SB-0704, As Passed Senate, June 12, 2014

 

 

 

 

 

 

 

 

 

 

 

HOUSE SUBSTITUTE FOR

 

SENATE BILL NO. 704

 

 

 

 

 

 

 

 

 

 

 

     A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

by amending sections 16233, 16241, 17702, 17704, 17706, 17707,

 

17709, 17742, and 17748 (MCL 333.16233, 333.16241, 333.17702,

 

333.17704, 333.17706, 333.17707, 333.17709, 333.17742, and

 

333.17748), sections 16233 and 16241 as amended by 2013 PA 268,

 

section 17702 as amended by 2012 PA 209, section 17706 as amended

 

by 1986 PA 304, section 17707 as amended by 1990 PA 333, section

 

17709 as amended by 2006 PA 672, section 17742 as added by 1987 PA

 

250, and section 17748 as amended by 1988 PA 462, and by adding

 

sections 17748a, 17748b, 17748c, and 17748d.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 16233. (1) The department may conduct an investigation

 

necessary to administer and enforce this article. Investigations

 


may include written, oral, or practical tests of a licensee's or

 

registrant's competency. The department may establish a special

 

paralegal unit to assist the department.

 

     (2) The department may order an individual to cease and desist

 

from a violation of this article, article 7, or article 8 or a rule

 

promulgated under this article, article 7, or article 8.

 

     (3) An individual ordered to cease and desist under subsection

 

(2) is entitled to a hearing before a hearings examiner if the

 

individual files a written request for a hearing within 30 days

 

after the effective date of the cease and desist order. The

 

department shall subsequently present the notice, if any, of the

 

individual's failure to respond to a complaint, or attend or be

 

represented at a hearing as described in sections 16231 and 16231a,

 

or the recommended findings of fact and conclusions of law to the

 

appropriate disciplinary subcommittee to determine whether the

 

order is to remain in effect or be dissolved.

 

     (4) Upon a violation of a cease and desist order issued under

 

subsection (2), the department of attorney general may apply in the

 

circuit court to restrain and enjoin, temporarily or permanently,

 

an individual from further violating the cease and desist order.

 

     (5) After consultation with the chair of the appropriate board

 

or task force or his or her designee, the department may summarily

 

suspend a license or registration if the public health, safety, or

 

welfare requires emergency action in accordance with section 92 of

 

the administrative procedures act of 1969, MCL 24.292. If a

 

licensee or registrant is convicted of a felony; a misdemeanor

 

punishable by imprisonment for a maximum term of 2 years; or a

 


misdemeanor involving the illegal delivery, possession, or use of a

 

controlled substance, the department shall find that the public

 

health, safety, or welfare requires emergency action and, in

 

accordance with section 92 of the administrative procedures act of

 

1969, MCL 24.292, shall summarily suspend the licensee's license or

 

the registrant's registration. If a licensee or registrant is

 

convicted of a misdemeanor involving the illegal delivery,

 

possession, or use of alcohol that adversely affects the licensee's

 

ability to practice in a safe and competent manner, the department

 

may find that the public health, safety, or welfare requires

 

emergency action and, in accordance with section 92 of the

 

administrative procedures act of 1969, MCL 24.292, may summarily

 

suspend the licensee's license or the registrant's registration.

 

     (6) The department may summarily suspend a pharmacy license if

 

the department has received a notice from the United States food

 

and drug administration or the centers for disease control and

 

prevention that there is an imminent risk to the public health,

 

safety, or welfare and emergency action in accordance with section

 

92 of the administrative procedures act of 1969, MCL 24.292, is

 

appropriate. A suspension under this subsection remains in effect

 

for the duration of the emergency situation that poses a risk to

 

the public health, safety, or welfare. Notwithstanding any

 

provision of this act to the contrary, the department is not

 

required to conduct an investigation or consult with the board of

 

pharmacy to take emergency action under this subsection.

 

     Sec. 16241. (1) After administrative disciplinary action is

 

final, the department shall publish a list of the names and

 


addresses of disciplined individuals. The department of commerce

 

shall indicate on the list that a final administrative disciplinary

 

action is subject to judicial review. The department shall report

 

disciplinary action to the department of public community health,

 

the director of the department of insurance and financial services,

 

the state and federal agencies responsible for fiscal

 

administration of federal health care programs, and the appropriate

 

professional association.

 

     (2) Once each calendar year, the department shall transmit to

 

the library of Michigan sufficient copies of a compilation of the

 

lists required under subsection (1) for the immediately preceding 3

 

calendar years. The library of Michigan shall distribute the

 

compilation to each depository library in this state. The

 

department shall also transmit the compilation to each county clerk

 

in this state once each calendar year.

 

     (3) The department of community health shall report the

 

disciplinary actions to appropriate licensed health facilities and

 

agencies. The director of the department of insurance and financial

 

services shall report the disciplinary actions received from the

 

department to insurance carriers providing professional liability

 

insurance.

 

     (4) In case of a summary suspension of a license under section

 

16233(5), the department shall report the name and address of the

 

individual whose license has been suspended to the department of

 

community health, the director of the department of insurance and

 

financial services, the state and federal agencies responsible for

 

fiscal administration of federal health care programs, and the

 


appropriate professional association. In case of a summary

 

suspension of a license under section 16233(6), the department

 

shall report the name and address of the pharmacy license that has

 

been suspended to the department of community health, the

 

department of insurance and financial services, the state and

 

federal agencies responsible for fiscal administration of federal

 

health care programs, and the appropriate professional association.

 

     (5) A licensee or registrant whose license or registration is

 

revoked or suspended under this article shall give notice of the

 

revocation or suspension to each patient who contacts the licensee

 

or registrant for professional services during the term of the

 

revocation or suspension. The licensee or registrant may give the

 

notice required under this subsection may be given orally and shall

 

be given give the notice required under this subsection at the time

 

of contact.

 

     (6) A licensee or registrant whose license or registration is

 

revoked or is suspended for more than 60 days under this article

 

shall notify in writing each patient or client to whom the licensee

 

or registrant rendered professional services in the licensee's or

 

registrant's private practice during the 120 days immediately

 

preceding the date of the final order imposing the revocation or

 

suspension and to each individual who is already scheduled for

 

professional services during the first 120 days after the date of

 

the final order imposing the revocation or suspension. The notice

 

shall must be on a form provided by the licensee's or registrant's

 

board or task force and shall state, at a minimum, the name,

 

address, and license or registration number of the licensee or

 


registrant, the fact that his or her license or registration has

 

been revoked or suspended, the effective date of the revocation or

 

suspension, and the term of the revocation or suspension. Each

 

board or task force shall develop a notice form that meets at least

 

the minimum requirements of this subsection. The licensee or

 

registrant shall send the notice to each patient or client to whom

 

the licensee or registrant rendered professional services in the

 

licensee's or registrant's private practice during the 120 days

 

immediately preceding the date of the final order imposing the

 

revocation or suspension within 30 days after the date of the final

 

order imposing the revocation or suspension and shall

 

simultaneously transmit a copy of the notice to the department. The

 

licensee or registrant orally shall notify each individual who

 

contacts the licensee or registrant for professional services

 

during the first 120 days after the date of the final order

 

imposing the revocation or suspension. The licensee or registrant

 

shall also provide a copy of the notice within 10 days after the

 

date of the final order imposing the revocation or suspension to

 

his or her employer, if any, and to each hospital, if any, in which

 

the licensee or registrant is admitted to practice.

 

     (7) A licensee or registrant who is reprimanded, fined, placed

 

on probation, or ordered to pay restitution under this article or

 

an applicant whose application for licensure or registration is

 

denied under this article shall notify his or her employer, if any,

 

and each hospital, if any, in which he or she is admitted to

 

practice, in the same manner as provided for notice of revocation

 

or suspension to an employer or hospital under subsection (6),

 


within 10 days after the date of the final order imposing the

 

sanction.

 

     (8) The department shall annually report to the legislature

 

and to each board and task force on disciplinary actions taken

 

under this article, article 7, and article 8. The report department

 

shall contain, include, at a minimum, all of the following

 

information in the report required under this subsection:

 

     (a) Investigations conducted, complaints issued, and

 

settlements reached by the department, separated out by type of

 

complaint and health profession.

 

     (b) Investigations and complaints closed or dismissed.

 

     (c) Actions taken by each disciplinary subcommittee, separated

 

out by type of complaint, health profession, and final order

 

issued.

 

     (d) Recommendations by boards and task forces.

 

     (e) The number of extensions and delays granted by the

 

department that were in excess of the time limits required under

 

this article for each phase of the disciplinary process, and the

 

types of cases for which the extensions and delays were granted.

 

     Sec. 17702. (1) "Agent" means an individual designated by a

 

prescriber to act on behalf of or at the discretion of that

 

prescriber as provided in section 17744.

 

     (2) "Brand name" means the registered trademark name given to

 

a drug product by its manufacturer.

 

     (3) Except as otherwise provided in subsection (4),

 

"compounding" means the preparation, mixing, assembling, packaging,

 

and labeling of a drug or device by a pharmacist under the

 


following circumstances:

 

     (a) Upon the receipt of a prescription for a specific patient.

 

     (b) Upon the receipt of a medical or dental order from a

 

prescriber or agent for use in the treatment of patients within the

 

course of the prescriber's professional practice.

 

     (c) In anticipation of the receipt of a prescription or

 

medical or dental order based on routine, regularly observed

 

prescription or medical or dental order patterns.

 

     (d) For the purpose of or incidental to research, teaching, or

 

chemical analysis and not for the purpose of sale or dispensing.

 

     (4) "Compounding" does not include any of the following:

 

     (a) Except as provided in section 17748c, the compounding of a

 

drug product that is essentially a copy of a commercially available

 

product.

 

     (b) The reconstitution, mixing, or other similar act that is

 

performed pursuant to the directions contained in approved labeling

 

provided by the manufacturer of a commercially available product.

 

     (c) The compounding of allergenic extracts or biologic

 

products.

 

     (5) "Compounding pharmacy" means a pharmacy that is licensed

 

under this part and is authorized to offer compounding services

 

under sections 17748, 17748a, and 17748b.

 

     (6) (3) "Current selling price" means the retail price for a

 

prescription drug that is available for sale from a pharmacy.

 

     Sec. 17704. (1) "Federal act" means the federal food, drug,

 

and cosmetic act, of 1938, 21 U.S.C. 301 to 392.21 USC 301 to 399f.

 

     (2) "Food and drug administration" or "FDA" means the United

 


States food and drug administration.

 

     (3) (2) "Generic name" means the established or official name

 

of a drug or drug product.

 

     (4) (3) "Harmful drug" means a drug intended for use by human

 

beings which that is harmful because of its toxicity, habit-forming

 

nature, or other potential adverse effect; , the method of its use;

 

, or the collateral measures necessary to its safe and effective

 

use , and which that is designated as harmful by the board

 

according to a rule promulgated under this part.

 

     (5) (4) "Internship" means an educational program of

 

professional and practical experience for an intern.

 

     Sec. 17706. (1) "Manufacturer" means a person who that

 

prepares, produces, derives, propagates, compounds, processes,

 

packages, or repackages a drug or device salable on prescription

 

only, or otherwise changes the container or the labeling of a drug

 

or device salable on prescription only, and who that supplies,

 

distributes, sells, offers for sale, barters, or otherwise disposes

 

of that drug or device and any other drug or device salable on

 

prescription only, to another person for resale, compounding, or

 

dispensing.

 

     (2) "Official compendium" means the United States

 

pharmacopoeia and the national formulary, or the homeopathic

 

pharmacopoeia of the United States, or a supplement thereof

 

existing on July 1, 1983.as applicable. If an official compendium

 

is revised after the effective date of the amendatory act that

 

added this sentence, the department shall officially take notice of

 

the revision. Within 30 days after taking notice of the revision,

 


the department, in consultation with the board, shall decide

 

whether the revision continues to protect the public health as it

 

relates to the manner that the official compendium is used in this

 

act. If the department, in consultation with the board, decides

 

that the revision continues to protect the public health, the

 

department may issue an order to incorporate the revision by

 

reference. If the department issues an order under this subsection

 

to incorporate the revision by reference, the department shall not

 

make any changes to the revision.

 

     (3) "Outsourcing facility" means that term as defined in 21

 

USC 353b.

 

     Sec. 17707. (1) "Personal charge" means the immediate physical

 

presence of a pharmacist or dispensing prescriber.

 

     (2) "Pharmacist" means an individual licensed under this

 

article to engage in the practice of pharmacy.

 

     (3) "Pharmacist in charge" or "PIC" means the pharmacist who

 

is designated by a pharmacy, manufacturer, or wholesale distributor

 

as its pharmacist in charge under section 17748(2).

 

     (4) (3) "Pharmacist intern" or "intern" means an individual

 

who satisfactorily completes the requirements set forth in rules

 

promulgated by the board under this part and is licensed by the

 

board for the purpose of obtaining instruction in the practice of

 

pharmacy from a preceptor approved by the board.

 

     (5) (4) "Pharmacy" means a building or part of a building in

 

which the practice of pharmacy is conducted. For the purpose of a

 

duty placed on a pharmacy under this part, "pharmacy" means the

 

person to which the pharmacy license is issued, unless otherwise

 


specifically provided.

 

     (6) (5) "Practice of pharmacy" means a health service, the

 

clinical application of which includes the encouragement of safety

 

and efficacy in the prescribing, dispensing, administering, and use

 

of drugs and related articles for the prevention of illness, and

 

the maintenance and management of health. Professional functions

 

associated with the practice of pharmacy include:

 

     (a) The interpretation and evaluation of the prescription.

 

     (b) Drug product selection.

 

     (c) The compounding, dispensing, safe storage, and

 

distribution of drugs and devices.

 

     (d) The maintenance of legally required records.

 

     (e) Advising the prescriber and the patient as required as to

 

contents, therapeutic action, utilization, and possible adverse

 

reactions or interactions of drugs.

 

     Sec. 17709. (1) "Sign" means to affix one's signature manually

 

to a document or to use an electronic signature when transmitting a

 

prescription electronically.

 

     (2) "Sterile pharmaceutical" means a dosage form of a drug

 

that is essentially free from living microbes and chemical or

 

physical contamination to the point at which it poses no present

 

risk to the patient, in accordance with USP standards. As used in

 

this subsection, "dosage form" includes, but is not limited to,

 

parenteral, injectable, and ophthalmic dosage forms.

 

     (3) (2) "Substitute" means to dispense, without the

 

prescriber's authorization, a different drug in place of the drug

 

prescribed.

 


     (4) "USP standards" means the pharmacopeial standards for drug

 

substances, dosage forms, and compounded preparations based on

 

designated levels of risk as published in the official compendium.

 

     (5) (3) "Wholesale distributor" means a person, other than a

 

manufacturer, who supplies, distributes, sells, offers for sale,

 

barters, or otherwise disposes of, to other persons for resale,

 

compounding, or dispensing, a drug or device salable on

 

prescription only that the distributor has not prepared, produced,

 

derived, propagated, compounded, processed, packaged, or

 

repackaged, or otherwise changed the container or the labeling

 

thereof.of the drug or device.

 

     Sec. 17742. (1) The board may require an applicant or the

 

holder of a pharmacy, manufacturer's, or wholesale distributor's

 

license to fully disclose the identity of each partner,

 

stockholder, officer, or member of the board of directors of the

 

pharmacy, manufacturer, or wholesale distributor, as applicable.

 

     (2) As used in this section and section sections 17748,

 

17748a, and 17768, "applicant" means a person applying for a

 

pharmacy, manufacturer's, or wholesale distributor's license under

 

this article. Applicant includes only 1 or more of the following:

 

     (a) An individual, if the person applying is an individual.

 

     (b) All partners, including limited partners, if the person

 

applying is a partnership.

 

     (c) All stockholders, officers, and members of the board of

 

directors, if the person applying is a privately held corporation.

 

     Sec. 17748. (1) A To do business in this state, a pharmacy,

 

manufacturer, or wholesale distributor, of prescription drugs,

 


whether or not located in this state, but doing business in this

 

state, shall must be licensed by the board in accordance with under

 

this part. To do business in this state, a person that provides

 

compounding services must be licensed as a pharmacy or manufacturer

 

under this part and, if a pharmacy, authorized to provide

 

compounding services under this section and sections 17748a and

 

17748b. To do business in this state, an outsourcing facility must

 

be licensed as a pharmacy under this part. Licenses shall be

 

renewed are renewable biennially.

 

     (2) A pharmacy , manufacturer, or wholesale distributor may

 

shall designate an individual to be a pharmacist licensed in this

 

state as the licensee pharmacist in charge for the pharmacy. ,

 

manufacturer, or wholesale distributor and the licensee is A

 

manufacturer or wholesale distributor shall designate a pharmacist

 

licensed in or outside of this state as the pharmacist in charge

 

for the manufacturer or wholesale distributor. The pharmacy,

 

manufacturer, or wholesale distributor and the individual

 

designated as the PIC under this subsection are jointly responsible

 

for the pharmacy's, manufacturer's, or wholesale distributor's

 

compliance with this part and rules promulgated under this part.

 

     (3) Subject to this subsection, a pharmacist may be designated

 

as the PIC for more than 1 pharmacy. A PIC described in this

 

subsection shall work an average of at least 8 hours per week at

 

each pharmacy for which he or she is the PIC. The pharmacy and the

 

PIC shall maintain appropriate records and demonstrate compliance

 

with this subsection upon the request of the board or its designee.

 

     (4) A pharmacy, manufacturer, or wholesale distributor shall

 


report to the department a change in ownership, management,

 

location, or designated PIC not later than 30 days after the change

 

occurs.

 

     (5) A pharmacist in charge shall supervise the practice of

 

pharmacy for the pharmacy in which he or she has been designated

 

the PIC. The duties of the PIC include, but are not limited to, the

 

following:

 

     (a) Supervision of all activities of pharmacy employees as

 

they relate to the practice of pharmacy including the purchasing,

 

storage, compounding, repackaging, dispensing, and distribution of

 

drugs and devices to ensure that those activities are performed in

 

compliance with this part and the rules promulgated under this

 

part.

 

     (b) Enforcement and oversight of policies and procedures

 

applicable to the employees of the pharmacy for the procurement,

 

storage, compounding, and dispensing of drugs and the communication

 

of information to the patient in relation to drug therapy.

 

     (c) Establishment and supervision of the method and manner for

 

storage and safekeeping of pharmaceuticals, including maintenance

 

of security provisions to be used when the pharmacy is closed.

 

     (d) Establishment and supervision of the record-keeping system

 

for the purchase, sale, delivery, possession, storage, and

 

safekeeping of drugs and devices.

 

     (e) Establishment of policies and procedures for individuals

 

who are delegated responsibilities for any of the tasks described

 

in this subsection by the PIC.

 

     (6) Except as otherwise provided in this subsection, an

 


applicant for a new pharmacy, manufacturer, or wholesale

 

distributor license under this part who is not a health

 

professional licensed or otherwise authorized to engage in a health

 

profession under this article or who is a health professional but

 

was licensed or otherwise authorized to engage in his or her health

 

profession under this article before October 1, 2008 shall submit

 

fingerprints in the same manner as required in section 16174 for

 

the purpose of a criminal history check. The board, department, and

 

department of state police shall comply with section 16174 for the

 

purpose of a criminal history check on an applicant described in

 

this subsection. This subsection does not apply if a criminal

 

history check that meets the requirements of section 16174 has been

 

obtained for the applicant within the 2 years preceding the date of

 

the application. To qualify for the exception under this

 

subsection, the applicant shall submit proof of the previous

 

criminal history check with his or her application for a new

 

pharmacy, manufacturer, or wholesale distributor license under this

 

part. If the department or board determines that the criminal

 

history check does not meet the requirements of section 16174 or

 

was not obtained within the time period prescribed, the applicant

 

shall comply with this subsection.

 

     (7) If, as authorized or required under this article, the

 

department inspects or investigates an applicant for a new pharmacy

 

license for a pharmacy that will provide compounding services or a

 

compounding pharmacy, which applicant or compounding pharmacy is

 

located outside of this state, the applicant or compounding

 

pharmacy shall reimburse the department for its expenses incurred

 


in carrying out its authority or duty to inspect or investigate the

 

applicant or licensee under this article.

 

     Sec. 17748a. (1) Beginning on the effective date of this

 

section, an applicant for a new pharmacy license for a pharmacy

 

that will provide compounding services for sterile pharmaceuticals

 

shall submit verification of current accreditation through a

 

national accrediting organization approved by the board or verify

 

the pharmacy is in the accreditation process. The department shall

 

not issue a license to a pharmacy described in this subsection that

 

is not accredited unless the applicant demonstrates compliance with

 

USP standards in a manner determined by the board.

 

     (2) By 1 year after the effective date of this section, a

 

pharmacy that is licensed on the effective date of this section and

 

that provides compounding services for sterile pharmaceuticals must

 

be accredited by a national accrediting organization approved by

 

the board, be verified by the board as being in the accreditation

 

process, or be in compliance with USP standards in a manner

 

determined by the board.

 

     (3) Notwithstanding any provision of part 161 to the contrary,

 

a pharmacy that provides compounding services for sterile

 

pharmaceuticals shall submit with a license renewal application

 

verification of current accreditation or compliance with USP

 

standards, as applicable.

 

     (4) A person that provides services consistent with an

 

outsourcing facility shall comply with requirements of the FDA

 

applicable to compounding services for sterile pharmaceuticals.

 

     (5) A pharmacy shall notify the department of a complaint

 


filed by another state in which the pharmacy is licensed for

 

violations of that state's pharmacy laws, an investigation by

 

federal authorities regarding violations of federal law, or an

 

investigation by any agency into violations of accreditation

 

standards regarding compounding activities within 30 days of

 

knowledge of the complaint or investigation.

 

     (6) Except for distribution within a hospital or another

 

health care entity under common control when regulated by federal

 

law, a pharmacist shall maintain a record of a compounded sterile

 

pharmaceutical in the same manner and for the same retention period

 

as prescribed in rules for other prescription records. The

 

pharmacist shall include, but is not limited to including, all of

 

the following information in the record required under this

 

subsection:

 

     (a) The name, strength, quantity, and dosage form of the

 

compounded pharmaceutical.

 

     (b) The formula to compound that includes mixing instructions,

 

all ingredients and their quantities, and any additional

 

information needed to prepare the compounded pharmaceutical.

 

     (c) The prescription number or assigned internal

 

identification number.

 

     (d) The date of preparation.

 

     (e) The manufacturer and lot number of each ingredient.

 

     (f) The expiration or beyond-use date.

 

     (g) The name of the person who prepared the compounded

 

pharmaceutical.

 

     (h) The name of the pharmacist who approved the compounded

 


pharmaceutical.

 

     (7) A pharmacist shall not offer excess compounded

 

pharmaceuticals to other pharmacies for resale. A compounding

 

pharmacy shall not distribute samples or complimentary starter

 

doses of a compounded pharmaceutical to a health professional.

 

     (8) A compounding pharmacy may advertise or otherwise promote

 

the fact that they provide compounding services.

 

     (9) Based on the existence of a health professional/patient

 

relationship and the presentation of a valid prescription, or in

 

anticipation of the receipt of a prescription based on routine,

 

regularly observed prescription patterns, a pharmacist may compound

 

for a patient a nonsterile or sterile pharmaceutical that is not

 

commercially available in the marketplace.

 

     (10) Notwithstanding any provision of this act to the

 

contrary, a person shall not compound and manufacture drug products

 

or allow the compounding and manufacturing of drug products at the

 

same location.

 

     (11) The department, in consultation with the board, may

 

promulgate rules regarding conditions and facilities for the

 

compounding of nonsterile and sterile pharmaceuticals.

 

     Sec. 17748b. (1) Except as otherwise provided in this

 

subsection, a pharmacist or pharmacy shall not compound nonsterile

 

or sterile pharmaceuticals for a prescriber or health facility or

 

agency licensed under article 17 to administer to the prescriber's,

 

facility's, or agency's patients without a prescription, unless the

 

pharmaceutical compounded by the pharmacist or pharmacy complies

 

with the most recent guidance on pharmacy compounding of human drug

 


products under 21 USC 353a. Upon application by a pharmacist or

 

compounding pharmacy, the department may authorize the pharmacist

 

or compounding pharmacy to compound nonsterile or sterile

 

pharmaceuticals for a prescriber or health facility or agency

 

licensed under article 17 to administer to the prescriber's,

 

facility's, or agency's patients in limited quantities without a

 

prescription. This subsection does not apply to the compounding of

 

topical nonsterile pharmaceuticals. The department shall prescribe

 

the form of the application for use under this subsection, which

 

application must include at least all of the following information:

 

     (a) The name and license number of the pharmacist or pharmacy

 

requesting authorization to compound under this subsection.

 

     (b) The name of the specific prescriber or health facility or

 

agency that is requesting compounded pharmaceuticals and an

 

affidavit from the prescriber or designated agent of the health

 

facility or agency attesting to the need and that the compounded

 

pharmaceuticals are only for patients located in this state or in

 

states immediately adjacent to this state.

 

     (c) The pharmaceuticals to be compounded and the reason for

 

the need to compound the pharmaceuticals.

 

     (d) The anticipated quantities of pharmaceuticals to be

 

compounded each month and the frequency of the need to compound

 

before receipt of a prescription or documentation supporting the

 

anticipated quantities.

 

     (e) The conditions of operation including practices consistent

 

with USP standards and requirements for sterility testing.

 

     (2) A pharmacist or compounding pharmacy that is authorized to

 


compound nonsterile or sterile pharmaceuticals for a prescriber or

 

health facility or agency under subsection (1) shall do all of the

 

following:

 

     (a) Maintain complete and accurate records on a monthly basis

 

of requests from and pharmaceuticals compounded for each prescriber

 

or health facility or agency.

 

     (b) Provide the information described in subdivision (a) to

 

the department as specified in rules or upon request.

 

     (3) The authorization granted under subsection (1) is for a 2-

 

year period consistent with the 2-year license cycle of the

 

pharmacy. The department may, without prior notice to the

 

pharmacist or pharmacy, physically inspect the facility where the

 

compounding of nonsterile or sterile pharmaceuticals occurs.

 

     (4) The department shall not authorize a pharmacist or

 

compounding pharmacy to compound nonsterile or sterile

 

pharmaceuticals without a prescription if the pharmacist or

 

pharmacy is under investigation, is in the process of being

 

disciplined, or is in a disciplinary status.

 

     (5) Except as otherwise provided in this subsection, the

 

department may immediately revoke the authorization granted under

 

subsection (1) if there is a confirmed deviation or violation of

 

the compounding process or if an adverse event directly related to

 

sterility or integrity of the product and associated with a

 

compounded nonsterile or sterile pharmaceutical is detected. If the

 

health, safety, and welfare of the public are not in immediate

 

jeopardy, the department shall provide at least 30 days' notice of

 

the revocation of authorization under this subsection.

 


     (6) A pharmacy or pharmacist authorized to compound

 

pharmaceuticals under this section that becomes aware of an adverse

 

event attributed to the integrity of the product of a compounded

 

pharmaceutical shall report the adverse event to the department not

 

later than 10 calendar days after becoming aware of the adverse

 

event. For purposes of this subsection, an adverse event does not

 

include an isolated allergic reaction to a substance included in

 

the compound if the allergic reaction is treated and relieved with

 

standard protocol.

 

     (7) The department shall post and maintain a list of

 

pharmacies and pharmacists who are authorized to compound

 

pharmaceuticals under this section on its internet website. The

 

department shall update the list required under this subsection at

 

least quarterly.

 

     (8) A prescriber or health facility or agency that obtains

 

compounded pharmaceuticals under this section shall not redispense

 

or sell the compounded pharmaceutical to a patient, a prescriber,

 

or health facility or agency.

 

     Sec. 17748c. Except for pharmaceuticals on the Michigan

 

pharmaceutical product list maintained by the department of

 

community health, a pharmacist shall not compound a pharmaceutical

 

that is commercially available unless 1 of the following

 

requirements is met:

 

     (a) The commercially available pharmaceutical is modified to

 

produce a significant difference, in the professional judgment of

 

the prescriber, between the compounded pharmaceutical for the

 

patient and the comparable commercially available pharmaceutical.

 


     (b) The commercially available pharmaceutical is not available

 

from normal distribution channels in a timely manner to meet the

 

patient's needs and the dispensing of the compounded pharmaceutical

 

has been approved by the prescriber and the patient. A pharmacist

 

who compounds a commercially available pharmaceutical as provided

 

in this subdivision shall maintain documentation of the reason for

 

the compounding.

 

     Sec. 17748d. (1) Except as otherwise provided in this section,

 

a person that violates section 17748a or 17748b is guilty of a

 

misdemeanor.

 

     (2) Except as otherwise provided in this section, a person

 

that knowingly or willfully violates section 17748a or 17748b or a

 

person that falsifies prescriptions in order to compound a

 

pharmaceutical in bulk is guilty of a felony punishable by

 

imprisonment for not more than 2 years or a fine of not more than

 

$1,000.00, or both.

 

     (3) Except as otherwise provided in this section, a person

 

that knowingly or willfully violates section 17748a or 17748b or a

 

person that falsifies prescriptions in order to compound a

 

pharmaceutical in bulk, which activity results in personal injury,

 

is guilty of a felony punishable by imprisonment for not more than

 

4 years or a fine of not more than $4,000.00, or both.

 

     (4) A person that knowingly or willfully violates section

 

17748a or 17748b or a person that falsifies prescriptions in order

 

to compound a pharmaceutical in bulk, which activity results in

 

serious impairment of a body function, is guilty of a felony

 

punishable by imprisonment for not more than 5 years or a fine of

 


not more than $5,000.00, or both. As used in this subsection,

 

"serious impairment of a body function" means that term as defined

 

in section 58c of the Michigan vehicle code, 1949 PA 300, MCL

 

257.58c.

 

     (5) A person that knowingly or willfully violates section

 

17748a or 17748b or a person that falsifies prescriptions in order

 

to compound a pharmaceutical in bulk, which activity results in

 

death, is guilty of a felony punishable by imprisonment for not

 

more than 15 years or a fine of not more than $20,000,00, or both.

 

     (6) The state attorney general or county prosecutor may bring

 

and prosecute criminal charges described in this section.

 

     Enacting section 1. This amendatory act takes effect 90 days

 

after the date it is enacted into law.