BY PHARMACY TECHNICIANS
WHO OPERATE UNDER THE REMOTE SUPERVISION OF A LICENSED PHARMACIST VIA A
COMPUTER LINK, VIDEO LINK AND AUDIO LINK, OR OTHER FUNCTIONALLY EQUIV-
ALENT TELECOMMUNICATIONS EQUIPMENT.
32. "REMOTE SUPERVISION" MEANS SUPERVISION BY A LICENSED PHARMACIST
VIA COMPUTER LINK, VIDEO LINK AND AUDIO LINK, OR OTHER FUNCTIONALLY
EQUIVALENT TELECOMMUNICATIONS EQUIPMENT.
33. "TELEPHARMACY" MEANS THE PRACTICE OF PHARMACY PROVIDED BY A PHAR-
MACIST TO ONE OR MORE REMOTE SITE PHARMACIES IN WHICH ALL SITES ARE
CONNECTED VIA COMPUTER LINK, VIDEO LINK AND AUDIO LINK, OR OTHER FUNC-
TIONALLY EQUIVALENT TELECOMMUNICATIONS EQUIPMENT.
34. "TELEPHARMACY IN HOSPITALS" MEANS A CENTRAL HOSPITAL PHARMACY WITH
ONE OR MORE REMOTE SITE PHARMACIES IN WHICH ALL SITES ARE CONNECTED VIA
COMPUTER LINK, VIDEO LINK AND AUDIO LINK, OR OTHER FUNCTIONALLY EQUIV-
ALENT TELECOMMUNICATIONS EQUIPMENT.
§ 2. The education law is amended by adding a new section 6833 to read
as follows:
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD11017-02-3
A. 7592 2
§ 6833. TELEPHARMACY. 1. A REMOTE SITE PHARMACY SHALL COMPLY WITH
SECTION SIXTY-EIGHT HUNDRED EIGHT OF THIS ARTICLE, GOVERNING REQUIRE-
MENTS FOR REGISTRATION TO OPERATE A PHARMACY. THE REMOTE SITE PHARMACY
IS CONSIDERED TO BE UNDER THE PERSONAL CHARGE OF THE LICENSED PHARMACIST
WHO IS PROVIDING REMOTE SUPERVISION OF THE REMOTE SITE PHARMACY.
2. A REMOTE SITE PHARMACY SHALL EITHER BE JOINTLY OWNED BY A CENTRAL
PHARMACY OR BE OPERATED UNDER A CONTRACT WITH A CENTRAL PHARMACY, AND
CONNECTED TO ITS CENTRAL PHARMACY VIA COMPUTER LINK, VIDEO LINK AND
AUDIO LINK, OR OTHER FUNCTIONALLY EQUIVALENT TELECOMMUNICATIONS EQUIP-
MENT. A REMOTE SITE PHARMACY SHALL USE A PHARMACY MANAGEMENT SYSTEM
WHICH SHALL COMPLY WITH THE FOLLOWING MINIMUM REQUIREMENTS:
(A) ALL PRESCRIPTION RECORDS SHALL BE MAINTAINED AT THE REMOTE SITE
PHARMACY AND BE ELECTRONICALLY ACCESSIBLE FROM THE CENTRAL PHARMACY;
(B) PRESCRIPTIONS FILLED AT THE REMOTE SITE PHARMACY SHALL BE DISTIN-
GUISHABLE ON RECORDS FROM THOSE FILLED AT THE CENTRAL PHARMACY;
(C) DAILY REPORTS MUST BE SEPARATED FOR THE CENTRAL PHARMACY AND THE
REMOTE SITE PHARMACY, BUT SHALL BE ELECTRONICALLY ACCESSIBLE AT THE
CENTRAL PHARMACY;
(D) PHARMACIES SHALL BE ABLE TO GENERATE LABELS FROM THE CENTRAL PHAR-
MACY OR AT THE REMOTE SITE PHARMACY; AND
(E) ALL PRESCRIPTIONS DISTRIBUTED AT THE REMOTE SITE PHARMACY SHALL
HAVE A LABEL THAT MEETS REQUIREMENTS SET FORTH IN SECTION SIXTY-EIGHT
HUNDRED ELEVEN-A OF THIS ARTICLE ATTACHED TO THE FINAL DRUG CONTAINER
BEFORE THE PHARMACIST VERIFIES THE DISPENSING PROCESS.
3. A LICENSED PHARMACIST EMPLOYED BY THE CENTRAL PHARMACY SHALL
APPROVE EACH PRESCRIPTION BEFORE IT LEAVES THE REMOTE SITE PHARMACY. AT
A MINIMUM SUCH APPROVAL SHALL INCLUDE THE FOLLOWING FUNCTIONS, BUT NOT
BE LIMITED TO:
(A) AN AUDIT TRAIL WHICH IDENTIFIES ANY PHARMACIST OR PHARMACY TECHNI-
CIAN WHO PARTICIPATED IN THE DISPENSING PROCESS, AND BOTH THE
PHARMACIST'S AND THE PHARMACY TECHNICIAN'S INITIALS SHALL APPEAR ON THE
LABEL; AND
(B) A PHARMACIST SHALL COMPARE VIA VIDEO LINK THE CAPTURED IMAGES OF
THE STOCK BOTTLE, DRUG DISPENSED AND STRENGTH. THE ENTIRE LABEL SHALL BE
CHECKED FOR ACCURACY USING THE IMAGES CAPTURED VIA THE VIDEO LINK.
4. UNLESS A PHARMACIST IS ONSITE AT THE REMOTE SITE PHARMACY, COUN-
SELING SHALL BE ACCOMPLISHED BY A PHARMACIST USING A HIPAA COMPLIANT
VIDEO AND AUDIO LINK. THE PHARMACIST SHALL COUNSEL THE PATIENT OR THE
PATIENT'S AGENT ON ALL NEW PRESCRIPTIONS AND ANY CHANGES IN THERAPY AS
REQUIRED BY REGULATION.
5. A PHARMACIST SHALL COMPLETE MONTHLY INSPECTIONS OF THE REMOTE SITE
PHARMACY. INSPECTION CRITERIA SHALL BE INCLUDED IN THE POLICIES AND
PROCEDURES FOR THE SITE. THE INSPECTION REPORTS SHALL BE MAINTAINED FOR
FIVE YEARS.
6. THE REMOTE SITE PHARMACY SHALL HAVE A PRESCRIPTION INVENTORY.
CONTROLLED SUBSTANCES MAY BE KEPT AT THE REMOTE SITE PHARMACY.
(A) IF CONTROLLED SUBSTANCES ARE KEPT, THE REMOTE SITE PHARMACY SHALL
BE REGISTERED WITH THE DRUG ENFORCEMENT ADMINISTRATION AND SHALL OBTAIN
ITS OWN DRUG ENFORCEMENT ADMINISTRATION NUMBER.
(B) ALL RECORDS SHALL BE MAINTAINED AT THE REMOTE SITE PHARMACY AND
ELECTRONICALLY ACCESSIBLE FROM THE CENTRAL PHARMACY.
(C) POLICIES AND PROCEDURES SHALL BE IMPLEMENTED TO ENSURE THE SAFE
AND EFFECTIVE DISTRIBUTION OF PHARMACEUTICAL PRODUCTS AND DELIVERY OF
REQUIRED PHARMACEUTICAL CARE; INCLUDING, BUT NOT LIMITED TO AN ONGOING
REVIEW OF INCIDENT REPORTS AND OUTCOMES, WITH APPROPRIATE CORRECTIVE
ACTION TAKEN WHEN NECESSARY.
A. 7592 3
7. DISPENSING AND CONSULTATION MAY BE DONE WHEN THE PHARMACY TECHNI-
CIAN IS NOT PRESENT, UNDER THE FOLLOWING CIRCUMSTANCES:
(A) THE PRESCRIPTION HAS BEEN PREPARED BY THE PHARMACY TECHNICIAN AND
CHECKED BY THE LICENSED PHARMACIST;
(B) THE PRESCRIPTION AREA IS LOCKED;
(C) A SEPARATE LOCKED DRAWER OR CABINET IS MAINTAINED FOR
PRESCRIPTIONS READY FOR DISPENSING;
(D) A LOG IS MAINTAINED BY THE PHARMACY TECHNICIAN OF PRESCRIPTIONS
PLACED IN THE LOCKED DRAWER OR CABINET;
(E) A RECORD SHALL BE MADE BY THE PHARMACIST AS TO THE DATE AND TIME
AT WHICH DISPENSING AND COUNSELING OCCURS; AND
(F) UNLICENSED PERSONS TRAINED IN THE USE OF THE AUDIO LINK AND VIDEO
LINK, TO THE LICENSED PHARMACIST, ARE ON HAND, TO ASSIST THE PATIENTS.
8. THE HOLDER OF THE CENTRAL PHARMACY REGISTRATION OR THE PHARMACIST
IN CHARGE OF THE CENTRAL PHARMACY SHALL APPLY FOR A REGISTRATION FOR THE
REMOTE SITE PHARMACY. A REMOTE SITE PHARMACY REGISTRATION IS HEREBY
ESTABLISHED FOR THE PURPOSE OF CONDUCTING TELEPHARMACY. SUCH REGISTRA-
TIONS ARE ISSUED TO A REMOTE SITE PHARMACY CONNECTED TO A CENTRAL PHAR-
MACY VIA COMPUTER LINK, VIDEO LINK AND AUDIO LINK, OR OTHER FUNCTIONALLY
EQUIVALENT TELECOMMUNICATIONS EQUIPMENT.
9. TO THE EXTENT OF A CONFLICT WITH ANY PROVISION OF THIS ARTICLE AND
ARTICLE ONE HUNDRED THIRTY-SEVEN-A OF THIS TITLE, THE PROVISIONS OF THIS
ARTICLE GOVERN WITH RESPECT TO A TELEPHARMACY AND A REMOTE SITE PHARMACY
OPERATING IN COMPLIANCE WITH THIS CHAPTER. WITH THE FOLLOWING CONDI-
TIONS, THIS SECTION IS AN EXCEPTION TO THE FOLLOWING RULES:
(A) THE REMOTE SITE PHARMACY SHALL HAVE A PHARMACY TECHNICIAN PRESENT
AND A WORKING COMPUTER, VIDEO AND AUDIO LINK, OR OTHER FUNCTIONALLY
EQUIVALENT TELECOMMUNICATIONS EQUIPMENT CONNECTED TO A PHARMACIST AT ALL
TIMES THE PRESCRIPTION AREA IS OPEN. THE COMMUNICATION LINK SHALL BE
CHECKED DAILY AND THE REMOTE SITE PHARMACY SHALL BE CLOSED IF SUCH LINK
MALFUNCTIONS, UNLESS A PHARMACIST IS PHYSICALLY AT THE REMOTE SITE PHAR-
MACY OR UNTIL THE LINK RETURNS TO WORKING OPERATION. THE PHARMACY TECH-
NICIAN SHALL MEET THE FOLLOWING MINIMUM REQUIREMENTS:
(I) THE PHARMACY TECHNICIAN SHALL BE REGISTERED WITH THE STATE BOARD
OF PHARMACY.
(II) THE PHARMACY TECHNICIAN SHALL BE A GRADUATE OF AN APPROVED PHAR-
MACY TECHNICIAN EDUCATION PROGRAM OR MUST MAKE APPLICATION TO THE STATE
BOARD OF PHARMACY, WHICH DEMONSTRATES KNOWLEDGE AND EXPERIENCE IN PREPA-
RATION OF PRESCRIPTIONS FOR DISPENSING AND WORKING WITH PATIENTS.
(B) A PHARMACIST MAY OVERSEE NO MORE THAN FOUR REMOTE SITE PHARMACIES.
AS DISPENSING IS CONSIDERED DONE BY THE PHARMACIST, THE PHARMACIST SHALL
BE HELD RESPONSIBLE FOR AND HELD ACCOUNTABLE FOR THE REMOTE SITE PHARMA-
CY.
(C) THE PHARMACY TECHNICIAN MAY UNLOCK THE PRESCRIPTION AND STORAGE
AREAS. WHILE THE PHARMACY TECHNICIAN IS ON DUTY, THE PRESCRIPTION AREA
MAY REMAIN OPEN.
(D) THE INPUT OF DRUG INFORMATION SHALL BE DONE BY A PHARMACIST AT THE
CENTRAL PHARMACY OR IF ENTERED BY A PHARMACY TECHNICIAN AT THE REMOTE
SITE PHARMACY OR AT THE CENTRAL PHARMACY, SHALL BE VERIFIED BY A PHARMA-
CIST.
(I) NEW PRESCRIPTIONS MAY BE RECEIVED AT THE CENTRAL PHARMACY AND
ENTERED THERE WITH A LABEL PRINTING AT THE REMOTE SITE PHARMACY; AND
(II) NEW PRESCRIPTIONS RECEIVED AT THE REMOTE SITE PHARMACY MAY BE
ENTERED INTO THE COMPUTER SYSTEM THERE WITH ALL VERIFICATION, INTER-
ACTION CHECKING AND PROFILE REVIEW SHALL BE THE RESPONSIBILITY OF THE
PHARMACIST.
A. 7592 4
10. THE STATE BOARD OF PHARMACY MAY IMMEDIATELY SUSPEND THE REGISTRA-
TION OF ANY REMOTE SITE PHARMACY IF A DANGER TO THE PUBLIC EXISTS.
11. IN A HOSPITAL WHICH IS UTILIZING TELEPHARMACY, PURSUANT TO THIS
SECTION, NO PRESCRIPTION ORDER MAY BE RELEASED FOR ADMINISTRATION TO A
PATIENT UNTIL APPROVED BY A PHARMACIST VIA THE AUDIO LINK, VIDEO LINK
AND COMPUTER LINK, OR OTHER FUNCTIONALLY EQUIVALENT TELECOMMUNICATIONS
EQUIPMENT. THE POLICY AND PROCEDURES OF THE HOSPITAL PHARMACY SHALL
ADDRESS ALL ASPECTS OF THE TELEPHARMACY OPERATION, INCLUDING, BUT NOT
LIMITED TO, THE CONTROL OF THE PHARMACY BY THE PHARMACY TECHNICIAN IN
THE ABSENCE OF THE PHARMACIST.
§ 3. This act shall take effect immediately.