OLR Bill Analysis

sHB 5516 (as amended by House “B”)*



This bill allows the medical director of a “nursing home facility” to establish protocols for a prescription drug formulary system. These protocols must comply with (1) American Society of Health-System Pharmacists guidelines and (2) any applicable collaborative drug therapy management agreement.

A medical director who implements such a system may make a substitution for a drug prescribed to a patient of the facility in accordance with the facility's protocols. Before making any substitution, the bill requires the medical director, or designee, to notify the prescribing practitioner. The bill prohibits the substitution if the prescribing practitioner objects or does not authorize it.

The bill specifies, notwithstanding its provisions, that a facility must consider and administer prescription drugs to patients receiving benefits under a state medical assistance program in accordance with (1) the Department of Social Services' (DSS) Medicaid preferred drug lists, (2) Medicare Part D prescription drug formularies, or (3) the patient's health insurance policy as deemed appropriate by the facility's medical director.

The bill applies to “nursing home facilities” which the law defines as nursing homes, residential care homes (RCHs), rest homes with nursing supervision, and chronic and convalescent nursing homes. RCHs do not have medical directors. Thus, it appears that the bill does not apply to these facilities.

*House Amendment “B” changes “prescribing physician” to “prescribing practitioner” to include advanced practice nurse practitioners, physician assistants, dentists, and podiatrists. It also requires the facility to administer prescription drugs to state medical assistance beneficiaries in accordance with (1) DSS' Medicaid preferred drug lists, (2) Medicare Part D prescription drug formularies, or (3) the patient's health insurance policy, instead of only DSS' Medicaid preferred drug lists.

EFFECTIVE DATE: October 1, 2012


Collaborative Drug Therapy Management Agreements

The law permits physicians and pharmacists to enter collaborative agreements to manage the drug therapy of individual patients. These collaborative agreements must be governed by patient-specific written protocols established by the treating physician in consultation with the pharmacist. These agreements can authorize a pharmacist to implement, modify, or discontinue a drug therapy that the physician prescribes; order associated lab tests; and administer drugs (CGS 20-631).


Public Health Committee

Joint Favorable