Alabama Administrative Code › Title 540 - ALABAMA BOARD OF MEDICAL EXAMINERS › Chapter 540-X-26 - COLLABORATIVE PHARMACY PRACTICE › Section 540-X-26-.01 - Definitions

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The following
			 definitions are applicable to collaborative drug therapy management:
(a) "Agreement" means the Collaborative Drug
			 Therapy Management Agreement.
(b)
			 "Board of Medical Examiners" means the State Board of Medical Examiners
			 established pursuant to Ala. Code §
									34-24-53.
(c) "Board of Pharmacy" means the State Board
			 of Pharmacy established pursuant to Ala. Code §
									34-23-90.
(d) "Collaborative Drug Therapy Management"
			 means the practice of pharmacy whereby an individual pharmacist licensed in
			 this state jointly and voluntarily works with an individual physician licensed
			 in this state under a Collaborative Drug Therapy Management Agreement to
			 provide a range of services to a patient of the Collaborating Physician and the
			 Collaborating Pharmacist intended to optimize therapeutic outcomes; detect and
			 prevent adverse medication interactions and side effects; provide education on
			 the patient's medications used to treat the disease state so that medications
			 are taken correctly; monitor, modify, and discontinue drug therapy as directed
			 by the physician; provide education on managing medication side effects;
			 communicate with third party payors and insurers regarding prior authorization
			 for prescription medications; and any other activity or service specified in a
			 protocol approved by both the Board of Medical Examiners and the Board of
			 Pharmacy, or otherwise authorized by this Chapter.
(e) "Collaborating Pharmacist" means a
			 pharmacist who is licensed to practice pharmacy in Alabama, who is a party to a
			 Collaborative Drug Therapy Management Agreement, and who has a direct
			 pharmacist-patient relationship with the patient served by the
			 Agreement.
(f) "Collaborating
			 Physician" means a doctor of medicine or a doctor of osteopathy licensed to
			 practice medicine in Alabama who is a party to a Collaborative Drug Therapy
			 Management Agreement, who has a direct physician-patient relationship, or
			 otherwise authorized by this Chapter, with the patient served by the Agreement,
			 and who has prepared the patient-specific, drug or drug class-specific,
			 disease-specific, and condition-specific plan of care based on a physical
			 examination of the patient where required under this Chapter.
(g) "Covering Pharmacist" means a pharmacist
			 licensed to practice pharmacy in Alabama who agrees in writing to be readily
			 available to fulfill the duties of a Collaborating Pharmacist pursuant to a
			 Collaborative Drug Therapy Management Agreement during the absence of the
			 Collaborating Pharmacist. The Covering Pharmacist shall be an employee of the
			 same pharmacy practice as the Collaborating Pharmacist, demonstrate the ability
			 to provide the services listed in the Agreement, and abide by the rules and
			 regulations of the Board of Medical Examiners and Board of Pharmacy.
(h) "Covering Physician" means a doctor of
			 medicine or a doctor of osteopathy licensed to practice medicine in Alabama who
			 agrees in writing to be readily available to fulfill the duties of a
			 Collaborating Physician pursuant to a Collaborative Drug Therapy Management
			 Agreement during the absence of the Collaborating Physician. The covering
			 physician shall be either a member of the same medical practice, practice
			 group, or multidisciplinary medical team, or of the same or similar practice
			 specialty as the Collaborating Physician and shall abide by the rules and
			 regulations adopted by the Board of Medical Examiners and Board of
			 Pharmacy.
(i) "Formulary" means a
			 list of legend drugs or drug classes that may be utilized under a Collaborative
			 Drug Therapy Management Agreement.
(j) "Joint Committee" means the Joint
			 Committee on Pharmacy Collaborative Practice, established for the purpose of
			 enabling a mechanism for the exchange of information between the Board of
			 Medical Examiners and the Board of Pharmacy on matters related to
			 physician-pharmacist collaboration.
(k) "Licensed Healthcare Facility" means a
			 hospital, as defined in Ala. Code §
									22-21-20(1),
			 licensed by the Alabama Department of Public Health, or a Federally Qualified
			 Health Center, as defined by Ala. Admin. Code r.
			 560-X-48-.01(1).
(l) "Patient Care Services" means services
			 rendered by Collaborating Physicians and Collaborating Pharmacists for the
			 benefit of the patient and which must be within the professional training and
			 experience of the Collaborating Physician and Collaborating Pharmacist and be
			 covered by the Collaborative Drug Therapy Management Agreement.
(m) "Protocol" means a document approved by
			 the Board of Medical Examiners and Board of Pharmacy establishing the
			 permissible functions and activities to be performed by a Collaborating
			 Pharmacist and signed by the parties to the Collaborative Drug Therapy
			 Management Agreement.
(n) "Quality
			 Assurance" means documented evaluation by the Collaborating Physician of the
			 parties' adherence to the Agreement and patient outcomes against defined
			 quality outcome measures, using a selected, meaningful sample of patient
			 records, which will identify outcomes needing improvement, set performance
			 goals, and assess progress towards meeting established goals, with a summary of
			 findings, conclusions, and, if indicated, recommendations for change. The
			 physician's signature on the patient record does not constitute quality
			 assurance monitoring.
(o) "Routine
			 Scope of Practice and Services" means any patient care service provided by the
			 Collaborating Physician and his or her practice in compliance with his or her
			 medical education, training, experience, and the Board of Medical Examiners'
			 laws, rules, policies, and procedures, and that of the collaborating pharmacist
			 and his or her practice in compliance with his or her pharmacy education,
			 training, experience, and the Board of Pharmacy's laws, rules, policies, and
			 procedures.
(p) "Unrestricted," for
			 the purpose of this Chapter, means an active pharmacy permit, pharmacy Drug
			 Enforcement Administration (DEA) registration, pharmacist license, medical
			 license, and Alabama Controlled Substances Certificate that is not revoked,
			 suspended, or on probation at the time of application and is not subject to any
			 conditions, restrictions, or limitations imposed by the applicable licensing
			 board which relate directly to the delivery of health care services. A
			 condition, restriction, or limitation directly relates to the delivery of
			 health care services when it prevents a provider from treating certain types of
			 patients or certain types of ailments or injuries, or otherwise limits a
			 provider from fully engaging in the practice which would otherwise be
			 authorized pursuant to his or her license.
(q) "Acute, uncomplicated illness or injury"
			 means a recent or new short-term problem with low risk of morbidity for which
			 treatment is considered and full recovery without functional impairment is
			 expected. For the purposes of this section, and acute, uncomplicated illness or
			 injury includes:
(a) Influenza.
(b) Streptococcus.
(c) Any other condition as recommended by the
			 Joint Committee.
Under this definition, a pharmacist may use any tests which the
				Centers for Medicare and Medicaid Services has determined qualifies for a
				waiver under the federal Clinical Laboratory Improvement Amendments of 1988, or
				the federal rules adopted thereunder, or any established screening procedures
				that can safely be performed by a pharmacist.