Section 12.40.983. Cooperative practice agreements with pharmacists.

	(a)  A physician may enter into a cooperative practice agreement with a pharmacist licensed under AS 08.80  as provided in this section. The initial agreement may not exceed two years and is subject to renewal under (j) of this section.  
	(b)  A physician planning to enter into a cooperative practice agreement with a pharmacist must submit to the board a written proposed agreement that meets the requirements of this section. The proposed agreement must be approved by the board before cooperative practice under the agreement, if approved, begins. A proposed modification to an agreement must be submitted to the board for approval, before the modification, if approved, is implemented. The board will approve a proposed agreement or modification if it is medically appropriate and provides for the safety of the patient. If the board disapproves a proposed agreement or modification, the board shall state the reasons for its action.  
	(c)  A cooperative practice agreement between a physician and a pharmacist must include  
		(1) the physician's authorization to a pharmacist or group of pharmacists to manage a patient's medication therapy;  
		(2) the full name, medical license number, date of issuance of license, and specialty, if any, of each physician who is a party to the agreement;   
		(3) the full name, place of employment, mailing address, pharmacist license number, and date of issuance of license, of each pharmacist who is a party to the agreement;  
		(4) a statement of the duration of the agreement, which may not exceed two years;  
		(5) the types of cooperative practice decisions that the physician is authorizing the pharmacist to make under the agreement, including  
			(A) types of diseases, medications, or medication categories involved and the type of cooperative authority to be exercised in each case; and  
			(B) procedures, decision criteria, or plans the pharmacist must follow when making therapeutic decisions, particularly when initiating or modifying medication;  
		(6) requirements that a pharmacist must follow when exercising cooperative authority, including documentation of decisions made, and a plan for communication and feedback to the physician concerning specific decisions made;  
		(7) a plan for the physician to review the decisions made by the pharmacist at least once every three months;  
		(8) a plan for providing to the physician patient records created under the agreement;  
		(9) a provision that allows the physician to override the agreement if the physician considers it medically necessary or appropriate;  
		(10) an acknowledgement that the physician will not receive any compensation from a pharmacist or pharmacy as a result of the care or treatment of any patient under the agreement;  
		(11) a prohibition on the administration or dispensing of any schedule I, II, III, or IV controlled substances.  
	(d)  The physician, or a physician assistant under the supervision of the physician, must physically examine and evaluate a patient before that patient may be included under a cooperative practice agreement to which that physician is a party. The physician must issue a prescription or medication order for each patient valid for up to one year. The physician, or a physician assistant under the supervision of the physician, must conduct a physical examination of a patient at least once a year while that patient is included under a cooperative practice agreement to which that physician is a party. The requirements of this subsection do not apply to a cooperative practice agreement allowing the administration of emergency contraception, immunizations of persons 18 years of age or older, and those immunizations recommended to be given on a yearly basis by the United States Department of Health and Human Services Centers for Disease Control and Prevention.  
	(e)  Only a physician in active practice in this state may enter into a cooperative practice agreement under this section. An authority authorized by a physician must be within the physician's current scope of practice.  
	(f)  A physician who enters into a cooperative practice agreement shall keep a copy of the written agreement and the records of all patients treated under it during the period of the agreement. The physician shall retain the agreement and records required by this subsection for at least seven years after the termination of the agreement.   
	(g)  A cooperative practice agreement is terminated upon written notice by either the physician or the pharmacist. The physician shall notify the board in writing within 30 days after an agreement is terminated.  
	(h)  The board may periodically review cooperative practice agreements approved under this section.  
	(i)  The requirements of this section do not apply to cooperative practice agreements adopted by the physicians on medical staff of a hospital or nursing facility licensed under AS 47.32  for treatment of patients of that facility.  
	(j)  The physician may seek renewal of a cooperative practice agreement for additional two-year periods.  
	(k)  Notwithstanding the requirements of (b) of this section, a physician who, before the effective date of this section, has entered into a collaborative practice agreement with a pharmacist that has been approved by the Board of Pharmacy under 12 AAC 52.240 and is still current, must obtain the board's approval of that agreement under this section within six months after this section takes effect. After that time, a physician may not participate in a cooperative practice agreement with a pharmacist except as allowed under this section.  
	(l)  In this section, "cooperative practice agreement" means an agreement between a physician and a pharmacist by which a physician authorizes the pharmacist to manage a patient's medication therapy as specified in the agreement.  

Authorities

08.64.100;08.64.326

Notes

Authority

AS 08.64.100 AS 08.64.326

History

Eff. 6/1/2006, Register 178