Analysis
DATE: February 25, 1997
HOUSE BILL NO.:HB 4149 (introduced January 30, 1997)
TOPIC:Out-of-state prescriptions
SPONSOR(S):Nye, Owen and Rocca
HOUSE COMMITTEE:Health Policy
POSITION:
The Department of Consumer & Industry Services supports this legislation.
PROBLEM/BACKGROUND:
The purpose of this legislation is to provide reciprocity among states in terms of recognizing
prescriptions written in one state and filled in another state. Currently, Michigan is one of two states
which does not allow prescriptions for out-of-state prescribers to be filled for non-controlled
substances and one of four states which does not allow prescriptions for out-of-state prescribers for
controlled substances. The passage of this legislation will enable out-of-state physicians and certain
other health care licensees to prescribe medications for their patients to be filled in Michigan.
Vacationers, part-time Michigan residents, and Michigan residents who are under the care of out-of-state specialists have had difficulty in filling prescriptions in Michigan written by their physicians
in other states.
DESCRIPTION OF BILL:
The bill enables a doctor of medicine, a doctor of osteopathic medicine and surgery, a doctor of
podiatric medicine and surgery, a dentist, an optometrist (appropriately certified to write
prescriptions), a veterinarian or other licensed health professional acting under the delegation of a
doctor who is licensed outside of Michigan to write a prescription to be filled in Michigan.
However, the bill excludes filling of prescriptions for controlled substances from out-of-state
prescribers unless they are located in a border state and have a practice that extends into Michigan.
This change is accomplished through amendments of several sections in the Public Health Code as
described here:
Amendment to Section 7405 Prohibited conduct generally. The proposed amendment
changes in (d) makes the language more clear to address controlled substances; adds section
(e) to permit controlled substances to be filled by pharmacists when the prescription is
written by a prescriber in a land border state (Ohio, Indiana, Wisconsin) whose practice
extends into Michigan but who does not have a Michigan office; and adds (2) to include
violations of this section being subject to penalties described in Sec. 7406.
Amendment to Section 16106 Definitions; I to L. This proposed amendment effectively
broadens the definition of license to include a license issued in another state by including a
legislative bridge to the definition of prescriber in Sec. 17708(2)
Amendment to Section 17708 Definitions; P. This proposed amendment defines prescription
to include a drug written by a prescriber licensed to practice in another state and includes
controlled substances written by a prescriber in a land border state by reference.
Amendment to Section 17751 Dispensing prescription drug; requirements. This proposed
amendment includes language to require the pharmacist to determine the prescription was
issued pursuant to a bona fide practitioner-patient relationship, the prescription is authentic,
and the prescribed drug is necessary for a chronic or recurring condition.
Amendment to Section 17763 Grounds for fine, reprimand, or probation; grounds for
denying, limiting, suspending, or revoking license. This amendment adds (g) to include
grounds for administrative licensing sanction to include a Michigan pharmacist dispensing
a prescription for a controlled substance for out-of-state prescriptions for prescribers in other than land border states whose the health care practice extends into Michigan and who does
not have a Michigan office.
SUMMARY OF ARGUMENTS:
PRO
This bill will make Michigan's drug prescription laws more convenient for out-of-state
travelers and part-time residents as well as residents who see specialists located outside of
Michigan. It will also make Michigan more compatible with nearly all other states in terms
of reciprocity. The problems identified with the language of HB 5001, introduced in the last
legislative session, have been addressed in this new bill.
CON
Forged prescriptions of "out-of-state" prescriber for maintenance medications as well as
controlled substances may increase. These will be more difficult to detect, investigate, and
administratively sanction. The Office of Health Services will not be able to administratively
sanction out of state prescribers but will advise their home state. It may be difficult for
pharmacists to effectively determine there was a legitimate health care provider/patient
relationship.
SUPPORTERS/OPPONENTS:
Certain consumer groups where convenience of obtaining prescriptions is an issue may support this
legislation. Out-of-state physicians and other health care providers may support this legislation
although the Office of Health Services is unaware of any directed effort. Pharmacists and health care
providers who write prescriptions in this state as well as those concerned about the misuse of drugs
(regular and controlled substances) may oppose this legislation. It is our understanding the Michigan
Pharmacists Association supports this legislation.
FISCAL INFORMATION:
No fiscal information is available.
ECONOMIC IMPACT:
The ability of Michigan pharmacists to fill out-of-state prescriptions may increase their profitability.
ADMINISTRATIVE RULES IMPACT:
The pharmacy rules may require changes.
APPROVED:
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