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LRB-0994/5
MED:amn
2017 - 2018 LEGISLATURE
March 6, 2017 - Introduced by Representatives Kolste, Nygren, Jagler,
Horlacher, Ballweg, Kremer, Genrich, Rohrkaste, Tittl, Ripp, Spiros,
Born, C. Taylor, R. Brooks, E. Brooks, Berceau, Vruwink, Sargent,
Spreitzer, Pope, Petersen, Mason, Doyle, Subeck, Steffen, Considine,
Fields, Hesselbein, Stuck, Tauchen, Weatherston, Goyke, Crowley,
Bernier, Sinicki, Hebl, Ohnstad, Milroy, Knodl, Brostoff, Anderson,
Riemer, Zamarripa, Edming, Billings, Shankland, Stafsholt, Hutton and
Barca, cosponsored by Senators Vukmir, Johnson, Carpenter, Ringhand,
Cowles, Wirch, Marklein, Petrowski, Olsen, Hansen, Testin, C. Larson,
Risser, Bewley, Harsdorf, Nass and Vinehout. Referred to Committee on
Health.
AB125,1,3 1An Act to amend 450.11 (5) (a); and to create 450.11 (5) (bm) of the statutes;
2relating to: prescription order extensions for when a refill authorization
3cannot be obtained.
Analysis by the Legislative Reference Bureau
This bill allows a pharmacist to extend a prescription drug order under certain
circumstances where authorization for a refill cannot be obtained and dispense a
limited supply of the drug for the patient, subject to certain limitations.
Under current law, no prescription may be refilled unless certain requirements
that apply to prescription orders are satisfied and written, oral, or electronic
authorization has been given by the prescribing practitioner.
Under this bill, in the event a pharmacist receives a request for a prescription
to be refilled and the prescription cannot otherwise be refilled as provided under law,
the pharmacist may extend the existing prescription order and dispense (provide)
the drug to the patient if 1) the pharmacist has been unsuccessful in attempting to
procure a new prescription order or refill authorization from the prescribing
practitioner after attempting to contact the prescribing practitioner or his or her
office; 2) the patient is on a consistent drug therapy program and has previously
refilled the prescription at that pharmacy or through another pharmacy in the same
pharmacy chain; 3) the drug is essential to the life of the patient, or the interruption
of the drug therapy could result in undesirable consequences for the patient's health;
and 4) the pharmacist has not received and is not otherwise aware of instructions
from the prescribing practitioner prohibiting further dispensing pursuant to or
extension of the prescription order.

Under the bill, however, the following limitations apply: 1) a prescribing
practitioner may indicate in a prescription order “no extensions,” in which case the
pharmacist would be prohibited from extending the prescription order as provided
in the bill; 2) the authority may not be used by a pharmacist to dispense more than
a seven-day supply of the prescribed drug or the minimum amount necessary to
dispense at least a seven-day supply of the drug, whichever is less; 3) a pharmacist
may not extend a prescription order for a controlled substance; 4) a pharmacist may
not extend a prescription order for a particular patient if a prescription order was
previously extended for that patient in the previous one-year period for that drug;
and 5) the pharmacist, after extending a prescription order and dispensing the drug
to the patient, must notify the prescribing practitioner or his or her office.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB125,1 1Section 1. 450.11 (5) (a) of the statutes is amended to read:
AB125,2,112 450.11 (5) (a) No Except as provided in par. (bm), no prescription may be refilled
3unless the requirements of sub. (1) and, if applicable, sub. (1m) have been met and
4written, oral, or electronic authorization has been given by the prescribing
5practitioner. Unless the prescribing practitioner has specified in the prescription
6order that dispensing a prescribed drug in an initial amount followed by periodic
7refills as specified in the prescription order is medically necessary, a pharmacist may
8exercise his or her professional judgment to dispense varying quantities of the
9prescribed drug per fill up to the total number of dosage units authorized by the
10prescribing practitioner in the prescription order including any refills, subject to par.
11(b).
AB125,2 12Section 2. 450.11 (5) (bm) of the statutes is created to read:
AB125,2,1613 450.11 (5) (bm) 1. In the event a pharmacist receives a request for a prescription
14to be refilled and the prescription cannot be refilled as provided in par. (a), the
15pharmacist may, subject to subd. 2. a. to e., extend the existing prescription order and
16dispense the drug to the patient, if all of the following apply:
AB125,3,3
1a. The pharmacist has been unsuccessful in attempting to procure a new
2prescription order or refill authorization for the drug after attempting to contact the
3prescribing practitioner or his or her office.
AB125,3,64 b. The patient is on a consistent drug therapy program and the patient has
5previously refilled the prescription at that pharmacy or through another pharmacy
6in the same pharmacy chain.
AB125,3,87 c. The drug is essential to the life of the patient, or the interruption of the drug
8therapy could result in undesirable consequences for the patient's health.
AB125,3,119 d. The pharmacist has not received and is not aware of written or oral
10instructions from the prescribing practitioner prohibiting further dispensing
11pursuant to or extension of the prescription order.
AB125,3,1712 2. a. A prescribing practitioner may indicate, by writing on the face of the
13prescription order or, with respect to a prescription order transmitted electronically,
14by designating in electronic format the phrase “No extensions,” or words of similar
15meaning, that no extension of the prescription order may be made under subd. 1. If
16such indication is made, the pharmacist may not extend the prescription order under
17subd. 1.
AB125,3,2318 b. A pharmacist acting under subd. 1. may not extend a prescription order to
19dispense more than a 7-day supply of the prescribed drug, except that if the drug is
20typically packaged in a form that requires a pharmacist to dispense the drug in a
21quantity greater than a 7-day supply, the pharmacist may extend the prescription
22order as necessary to dispense the drug in the smallest quantity in which it is
23typically packaged.
AB125,3,2524 c. A pharmacist may not extend a prescription order under subd. 1. for a drug
25that is a controlled substance.
AB125,4,3
1d. A pharmacist may not extend a prescription order under subd. 1. for a
2particular patient if a prescription order was previously extended under subd. 1. for
3that patient in the previous one-year period for that drug.
AB125,4,54 e. A pharmacist shall, at the earliest reasonable time after acting under subd.
51., notify the prescribing practitioner or his or her office.
AB125,4,66 (End)
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