General Provisions

PURPOSE: This rule establishes definitions for 20 CSR 2220-6.060 to 20 CSR 2220-6.080 governing medication therapy services by pharmacists. (1) Definitions. The following definitions shall apply for purposes of 20 CSR 2220-6.060 to 20 CSR 2220-6.080: (A) Authorizing physician(s)—The physician identified in the written protocol as authorizing the pharmacist to provide medication therapy services; (B) Health care entity—For purposes of this rule, a health care entity shall be defined as any entity or organization that is licensed or certified by the state or federal government as a hospital, hospice facility, ambulatory surgical center, nursing home, long-term care facility, residential care facility, assisted living facility, intermediate care facility, skilled nursing facility, or a habilitation center as defined by Chapter 630, RSMo, and that is required to maintain patient medical records by state or federal law; (C) Medication therapy protocol—A written agreement between a physician and a pharmacist for the provision of medication therapy services. A medication therapy protocol shall comply with the provisions of 20 CSR 2220-6.080; (D) Medication therapy services—The designing, initiating, implementing, or monitoring of a plan to monitor the medication therapy or device usage of a specific patient, or to enhance medication therapeutic outcomes of a specific patient, by a pharmacist who has authority to initiate or implement a modification of the patient’s medication therapy or device usage pursuant to a medication therapy protocol. For purposes of 20 CSR 2220-6.060 to 20 CSR 2220-6.080, modification shall include selecting a new, different, or additional medication or device, discontinuing a current medication or device, or selecting a new, different, or additional strength, dose, dosage form, dosage schedule, or route of administration for a current medication or device, and implementing such selection(s). Medication therapy services shall not include the sole act of dispensing a drug or device pursuant to a valid prescription for the product, generic substitutions made pursuant to section 338.056, RSMo, or medication therapy management that does not include the initiation or implementation of a modification of medication therapy, as provided herein; (E) Pharmacy resident—A Missouri-licensed pharmacist enrolled in a residency training program accredited by the American Society of Health-System Pharmacists or a residency training program with a valid application for accreditation pending with the American Society of Health-System Pharmacists; (F) Prescription order for medication therapeutic plan—A lawful order that is issued by the authorizing physician within the scope of his/her professional practice for the provision of medication therapy services by a pharmacist for a specific patient, including, patients of a health care entity; and (G) Protocol—A medication therapy protocol, as defined herein. (2) The provisions of 20 CSR 2220-6.060 to 20 CSR 2220-6.080 and 20 CSR 2150-5.026 to 20 CSR 2150-5.028 shall only be deemed applicable to persons or entities under the jurisdiction of the Missouri State Board of Pharmacy and the Missouri State Board of Registration for the Healing Arts, as established by Chapter 338, RSMo, and Chapter 334, RSMo. AUTHORITY: sections 338.010, 338.140.1., and 338.380, RSMo Supp. 2011.* Original rule filed Jan. 13, 2012, effective Aug. 30, 2012. *Original authority: 338.010, RSMo 1939, amended 1951, 1989, 1990, 2007, 2009, 2011; 338.140, RSMo 1939, amended 1981, 1989, 1997, 2011; and 338.380, RSMo 2007.