PETITION OF:

SECTION 1.

Section 80B of Chapter 112 of the Massachusetts General Laws, as so appearing in the 2004 Official Edition is hereby amended by striking the second paragraph and inserting in place there of the following:--

“Nursing practice involves clinical decision making leading to the development and implementation of a strategy of care to accomplish defined goals, the administration of medication, therapeutics and treatment prescribed by duly authorized nurses in advanced practice, as defined by the board of registration in nursing; dentists; physicians; and physician assistants’ and the evaluation of responses to care and treatment. It shall include, but not be limited to the performance of services which promote and support optimal functioning across the life span; the collaboration with other members of the health team to achieve defined goals; health counseling and teaching; the provision of comfort measures; teaching and supervising others; and participation in research which contributes to the expansion of nursing knowledge.”

SECTION 2.

Section 80B of said Chapter 112, is further amended by striking the sixth paragraph and inserting in place thereof the following paragraph:-- “Advanced practice nursing regulations which govern the ordering and interpretation of tests, ordering therapeutics and prescribing of medications shall be promulgated by the board.”

SECTION 3.

Section 80E of said Chapter 112, is hereby amended by striking the entire section and inserting thereof the following section: --

“Section 80E. A nurse authorized to practice as a nurse practitioner or a psychiatric nurse mental health clinical specialist may order and interpret tests, order therapeutics and prescribe medications in accordance with regulations promulgated by the board and subject to the provisions of paragraph (i) of section seven of chapter ninety-four C.”

SECTION 4.

Section 80G of said Chapter 112 is hereby amended by striking the entire section and inserting in place thereof the following new section: --

“Section 80G. A nurse authorized to practice as a nurse-midwife may order and interpret tests, order therapeutics and prescribe medications in accordance with regulations promulgated by the board and subject to the provisions of paragraph (i) of section seven of chapter ninety-four C.”

SECTION 5.

Said Chapter 112 is hereby further amended by adding the following new section:--

“Section 80H. A nurse authorized to practice as a nurse anesthetist may order and interpret tests, order therapeutics and prescribe medications in accordance with regulations promulgated by the board and subject to the provisions of paragraph (i) of section seven of chapter ninety-four C.”

SECTION 6.

Section 1 of Chapter 94C of the General Laws, as so appearing in the 2004 Official Edition, is hereby amended by adding a new subsection to the definition of “Practitioner”:--

“(d) An Advanced Practice Nurse authorized by sections 80B, 80E, 80G, and 80H of Chapter 112 and registered pursuant in paragraph (i) of section 7 to utilize and prescribe therapeutic pharmaceutical agents in the course of professional practice in the commonwealth.”

SECTION 7.

Section 7 of said Chapter 94C is hereby amended by striking out paragraphs two and three in subsection (g).

SECTION 8.

Section 7 of said Chapter 94C is hereby further amended at the end thereof with the following:--

“(i) The commissioner shall promulgate regulations which provide for the automatic registration of advanced practice nurses, upon the receipt of the fee as herein provided, to written issue prescriptions in accordance with the provisions of sections 80B, 80E, 80G, and 80H of chapter 112, unless the registration of such advanced practice nurse has been suspended or revoked pursuant to the provisions of section 13 or section 14 or unless such registration is denied for cause by the commissioner pursuant to the provisions of chapter 30A. Prior to promulgating such regulations, the commissioner shall consult with the board of registration in nursing.”

SECTION 9.

Section 9 of said Chapter 94C is herby amended by striking out the entire section and inserting in place thereof the following section:-

“Section 9. (a) A physician, dentist, podiatrist, optometrist as limited by sections 66 and 6613 of chapter 112 and paragraph (h) of section 7, advanced practice nurse as limited by sections 80B, 80E, 80G or 80H of chapter 112 and paragraph (i) of section 7, physician assistant as limited by said paragraph (g) of said section 7 and section 9E of said chapter 112, or a veterinarian when registered pursuant to the provisions of said section 7 and acting in accordance with the provisions of applicable federal law and any provision of this chapter which is consistent with federal law, in good faith and in the course of a professional practice for the alleviation of pain all suffering or for the treatment or alleviation of disease, may possess such controlled substances as may reasonably be required for the purpose of patient treatment and may administer controlled substances or may cause the same to be administered under his direction by a nurse.
A practitioner, as defined in section 1, may cause controlled substances to be administered under his direction by a licensed dental hygienist, for the purposes of local anesthesia only.

     (b) Notwithstanding the provisions of section 17, a physician, physician assistant, dentist, podiatrist, optometrist, advanced practice nurse, or veterinarian who is registered pursuant to the provisions of section 7, when acting in good faith and in the practice of medicine, dentistry, podiatry, optometry, advanced practice nursing or veterinary medicine or a nurse, when authorized by a physician, dentist, podiatrist, optometrist, advanced practice nurse or veterinarian in the course of such nurse's professional practice, may dispense by delivering to an ultimate user, a controlled substance in a single dose or in such quantity as is, in the opinion of such physician, dentist, podiatrist, optometrist, advanced practice nurse , physician assistant, or veterinarian, essential for the treatment of the patient; provided, however, that such amount or quantity of such controlled substance shall not exceed the amount needed for the immediate treatment of the patient and that all such controlled substances required by the patient as part of such, treatment shall be dispensed by prescription to such ultimate user in accordance with the provisions of this chapter.
     For the purposes of this section, the words "amount needed for the immediate treatment of the patient" shall mean the quantity of, a controlled substance which is necessary for the proper treatment of the patient until it is possible for such patient to have a prescription filled by a pharmacy.

     This section shall not be construed to prohibit or limit the dispensing of any prescription medication that is classified by the department of public health as schedule VI and that is provided free of charge by the manufacturer as part of an indigent patient program or for use as samples if such prescription medications are: (1) dispensed to the patient, by a professional authorized to dispense controlled substances pursuant to this section; (2) dispensed in the package provided by the manufacturer; and (3) provided at no charge to the patient.
     The department shall promulgate rules and regulations governing the dispensing of medication pursuant to this section. Said rules and regulations shall include, but not be limited to, the types and amounts of medications that may be dispensed and the appropriate safeguards for the labeling and dispensing of such medications.

     (c) An nurse who has obtained from a physician, dentist, physician assistant, podiatrist, advanced practice nurse, or veterinarian, a controlled substance for dispensing to an ultimate user, pursuant to the provisions of paragraph (b) or for administration to a patient pursuant to the provisions of paragraph (a), during the absence of such physician, physician assistant, dentist, podiatrist, advanced practice nurse or veterinarian shall return to such physician, physician assistant, dentist, podiatrist, advanced practice nurse or veterinarian any unused portion of such substance which is no longer required by the patient.

     A licensed dental hygienist who has obtained a controlled substance from a practitioner, as defined in section 1, for dispensing to an ultimate user pursuant to paragraph (a) shall return to such practitioner any unused portion of the substance which is no longer required by the patient.

     (d) Every physician, physician assistant, dentist, podiatrist, advanced practice nurse or veterinarian shall, in the course of a professional practice, keep and maintain records open to inspection by the commissioner during reasonable business hours, which shall contain the names and quantities of any controlled substances in Schedule I, II or III received by such practitioner; the name and address of the patient to whom such controlled substance is administered or dispensed; the name, dosage and strength per dosage unit of such controlled substance and the date of such administration or dispensing.

     (e) Notwithstanding the provisions of. paragraph (b), a physician, advanced practice nurse , physician assistant, or , when acting in good faith and providing care under a program funded in whole or in part by 42 USC 300, or in a clinic licensed by the department to provide comparable medical services or a registered nurse, registered pursuant to the provisions of section seventy-four -of chapter one hundred and twelve and authorized by such physician, advanced practice nurse , physician assistant or , may lawfully dispense controlled substances pursuant to Schedule VI to recipients of such services in such quantity as needed for treatment, and shall be exempt from the requirement that such dispensing be in a single dosage or as necessary for immediate treatment; provided, however, that such registered nurse shall not so dispense except as provided in section seventeen. The department may establish rules and regulations controlling the dispensing of said medications including, but not limited to, the types and amounts of medications dispensed and appropriate safeguards for dispensing.”

SECTION 10.

Section 18 (c) of said Chapter 112 is hereby amended by striking the entire section and inserting thereof the following section:-

“(c) A prescription for a controlled substance contained in schedules III to VI, inclusive, as defined in section three may also be issued by an authorized practitioner who is duly licensed to practice medicine and duly registered in the state wherein he resides, if required, and duly registered under federal law to write prescriptions; or by an authorized advanced practice nurse who is duly licensed to so practice and duly registered under federal law to write prescriptions. It is the duty of the registered pharmacist who is filling a prescription under this paragraph to determine, in accordance with professional standards and personal judgment, that such prescription is authentic and valid; provided, however, that if the substance is in schedules III to V, inclusive, the registered pharmacist shall verify the prescription by telephone or other means. A pharmacist shall not fill a prescription for which said verification cannot be obtained. The pharmacist shall not be held liable for refusing to fill a prescription for which said verification cannot be obtained, provided that documented good faith efforts were made to determine the authenticity and validity of the prescription. This paragraph shall be valid only for the purpose of authorizing the filling of prescriptions, issued within the preceding thirty days, and shall not authorize said physician or advanced practice nurse to process, administer or dispense controlled substances as provided in section nine or to practice medicine or advanced practice nursing within the commonwealth. In the case of any oral prescription for a schedule III through V substance, the pharmacist shall record that he has requested that the practitioner deliver or mail to the dispensing pharmacy a written prescription for the controlled substance within seven days or such shorter period required by Federal law. Any prescription issued under this paragraph shall be issued in the manner prescribed in section twenty-two and all relevant provisions of this chapter shall apply to such physician and prescription. Nothing contained in this section shall be deemed to authorize any mail order pharmacies.”

SECTION 11.

Section 18 (d) of said Chapter 112 is hereby further amended by striking the entire section and inserting thereof the following section:-

“(d) A prescription for a controlled substance contained in Schedule II of section three may also be issued by a physician who is licensed to practice medicine and registered in a another state where he resides or practices, if required, and registered under federal law to write prescriptions; or by an advanced practice nurse who is so licensed to practice and registered in another state where she resides or practices, if required, and registered under federal law to write prescriptions. A registered pharmacist filling a prescription under the provisions of this paragraph shall determine, in accordance with professional standards and personal judgment, that such prescription is authentic and valid; and shall verify such prescription by telephone or other means. A pharmacist shall not fill a prescription for which said verification cannot be obtained. A pharmacist shall not be held liable for refusing to fill such prescription for which said verification cannot be obtained; provided, however, that documented good faith efforts were made to determine the authenticity and validity of such prescription. This paragraph is only for the purpose of authorizing the filling of prescriptions within the commonwealth, issued within the preceding five days, and shall not authorize such practitioner to possess, administer or dispense controlled substances as provided in section nine, or to practice medicine or advanced practice nursing within the commonwealth. Any prescription issued under the provisions of this paragraph shall be issued in the manner prescribed in section twenty-two and all relevant provisions of this chapter shall apply to such practitioner and prescription. In the case of any prescription for a Schedule II substance filled under the provisions of this paragraph, a pharmacist filling such prescription shall within thirty days after the filling of such prescription deliver to the department a copy of each such Schedule II prescription; provided, however, that such copy shall not include the name and address of the patient for whom the prescription is issued and that such copy and the information contained thereon shall not be deemed to be public record within the meaning of section seven of chapter four and shall be subject to the restrictions set forth in section two of chapter sixty-six A. Nothing contained in this section shall be deemed to authorize any mail order pharmacies.”