Amendment #144 to H4000

Rx Waste Amendment

Ms. Cole of Peabody move to amend the bill by adding the following sections:

“SECTION XX. Chapter 111 of the General Laws, as appearing in the 2012 Official Edition, is hereby amended by striking out section 25I, and inserting in place thereof the following section:-

Section 25I.  The department, in conjunction with the board of registration in pharmacy and the division of medical assistance, shall establish and implement methods to reduce medication waste in facilities licensed by the departments of public health, mental health and corrections. The department shall establish such methods, based on its review, that are determined to be effective in reducing waste without imposing unreasonable costs on the health care delivery system. Such methods may be based on, but not be limited to, the following: (1) current technology, standards and reimbursement mechanisms for dispensing and distributing medications to facilities; (2) other states' requirements for limiting prescription drug waste and any cost savings realized; (3) the commonwealth's standards for the return and re-dispensing of patient-specific schedule VI prescription drugs; and (4) possible incentive mechanisms to prevent the creation of prescription drug waste. The department shall promulgate regulations to implement this section.’

SECTION XX.  Section 70E of said chapter 111, as so appearing, is hereby amended by inserting after subsection (o), the following subsection:-

(p) to obtain from the facility in charge of the patient’s care, upon discharge, any bulk medications that were prescribed for the patient during the patient’s stay including, but not limited to, aerosol inhalers, topical products such as creams and powders eye drops, insulins and special order items, provided that any such items are patient specific and personal and would not otherwise be used in the treatment of another patient.  Upon discharge from the hospital, these bulk items shall be considered the personal property of the patient and at the prescribing physician’s discretion may include in discharge orders that the patient be provided with the specific bulk products that were used in the hospital with use directions.  The department shall promulgate regulations to implement this section.’

; and, further, by inserting, after section XX, the following section:

‘SECTION XX.  The department of public health, in consultation with the board of registration in pharmacy shall, as  shall provide to the joint committee on health care financing and the joint committee on public health, on or before  April 1, 2015 a report and legislative recommendations relative to issues of implementation of  the programs established under subsection p of section 70E of chapter 111 and section 25I of chapter 111, including, but not limited to: savings and costs related to the implementation of the programs established and recommendations related to penalties for violations of subsection (p) of section 70E of chapter 111 and section 25I of chapter 111.

SECTION XX.  Notwithstanding any general or special law to the contrary, the department of public health, in consultation with the department of environmental protection, shall make an investigation and study regarding the issue of pharmaceutical drug waste and its effect on the environment in the Commonwealth.  The department shall report on the following: (1) the estimated quantity of pharmaceutical drug waste in the Commonwealth; (2) the quantity of such waste that may be recovered prior to disposal; (3) the methods and techniques used in other states or local governments to reduce the amount of pharmaceutical drug waste, and identify model programs used to recover or recycle such waste; and (4) the efforts of pharmaceutical drug industry to mitigate waste through consumer support or take-back programs.  The department shall make recommendations, consistent with its report, regarding: (1) the feasibility of expanding a drug recycling program similar to that prescribed in section 25I of chapter 111 to all consumers; (2) the feasibility of adopting similar programs adopted by other states or local governments to reduce drug waste; and (3) the feasibility of the department assisting municipal governments to establish local programs to reduce such waste.  The department shall make its report and recommendations together with legislation to implement those recommendations by filing the same with the clerks of the senate and house not later than July 31, 2015.’’.