TITLE XXX
OCCUPATIONS AND PROFESSIONS
Chapter 318
PHARMACISTS AND PHARMACIES
Section 318:1
318:1 Definitions. –
In this chapter:
I. "Administer" means an act whereby a single dose of a drug is instilled into the body of, applied to the body of, or otherwise given to a person or animal for immediate consumption or use.
I-a. "Advanced practice registered nurse" means a person licensed to practice as an advanced practice registered nurse in this state pursuant to RSA 326-B:18.
II. "At retail" means the dispensing of drugs or medicines pursuant to the order of a physician, dentist, veterinarian, or advanced practice registered nurse, whether or not such drugs or medicines are dispensed for a valuable consideration.
III. "Board", when not otherwise limited, means the New Hampshire pharmacy board.
III-a. "Compounding" means the preparation, mixing, assembling, packaging or labeling of a drug or device as a result of a practitioner's prescription drug order or initiative based on the pharmacist-patient-prescriber relationship in the course of professional practice or, for the purpose of, or as an incident, to research, teaching, or chemical analysis, but not selling or dispensing. "Compounding" also includes the preparation of drugs or devices in anticipation of prescription drug orders based on routine, regularly observed prescribing patterns. "Compounding" shall not include the reconstitution of powdered formulations before dispensing or the addition of flavoring. "Compounding" shall not include the simple addition of flavoring, nor shall it include the preparation of a single dose of a nonhazardous commercially available drug or licensed biologic for administration within 2 hours of preparation to an individual patient when done in accordance with the manufacturer's approved labeling or instructions consistent with that labeling.
IV. "Dentist" means a practitioner of dentistry duly registered under the laws of this or some other state.
V. "Dispense" means to distribute, leave with, give away, dispose of, deliver, or sell one or more doses of a drug that will be administered or taken at a later date, time, or location and shall include the transfer of more than a single dose of a medication from one container to another and the labeling or otherwise identifying a container holding more than a single dose of a drug.
V-a. "Distributor" means a person or persons who supply or facilitate the supply of prescription drugs to persons other than consumers.
VI. "Drugs", when not otherwise limited, means all substances used as medicines or in the practice of medicine.
VI-a. "Fee splitting" means any discount, rebate, dividend, shared income, or economic benefit from the sale of prescription medicine by a pharmacist or pharmacy with an individual licensed to prescribe medicine or such individual's spouse or dependent children.
VI-b. "Emergency medical care provider" means a person licensed to provide emergency medical care under RSA 151-B.
VI-c. "Foreign pharmacy graduate" is a pharmacist whose undergraduate pharmacy degree was conferred outside the United States by a pharmacy school listed in the World Directory of Schools of Pharmacy published by the World Health Organization.
VI-d. "FPGEC" means the Foreign Pharmacy Graduate Equivalency Committee administered by the National Association of Boards of Pharmacy.
VI-e. "FPGEE" means the Foreign Pharmacy Graduate Equivalency Examination administered by the National Association of Boards of Pharmacy and recognized and approved by the board.
VI-f. "Hormonal contraceptives" means pills, patches, and rings which the United States Food and Drug Administration (FDA) classifies as available by prescription for the purpose of contraception or emergency contraception. It does not include similar items classified as "over the counter" by the FDA, intrauterine devices, shots, or intradermal implants.
VI-g. "Law enforcement officer" means any officer of the state or political subdivision of the state who is empowered by law to conduct investigations of or to make arrests for offenses enumerated in this chapter.
VII. "Licensed pharmacist" or "pharmacist", when not otherwise limited, means a person holding a license under RSA 318:18 and who is, therefore, legally authorized to practice the profession of pharmacy in this state.
VII-a. "Limited retail drug distributor" means a distributor of legend devices or medical gases delivered directly to the consumer pursuant to a practitioner's prescription order, or federally funded clinics operated under contract with the department of health and human services and drug abuse treatment centers, where legend and controlled drugs are held, stored, or dispensed to patients pursuant to the order of an authorized practitioner.
VII-b. "Mail-order pharmacy" means a pharmacy that is located in a state of the United States, other than this state, whose primary business is to dispense a prescription drug or device under a prescription drug order and to deliver the drug or device to a patient, including a patient in this state, by the United States mail, a common carrier, or a delivery service. Mail-order pharmacies include, but are not limited to, pharmacies that do business via the Internet or other electronic media.
VIII. "Manufacturing" means the production, preparation, propagation, conversion or processing of a drug or device, either directly or indirectly, by large volume extraction from substances of natural origin, or independently by means of chemical or biological synthesis, and includes any packaging or repackaging of a substance or labeling or relabeling of its container, and the promotion and marketing of such drugs and devices for resale. Manufacturing shall be governed by Good Manufacturing Practices as adopted and enforced by the federal Food and Drug Administration.
IX. "Medicine", when not otherwise limited, means a drug or preparation of drugs in suitable form for use as a curative or remedial substance.
IX-a. "Nurse" means a person licensed to perform registered nursing as defined in RSA 326-B.
X. [Repealed.]
XI. "Pharmacy", when not otherwise limited, means the place registered by the board where the profession of pharmacy is practiced and where drugs, chemicals, medicines, prescriptions, or poisons are compounded, dispensed, stored, or retailed.
XI-a. "Pharmacy benefits manager" means "pharmacy benefits manager" as defined in RSA 402-N:1, VIII.
XI-b. "Pharmacy technician" means a person, other than a pharmacist or a pharmacy intern, either registered or certified by the board for the purpose of assisting a pharmacist in the practice of pharmacy.
XI-aa. "Pharmacy intern" means a person who is registered by the board pursuant to RSA 318:15-b and:
(a) Is enrolled in a professional degree program of a school or college of pharmacy that has been approved by the board and is satisfactorily progressing toward meeting the requirements for licensure as a pharmacist starting no earlier than 4 months prior to the third year of study; or
(b) Is a graduate of an approved professional degree program of a school or college of pharmacy or is a graduate who has established educational equivalency by obtaining a Foreign Pharmacy Graduate Examination Committee (FPGEC) Certificate, who is currently licensed by the board of pharmacy for the purpose of obtaining practical experience as a requirement for licensure as a pharmacist; or
(c) Is a qualified applicant awaiting examination for licensure or meeting board requirements for re-licensure; or
(d) Is participating in a residency or fellowship program.
XII. "Physician" means a practitioner of medicine duly licensed under the laws of this or some other state.
XII-a. "Physician assistant" means a person licensed as a physician assistant under RSA 328-D.
XII-b. "Podiatrist" means a person authorized by law to practice podiatry in this state pursuant to RSA 315.
XIII. "Poisons", when not otherwise limited, means any drug, chemical medicine or preparation liable to be destructive to adult human life in quantities of 60 grains or less.
XIV. "Practice of pharmacy" means the professional acts performed by a pharmacist and shall include the interpretation and evaluation of prescription orders; the administration, compounding, dispensing, labeling and distribution of drugs and devices; the participation in drug selection and drug-related device selection; drug evaluation; utilization or regimen review; the monitoring of drug therapy and use; medication therapy management in accordance with collaborative pharmacy practice agreements; the proper and safe storage and distribution of drugs and devices, and the proper maintenance of proper records; the responsibility of advising, when necessary or when regulated, of therapeutic values, hazards, and use of drugs and devices; the initiating, ordering, administering, and analyzing of FDA approved Emergency Use Authorization SARS-CoV-2 (COVID-19) point-of-care diagnostic kits (COVID-19 tests or test kits) to detect SARS-CoV-2 or its antibodies, so long as the pharmacist has received the adequate education and training to do so; and the offering or performing of these acts, services, operations, or transactions necessary in the conduct, operation, management, and control of pharmacy.
XV. "Practitioner" or "licensed practitioner" means any person who is lawfully entitled to prescribe, administer, dispense or distribute legend drugs to patients.
XV-a. "Practitioner-patient relationship" means a medical connection between a licensed practitioner and a patient that includes an in-person exam or an exam using telemedicine, as defined in RSA 310, provided the health care practitioner: (i) verifies the identity of the patient receiving health care services through telemedicine; (ii) discloses to the patient the health care practitioner's name, contact information, and the type of health occupation license held by the health care practitioner; (iii) obtains oral or written consent from the patient or from the patient's parent or guardian, if state law requires the consent of a parent or guardian for use of telemedicine services; and (iv) meets the standard of care. A health care practitioner shall complete or review a history, a diagnosis, a treatment plan appropriate for the practitioner's scope of practice, and documentation of all prescription drugs including name and dosage. A practitioner may prescribe for a patient whom the practitioner does not have a practitioner-patient relationship under the following circumstances: for a patient of another practitioner for whom the prescriber is taking call; for a patient examined by another New Hampshire licensed practitioner; or for medication on a short-term basis for a new patient prior to the patient's first appointment. The definition of a practitioner-patient relationship shall not apply to a practitioner licensed in another state who is consulting to a New Hampshire licensed practitioner with whom the patient has a relationship.
XVI. "Prescription" means a verbal, or written, or facsimile or electronically transmitted order for drugs, medicines and devices by a practitioner licensed in the United States, to be compounded and dispensed by licensed pharmacists in a duly registered pharmacy, and to be kept on file for a period of 4 years. A written order shall include an electronic transmission prescription received and retained in a form complying with rules adopted pursuant to RSA 318:5-a, XV. Prescriptions may also apply to the finished products dispensed or administered by the licensed pharmacist in the registered pharmacy, on order of a licensed practitioner as defined in this section.
XVI-a. "Prescription device" or "legend device" means an instrument, apparatus, implement, machine, contrivance, implant, or other similar or related article, including any component part or accessory, which is restricted for distribution and use only upon the order of a licensed practitioner.
XVII. "Prescription drug", "legend drug," or "potent drug" means:
(a) A drug which under federal law is required, prior to being dispensed or delivered, to be labelled with any of the following statements:
(1) "Caution federal law prohibits dispensing without prescription", or
(2) "Caution federal law restricts this drug to use by or on the order of the licensed veterinarian", or
(3) "RX only", or
(b) A drug which is required by any applicable federal or state law or regulation to be dispensed on prescription only or is restricted to use by practitioners.
XVIII. "Nonprescription or proprietary medicine" shall mean non-narcotic medicines or drugs which may be sold without a prescription and which are prepackaged for use by the consumer and labeled in accordance with the requirements of the laws of this state and the federal government, provided that this definition shall not include the following:
(a) A drug, the label of which bears substantially either the statement "Caution-federal law prohibits dispensing without prescription" or "Warning-may be habit forming."
(b) A drug intended for injection.
XIX. "Supervision" means under the direct charge or direction and does not contemplate absence of the person responsible for providing such supervision, except where permitted by rules of the board under RSA 318:5-a, XIV.
XIX-a. "TOEFL" is the Test of English as a Foreign Language, as administered by American College Testing (ACT), or its successor, and certified by the FPGEC.
XX. "Veterinarian" means a practitioner of veterinary medicine duly registered under the laws of this or some other state.
XXI. "Wholesaler" means a person with facilities in or outside this state who obtains drugs for distribution or delivery to persons other than consumers.
XXII. "Automated pharmacy system" means mechanical systems that perform operations or activities, other than compounding or administration, relative to the storage, packaging, dispensing, or distribution of medications, and which collects, controls, and maintains all transaction information.
XXIII. "Central prescription processing" means the processing by a pharmacy of a request from another pharmacy to fill or refill a prescription drug order or to perform processing functions, such as dispensing, drug utilization review, claims adjudication, refill authorizations, and therapeutic interventions.
XXIV. "Electronic transmission prescription" means both image transmissions of a prescription order for which a facsimile of the order is received by a pharmacy from a licensed prescriber, and data transmissions of a prescription order, other than an electronic image transmission prescription, that is electronically transmitted by computer link, modem, or other computer communication device from a licensed prescriber to a pharmacy.
XXIV-a. "Electronic signature" means an electronic sound, symbol, or process attached to or logically associated with a record and executed or adopted by a person with the intent to sign the record.
XXV. "Attending practitioner" means the physician or advanced practice registered nurse who has the primary responsibility for the treatment and care of the patient.
XXVI. "Collaborative pharmacy practice" means the practice of pharmacy whereby one or more pharmacists jointly agree, on a voluntary basis, to work in conjunction with one or more attending practitioners under written protocol whereby the collaborating pharmacist or pharmacists may perform medication therapy management authorized by the attending practitioner or practitioners under certain specified conditions and limitations.
XXVII. "Collaborative pharmacy practice agreement" means a written and signed specific agreement between a pharmacist and an attending practitioner, that provides for collaborative pharmacy practice for the purpose of medication therapy management for the patient.
XXVIII. "Medication therapy management" means the review of medication therapy regimens of patients by a pharmacist for the purpose of evaluating and rendering advice to a practitioner, or evaluating and modifying the medication regimen in accordance with the collaborative pharmacy practice agreement. Decisions involving medication therapy management shall be made in the best interest of the patient. Medication therapy management shall be limited to:
(a) Implementing, modifying, and managing medication therapy according to the terms of the collaborative pharmacy practice agreement;
(b) Collecting and reviewing patient histories within the context of needs for pharmacy practice;
(c) Obtaining and checking vital signs, such as pulse, temperature, blood pressure, and respiration;
(d) Ordering laboratory tests as specifically set out in the collaborative pharmacy practice agreement between the pharmacist and the attending practitioner that are specific to the medication or protocol-driven;
(e) Formulating a medication treatment plan that will be shared with the patient's attending practitioner;
(f) Monitoring and evaluating the patient's response to therapy, including safety and effectiveness;
(g) Performing a comprehensive medication review, in conjunction with the attending practitioner, to identify, resolve, and prevent medication-related problems, including adverse drug events;
(h) Documenting the care delivered and, if applicable, communicating essential information to the patient's other health care providers; and
(i) Providing education and training designed to enhance patient understanding and the appropriate use of his or her medications.
XXIX. "Reverse distributor" means a person or persons who facilitate the removal, disposal, or destruction of prescription drugs to persons other than consumers.
XXX. "Outsourcing facility" means a facility at one geographic location or address that is engaged in the compounding of sterile drugs, has elected to register as an outsourcing facility, and complies with all of the requirements of section 503B of the Federal Food, Drug, and Cosmetic Act.
XXXI. (a) "Research organization" means an entity, including a biotechnology company or research institute, whose primary goal is to conduct fundamental research, industrial research, or experimental development relating to drug products, disease and drug diagnostics, and/or drug manufacturing technologies.
(b) A "research organization" shall not include:
(1) A "sponsor," "sponsor-investigator," or "contract research organization" as such terms are defined in 21 C.F.R. section 312.3;
(2) An "applicant" as such term is defined in 21 C.F.R. section 314.3; a "manufacturer," "processor," "packer," or "distributor" as such terms are used in the Federal Food, Drug, and Cosmetic Act (21 U.S.C. section 301 et. seq.); or
(3) A "manufacturer" or "applicant" as such terms are used in 21 C.F.R. section 601.2.
XXXII. "Researcher" means a qualified person representing a research organization licensed by the board pursuant to RSA 318:51-f.
XXXIII. "Licensed advanced pharmacy technician" means a person licensed by the board who:
(a) May perform all functions allowed by federal or state law and approved by the board, under the supervision of a licensed pharmacist who is physically on premises and holds an unrestricted license issued by the board.
(b) May conduct product verification, process refills, verify repackaging of drugs, and perform other pharmacist tasks not required to be completed by a licensed pharmacist.
(c) May perform duties allowed by either certified or registered pharmacy technicians.
(d) Shall not interpret or evaluate a prescription or drug order, verify a compounded drug, or counsel or advise individuals related to the clinical use of a medication.
XXXIV. "Remote processing" means accessing the pharmacy database to perform non-dispensing activities other than at a licensed pharmacy. The pharmacy shall establish controls to protect the confidentiality and integrity of patient information, as required by HIPAA, and prevent any patient information from being downloaded, duplicated, or removed from the electronic database.
XXXV. "Non-dispensing activities" are activities permitted under that individual's scope of practice that do not require the physical possession of prescription drugs. Non-dispensing activities include, but are not limited to, prescription transfers, drug utilization reviews, product verification tasks, claims adjudications, refill authorizations, entering patient and prescription information into a pharmacy's electronic database, any other task permitted under that individual's scope of practice that does not require the physical possession of prescription drugs, or other activities established by rules of the board adopted pursuant to RSA 541-A.
XXXVI. "Nicotine cessation therapy" means medications which the United States Food and Drug Administration (FDA) classifies as available by prescription or without a prescription for the purpose of nicotine cessation.
XXXVII. "Permit holder" means the entity that owns or operates the pharmacy licensed to operate in the state and is responsible for the facility and overall operation of the pharmacy.
Source. 1921, 122:1. 1925, 84:1. PL 210:1. 1941, 140:1. RL 256:1. RSA 318:1. 1957, 72:1, 2. 1967, 82:1. 1973, 453:3. 1979, 155:1-9. 1981, 484:18, 19. 1985, 324:1. 1992, 245:1. 1993, 67:1; 78:1-3. 1994, 333:1-3. 1996, 267:20. 1997, 149:1-3. 1998, 67:2. 2000, 187:1; 188:1; 271:4. 2001, 15:1; 282:1-3. 2002, 281:1-3. 2005, 177:126, 127; 293:6. 2006, 164:1-3. 2007, 202:1-3. 2008, 217:1. 2009, 54:5. 2010, 74:1; 259:9. 2011, 63:3; 111:1. 2013, 105:3; 121:1, 2. 2014, 150:2, eff. Aug. 15, 2014. 2015, 180:2, 203:1, eff. July 1, 2015; 246:1, eff. Sept. 11, 2015. 2018, 205:1, eff. Aug. 7, 2018; 263:1, eff. June 12, 2018. 2019, 58:1, eff. July 1, 2019; 320:3, eff. Jan. 1, 2020. 2021, 76:1, eff. June 11, 2021; 121:3, eff. July 9, 2021; 189:3, eff. Jan. 1, 2022. 2022, 168:1, eff. Aug. 6, 2022; 341:3, eff. Aug. 3, 2022. 2023, 112:11, eff. July 1, 2023; 152:1, 6, eff. Sept. 26, 2023; 235:18, eff. Sept. 26, 2023.
Section 318:1-a
318:1-a Exceptions and Exemptions Not Required to be Negated. –
In any complaint, information, or indictment, and in any action or proceeding brought for the enforcement of any provision of this chapter, it shall not be necessary to negate any exception, excuse, proviso, or exemption contained herein, and the burden of proof of any such exception, excuse, proviso or exemption shall be upon the defendant.
Source. 1987, 181:4, eff. May 12, 1987.
Pharmacy Board
Section 318:2
318:2 Board. –
There shall be a pharmacy board consisting of 5 members; including 4 practicing pharmacists, at least one of whom shall be a full-time hospital pharmacist, and one public member, each to be appointed by the governor, with the approval of the council, to a term of 5 years. No member shall be appointed to more than 2 consecutive terms and no member shall serve for more than 10 consecutive years. Only board members provided for in this section shall have the authority to vote in board determinations. The public member shall be a resident of the state of New Hampshire who is not, and never has been, a member of the pharmacy profession or the spouse of any such person. The public member shall not have, and shall never have had, a material financial interest in either the provision of pharmaceutical services or an activity directly related to pharmaceutical services, including the representation of the board or its predecessor or the profession for a fee at any time during the 5 years preceding the date of appointment.
Source. 1921, 122:2. PL 210:2. RL 256:2. RSA 318:2. 1973, 453:13. 1979, 155:10. 1981, 484:3. 2009, 66:1, eff. Aug. 8, 2009. 2023, 79:304, eff. Sept. 1, 2023; 212:31, eff. Oct. 3, 2023.
Section 318:2-a
318:2-a Repealed by 2015, 276:108, IX, eff. July 1, 2015. –
Section 318:3
318:3 Eligibility. –
I. Pharmacist members of the board shall have been licensed pharmacists for at least 10 years, and at the time of their appointment shall have practiced pharmacy in this state for at least 5 years.
II. The public member of the board shall be a person who is not, and never was, a member of the pharmaceutical profession or the spouse of any such person, and who does not have, and never has had, a material financial interest in either the provision of pharmaceutical services or an activity directly related to pharmacy, including the representation of the board or profession for a fee at any time during the 5 years preceding appointment.
Source. 1921, 122:2. PL 210:3. RL 256:3. RSA 318:3. 1973, 453:1. 1981, 484:4, eff. July 1, 1981.
Section 318:4
318:4 Repealed by 2021, 197:105, I, eff. July 1, 2021. –
Section 318:5
318:5 Repealed by 2023, 79:318, I, eff. Sept. 1, 2023. –
Section 318:5-a
318:5-a Rulemaking Authority. –
The board shall adopt rules, pursuant to RSA 541-A, relative to:
I. [Repealed.]
II. The qualifications of applicants in addition to those requirements set by statute;
III. [Repealed.]
IV. How an applicant shall be examined, including:
(a) Time and place of examination;
(b) The subjects to be tested;
(c) Passing grade; and
(d) Disposition of examination papers;
IV-a. The standards for registering pharmacies and licensing pharmacists and the practice of pharmacy;
IV-b. The standards for licensure of research organizations;
V. [Repealed.]
VI. Ethical standards required to be met by each holder of any license issued under this chapter and how such license may be revoked for violation of these standards;
VII. [Repealed.]
VII-a. Continuing education requirements under this chapter;
VIII. [Repealed.]
IX. Standards for the inspection of licensees;
X. Registration or certification of pharmacy technicians, including:
(a) Requirements for registration or certification;
(b) The duties, functions, and standards of conduct of pharmacy technicians;
(c) Requirements for the supervision of pharmacy technicians by licensed pharmacists;
(d) Standards for denial and revocation of registration and certification;
(e) [Repealed.]
(f) Requirements for renewal of registration or certification; and
(g) Requirements for reinstatement of registration or certification.
XI. [Repealed.]
XI-a. Registration of pharmacy interns, including:
(a) Requirements for registration;
(b) The duties, functions, and standards of conduct of pharmacy interns;
(c) Requirements for the supervision of pharmacy interns by licensed pharmacists;
(d) Standards for denial and revocation of registration;
(e) [Repealed.]
(f) Requirements for renewal of registration; and
(g) Requirements for reinstatement of registration.
XI-b. [Repealed.]
XI-c. Licensure of advanced pharmacy technicians, including:
(a) Requirements for licensure, including experience and education requirements.
(b) The duties, functions, and standards of conduct of licensed advanced pharmacy technicians.
(c) Standards for the supervision of licensed advanced pharmacy technicians by licensed pharmacists.
(d) Standards for denial and revocation of licensure.
(e) [Repealed.]
(f) Requirements for renewal of a license.
(g) Requirements for reinstatement of a license.
XII. Procedures for the use, documentation, security, maintenance, and monitoring of automated pharmacy systems, including the placement of automated pharmacy systems in long-term care facilities, hospices, and state or county correctional institutions, for the purposes of storage and dispensing of controlled and non-controlled prescription drugs.
XIII. Standards for contracting, implementation, and operation of central prescription processing.
XIV. The adoption of protocols and procedures for the temporary absence of a pharmacist from a pharmacy while on duty.
XV. The requirements for the use of electronic transmission prescriptions, including the contents of such order and the verification of electronic signatures.
XVI. Procedures and protocols for emergency contraception drug therapy, pursuant to RSA 318:47-e.
XVII. The education and training standards and other requirements for pharmacists who, pursuant to prescriber-approved protocol:
(a) Administer prescription medications, including influenza immunizations.
(b) Engage in collaborative pharmacy practices.
XVIII. Disclosure and confidentiality relative to the New Hampshire Rx advantage program, pursuant to RSA 161-L:3.
XIX. Dispensing hormonal contraceptives in accordance with RSA 318:47-l.
XX. The standards and procedures for licensure of drug or device distribution agents.
Source. 1981, 484:5. 1985, 324:3. 1988, 106:1; 210:3. 2000, 188:2. 2001, 282:5, 6. 2002, 281:4. 2005, 131:2; 177:128, 129. 2006, 164:4. 2007, 202:5, 6; 297:9. 2013, 105:2, eff. Aug. 23, 2013. 2015, 203:2, 3, eff. July 1, 2015. 2018, 205:3, eff. Aug. 7, 2018. 2019, 58:2, eff. July 1, 2019; 264:2, eff. Sept. 17, 2019. 2021, 197:105, II, eff. July 1, 2021. 2023, 79:305, 306, I to IV, eff. Sept. 1, 2023; 212:32, I, eff. Oct. 3, 2023.
Section 318:5-b
318:5-b Completion of Survey; Rulemaking. –
The board shall adopt rules, pursuant to RSA 541-A, requiring, as part of the license renewal process, completion by licensees of a survey or opt-out form provided by the office of rural health, department of health and human services, for the purpose of collecting data regarding the New Hampshire primary care workforce, pursuant to the commission established in RSA 126-T. Any rules adopted under this section shall provide the licensee with written notice of his or her opportunity to opt-out from participation in the survey.
Source. 2017, 131:4, eff. June 16, 2017. 2019, 254:6, eff. July 1, 2019.
Section 318:6
318:6 Repealed by 2021, 197:105, III, eff. July 1, 2021. –
Section 318:6-a
318:6-a Repealed by 2023, 79:318, II, eff. Sept. 1, 2023. –
Section 318:7
318:7 Repealed by 2002, 254:5, IX, eff. July 1, 2002. –
Section 318:8
318:8 Enforcement of Law. –
It shall be the duty of the board, through officials and employees appointed by it or under its supervision for that purpose, and of all peace officers within the state, and of all county attorneys, to enforce all the provisions of this chapter. When so requested, the department of health and human services and its officials and employees shall cooperate with the board in collecting and analyzing samples of drugs and medicines sold, or suspected of being sold, in violation of this chapter. The members of the board, its inspectors and investigators shall have free access during business hours to all places where drugs, medicines, poisons or hypodermic devices are held, stored, or offered for sale and to all records of sale and disposition of drugs.
Source. 1921, 122:5. PL 210:8. 1931, 123:1. RL 256:8. RSA 318:8. 1965, 275:2. 1981, 484:18. 1985, 324:4. 1995, 310:181, eff. Nov. 1, 1995.
Section 318:8-a
318:8-a Inspection and Regulation of Certain Users of Prescription Drugs. –
All physicians, veterinarians, dentists, advanced registered nurse practitioners, physician assistants, and clinics under contract to the department of health and human services and agricultural, technical, or industrial users of prescription drugs shall be subject to inspection and regulation by the board of pharmacy with regard to the storage, labeling, distribution, and disposal of prescription drugs.
Source. 1988, 158:1. 1994, 333:4. 1995, 310:181. 1998, 67:3, eff. July 11, 1998.
Section 318:9
318:9 Repealed by 2015, 276:108, X, eff. July 1, 2015. –
Section 318:9-a
318:9-a Inspectional Services. –
The office of professional licensure and certification shall provide inspectional services under this chapter and RSA 318-B:25 to the board of medicine, the board of veterinary medicine, the board of podiatry, the board of registration in optometry, the board of dental examiners, the board of nursing, and the naturopathic board of examiners. Pharmacy board inspections shall be provided by pharmacists or pharmacy technicians licensed by the New Hampshire board of pharmacy who have training and experience regarding pharmacy statutes and rules.
Source. 1985, 363:2. 1993, 333:1. 1994, 333:5. 1995, 286:26. 2013, 144:106, eff. July 1, 2013. 2018, 80:11, eff. July 24, 2018. 2021, 197:102, eff. July 1, 2021. 2023, 79:307, eff. Sept. 1, 2023.
Section 318:10
318:10 Examinations. –
The board shall hold meetings for the granting of licenses and the transaction of other business at least quarterly, and at such time and place as they may see fit. They shall evaluate through an examination all persons, in the art and science of pharmacy and its allied branches, who meet the requirements herein provided and who make application for licensure as licensed pharmacists.
Source. 1921, 122:6. PL 210:10. RL 256:10. RSA 318:10. 1981, 484:18, 20. 2010, 259:1, eff. July 6, 2010.
Section 318:11
318:11 Repealed by 2021, 197:105, IV, eff. July 1, 2021. –
Licensed Pharmacists
Section 318:12
318:12 Repealed by 1988, 158:5, I, eff. June 21, 1988. –
Section 318:13
318:13 Repealed by 1988, 158:5, II, eff. June 21, 1988. –
Section 318:13-a
318:13-a Filling of Prescriptions. –
No licensed pharmacist shall face non-disciplinary or disciplinary action by the pharmacy board for filling a valid prescription for an off-label use.
Source. 2022, 306:4, eff. July 1, 2022.
Section 318:14
318:14 Pharmacy. –
A licensed pharmacist shall have the right to conduct a pharmacy for the compounding, according to the provisions of RSA 318:14-a, of medicines upon physicians', dentists', optometrists', podiatrists', veterinarians', advanced practice registered nurses', naturopathic doctors', and physician assistants' prescriptions or valid orders for the sale and distribution of drugs, medicines, and poisons.
Source. 1921, 122:8. PL 210:14. RL 256:14. RSA 318:14. 1981, 484:19. 1994, 333:6. 2010, 259:2. 2013, 121:3, eff. Jan. 1, 2014.
Section 318:14-a
318:14-a Compounding. –
I. Products that are not commercially available may be compounded for hospital or office use but shall not be resold or dispensed. Nonprescription items may be compounded upon order by a practitioner for sale as long as the labeling complies with RSA 318:47-a and the product is not a copy of, or similar to, prescription or nonprescription products. Except as provided in rules adopted under paragraph V for veterinarians, all compounding shall be done in compliance with the United States Pharmacopeia as defined by board of pharmacy rules.
II. The compound drug product shall bear the label of the pharmacy responsible for compounding and dispensing the product directly to the patient for administration, and the prescription shall be filed at that pharmacy. Compounded prescription labels shall include the phrase "compounded per subscriber request" or a similar statement on the prescription label or through the use of an auxiliary label attached to the prescription container.
III. A pharmacist shall offer a compounded drug product to a practitioner for administration to an individual patient, in limited quantities. The compounded drug products are for practitioner administration only and shall not be re-dispensed. The pharmacist shall maintain records to indicate what compounded drug products were provided to the medical office or practice. Compounding pharmacies may advertise or otherwise promote the fact that they provide prescription compounding services, in accordance with state law and rules of the board, as well as applicable federal laws.
IV. Where a commercial drug shortage exists because a manufacturer is the only entity currently manufacturing a drug product of a specific strength, dosage form, or route of administration for sale in the United States, and the manufacturer cannot supply the drug product to the public or to practitioners for use, a pharmacist may compound a limited quantity using the active pharmaceutical ingredient and sell to a patient with a valid prescription from a valid prescriber. When the compounded drug product is sold to a medical office or practice it is for the practitioner to administer to patients, and shall not be for resale.
V. The board shall adopt rules under RSA 541-A concerning the regulation of compounding, including exceptions for veterinarians from compliance with the United States Pharmacopeia chapter 797.
VI. Labeling requirements pursuant to paragraph II shall not apply when medication is dispensed to institutionalized patients as provided under RSA 318:47-b.
Source. 2013, 121:4, eff. Jan. 1, 2014. 2019, 296:1, 2, eff. Sept. 27, 2019.
Section 318:14-b
318:14-b COVID-19 Testing. –
Pharmacists may administer COVID-19 testing if the following conditions are met:
I. The pharmacist received adequate education and training to initiate, order, administer, and analyze COVID-19 test kits.
II. The COVID-19 tests are administered at a pharmacy that holds the appropriate clinical certificate under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) and a New Hampshire laboratory license issued by the department of health and human services (DHHS) or DHHS waiver.
III. The pharmacy creates and implements policies and procedures to address the collection, storage, transport, and analysis of samples collected as a result of administering and analyzing COVID-19 test kits. Such policies and procedures shall be in accordance with the manufacturer's instructions and supplemented as needed.
Source. 2021, 121:4, eff. July 9, 2021.
Section 318:15
318:15 Repealed by 1979, 155:31, eff. Aug. 5, 1979. –
Section 318:15-a
318:15-a Pharmacy Technician. –
No person shall perform the functions or duties of a pharmacy technician unless such person is either registered by the board to perform certain functions or, upon completion of training, certified to perform certain functions, and does so under standards of supervision established by rules of the board adopted pursuant to RSA 541-A.
Source. 2000, 188:4. 2007, 202:8, eff. Jan. 1, 2008.
Section 318:15-b
318:15-b Pharmacy Interns. –
No person shall perform the functions or duties of a pharmacy intern unless such person is registered by the office of professional licensure and certification to perform certain functions, and does so under standards of supervision established by rules of the board adopted pursuant to RSA 541-A.
Source. 2013, 105:1, eff. Aug. 23, 2013. 2023, 79:308, eff. Sept. 1, 2023.
Section 318:15-c
318:15-c Licensed Advanced Pharmacy Technician. –
I. No person employed as a licensed advanced pharmacy technician shall perform the functions or duties of a licensed advanced pharmacy technician as defined in RSA 318:1, XXXIII unless such person is issued a license by the board and does so under standards of supervision established by rules of the board adopted pursuant to RSA 318:5-a, XI-c.
II. When a pharmacy employs a licensed advanced pharmacy technician, in addition to dispensing prescriptions the pharmacist shall provide clinical services and the pharmacy owner shall provide the resources necessary for the pharmacist to safely provide the clinical services as determined in rules adopted by the board.
III. Nothing in this section shall require a pharmacy to employ a licensed advanced pharmacy technician.
Source. 2019, 58:3, eff. July 1, 2019.
Section 318:15-d
318:15-d Remote Processing. –
I. New Hampshire licensed pharmacists, certified New Hampshire pharmacy technicians, or registered New Hampshire pharmacy interns may engage in remote processing, provided that all work requiring pharmacist supervision is supervised by a licensed pharmacist through electronic or other remote means.
II. Notwithstanding the above, the board may allow registered technicians to perform remote processing activities after completion of a board-approved training program on remote processing.
Source. 2021, 76:2, eff. June 11, 2021.
Section 318:16
318:16 Special Permits. –
In case of death or under extreme conditions, the board may, in its discretion, issue a special permit to operate a pharmacy in a manner and under conditions that will safeguard the interests of the public for a period not to exceed 60 days.
Source. 1921, 122:9. PL 210:16. RL 256:16. RSA 318:16. 1981, 484:18, eff. July 1, 1981.
Section 318:16-a
318:16-a Standards for Collaborative Pharmacy Practice. –
I. For a pharmacist to participate in a collaborative pharmacy practice agreement, the pharmacist shall:
(a) Hold an unrestricted and current license to practice as a pharmacist in New Hampshire.
(b) Have at least $1,000,000 of professional liability insurance coverage.
(c) Have the knowledge base necessary for proper monitoring, including, but not limited to, associated disease states, relevant laboratory tests, adverse events, drug and food interactions, safety, and efficacy. Depending upon the complexity of the services being provided, the pharmacist may be required to have additional credentials or training and shall demonstrate the receipt of approval by the board of pharmacy.
II. Any practitioner with prescriptive authority who holds an active, unrestricted license in the state of New Hampshire may enter into a collaborative pharmacy practice agreement. A service authorized by a practitioner to be performed by a pharmacist under a collaborative pharmacy practice agreement must be within the practitioner's current scope of practice.
III. Collaborative pharmacy practice agreements may be between single or multiple pharmacists and a single or multiple practitioners.
IV. Collaborative pharmacy practice agreements shall meet the following general requirements:
(a) Each protocol developed pursuant to the collaborative pharmacy practice agreement shall contain detailed direction concerning the services that the pharmacist may perform for patients. The protocol shall include, but not be limited to:
(1) The specific drug or drugs to be managed by the pharmacist.
(2) The terms and conditions under which drug therapy may be implemented, modified, or discontinued.
(3) The conditions and events upon which the pharmacist is required to notify the collaborating practitioner and the manner and time frame in which notification will occur.
(4) The laboratory tests that may be ordered in accordance with medication therapy management.
(5) Activities which may be performed by the pharmacist in conjunction with the protocol, which shall be documented as specified in the protocol.
(6) A statement of the expected amount of time the pharmacist will dedicate to performing duties specified under the protocol.
(b) Collaborative pharmacy practice agreements shall state the beginning and ending dates of the period of time during which the agreement is in effect, and may be terminated, in writing, by either party at any time. Collaborative pharmacy practice agreements shall be renewed at a minimum every 2 years. When collaborative pharmacy practice agreements are terminated, the patient shall be informed and provided with details to allow for the uninterrupted continuation of their medication therapy management regimen.
(c) Ongoing metrics for quality assurance and safety monitoring shall be agreed upon by the practitioner and pharmacist and shall be included in the collaborative practice agreement. These metrics shall be consistent with metrics adopted or enforced by regulatory bodies.
V. Supervision of the collaborative pharmacy practice agreement shall include:
(a) Protocols developed based on evidence-based guidelines for best practices.
(b) The referring practitioner receiving progress visit notes from each patient encounter in a time specified in the agreement.
(c) The referring practitioner providing supervision for the treatment management of the referred patient.
(d) The retention on file of the collaborative pharmacy practice agreement and protocols at the pharmacist's place of practice and at the practitioner's administrative office or place of practice, which shall be available upon request.
VI. Neither the attending practitioner nor the pharmacist in a collaborative practice pharmacy agreement may seek to gain personal financial benefit by participating in any incentive-based program or accept any inducement that influences or encourages therapeutic or product changes or the ordering of tests or services.
Source. 2006, 164:6, eff. July 23, 2006. 2016, 214:1, eff. Aug. 6, 2016.
Section 318:16-b
318:16-b Pharmacist Administration of Vaccines. –
A pharmacist, pharmacy intern, licensed advanced pharmacy technician, or certified pharmacy technician, under the supervision of an on-site immunizing pharmacist may administer influenza and a COVID-19 vaccine, if available, to the general public. A pharmacist, pharmacy intern, or licensed advanced pharmacy technician, under the supervision of an on-site immunizing pharmacist may administer haemophilus influenza, hepatitis A, hepatitis B, hepatitis A and B, human papillomavirus, meningococcal, pneumococcal, tetanus and diphtheria, varicella, zoster, RSV (respiratory syncytial virus), MMR (measles, mumps, and rubella), and Tdap (tetanus, diphtheria and pertussis) vaccines, which have been approved by the Food and Drug Administration, to individuals 18 years of age or older as ordered by an immunizing pharmacist. The pharmacist, pharmacy intern, licensed advanced pharmacy technician, or certified pharmacy technician shall:
I. Hold a current license to practice as a pharmacist, be registered as a pharmacy intern under RSA 318:15-b in New Hampshire, or be licensed as a licensed advanced pharmacy technician under RSA 318:15-c, or be a certified pharmacy technician and registered with the board pursuant to RSA 318:15-a.
II. Possess at least $1,000,000 of professional liability insurance coverage.
III. In order to administer vaccines, have completed training specific to administration of the respective vaccines that includes programs approved by the Accreditation Council for Pharmacy Education (ACPE) or curriculum-based programs from an ACPE-accredited college of pharmacy or state or local health department programs or programs recognized by the board. This training shall include hands-on injection technique and the recognition and treatment of emergency reactions to vaccinations.
IV. Have a current certificate in basic cardiopulmonary resuscitation.
V. Provide to the board evidence of compliance with paragraphs I- IV.
VI. Provide notice to the primary care provider, when designated by the patient, of the administration of any vaccine.
VII. Record the vaccination in the state vaccine registry in accordance with RSA 141-C:20-f and/or when required by state and federal law and maintain a record of the vaccination as required by state and federal law.
VIII. Submit reports of any adverse reactions following vaccination to the Centers for Disease Control (CDC) Vaccine Adverse Event Reporting System (VAERS).
IX. Review the vaccine registry or other vaccination records before administering the vaccination.
Source. 2008, 283:1. 2011, 213:1, eff. Aug. 26, 2011. 2017, 51:1, eff. July 11, 2017. 2020, 39:58, eff. July 29, 2020. 2021, 192:1, eff. Nov. 8, 2021. 2022, 274:1, eff. Sept. 22, 2022. 2023, 53:1, eff. June 1, 2023.
Section 318:16-c
318:16-c Repealed by 2015, 190:3, eff. Nov. 2, 2015. –
Section 318:16-d
318:16-d Repealed by 2021, 192:2, eff. Nov. 8, 2021. –
Section 318:16-e
318:16-e Repealed by 2023, 79:318, III, eff. Sept. 1, 2023. –
Section 318:16-f
318:16-f Repealed by 2022, 274:2, eff. Sept. 22, 2022. –
Examinations and Licenses
Section 318:17
318:17 Repealed by 1981, 484:22, I, eff. July 1, 1981. –
Section 318:18
318:18 Pharmacists. –
I. (a) An applicant for examination and licensure as a pharmacist shall have graduated with the basic, professional pharmacy baccalaureate degree or pharmacy doctor degree from a school of pharmacy, college of pharmacy, or pharmacy department of a university approved by the board including programs accredited by the American Council on Pharmaceutical Education or the Canadian Council for Accreditation of Pharmacy Programs or, if a graduate of a foreign school or college of pharmacy other than Canadian, the applicant shall be fully certified by the Foreign Pharmacy Graduate Equivalency Committee (FPGEC) which shall include passing the Foreign Pharmacy Graduate Equivalency Examination (FPGEE) and Test of English as a Foreign Language (TOEFL), with scores approved by the board of pharmacy as set forth in the rules.
(b) In addition to the above, all applicants for examination and licensure as a pharmacist shall:
(1) Not be less than 18 years of age;
(2) Be of good professional character and temperate habits; and
(3) File proof satisfactory to the office of professional licensure and certification, substantiated by proper affidavits, of a minimum of one year (1,500 hours) internship activity in a community or institutional pharmacy in the United States or Canada or an equivalent program which has been approved by the board of pharmacy; and shall pass the national examination administered by the National Association of Boards of Pharmacy (NABP) to establish his or her fitness to practice the profession of pharmacy. The internship required in this section shall be service and experience in a community or institutional pharmacy under the supervision of a licensed pharmacist and shall be predominantly related to the selling of drugs and medical supplies; interpreting, compounding, preparing and dispensing of prescriptions; preparing of pharmaceutical products; keeping records and making reports required under federal and state statutes; and otherwise practicing pharmacy under the immediate supervision and direction of a licensed pharmacist.
II. The office of professional licensure and certification may deny licensure as a pharmacist for grounds which include, but which shall not be limited to, prior conviction of a felony; or of a misdemeanor resulting from a violation of a federal, state or local drug or pharmacy-related law, rule, or regulation.
Source. 1921, 122:11. 1925, 84:2. PL 210:18. RL 256:18. 1949, 280:3. RSA 318:18. 1969, 276:1. 1973, 72:68. 1979, 155:16. 1981, 484:7, 20. 1985, 324:5. 1988, 106:2. 1997, 149:4. 2001, 282:4. 2010, 259:3, eff. July 6, 2010. 2023, 79:309, 310, eff. Sept. 1, 2023.
Section 318:18-a
318:18-a Prior Registration. –
Any person registered as a pharmacist in this state on January 1, 1977, shall have all the rights granted to pharmacists under this chapter, as long as such person complies with the licensing requirements of this chapter.
Source. 1988, 158:2, eff. June 21, 1988.
Section 318:19
318:19 Examinations. –
Applicants for licensure as pharmacists shall, to prove their respective requisite knowledge, be examined to a properly varying degree in pharmacy-related subject areas which may include chemistry, math, pharmacology, pharmacy theory, the practice of pharmacy and pharmacy law, and any other areas as the board may prescribe.
Source. 1921, 122:13. PL 210:20. RL 256:20. 1949, 280:1, 2. 1981, 484:18, 20. 1985, 324:6, eff. Jan. 1, 1986.
Section 318:20
318:20 Impersonating Applicant. –
I. No one shall impersonate an applicant before the board of pharmacy applying for licensure under the provisions of this chapter.
II. No third party shall sign an application, complete an application, call to check on the status of an application, or submit an application and documentation on behalf of an applicant.
III. No third party shall complete an online renewal, paper renewal, or make any changes or updates to an original application on behalf of an applicant.
IV. Authorization and release forms shall not be accepted as a form of release.
Source. 1921, 122:14. PL 210:21. RL 256:21. RSA 318:20. 1981, 484:18, 20, eff. July 1, 1981. 2019, 264:3, eff. Sept. 17, 2019.
Section 318:21
318:21 Repealed by 2023, 79:318, IV, eff. Sept. 1, 2023. –
Section 318:22
318:22 Repealed by 2010, 259:11, eff. July 6, 2010. –
Section 318:23
318:23 Repealed by 2023, 79:318, V, eff. Sept. 1, 2023. –
Section 318:24
318:24 Repealed by 1979, 155:32, eff. Aug. 5, 1979. –
Section 318:25
318:25 Repealed by 2023, 79:318, VI, eff. Sept. 1, 2023. –
Section 318:26
318:26 Repealed by 2023, 79:318, VII, eff. Sept. 1, 2023. –
Section 318:26-a
318:26-a Change in Name, Employment, or Residence. –
Any pharmacist, licensed advanced pharmacy technician, or pharmacy technician who changes his or her name, place or status of employment, or residence shall notify the office of professional licensure and certification in writing within 15 days. For failure to report such a change within 15 days, the board may suspend the pharmacist's license, the advanced pharmacy technician's license, or the pharmacy technician's registration. Reinstatement shall be made only upon payment of a reasonable fee as established by the board.
Source. 1979, 155:21. 1981, 484:18, 21. 1985, 324:8. 2010, 259:5, eff. July 6, 2010. 2019, 58:5, eff. July 1, 2019. 2023, 79:311, eff. Sept. 1, 2023.
Section 318:27
318:27 Repealed by 1979, 155:33, eff. Aug. 5, 1979. –
Section 318:28
318:28 Display of Licenses. –
All licenses as pharmacists shall at all times be conspicuously displayed in the pharmacy where the licensee is engaged as such.
Source. 1921, 122:18. PL 210:29. RL 256:29. 1949, 280:1, 2. RSA 318:28. 1973, 453:5. 1981, 484:21, eff. July 1, 1981.
Section 318:29
318:29 Repealed by 2023, 79:318, VIII, eff. Sept. 1, 2023. –
Section 318:29-a
318:29-a Impaired Pharmacist Program. –
I. Any pharmaceutical peer review committee may report relevant facts to the board or office of professional licensure and certification relating to the acts of any pharmacist in this state if they have knowledge relating to the pharmacist which, in the opinion of the peer review committee, might provide grounds for disciplinary action as specified in RSA 318:29, II.
II. Any committee of a professional society comprised primarily of pharmacists, its staff, or any district or local intervenor participating in a program established to aid pharmacists impaired by substance abuse or mental or physical illness may report in writing to the board or office of professional licensure and certification the name of the impaired pharmacist together with the pertinent information relating to his impairment. The board or office of professional licensure and certification may report to any committee of such professional society or the society's designated staff information which it may receive with regard to any pharmacist who may be impaired by substance abuse or mental or physical illness.
III. Notwithstanding the provisions of RSA 91-A, the records and proceedings of the board, compiled in conjunction with an impaired pharmacist peer review committee, shall be confidential and are not to be considered open records unless the affected pharmacist so requests; provided, however, the board may disclose this confidential information only:
(a) In a disciplinary hearing before the board or in a subsequent trial or appeal of a board action or order;
(b) To the pharmacist licensing or disciplinary authorities of other jurisdictions; or
(c) Pursuant to an order of a court of competent jurisdiction.
IV. (a) No employee or member of the board, peer review committee member, pharmaceutical organization committee member, pharmaceutical organization district or local intervenor furnishing in good faith information, data, reports, or records for the purpose of aiding the impaired pharmacist shall by reason of furnishing such information be liable for damages to any person.
(b) No employee or member of the board or such committee, staff, or intervenor program shall be liable for damages to any person for any action taken or recommendations made by such board, committee, or staff unless he is found to have acted recklessly or wantonly.
V. The office of professional licensure and certification may contract with other organizations to operate the impaired pharmacist program for pharmacists who are impaired by drug or alcohol abuse or mental or physical illness. This program shall include, but is not limited to, education, intervention and post-treatment monitoring.
Source. 1985, 324:11. 1992, 20:1. 2014, 311:1, eff. Jan. 1, 2015. 2019, 264:6, eff. Sept. 17, 2019. 2023, 79:312, eff. Sept. 1, 2023.
Section 318:29-b
318:29-b Repealed by 2023, 79:318, IX, eff. Sept. 1, 2023. –
Section 318:29-c
318:29-c Repealed by 2023, 79:318, X, eff. Sept. 1, 2023. –
Section 318:29-d
318:29-d Pharmacists Not Liable. –
A pharmacist who dispenses drugs to a midwife certified under RSA 326-D shall not be liable for any adverse reactions caused by any method of use by the midwife.
Source. 1999, 213:3, eff. July 6, 1999.
Section 318:30
318:30 Repealed by 2023, 79:318, XI, eff. Sept. 1, 2023. –
Section 318:30-a
318:30-a Repealed by 2023, 79:318, XII, eff. Sept. 1, 2023. –
Section 318:31
318:31 Repealed by 2023, 79:318, XIII, eff. Sept. 1, 2023. –
Section 318:32
318:32 Repealed by 1981, 484:22, II, eff. July 1, 1981. –
Conferences of Boards, Etc.
Section 318:33
318:33 Repealed by 2023, 79:318, XIV, eff. Sept. 1, 2023. –
Section 318:34
318:34 Repealed by 1981, 484:22, III, eff. July 1, 1981. –
Section 318:35
318:35 Repealed by 2023, 79:318, XV, eff. Sept. 1, 2023. –
Section 318:36
318:36 Repealed by 2023, 79:318, XVI, eff. Sept. 1, 2023. –
Licensure of Pharmacies
Section 318:37
318:37 Required; Compliance. –
I. No person shall conduct or operate a pharmacy for the sale at retail of drugs and medicines unless such pharmacy is registered with and a permit therefor has been issued by the office of professional licensure and certification in accordance with rules adopted by the pharmacy board, except as provided in this chapter.
II. (a) No person shall conduct or operate a mail-order pharmacy located outside of this state by shipping, mailing, or delivering prescription drugs into this state unless such pharmacy is registered in New Hampshire and a permit has been issued by the New Hampshire pharmacy board.
(b) To obtain a permit, a mail-order pharmacy shall comply with each of the following:
(1) Maintain a license in good standing from the state in which the mail-order pharmacy is located;
(2) Submit to the New Hampshire office of professional licensure and certification an application for registration ;
(3) Pay all appropriate registration fees;
(4) Submit to the New Hampshire office of professional licensure and certification a copy of the state pharmacy license from the state in which the mail-order pharmacy is located;
(5) Submit to the New Hampshire office of professional licensure and certification a copy of the state and federal controlled substance registrations from the state in which it is located, if controlled substances are to be shipped into this state.
(c) When requested to do so by the New Hampshire pharmacy board, each mail-order pharmacy shall supply the New Hampshire pharmacy board with any inspection reports, warning notices, disciplinary actions, notice of deficiency reports, or any other related reports from the state in which it is located concerning the operation of a mail-order pharmacy for review of compliance with state and federal drug laws.
(d) Except in emergencies that constitute an immediate threat to the public health and require expedited action by the board, the New Hampshire pharmacy board shall file a complaint with the licensing board of the state in which the mail-order pharmacy is located when known or suspected violations of the laws of the state in which the pharmacy is located are uncovered. If the licensing board in the state in which the mail-order pharmacy is located initiates disciplinary action, the New Hampshire pharmacy board may request the appropriate documents involved in the action for consideration of discipline against the pharmacy registration of the mail-order pharmacy. If no action is taken against the mail-order pharmacy by the licensing board of the state in which it is located, the New Hampshire pharmacy board may request copies of any investigation reports available from that state.
(e) The New Hampshire pharmacy board shall extend reciprocal cooperation to any state that licenses and regulates mail-order pharmacies for the purpose of investigating complaints against pharmacies located in New Hampshire or the sharing of information and investigative reports, as long as the other state shall extend the same reciprocal cooperation to the New Hampshire pharmacy board.
Source. 1921, 122:24. PL 210:38. RL 256:38. RSA 318:37. 1973, 453:6. 1979, 155:27. 1981, 484:18. 2000, 187:2, eff. Oct. 1, 2000. 2021, 197:103, eff. July 1, 2021. 2023, 79:313, eff. Sept. 1, 2023.
Section 318:37-a
318:37-a Repealed by 2021, 121:10, II, effective Jan. 31, 2022. –
Section 318:38
318:38 Repealed by 2023, 79:318, XVII, eff. Sept. 1, 2023. –
Section 318:39
318:39 Application; Display. –
Application for a permit shall be made in such manner and in such form as the board may determine. The permit shall at all times be exposed in a conspicuous place in the pharmacy for which it is issued.
Source. 1921, 122:26. PL 210:40. 1931, 123:3. RL 256:40. RSA 318:39. 1973, 453:8, eff. Aug. 29, 1973.
Regulation of Pharmacies
Section 318:40
318:40 Unauthorized Practice of Pharmacy. –
Except as provided by RSA 318:42, no person shall engage in the practice of pharmacy without first being licensed by the board. No person shall impersonate a pharmacist or falsely claim to be a pharmacist. No person owning, managing, or conducting any store, not being a licensed pharmacist or having one in his employ, shall exhibit within or outside of such store, or include in any advertisement, the words "drug store", "pharmacy", "apothecary", "drug", "drugs", "medicine", or "medicine shop", or any combination of these terms or other words indicating that such store is a place where medicines are compounded or sold, or exhibit within or without his place of business or in connection with his business any show bottle or globe of colored glass or globe filled with colored liquid which creates the impression that prescription drugs are being offered for sale.
Source. 1921, 122:23. 1925, 84:5. PL 210:41. 1931, 123:4. 1933, 61:1. RL 256:41. RSA 318:40. 1973, 528:202. 1988, 158:3, eff. June 21, 1988.
Section 318:41
318:41 Books and Equipment. –
Each pharmacy shall be equipped with those pharmaceutical utensils, technical equipment and professional references which the board deems necessary for the safe, effective practice of pharmacy. The prescribed equipment and references shall be open to the inspection of the board and its representatives. No pharmacy permit shall be issued or renewed until the pharmacy complies with the provisions of this section, and the board may suspend or revoke a pharmacy permit whenever the pharmaceutical utensils or equipment or the professional references fail to conform with the prescribed list.
Source. 1921, 122:21. PL 210:42. 1939, 43:1. RL 256:42. RSA 318:41. 1973, 453:9. 1979, 155:29. 1981, 484:18, eff. July 1, 1981.
Section 318:42
318:42 Dealing in or Possessing Prescription Drugs. –
It shall be unlawful for any person who is not a licensed pharmacist in a pharmacy registered in accordance with the provisions of this chapter to manufacture, compound, dispense, sell, offer for sale or have in possession any prescription drug as defined in RSA 318:1, XVII, provided that this section shall not prevent the following:
I. Persons from possessing prescription drugs dispensed to them pursuant to a lawful prescription or who are acting as an authorized agent for a person holding a lawful prescription. For purposes of this section, an authorized agent shall mean any person, including but not limited to a family member or caregiver, who has the intent to deliver the prescription drug to the person to whom the prescription drugs are lawfully prescribed.
II. Physicians, dentists, optometrists, podiatrists, veterinarians, advanced practice registered nurses, naturopathic doctors, and physician assistants from possessing, compounding in accordance with RSA 318:14-a, personally administering, or distributing prescription drugs to meet the immediate medical needs of their patients. For advanced practice registered nurses and physician assistants, compounding shall be limited according to RSA 318:42, VIII.
(a) Nothing in this section shall prohibit the dispensing of noncontrolled prescription drugs by an authorized agent of a veterinarian for an animal under the agent's care, provided that the drugs were compounded by or under the supervision of the licensed veterinarian.
(b) Nothing in this section shall prohibit the dispensing or sale by an ophthalmologist of therapeutic contact lenses or the dispensing or sale by an optometrist of therapeutic contact lenses pursuant to RSA 327:6-a.
(c) Nothing in this section shall prohibit a dental hygienist from possessing, administering, dispensing, or prescribing a fluoride supplement, topically applied fluoride, and chlorhexidine gluconate oral rinse pursuant to RSA 317-A:21-c, I(g).
II-a. Midwives certified pursuant to RSA 326-D, from obtaining, possessing, or administering prescription drugs to meet the immediate medical needs of their patients. Such authority to obtain, possess, or administer shall be limited to those drugs listed in RSA 326-D:12. Nothing shall prohibit a pharmacist, in good faith, from selling and dispensing drugs listed in RSA 326-D:12 to midwives certified pursuant to RSA 326-D.
III. The sale of prescription drugs by licensed manufacturers or wholesalers to persons or entities legally authorized to possess such drugs.
IV. The possession of prescription drugs for such agricultural, technical, or industrial uses as may be approved by the board, the Federal Drug Enforcement Administration, or by other state or federal statutes or regulations.
V. The sale and distribution of nonprescription drugs as defined in RSA 318:1, XVIII by non-pharmacy retail stores and outlets. Retail stores and outlets engaging in the sale and distribution of such items shall not be deemed to be improperly engaged in the practice of pharmacy. No rule shall be adopted by the board under this chapter which shall require the sale of nonprescription drugs by a licensed pharmacist or under the supervision of a licensed pharmacist. The commissioner of the department of health and human services may make a determination that a specific product may only be dispensed upon a written prescription of a practitioner.
VI. The department of health and human services from possessing and distributing "biological drugs" to the public within the meaning of RSA 141-C:17.
VII. The dispensing of noncontrolled prescription drugs at a clinic by a licensed health professional legally authorized to administer immunizations or dispense medications, or by registered nurses in clinics of nonprofit family planning agencies under contract with the department of health and human services, provided that:
(a) The drugs are dispensed under a written protocol established by a licensed physician, physician assistant, or by an advanced practice registered nurse, which provides for responsible supervision over the activities in question and mentions the name of each health care provider for whom the physician, physician assistant, or advanced practice registered nurse is assuming supervisory responsibility. A written and signed copy of the protocol showing the date it was approved shall be kept at the clinic at all times and shall be made available during any inspection conducted under RSA 318:8.
(b) The drugs appear on the current vaccine schedule recommended by the federal advisory committee on immunization practices or the current formulary approved pursuant to RSA 326-B.
(c) The drugs are dispensed or administered only to bona fide clients of the clinic for their personal needs pursuant to written eligibility criteria established by the licensed physician, physician assistant, or advanced practice registered nurse who established the written and signed protocol.
(d) Nothing in this section shall be construed to negate any authority of the board of pharmacy pursuant to RSA 318:8.
(e) [Repealed].
VII-a. (a) The possession and administration, with written parental authorization, of flu vaccine, immunizations, and mantoux tests for the purpose of disease prevention and tuberculosis screening by registered nurses employed or contracted by public school systems.
(b) The possession and administration of epinephrine for the emergency treatment of anaphylaxis by licensed practical nurses or registered nurses employed or contracted by public school systems or by licensed campus medical professionals in postsecondary educational institutions or independent schools.
(c) The possession, provision, and administration of a bronchodilator, spacer, or nebulizer by a school nurse or designated unlicensed assistive personnel pursuant to RSA 200:53 through RSA 200:57.
VII-b. The management of medication therapy and administration of non-controlled prescription drugs including injectable medications, biologicals, and immunizations by qualified pharmacists pursuant to collaborative pharmacy practice agreements.
VIII. A registered nurse or physician assistant from:
(a) Making dilutions from concentrated solutions or pre-weighed or pre-measured packets.
(b) Adding prepared sterile additives.
(c) Reconstituting or diluting medications following manufacturers specific directions.
(d) Entering an institutional pharmacy in an institutional setting specially designated for this purpose by the institution in the absence of a pharmacist to obtain those drugs needed in an emergency situation.
IX. A pharmacy student serving an internship from performing the duties of a pharmacist in the presence of, and under the direction and supervision of, a licensed pharmacist.
X. The possession, for emergency use only, by emergency medical care providers licensed under RSA 153-A of such noncontrolled prescription drugs as are specified by the state emergency medical services medical control board, with the concurrence of the pharmacy board, provided that there has been prior establishment of medical control for possession of such drugs. The emergency medical care provider may only administer such prescription drugs upon receipt of orders to do so from a supervising physician or an emergency/trauma advanced practice registered nurse. Such orders may be transmitted either directly or by telephone or by radio or by other communication medium, or by standing order of local medical control delineated in a protocol as defined in RSA 153-A.
XI. A nurse licensed under RSA 326-B who is an employee of a home health care or hospice agency licensed pursuant to RSA 151:2, and is acting in the course of his or her employment, from possessing such noncontrolled prescription drugs as are approved by the board of nursing and agreed upon jointly by the board of registration in medicine and the pharmacy board and from administering such preapproved noncontrolled prescription drugs according to written protocols approved annually by such employer's professional advisory committee which includes a physician licensed by the board of registration in medicine.
XII. A registered or certified pharmacy technician from performing functions and duties supervised by a licensed pharmacist as authorized by rules adopted by the board under RSA 541-A.
XII-a. A registered or certified pharmacy technician from performing transport for the authorized transfer of prescription drugs between pharmacies.
XIII. A nurse licensed under RSA 326-B, who is an employee of a home health care or hospice agency licensed pursuant to RSA 151:2 and is acting in the course of employment, from organizing the prescription and nonprescription drugs of clients into containers designed to aid clients in carrying out a prescriber's directions, provided that the organizing of drugs is documented in the client's nursing record and that the original prescription containers remain in the client's possession.
XIV. A nurse, licensed under RSA 326-B, who is an employee of a health facility, licensed by the state of New Hampshire, and acting in the course of his or her employment, from organizing the prescription and non-prescription drugs of clients into containers designed to aid clients in carrying out prescriber's directions; provided, that the organizing of the drugs is documented in the client's nursing record and that the original prescriptions will be kept at the facility or client's home and the medication container is set up on a weekly basis.
XV. The placement of automated pharmacy systems in long-term care facilities, hospices, and state correctional institutions, for the purpose of storage and dispensing of controlled and non-controlled prescription drugs under the supervision and control of a licensed pharmacist. Only pharmacies registered by the Federal Drug Enforcement Administration may provide controlled substances for storage in and dispensing from automated pharmacy systems.
XVI. Law enforcement officers who are acting within the scope of their employment and official duties, from possessing prescription drugs for the purpose of collection, storage, and disposal of such prescription drugs, in conjunction with a pharmaceutical drug take-back program established pursuant to RSA 318-E.
XVII. Persons who possess prescription drugs pursuant to a lawful prescription or who are acting as an authorized agent for a person holding a lawful prescription, from delivering any unwanted or unused prescription drugs to law enforcement officers for the purpose of disposal of such prescription drugs in conjunction with a pharmaceutical drug take-back program established pursuant to RSA 318-E, or residents lawfully in possession of prescription drugs in long-term care facilities, nursing homes, or assisted living facilities, or persons lawfully acting as an authorized agent for said resident, from disposing of any discontinued, unused, unwanted, or expired prescription drug, including controlled drugs, in accordance with a drug take-back program set forth under RSA 318-E and any applicable federal or state laws or regulations.
XVIII. A research organization licensed by the board pursuant to RSA 318:51-f, and researchers representing such organization, from possessing prescription drugs for research operations.
Source. 1921, 122:27. PL 210:43. 1931, 123:5. 1941, 207:1. RL 256:43. 1949, 280:2. RSA 318:42. 1967, 82:2. 1973, 453:10. 1981, 484:19. 1988, 158:4. 1991, 189:1; 382:19. 1992, 245:2. 1993, 333:2. 1994, 333:8-10. 1995, 65:1; 286:26; 310:181, 182. 1996, 56:1; 267:21; 277:3. 1997, 326:2. 1998, 67:4, 5. 1999, 213:4; 345:7. 2000, 91:1; 188:5; 271:6, 7. 2001, 15:2. 2002, 281:7. 2003, 310:64. 2004, 49:1. 2005, 274:5; 293:7. 2006, 164:5. 2007, 202:9-11. 2009, 54:2, 5; 152:1. 2010, 37:1. 2011, 63:9. 2012, 36:1. 2013, 121:5, eff. Jan. 1, 2014. 2015, 45:2, eff. July 17, 2015; 203:4, eff. July 1, 2015. 2016, 42:2; 45:2 eff. July 2, 2016. 2019, 264:8, 9, eff. Sept. 17, 2019; 287:11, eff. July 19, 2019. 2023, 58:3, eff. July 31, 2023.
Section 318:42-a
318:42-a Automated Pharmacy Systems; Long-term Care Facilities, Hospices, or State Correctional Institutions. –
I. A pharmacy may provide pharmacy services to a long-term care facility or hospice licensed under RSA 151 or to a state correctional institution through the use of an automated pharmacy system that need not be located at the same location as the pharmacy.
II. The board shall adopt rules governing the use of an automated pharmacy system under this section, not later than January 1, 2022, which shall specify:
(a) Recordkeeping requirements;
(b) Security requirements; and
(c) Labeling requirements.
Source. 2021, 179:2, Pt. II, Sec. 1, eff. Sept. 28, 2021.
Section 318:43
318:43 Repealed by 1979, 155:34, eff. Aug. 5, 1979. –
Section 318:44
318:44 Repealed by 1979, 155:35, eff. Aug. 5, 1979. –
Section 318:45
318:45 Repealed by 2019, 264:15, I, eff. Sept. 17, 2019. –
Section 318:45-a
318:45-a Continuous Quality Improvement. –
I. Each licensed pharmacy shall establish a continuous quality improvement program (CQI). The purpose of the program shall be to assess errors that occur in the pharmacy during the review, preparation, and dispensing of prescription medications and to allow the pharmacy to take appropriate action to prevent or reduce the likelihood of a recurrence. The program is non-punitive and seeks to identify weaknesses in processes and systems, in order to make appropriate corrections to improve them.
II. A CQI program may be comprised of staff members of the pharmacy, including pharmacists, registered pharmacist interns, licensed advanced pharmacy technicians, registered pharmacy technicians, clerical staff, and other personnel deemed necessary by the permit holder or the consultant pharmacist of record.
III. A CQI program shall require that the permit holder or the consultant pharmacist of record ensure that a review of quality-related events occurs at least every 3 months, contain a planned process to record and assess quality related events, include a process for documenting actions to improve the quality of patient care, and maintain a summary of the documented actions. The review should consider environment and systems-based contributing factors.
IV. (a) The pharmacy shall either:
(1) Report incidents and unsafe events as quality-related events through a contracted patient safety organization (PSO) recognized by the Agency for Healthcare Research and Quality (AHRQ) whose primary mission is pharmacy continuous quality improvement; or
(2) Document incidents and unsafe events as quality-related events in an internal program in the pharmacy in a written record or computer database created solely for that purpose.
(b) The quality-related event shall be documented by the individual who discovers the event or the individual to whom it is initially reported. Documentation of quality-related events shall include a description of the event that is sufficient to permit categorization and analysis of the event. Pharmacies shall maintain such records at least until the event has been considered and incorporated in a summary of documented actions.
V. As a component of its CQI program, each licensed pharmacy shall assure that, following a quality-related event, all reasonably necessary steps have been taken to prevent or minimize patient harm.
VI. CQI programs shall be confidential. The summarization document shall analyze process improvements undertaken following a quality-related event. No patient names or employee names shall be included in this summarization. The summarization shall be maintained for 4 years and be made available within 3 business days of a request by the board's inspectors. Continuous quality improvement records shall be considered peer-review documents and not subject to discovery in civil litigation or administrative actions.
VII. The board may establish by rules adopted under RSA 541-A program requirements and recordkeeping requirements of a pharmacy CQI program.
Source. 2017, 221:1, eff. Sept. 8, 2017. 2019, 58:6, eff. July 1, 2019. 2023, 152:4, eff. Sept. 26, 2023.
Section 318:46, 318:47
318:46, 318:47 Repealed by 2019, 264:15, II, eff. Sept. 17, 2019. –
Section 318:47-a
318:47-a Prescription Labels. –
Whenever a pharmacist dispenses a noncontrolled drug pursuant to a prescription, he or she shall affix to the container in which such drug is dispensed a label that meets the requirements of the New Hampshire board of pharmacy; the prescription identification number assigned by the pharmacy; the date dispensed; any directions as may be stated on the prescription; the name of the prescribing practitioner; the name of the patient; all pertinent auxiliary labels; and, unless otherwise indicated by the prescribing physician, dentist, veterinarian, or advanced practice registered nurse, the name, strength, and quantity of the drug dispensed. All drugs dispensed to a patient that have been filled using a centralized prescription processing system shall bear a label containing an identifiable code that provides a complete audit trail of the dispensing of the drug and pharmaceutical care activities. A biological product, as defined in RSA 318:47-dd, I, shall also be labeled as provided in RSA 318:47-dd, VII. No person shall alter, deface, or remove any label so affixed. A compounded drug product shall also be labeled as provided in RSA 318:14-a, II. The compound drug product shall bear the label of the pharmacy responsible for compounding and dispensing the product directly to the patient for administration, and the prescription shall be filed at that pharmacy. Compounded prescription labels shall include the phrase "compounded per subscriber request" or a similar statement on the prescription label or through the use of an auxiliary label attached to the prescription container.
Source. 1979, 155:30. 1985, 324:13. 1994, 333:12. 2002, 281:5. 2009, 54:5. 2013, 121:6, eff. Jan. 1, 2014. 2018, 164:2, eff. Jan. 1, 2019. 2023, 152:5, eff. Sept. 26, 2023.
Section 318:47-b
318:47-b Labeling Exemption. –
Labeling requirements as specified in 318:47-a are exempted when medication is dispensed to institutionalized patients and as provided for under RSA 141-C:17.
Source. 1979, 155:30. 2008, 271:8, eff. June 26, 2008.
Section 318:47-c
318:47-c Prescriptions. –
I. (a) A prescription may be written, oral, or electronically transmitted. All oral prescriptions shall be immediately reduced to writing by the pharmacist, authorized technician, or licensed advanced pharmacy technician receiving the oral prescription and shall indicate at least the name of the patient; the name, strength, and quantity of the drug prescribed; any directions specified by the prescriber; the name of the practitioner prescribing the medication; the date the prescription was ordered; a statement that the prescription was presented orally; and the name of the pharmacist who took the oral order. The pharmacist who dispensed an original prescription shall indicate on the face of the prescription at least the assigned prescription identification number; the date of dispensing; the quantity actually dispensed; and his or her name or unique identifiers. The prescription shall be filed numerically by the assigned identification number for a period not less than 4 years. Such prescription files shall be open to inspection by the pharmacist board and its agents.
(b) A patient shall be entitled to receive a paper prescription instead of an oral or electronically transmitted prescription, except prescriptions for controlled drugs as defined in RSA 318-B:1, VI.
II. (a) A prescription that is electronically generated by a licensed prescriber, transmitted and received at the pharmacy by computer systems shall contain at least the name of the patient, the name, strength, and quantity of the drug prescribed, any directions specified by the prescriber, the name of the practitioner prescribing the medication, and shall be dated and signed using an electronic signature by the prescribing practitioner on the day issued. Such electronic signature shall be made in accordance with RSA 294-E.
(b) Electronic prescribing shall not interfere with a patient's freedom to choose a pharmacy.
(c) Electronic prescribing software shall not use any means or permit any other person to use any means, including, but not limited to, advertising, instant messaging, and pop-up ads, to influence or attempt to influence, through economic incentives or otherwise, the prescribing decision of a prescribing practitioner at the point of care. Such means shall not be triggered by or in specific response to the input, selection, or act of a prescribing practitioner or his or her agent in prescribing a certain pharmaceutical or directing a patient to a certain pharmacy.
(d) Electronic prescribing software may show information regarding a payor's formulary, co-payment, or benefit plan as long as nothing is designed to preclude or make more difficult the act of a prescribing practitioner or patient selecting any particular pharmacy or pharmaceutical.
(e) No person who has access to electronic prescription information solely by transmitting or facilitating the transmission of prescriptions between the licensed prescriber generating the prescription and the pharmacy receiving the prescription, or any intermediary, shall retain the prescription or any information it contains for longer than is mandated by federal or state law, after which time the prescription information shall be destroyed. No such person shall sell, use, or otherwise make available the prescription information for any purpose other than transmission of prescriptions, prescription refills, and clinical information displayed to the prescriber or pharmacist.
III. (a) Notwithstanding any provision of law to the contrary, no person shall issue a prescription for a controlled drug unless the prescription is made by electronic prescription from the person issuing the prescription to a pharmacy and the electronic prescription contains the information and signature required in paragraph II, except for prescriptions issued:
(1) In circumstances where electronic prescribing is not available due to temporary technological or electrical failure.
(2) By a practitioner to be dispensed by a pharmacy located outside of New Hampshire, provided that such pharmacy complies with the laws and regulations of the state where the pharmacy is located.
(3) When the prescriber is the dispenser.
(4) By a practitioner for a drug that the federal Food and Drug Administration (FDA) requires the prescription to contain certain elements that are not able to be accomplished with electronic prescribing.
(5) By practitioners who have received a waiver or a renewal thereof for a specified period determined by the practitioner's licensing board, not to exceed one year, from the requirement to use electronic prescribing, pursuant to a process established in rules of the board, due to economic hardship, technological limitations that are not reasonably within the control of the practitioner, or other exceptional circumstance demonstrated by the practitioner.
(6) In circumstances where electronic prescribing is not available due to RSA 318-B:2, VI-a.
(7) For a compounded prescription for a hospice patient or in circumstances where access to electronic prescribing technology is temporarily unavailable to electronically prescribe a controlled drug for a hospice patient.
(8) By a veterinarian, until such time that the New Hampshire board of veterinary medicine determines that electronic prescribing software is widely available for veterinarians and notifies the pharmacy board. The board of veterinary medicine shall at least annually make such a determination.
(b) A pharmacist who receives a written, oral, or faxed prescription shall not be required to verify that the prescription properly falls under one of the exceptions under subparagraph (a). Pharmacists may continue to dispense medications from otherwise valid written, oral, or faxed prescriptions that are consistent with this section.
Source. 1979, 155:30. 1985, 324:14. 2005, 177:134. 2007, 320:2. 2008, 217:2. 2010, 259:8, eff. July 6, 2010. 2019, 58:7, eff. July 1, 2019. 2021, 183:1, 2, eff. Jan. 1, 2022.
Section 318:47-d
318:47-d Pharmacies; Substituting Generic Drugs. –
Pharmacies, including mail-order pharmacies, may substitute generically equivalent drug products for all legend and non-legend prescriptions unless the prescribing practitioner handwrites "medically necessary" on each paper prescription, or uses electronic indications when transmitted electronically, or gives instructions when transmitted orally that the brand name drug product is medically necessary. In this section, "drug product" does not include a biological product.
Source. 2002, 123:1. 2008, 23:1, eff. July 11, 2008. 2018, 164:3, eff. Jan. 1, 2019.
Section 318:47-dd
318:47-dd Pharmacies; Substituting Biological Products. –
I. In this section:
(a) "Biological product" means a virus, therapeutic serum, toxin, antitoxin, vaccine, blood, blood component or derivative, allergenic product, protein (except any chemically synthesized polypeptide), or analogous product, or arsphenamine or derivative of arsphenamine (or any other trivalent organic arsenic compound), applicable to the prevention, treatment, or cure of a disease or condition of human beings.
(b) "Proper name" means the nonproprietary name for a biological product designated by the federal Food and Drug Administration license for use upon each package of the product.
(c) "Interchangeable biological product" means a biological product that the federal Food and Drug Administration:
(1) Has licensed and determined meets the standards for interchangeability pursuant to 42 U.S.C. section 262(k)(4); or
(2) Has determined is therapeutically equivalent as set forth in the latest edition of or supplement to the federal Food and Drug Administration's Approved Drug Products with Therapeutic Equivalence Evaluations.
II. The board shall maintain a link on its website to the federal Food and Drug Administration's Lists of Licensed Biological Products with Reference Product Exclusivity and Biosimilarity or Interchangeability Evaluations.
III. A pharmacist may substitute a biological product pursuant to this section only if it has been licensed by the federal Food and Drug Administration as an interchangeable biological product for the prescribed biological product.
IV. When a pharmacist dispenses an interchangeable biological product for the prescribed biological product, the pharmacist or his or her designee shall inform the patient.
V. A pharmacist shall not substitute an interchangeable biological product pursuant to this section if the prescriber indicates that substitution is not authorized by specifying on the prescription "medically necessary" on a paper prescription, or uses electronic indications when transmitted electronically, or gives instructions when transmitted orally that the biological product prescribed is medically necessary.
VI. (a) Within 3 business days following the dispensing of a biological product, the dispensing pharmacist or the pharmacist's designee shall make an entry of the specific product provided to the patient, including the name of the product and the manufacturer. The communication shall be conveyed by making an entry that is electronically accessible to the prescriber through:
(1) An interoperable electronic medical records system;
(2) An electronic prescribing technology; or
(3) A pharmacy benefit management system; or
(4) A pharmacy record.
(b) Entry into an electronic records system as described in this paragraph is presumed to provide notice to the prescriber. Otherwise, the pharmacist shall communicate the biological product dispensed to the prescriber using facsimile, telephone, electronic transmission, or other prevailing means, provided that the communication shall not be required where:
(1) There is no federal Food and Drug Administration-approved interchangeable biological product for the biological product prescribed; or
(2) A refill prescription is not changed from product dispensed on the prior filling of the prescription.
VII. The label of all biological products dispensed by a pharmacist shall include the proper name and the name of the manufacturer of the product.
Source. 2018, 164:4, eff. Jan. 1, 2019.
Section 318:47-e
318:47-e Repealed by 2019, 264:15, III, eff. Sept. 17, 2019. –
Section 318:47-f
318:47-f Prescription Information to be Kept Confidential. –
Records relative to prescription information containing patient-identifiable and prescriber-identifiable data shall not be licensed, transferred, used, or sold by any pharmacy benefits manager, insurance company, electronic transmission intermediary, retail, mail order, or Internet pharmacy or other similar entity, for any commercial purpose, except for the limited purposes of pharmacy reimbursement; formulary compliance; care management; utilization review by a health care provider, the patient's insurance provider or the agent of either; health care research; or as otherwise provided by law. Commercial purpose includes, but is not limited to, advertising, marketing, promotion, or any activity that could be used to influence sales or market share of a pharmaceutical product, influence or evaluate the prescribing behavior of an individual health care professional, or evaluate the effectiveness of a professional pharmaceutical detailing sales force. Nothing in this section shall prohibit the dispensing of prescription medications to a patient or to the patient's authorized representative; the transmission of prescription information between an authorized prescriber and a licensed pharmacy; the transfer of prescription information between licensed pharmacies; the transfer of prescription records that may occur in the event a pharmacy ownership is changed or transferred; care management educational communications provided to a patient about the patient's health condition, adherence to a prescribed course of therapy or other information about the drug being dispensed, treatment options, or clinical trials. Nothing in this section shall prohibit the collection, use, transfer, or sale of patient and prescriber de-identified data by zip code, geographic region, or medical specialty for commercial purposes. In addition to other appropriate remedies under this chapter, a violation of this section is an unfair or deceptive act or practice within the meaning of RSA 358-A:2. Any right or remedy set forth in RSA 358-A may be used to enforce the provisions of this section.
Source. 2006, 328:1, eff. June 30, 2006.
Section 318:47-g
318:47-g Patient Assistance Program. –
I. Following the close of each calendar year, any clearinghouse that provides information to New Hampshire residents about pharmaceutical manufacturers' patient assistance programs shall, to the extent that the clearinghouse collects such information, provide aggregate information to the commissioner of the department of health and human services relative to either:
(a) The number of people in New Hampshire who may qualify for any manufacturer or government program during the calendar year; or
(b) The number of patients served during the calendar year.
II. An individual company may provide additional information about the individual company's patient assistance program; however, the commissioner shall combine all information from all sources, including individual companies and the clearinghouse, and shall report only aggregate information to the public.
Source. 2006, 328:1, eff. June 30, 2006.
Section 318:47-h
318:47-h Price of Filling Prescriptions. –
I. A pharmacy benefits manager or insurer shall require a contracted pharmacy to charge an enrollee or insured person the pharmacy's usual and customary price of filling the prescription or the contracted copayment, whichever is less.
II. Once it has settled a claim for filling a prescription for an enrollee or insured person and notified the pharmacy of the amount the pharmacy benefits manager or insurer will pay to the pharmacy for that prescription, the pharmacy benefits manager or insurer shall not lower the amount to be paid to the pharmacy by the pharmacy benefits manager or the insurer for such settled claim; provided, however, that this paragraph shall not apply if the claim was submitted fraudulently or with inaccurate or misrepresented information.
III. The board shall adopt rules under RSA 541-A establishing procedures to receive complaints of violations of paragraphs I and II. Such rules shall include:
(a) Criteria and procedure to refer complaints to the insurance department.
(b) Method for tracking the status of complaints referred to the insurance department and receiving department of insurance reports on the status.
(c) Procedures for reporting to the senate president, the speaker of the house of representatives, and the chairpersons of the house and senate committees with oversight of pharmacy benefit manager regulation, the number of complaints received, the number and nature of complaints referred to the insurance department, and the status of referred complaints.
Source. 2008, 29:1. 2010, 202:1, eff. Aug. 21, 2010. 2016, 221:5, eff. June 9, 2016.
Section 318:47-i
318:47-i Emergency Prescription. –
In the event a pharmacist receives a request for a prescription that requires a prior authorization that has neither been approved nor denied, and such medication is determined by the pharmacist to be essential to the maintenance of life or to the continuation of therapy in a chronic condition, or the interruption of therapy might reasonably produce undesirable health consequences or may cause physical or mental discomfort, the pharmacist may dispense a one-time emergency prescription of a maximum 72-hour supply of the prescribed medication to be reimbursed according to RSA 420-J:7-b, IX. A product that is packaged in a dosage form that is fixed and unbreakable may be dispensed as a 72-hour supply.
Source. 2014, 311:2, eff. Jan. 1, 2015.
Section 318:47-j
318:47-j Medicaid Coverage for Telehealth Services. –
Under this chapter, Medicaid coverage for telehealth services shall comply with the provisions of 42 C.F.R. section 410.78 and RSA 167:4-d.
Source. 2015, 246:2, eff. July 6, 2015 at 12:01 a.m.
Section 318:47-k
318:47-k Repealed by 2017, 23:2, effective Dec. 1, 2017. –
Section 318:47-l
318:47-l Hormonal Contraceptives; Dispensing. –
I. In this section, "standing order" means a written and signed protocol authored by one or more physicians licensed under RSA 329:12 or one or more advanced practice registered nurses licensed under RSA 326-B:18. Such agreement shall specify a protocol allowing the pharmacist licensed under RSA 318:18 to dispense hormonal contraceptives under the delegated prescriptive authority of the physician or APRN, specify a mechanism to document screening performed and the prescription in the patient's medical record, and include a plan for evaluating and treating adverse events. Any such prescription shall be regarded as being issued for a legitimate medical purpose in the usual course of professional practice.
II. Licensed pharmacists following standing orders may dispense hormonal contraceptives to persons in this state without a prior prescription.
III. A pharmacist, pharmacy, physician, or APRN issuing or following standing orders shall be prohibited from seeking personal financial benefit by participating in any incentive-based program or accepting any inducement that influences or encourages therapeutic or product changes or the ordering of tests or services.
IV. Prior to dispensing hormonal contraceptives under this section, a pharmacist shall complete an Accreditation Council for Pharmacy Education (ACPE) accredited educational training program related to hormonal contraceptives. In addition, pharmacists shall comply with the most current United States Medical Eligibility Criteria (USMEC) for Contraceptive Use as adopted by the Centers for Disease Control and Prevention.
V. The pharmacist shall provide each recipient of hormonal contraceptives pursuant to this section with a standardized information sheet written in plain language, which shall include, but is not limited to, the indication for the use of the hormonal contraceptive, the importance of follow-up care, and health care referral information.
VI. The board shall adopt rules, pursuant to RSA 541-A, relative to:
(a) Education and training required under paragraph IV.
(b) Content and format of the information sheet required under paragraph V, in consultation with the commissioner of the department of health and human services.
(c) A model statewide protocol, with the consent of the board of medicine, the board of nursing, and the department of health and human services to be used for the purposes of paragraph I.
(d) Other matters necessary to the proper administration of this section.
VII. The board of medicine shall not deny, revoke, suspend, or otherwise take disciplinary action against a physician based on a pharmacist's failure to follow standing orders provided the provisions of this section and the rules adopted under this section are satisfied. The board of nursing shall not deny, revoke, suspend, or otherwise take disciplinary action against an APRN based on a pharmacist's failure to follow standing orders provided the provisions of this section and the rules adopted under this section are satisfied. The board of pharmacy shall not deny, revoke, suspend, or otherwise take disciplinary action against a pharmacist who follows standing orders based on a defect in those standing orders provided the provisions of this section and the rules adopted under this section are satisfied.
Source. 2018, 205:2, eff. Aug. 7, 2018.
Section 318:47-m
318:47-m Nicotine Cessation Therapy. –
I. In this section, "standing order" means a written and signed protocol authored by a physician licensed under RSA 329:12, a physician assistant licensed under RSA 328-D:2, or an advanced practice registered nurse licensed under RSA 326-B:18. The agreement shall specify a protocol allowing a licensed pharmacist to provide nicotine cessation therapy under the delegated prescriptive authority of the physician, physician assistant, or APRN, a mechanism to document screening performed and the prescription in the patient's medical record, and include a plan for evaluating and treating adverse events. The prescriptions shall be considered a legitimate medical purpose in the usual course of professional practice.
II. Licensed pharmacists following standing orders may provide nicotine cessation therapy to persons in this state without a prior prescription.
III. A pharmacist, pharmacy, physician, physician assistant, or APRN issuing or following standing orders shall be prohibited from seeking personal financial benefit by participating in any incentive-based program or accepting any inducement that influences or encourages therapeutic or product changes or the ordering of tests or services.
IV. Prior to providing nicotine cessation therapy under this section, a pharmacist shall complete an Accreditation Council for Pharmacy Education (ACPE) accredited educational training program related to nicotine cessation.
V. The pharmacist shall provide each recipient of nicotine cessation therapy with a standardized information sheet written in plain language, which shall include, but is not limited to, the indication for the use of the nicotine cessation therapy, the importance of follow-up care, and health care referral information.
VI. The board shall adopt rules, pursuant to RSA 541-A, relative to:
(a) Education and training required under paragraph IV.
(b) Content and format of the information sheet required under paragraph V, in consultation with the commissioner of the department of health and human services.
(c) A model statewide protocol, with the consent of the board of medicine, the board of nursing, and the department of health and human services to be used for the purposes of paragraph I.
(d) Communication to the patient's primary care provider with the consent of the patient.
VII. The board of medicine shall not deny, revoke, suspend, or otherwise take disciplinary action against a physician or physician assistant based on a pharmacist's failure to follow standing orders provided the provisions of this section and the rules adopted under this section are satisfied. The board of nursing shall not deny, revoke, suspend, or otherwise take disciplinary action against an APRN based on a pharmacist's failure to follow standing orders provided the provisions of this section and the rules adopted under this section are satisfied. The board of pharmacy shall not deny, revoke, suspend, or otherwise take disciplinary action against a pharmacist who follows standing orders based on a defect in those standing orders provided the provisions of this section and the rules adopted under this section are satisfied.
Source. 2021, 189:4, eff. Jan. 1, 2022.
Possession and Sale of Drugs and Devices for Administration of Drugs
Section 318:48 to 318:51
318:48 to 318:51 Repealed by 1963, 276:2, eff. July 1, 1963 –
Section 318:51-a
318:51-a Licensing of Manufacturers and Wholesalers Required. –
I. No person shall manufacture legend drugs or controlled drugs as that term is defined in RSA 318-B:1, VI and no person as a wholesaler, distributor, or reverse distributor shall supply the same without first having obtained a license to do so from the board. Such license shall expire biennially on June 30 of every even-numbered year. An application together with a reasonable fee as established by the board shall be filed biennially by midnight on June 30 of every even-numbered year.
II. No license shall be issued under this section unless the applicant has furnished proof satisfactory to the board of pharmacy:
(a) That the applicant is of good moral character or, if that applicant is an association or corporation, that the managing officers are of good moral character.
(b) That the applicant has sufficient land, buildings, and such security equipment so as to properly carry on the business described in his application.
III. No license shall be granted to any person who has within 5 years been convicted of a violation of any law of the United States, or of any state, relating to drugs, as defined in this chapter or RSA 318-B, or to any person who is a drug-dependent person.
IV. Any person licensed pursuant to this section is subject to the provisions of RSA 318:29.
V. (a) The manufacturer, wholesaler, distributor, reverse distributor, or broker to which a license has been issued shall, within 30 days of any change of information supplied in the original application, notify the board.
(b) The notice required pursuant to subparagraph (a) shall contain:
(1) Current New Hampshire license number of the manufacturer, wholesaler, distributor, reverse distributor, or broker.
(2) Name of the manufacturer, wholesaler, distributor, reverse distributor, or broker, old and new, if applicable.
(3) Address of the manufacturer, wholesaler, distributor, reverse distributor, or broker, old and new, if applicable.
(4) [Repealed.]
(c) A new license shall be required for a change of ownership of an established manufacturer, wholesaler, distributor, reverse distributor, or broker to a successor business entity which results in a change in the controlling interest in the manufacturer, wholesaler, distributor, reverse distributor, or broker.
Source. 1985, 324:15. 1989, 258:3. 2011, 111:2, 3, eff. July 30, 2011. 2019, 264:10, 15, IV, eff. Sept. 17, 2019.
Section 318:51-b
318:51-b Licensing of Limited Retail Drug Distributors Required. –
I. No person shall operate as a limited retail drug distributor, as defined in RSA 318:1, VII-a, without first having obtained a license to do so from the office of professional licensure and certification according to the eligibility requirements set forth in rule by the pharmacy board.
II. No license shall be issued under this section unless the applicant has furnished proof satisfactory to the board that:
(a) The applicant is of good moral character or, if that applicant is an association or corporation, that the managing officers are of good moral character.
(b) The applicant has sufficient space and security equipment as to properly carry on the business described in the application.
(c) The license granted by this chapter shall at all times be displayed in a conspicuous place in the facility for which it is issued.
(d) The applicant, other than a distributor of legend devices or medical gases, has a written contract with a pharmacist licensed in the state to serve as a consultant on all matters relating to the storage and dispensing of prescription drugs.
III. No license shall be granted to any person who has within 5 years been convicted of a violation of any law of the United States, or of any state, relating to drugs, as defined in this chapter or RSA 318-B, or to any person who is a drug-dependent person.
IV. Any person licensed pursuant to this section is subject to the provisions of RSA 318:29.
Source. 2000, 271:5. 2007, 202:12, eff. Jan. 1, 2008. 2019, 264:11, eff. Sept. 17, 2019. 2023, 79:314, eff. Sept. 1, 2023.
Section 318:51-c
318:51-c Licensing of Outsourcing Facilities Identified as Section 503B Facilities by the United States Food and Drug Administration. –
I. No person shall compound legend drugs or controlled drugs, as defined in RSA 318-B:1, VI, and no person acting as or employed by an outsourcing facility shall supply such drugs, without first having obtained a license from the office of professional licensure and certification according to the eligibility requirements set forth in rule by the pharmacy board.
II. No license shall be issued under this section unless the applicant has furnished proof:
(a) That the applicant is of good moral character or, if that applicant is an association or corporation, that the managing officers are of good moral character.
(b) That the applicant has sufficient land, buildings, and security equipment as to properly carry on the business described in the application.
III. No license shall be granted to any person who has within 5 years been convicted of a violation of any law of the United States, or of any state, relating to drugs, as defined in this chapter or RSA 318-B, or to any person who is a drug-dependent person.
IV. Any person licensed pursuant to this section shall be subject to the provisions of RSA 318:29.
V. (a) The outsourcing facility to which a license has been issued shall, within 30 days of any change of information supplied in the original application, notify the board.
(b) The notice required pursuant to subparagraph (a) shall contain:
(1) Current New Hampshire license number of the outsourcing facility.
(2) Name of the outsourcing facility, old and new, if applicable.
(3) Address of the outsourcing facility, old and new, if applicable.
(4) Names, addresses, and titles of new corporate officers, partners, or owners.
(c) A new license shall be required for a change of ownership of an established outsourcing facility to a successor business entity which results in a change in the controlling interest in the outsourcing facility.
VI. The outsourcing facility to which a license has been issued shall, within 30 days of any written warnings or disciplinary action from any state or federal licensing or enforcement agency, notify the board and provide a copy of the action.
Source. 2015, 180:3, eff. July 1, 2015. 2019, 264:12, eff. Sept. 17, 2019. 2023, 79:315, eff. Sept. 1, 2023.
Section 318:51-d
318:51-d Repealed by 2015, 180:4, eff. July 22, 2017. –
Section 318:51-e
318:51-e Rulemaking. –
The board shall adopt rules pursuant to RSA 541-A relative to:
I. [Repealed.]
II. Content of the application;
III. The standards for licensing of outsourcing facilities;
IV. [Repealed.]
V. Standards for denial and revocation of license;
VI. Inspection requirements;
VII. Dispensing and distribution requirements of prescription drugs;
VIII. Record keeping requirements; and
IX. Requirements for outsourcing facilities.
Source. 2015, 180:3, eff. July 1, 2015. 2021, 197:105, V, eff. July 1, 2021.
Section 318:51-f
318:51-f Licensure of Research Organizations. –
I. No research organization shall procure or conduct research operations with prescription drugs by researchers without first having obtained a license from the office of professional licensure and certification according to the eligibility requirements set forth in rule by the pharmacy board.
II. No license shall be issued under this section unless the applicant has furnished proof:
(a) That the applicant is of good moral character or, if that applicant is an association or corporation, that the managing officers are of good moral character.
(b) That the applicant has sufficient space and security equipment as to properly carry on the research operations described in the application.
III. The license granted under this section shall at all times be displayed in a conspicuous place in the research organization facility for which it is issued.
IV. No license shall be issued under this section to research organizations for sale, dispensing, or distribution of prescription drugs.
(a) Prescription drugs are to be used solely for research purposes only.
(b) Use of controlled drugs is prohibited under the license for research organizations issued under this section.
(c) No research organization shall distribute prescription drugs directly to a consumer or a patient, or operate in such a manner as to endanger the public health.
(d) The research organization shall effectively destroy all prescription drugs in due course by means of conducting routine research operations or disposal by approved methods.
(e) The research organization shall maintain up-to-date and accurate records indicating:
(1) The amount of prescription drug destroyed.
(2) The date on which the prescription drug was destroyed.
(3) The manner or method by which the prescription drug was destroyed.
(f) Inventories and disposal transactions shall be maintained for 2 years and made available for inspection by the board's inspectors within a period of 72 hours from notice.
V. No license shall be granted to any research organization if any of its managing officers or researchers have within 5 years been convicted of a violation of any law of the United States, or of any state, relating to drugs, as defined by this chapter or RSA 318-B, or is an impaired person.
VI. Any licensee under this section is subject to the provisions of RSA 318:29.
VII. (a) The licensee shall, within 30 days of any change of information supplied in the original license application, notify the board.
(b) The notice required pursuant to subparagraph (a) shall contain the:
(1) Current New Hampshire license number of the research organization.
(2) Name of managing officers and researchers, old and new, if applicable.
(3) Address of the research organization, old and new, if applicable.
VIII. A new license shall be required for a change of ownership of an established research organization to a successor business entity which results in a change in the controlling interest in the research organization.
Source. 2015, 203:5, eff. July 1, 2015. 2019, 264:13, eff. Sept. 17, 2019. 2023, 79:316, eff. Sept. 1, 2023.
Section 318:51-g
318:51-g Licensure of Drug or Device Distribution Agents. –
I. No person shall act as a prescription drug or device distribution agent, which includes controlled drugs as the term is defined in RSA 318-B:1, VI, without first having obtained a license to do so from the office of professional licensure and certification according to the eligibility requirements set forth in rule by the pharmacy board.
II. Any person licensed pursuant to this section shall be subject to the provisions of RSA 318:29.
III. For purposes of this section:
(a) A drug or device distribution agent shall include virtual manufacturers, virtual wholesaler distributors, jobbers or brokers (including sales/marketing offices), and third-party logistics companies, and any other agent involved in the handling or distribution of prescription drugs, medical gases, or prescription medical devices or equipment in the supply chain that affects the pedigree of the products.
(b) "Broker or jobber" is any party that mediates between a buyer and a seller for the sale or shipment of prescription drugs, gases, equipment, or devices.
(c) "Pedigree" is a document or an electronic file containing information that records each distribution of any given prescription drug, medical gas, or prescription medical device or equipment.
(d) "Third-party logistics provider" is a person that contracts with a wholesale distributor or a manufacturer to provide or coordinate warehousing, wholesale distribution, or other services on behalf of a manufacturer, but does not take title to the prescription drug, gas, device, or equipment.
(e) "Virtual manufacturer" is anyone that owns the NDA or ANDA for a prescription drug, gas, device, or equipment that contracts with others for the actual manufacturing.
(f) "Virtual wholesale distributor" is anyone engaged in wholesale distribution of prescription drugs, gases, devices, or equipment.
Source. 2019, 264:14, eff. Sept. 17, 2019. 2023, 79:317, eff. Sept. 1, 2023.
Section 318:52
318:52 Repealed by 1971, 135:2, eff. July 20, 1971. –
Section 318:52-a
318:52-a Fraud or Deceit. –
It is unlawful to obtain or attempt to obtain a drug or device sold by prescription of a physician, dentist, optometrist, podiatrist, veterinarian, naturopathic doctor, physician assistant, or advanced practice registered nurse that bears a statement that it is to be dispensed or sold only by or on the prescription of a physician, dentist, optometrist, podiatrist, veterinarian, naturopathic doctor, physician assistant, or advanced practice registered nurse by:
I. Fraud, deceit, misrepresentation or subterfuge;
II. The forgery or alteration of a prescription or of any written order;
III. The concealment of a material fact;
IV. The use of a false name or the giving of a false address; or
V. Submission of an electronic or on-line medical history form that fails to establish a valid practitioner-patient relationship.
Source. 1965, 275:1. 1994, 333:13. 2009, 54:5. 2010, 74:2, eff. Jan. 1, 2011; 259:10, eff. July 6, 2010; 259:12, eff. Jan. 1, 2011 at 12:01 a.m.
Section 318:52-b
318:52-b Destruction of Used Instruments in Health Care Facilities. –
It shall be unlawful for any possessor of a hypodermic syringe, needle, or any instrument adapted for the administration of controlled drugs, in health care facilities, to dispose of or discard any such instrument in any manner other than that provided in this section. Disposables which can cause injury, such as needles or syringes with needles, shall be placed intact in puncture resistant containers that are adapted with a secured lid which prevents easy access to the contents.
Source. 1970, 48:2. 1989, 34:1. 1990, 129:1, eff. June 18, 1990.
Section 318:52-c
318:52-c Sale of Hypodermic Syringes and Needles. –
I. No person shall sell, furnish, or give to any person, under 18 years of age, an instrument commonly known as a hypodermic syringe, hypodermic needle, or any instrument adapted for the administration of drugs by injection without the written or oral prescription of a licensed physician, physician assistant, dentist, veterinarian, podiatrist, or advanced practice registered nurse. Such prescription shall contain the name and address of the patient, the date of the prescription, the description of the instrument prescribed, and the number of instruments prescribed.
II. The following conditions shall apply to all purchases of hypodermic syringes or needles:
(a) Retailers and dispensers of hypodermic syringes, needles, or any instrument adapted for the administration of drugs by injection shall provide to each purchaser at the time of purchase information regarding the safe disposal of hypodermic syringes or needles, including local disposal locations or a telephone number to call for such information, if appropriate.
(b) Retailers and dispensers shall also provide purchasers with information on drug addiction treatment, including a local telephone number to get assistance, if appropriate.
Source. 1971, 135:1. 1973, 453:12. 1981, 484:15. 1989, 34:2. 1992, 102:1. 1994, 333:14. 1999, 213:5. 2000, 176:1. 2005, 177:135. 2009, 54:5. 2012, 171:26, XII, eff. Aug. 10, 2012. 2017, 117:2, eff. June 16, 2017.
Section 318:52-d
318:52-d Repealed by 2017, 117:6, eff. June 16, 2016. –
Section 318:52-e
318:52-e Control or Possession of Hypodermic or Like Instruments Without Prescription Prohibited for Minors. –
No person under 18 years of age shall have under such person's control or possess a hypodermic syringe, hypodermic needle, or any instrument adapted for the administration of drugs by injection, unless the person has received a written or oral prescription issued under RSA 318:52-c. For the purpose of this subdivision, no such prescription shall be valid which has been outstanding for more than one year.
Source. 1971, 135:1. 1973, 453:15. 1981, 484:16. 1989, 34:4. 1994, 333:15. 1999, 213:6. 2000, 176:3, eff. Jan. 1, 2001.
Section 318:53, 318:54
318:53, 318:54 Repealed by 1963, 276:2, eff. July 1, 1963 –
Penalty
Section 318:55
318:55 Repealed by 2023, 79:318, XVIII, eff. Sept. 1, 2023. –
Unused Prescription Drug Program
Section 318:56
318:56 Repealed by 2023, 79:318, XIX, eff. Sept. 1, 2023. –
Section 318:57
318:57 Repealed by 2023, 79:318, XX, eff. Sept. 1, 2023. –
Section 318:58
318:58 Repealed by 2023, 79:318, XXI, eff. Sept. 1, 2023. –
Section 318:58-a
318:58-a Repealed by 2018, 147:2, eff. Nov. 30, 2018. –
Section 318:59
318:59 Repealed by 2023, 79:318, XXII, eff. Sept. 1, 2023. –
Section 318:60
318:60 Repealed by 2023, 79:318, XXIII, eff. Sept. 1, 2023. –
Pharmacy Rights During Audit
Section 318:61
318:61 Definition. –
In this subdivision, "responsible party" means the entity responsible for payment of claims for health care services other than the individual to whom the health care services were rendered or that individual's guardian or legal representative.
Source. 2013, 159:1, eff. Jan. 1, 2014.
Section 318:62
318:62 Pharmacy Rights During Audit. –
Notwithstanding any other provision of law, whenever a managed care company, insurance company, third-party payer, or any entity that represents a responsible party conducts an audit of the records of a pharmacy, the pharmacy has a right to all of the following:
I. To have at least 7 days' advance notice of the initial on-site audit for each audit cycle. A pharmacy that requests an additional 7 days prior to the commencement of an audit shall be granted 7 additional days.
II. To have any audit that involves clinical judgment be done with a pharmacist who is licensed and is employed or working under contract with the auditing entity.
III. Not to have clerical or record-keeping errors, including typographical errors, scrivener's errors, and computer errors, on a required document or record, in the absence of any other evidence, deemed fraudulent. This subdivision does not prohibit recoupment of fraudulent payments.
IV. If required under the terms of the contract, to have the auditing entity provide a pharmacy, upon request, all records related to the audit in an electronic format or contained in digital media.
V. To have the properly documented records of a hospital or any person authorized to prescribe controlled substances for the purpose of providing medical or pharmaceutical care for their patients transmitted by any means of communication in order to validate a pharmacy record with respect to a prescription or refill for a controlled substance or narcotic drug, in compliance with state laws.
VI. If an on-site audit is conducted for a reason other than an identified problem, the audit shall be limited to no more than 250 selected prescriptions and the third party plan or audit company must provide a masked list of prescriptions to the pharmacy to assist in preparation. The list is considered masked if the last 2 numbers of the prescription are marked with an "X." This procedure allows the pharmacy to pull the book the audited prescription is in, however it does not allow the pharmacy to pull the specific prescription audited. Additionally, all of the invoices for actual dispensed prescriptions, with prices redacted, may be obtained from the pharmacy's wholesaler or distributor upon approval from the pharmacy.
VI-a. To have the same number of days to respond to a claim in an audit that have passed since the origination of the claim.
VII. To be subject to no more than 2 audits in one calendar year, unless fraud or misrepresentation is reasonably suspected.
VIII. Except for cases of Food and Drug Administration regulation or drug manufacturer safety programs, to be free of recoupments based on any of the following unless defined within the billing requirements set forth in the pharmacy provider manual:
(a) Documentation requirements in addition to or exceeding requirements for creating or maintaining documentation prescribed by the pharmacy board or by the provider manual or contract.
(b) A requirement that a pharmacy or pharmacist perform a professional duty in addition to or exceeding professional duties prescribed by the board.
IX. To be audited under the same standards and parameters as other similarly situated pharmacies audited by the same entity.
X. To have the period covered by an audit limited to 6 months from the date a claim was submitted to, or adjudicated by, a managed care company, an insurance company, a third-party payer, or any entity that represents responsible parties, unless a longer period is permitted by a federal plan under federal law.
XI. Not to be subject to the initiation or scheduling of audits during the first 5 calendar days of any month for any pharmacy that averages in excess of 600 prescriptions per week due to the high volume of prescriptions filled during that time and for patient care considerations, without the express consent of the pharmacy. The pharmacy shall cooperate with the auditor to establish an alternate date should the audit fall within the days excluded.
XII. Not to have the accounting practice of extrapolation used in calculating recoupments or penalties for audits, unless otherwise required by federal requirements or federal plans.
XIII. The auditor shall not include dispensing fees in the calculations of overpayments unless the prescription is considered a misfill. A misfill shall be defined as a prescription not dispensed, a medication error, a prescription whereby the prescriber denied authorization, or where an extra dispensing fee was charged.
XIV. (a) Auditors shall only have access to previous audit reports on a particular pharmacy if the previous audit was conducted by the same entity, except as required for compliance with state or federal law.
(b) Additionally, pharmacies subject to an audit may use the following records at the time of the audit to validate a claim for a prescription, refill, or change in a prescription:
(1) Electronic or physical copies of records of a health care facility, or a health care provider with prescribing authority.
(2) Any prescription that complies with state law.
Source. 2013, 159:1, eff. Jan. 1, 2014. 2020, 39:9, 10, eff. Sept. 27, 2020.
Section 318:63
318:63 Mandatory Appeals Process. –
I. Each entity that conducts an audit of a pharmacy shall establish an appeals process under which a pharmacy may appeal within 30 days after the report an unfavorable audit report to the entity.
II. If, following the appeal, the entity finds that an unfavorable audit report or any portion of the unfavorable audit report is unsubstantiated, the entity shall dismiss the unsubstantiated portion of the audit report without any further proceedings unless outlined in the contract.
III. Each entity conducting an audit shall provide a copy, if required under contractual terms, of the audit findings to the plan sponsor after completion of any appeals process.
IV. If any portion of an unfavorable audit report is not dismissed within 30 days after an appeal is made under paragraph I, the pharmacy may request a hearing from the insurance department pursuant to RSA 400-A:17.
Source. 2013, 159:1, eff. Jan. 1, 2014. 2020, 39:11, eff. Sept. 27, 2020.
Section 318:64
318:64 Pharmacy Audit Recoupments. –
I. Recoupments of any disputed funds shall occur only after final internal disposition of an audit, including the appeals process, unless fraud or misrepresentation is reasonably suspected or the discrepant amount exceeds $10,000.
II. Recoupment on an audit shall be refunded to the responsible party as contractually agreed upon by the parties.
III. The entity conducting the audit shall not charge or assess the responsible party, directly or indirectly, based on amounts recouped.
Source. 2013, 159:1, eff. Jan. 1, 2014. 2020, 39:12, eff. Sept. 27, 2020.
Section 318:65
318:65 Audit Information and Reports. –
An audit report shall be delivered to the pharmacy within 75 days, unless otherwise agreed to, after the conclusion of the audit. A pharmacy shall be allowed at least 30 days, unless otherwise agreed to, following receipt of the audit report to appeal any discrepancy found in the audit. A final audit report shall be delivered to the pharmacy within 90 days, unless otherwise agreed to, after receipt of the appeal. A charge-back, recoupment, or other penalty may not be assessed until the appeal process has been exhausted and the final report issued except as specified in RSA 318:64. Except as provided by state or federal law or contract, audit information may not be shared. Auditors may have access only to previous audit reports on a particular pharmacy conducted by that same entity.
Source. 2013, 159:1, eff. Jan. 1, 2014.
Section 318:66
318:66 Applicability. –
This subdivision shall not apply to any audit, review, or investigation that is based on suspected or alleged fraud, willful misrepresentation, or abuse. Nothing in this subdivision shall apply to claims that were paid for in part or in whole by Medicare or Medicaid program funds.
Source. 2013, 159:1, eff. Jan. 1, 2014.
New High-Cost Prescription Drugs
Section 318:67
318:67 Definitions. –
In this subdivision:
I. "Department" means the insurance department.
II. "Manufacturer" means any entity which is engaged in the production, preparation, propagation, compounding, conversion, or processing of prescription drugs, whether directly or indirectly by extraction from substances of natural origin, independently by means of chemical synthesis, or by a combination of extraction and chemical synthesis, or any entity engaged in the packaging, repackaging, labeling, relabeling, or distribution of prescription drugs. The term shall not include a wholesale distributor of prescription drugs, a retailer, or a pharmacist licensed under the board.
III. "Prescription drug" means a drug defined in 21 U.S.C. section 321.
Source. 2020, 4:1, eff. Jan. 1, 2020.
Section 318:68
318:68 Notice Required. –
I. A prescription drug manufacturer shall notify the department in writing if it is introducing a new prescription drug to market at a wholesale acquisition cost that exceeds the threshold set for a specialty drug under the Medicare Part D program. The manufacturer shall provide the written notice within 3 calendar days following the release of the drug in the commercial market. A manufacturer may make the notification pending approval by the United States Food and Drug Administration (FDA) if commercial availability is expected within 3 calendar days following the approval.
II. No later than 30 calendar days following notification required under paragraph I, the manufacturer shall provide the following information to the department in a format that the department prescribes:
(a) A description of the marketing and pricing plans used in the launch of the new drug in the United States and internationally.
(b) The estimated volume of patients who may be prescribed the drug.
(c) Whether the drug was granted breakthrough therapy designation or priority review by the FDA prior to final approval.
(d) The date and price of acquisition if the drug was not developed by the manufacturer.
III. The manufacturer may limit the information required under paragraph II to that which is otherwise in the public domain or publicly available.
IV. The department shall publish on its Internet website, at least quarterly, the information reported to it under this section. The information shall be published in a manner that identifies the information that is disclosed on a per-drug basis and shall not be aggregated in a manner that would not allow identification of the drug.
V. The attorney general may bring a civil action for injunctive relief, costs, and attorney's fees and impose on a manufacturer that fails to provide the information required under paragraph II, a civil penalty of not more than $1,000 per day for every day after the notification period described in paragraph II that the required information is not reported. In any action brought under this section, the attorney general shall have the same authority to investigate and obtain remedies as if the action were brought under the RSA 358-A.
Source. 2020, 4:1, eff. Jan. 1, 2020.