Be it enacted by the Senate and House
of Representatives in General Court assembled, and by the authority of the
same, as follows:
SECTION 1. Section 80B of chapter 112 of the General Laws, as appearing in the 2006 Official Edition, is hereby amended by striking out, in lines 11 to 13, the words “nurses in advanced roles, including certified nurse midwives, nurse practitioners and psychiatric nurse mental health clinical specialists” and inserting in place thereof the following words:— advanced practice nurses.
SECTION 2. Said section 80B of said chapter 112, as so appearing, is hereby further amended by striking out, in lines 42 and 43, the words “in advanced practice nursing roles” and inserting in place thereof the following words:— , as advanced practice nurses, in the roles of certified nurse midwives, nurse practitioners, psychiatric nurse mental health clinical specialists, or nurse anesthetists.
SECTION 3. Said chapter 112 is hereby further amended by striking out section 80E, as so appearing, and inserting in place thereof the following section:—
Section 80E. An advanced practice nurse may issue written prescriptions subject to paragraph (g) of section 7 of chapter 94C and may order tests and therapeutics in accordance with regulations promulgated jointly by the board and the board of registration in medicine after consultation with the board of registration in pharmacy. A prescription made by an advanced practice nurse shall include the name of the supervising physician with whom such nurse has developed and signed mutually agreed upon guidelines approved by said board and said board of registration in medicine under section 80B. The administration of anesthesia by a nurse anesthetist directly to a patient shall not require a written prescription or be considered to be prescribing medication.
SECTION 4. Section 80G of said chapter 112 is hereby repealed.
SECTION 5. The definition of “Practitioner” in section 1 of chapter 94C of the General Laws, as appearing in the 2006 Official Edition, is hereby amended by adding the following clause:—
(d) An advanced practice nurse authorized to issue written prescriptions under section 80E of chapter 112 and registered pursuant to paragraph (g) of section 7 to utilize and prescribe therapeutic pharmaceutical agents in the course of professional practice in the commonwealth.
SECTION 6. Paragraph g of Section 7 of said chapter 94C, as so appearing, is hereby amended by striking out the second and third paragraphs and inserting in place thereof the following paragraph:—
The commissioner shall promulgate regulations that provide for the registration of advanced practice nurses authorized to issue written prescriptions under section 80E of chapter 112. Prior to promulgating such regulations, the commissioner shall consult with the board of registration in nursing, the board of registration in medicine and the board of registration in pharmacy with regard to those schedules of controlled substances for which advanced practice nurses may be registered.
SECTION 7. Said chapter 94C is hereby further amended by striking out section 9, as so appearing, and inserting in place thereof the following section:—
Section 9. (a) A physician, dentist, podiatrist, optometrist as limited by sections 66 and 66B of chapter 112 and paragraph (h) of section 7, an advanced practice nurse as limited by paragraph (g) of section 7 and by section 80E of said chapter 112, 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 said section 7 and acting in accordance with 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 and 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 section 17, a physician, dentist, podiatrist, optometrist, advanced practice nurse, physician assistant, or veterinarian who is registered under 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, physician assistant 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 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) A nurse who has obtained from a physician, dentist, podiatrist, optometrist, advanced practice nurse, physician assistant or veterinarian, a controlled substance for dispensing to an ultimate user, pursuant to paragraph (b) or for administration to a patient pursuant to paragraph (a), during the absence of such physician, dentist, podiatrist, optometrist, advanced practice nurse, physician assistant or veterinarian shall return to such physician, dentist, podiatrist, optometrist, advanced practice nurse, physician assistant 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, dentist, podiatrist, optometrist, advanced practice nurse, physician assistant 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 paragraph (b), a physician, advanced practice nurse, or physician assistant 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 section 74 of chapter 112 and authorized by such physician, advanced practice nurse or physician assistant, 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 17. 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.
.