1.1    .................... moves to amend H.F. No. 2639 as follows:
1.2Delete everything after the enacting clause and insert:

1.3    "Section 1. Minnesota Statutes 2006, section 151.01, subdivision 23, is amended to
1.4read:
1.5    Subd. 23. Practitioner. "Practitioner" means a licensed doctor of medicine, licensed
1.6doctor of osteopathy duly licensed to practice medicine, licensed doctor of dentistry,
1.7licensed doctor of optometry, licensed podiatrist, or licensed veterinarian. For purposes
1.8of sections 151.15, subdivision 4, 151.37, subdivision 2, paragraph paragraphs (b) and
1.9(e), and 151.461, "practitioner" also means a physician assistant authorized to prescribe,
1.10dispense, and administer under chapter 147A, or an advanced practice nurse authorized to
1.11prescribe, dispense, and administer under section 148.235.

1.12    Sec. 2. Minnesota Statutes 2007 Supplement, section 151.37, subdivision 2, is
1.13amended to read:
1.14    Subd. 2. Prescribing and filing. (a) A licensed practitioner in the course of
1.15professional practice only, may prescribe, administer, and dispense a legend drug, and may
1.16cause the same to be administered by a nurse, a physician assistant, or medical student or
1.17resident under the practitioner's direction and supervision, and may cause a person who
1.18is an appropriately certified, registered, or licensed health care professional to prescribe,
1.19dispense, and administer the same within the expressed legal scope of the person's practice
1.20as defined in Minnesota Statutes. A licensed practitioner may prescribe a legend drug,
1.21without reference to a specific patient, by directing a nurse, pursuant to section 148.235,
1.22subdivisions 8 and 9 , physician assistant, or medical student or resident to adhere to
1.23a particular practice guideline or protocol when treating patients whose condition falls
1.24within such guideline or protocol, and when such guideline or protocol specifies the
1.25circumstances under which the legend drug is to be prescribed and administered. An
1.26individual who verbally, electronically, or otherwise transmits a written, oral, or electronic
2.1order, as an agent of a prescriber, shall not be deemed to have prescribed the legend drug.
2.2This paragraph applies to a physician assistant only if the physician assistant meets the
2.3requirements of section 147A.18.
2.4    (b) A licensed practitioner that dispenses for profit a legend drug that is to be
2.5administered orally, is ordinarily dispensed by a pharmacist, and is not a vaccine, must
2.6file with the practitioner's licensing board a statement indicating that the practitioner
2.7dispenses legend drugs for profit, the general circumstances under which the practitioner
2.8dispenses for profit, and the types of legend drugs generally dispensed. It is unlawful to
2.9dispense legend drugs for profit after July 31, 1990, unless the statement has been filed
2.10with the appropriate licensing board. For purposes of this paragraph, "profit" means (1)
2.11any amount received by the practitioner in excess of the acquisition cost of a legend drug
2.12for legend drugs that are purchased in prepackaged form, or (2) any amount received
2.13by the practitioner in excess of the acquisition cost of a legend drug plus the cost of
2.14making the drug available if the legend drug requires compounding, packaging, or other
2.15treatment. The statement filed under this paragraph is public data under section 13.03.
2.16This paragraph does not apply to a licensed doctor of veterinary medicine or a registered
2.17pharmacist. Any person other than a licensed practitioner with the authority to prescribe,
2.18dispense, and administer a legend drug under paragraph (a) shall not dispense for profit.
2.19To dispense for profit does not include dispensing by a community health clinic when the
2.20profit from dispensing is used to meet operating expenses.
2.21    (c) A prescription or drug order for a legend drug the following drugs is not
2.22valid if it is based solely on an online questionnaire, unless it can be established that
2.23the prescription or order was based on a documented patient evaluation, including an
2.24examination, adequate to establish a diagnosis and identify underlying conditions and
2.25contraindications to treatment:
2.26    (1) controlled substance drugs listed in section 152.02, subdivisions 3 through 5;
2.27    (2) drugs defined by the board of pharmacy as controlled substances pursuant to
2.28section 152.02, subdivisions 7, 8, and 12;
2.29    (3) muscle relaxants;
2.30    (4) centrally acting analgesics with opioid activity;
2.31    (5) drugs containing butalbital; or
2.32    (6) phoshodiesterase type 5 inhibitors when used to treat erectile dysfunction.
2.33    (d) For the purposes of paragraph (c), the requirement for an examination shall be
2.34met if an in-person examination has been completed in any of the following circumstances:
2.35    (1) the prescribing practitioner examines the patient at the time the prescription
2.36or drug order is issued;
3.1    (2) the prescribing practitioner has performed a prior examination of the patient;
3.2    (3) another prescribing practitioner practicing within the same group or clinic as the
3.3prescribing practitioner has examined the patient;
3.4    (4) a consulting practitioner to whom the prescribing practitioner has referred the
3.5patient has examined the patient; or
3.6    (5) the referring practitioner has performed an examination in the case of a
3.7consultant practitioner issuing a prescription or drug order when providing services by
3.8means of telemedicine.
3.9    (e) Nothing in paragraphs (c) or (d) prohibits a licensed practitioner from prescribing
3.10a drug through the use of a guideline or protocol pursuant to paragraph (a) of this
3.11subdivision.
3.12    (f) Nothing in this chapter prohibits a licensed practitioner from issuing a
3.13prescription or dispensing a legend drug in accordance with the Expedited Partner Therapy
3.14in the Management of Sexually Transmitted Diseases guidance document issued by the
3.15United States Centers for Disease Control and Prevention.
3.16(g) Nothing in paragraphs (c) or (d) limits prescription, administration, or dispensing
3.17of legend drugs through a public health clinic or other distribution mechanism approved
3.18by the commissioner of health or a board of health in order to prevent, mitigate, or treat
3.19a pandemic illness, infectious disease outbreak, intentional or accidental release of a
3.20biological, chemical, or radiological agent.
3.21    (h) No pharmacist employed by, under contract to or working for a pharmacy
3.22licensed under section 151.19, subdivision 1, may dispense a legend drug based on a
3.23prescription which the pharmacist knows, or would reasonably be expected to know, is not
3.24valid under paragraph (c) of this subdivision.
3.25    (i) No pharmacist employed by, under contract to or working for a pharmacy
3.26licensed under section 151.19, subdivision 2, may dispense a legend drug, to a resident of
3.27this state, based on a prescription which the pharmacist knows, or would reasonably be
3.28expected to know, is not valid under paragraph (c) of this subdivision.

3.29    Sec. 3. Minnesota Statutes 2006, section 151.37, subdivision 7, is amended to read:
3.30    Subd. 7. Exclusion for prescriptions. Nothing in this chapter shall prohibit the
3.31possession of a legend drug by a person for that person's use when it has been dispensed
3.32to the person in accordance with a written or oral prescription by a practitioner. Nothing
3.33in this chapter shall prohibit a person, for whom a legend drug has been dispensed in
3.34accordance with a written or oral prescription by a practitioner, from designating a family
3.35member, caregiver or other individual to handle the legend drug for the purpose of
3.36assisting the person in obtaining or administering the drug."
4.1Amend the title accordingly