BILL NUMBER: S6851 Revised 04/25/25
SPONSOR: WEBB
 
TITLE OF BILL:
An act to amend the public health law and the education law, in relation
to collaborative practice medication adherence; and to amend chapter 21
of the laws of 2011 amending the education law relating to authorizing
pharmacists to perform collaborative drug therapy management with
physicians in certain settings, in relation to making the provisions of
such chapter permanent
 
PURPOSE OR GENERAL IDEA OF BILL:
Authorizes physicians to refer selected patients to qualified pharma-
cists for collaborative practice medication adherence (CPMA) services
specified in a written protocol issued by the treating physician with
consent of the patient.
 
SUMMARY OF PROVISIONS:
Section 1 adds Article 29-H to Public Health Law entitled Collaborative
Practice Medication Adherence, includes definitions and authorizes a
treating physician to refer one or more patients to a qualified pharma-
cist for collaborative practice medication adherence services specified
in the written protocol. Section 1 defines patients eligible for refer-
ral by their treating physician as those with a chronic disease or
diseases, who have not met the clinical goals of therapy, are at risk
for hospitalization, or who are otherwise in need of extra medication-
related services as determined by their physician. Section 1 of the bill
lists medication-related services. The written protocol applies to an
individual named pharmacist and a named physician and is voluntary for
all parties including the patient. This section requires sharing of
patient data in real-time through a bi-directional interoperable medical
records system.
Section 2 amends Section 6801 of the Education Law to create a new para-
graph Section 6801-b. This section recognizes collaborative practice
medication adherence as a service that can be provided by a qualified
pharmacist pursuant to a protocol with a licensed physician, and
conforms to changes being made in Public Health Law.
Section 3 amend s Section 5 of chapter 21 of the laws of 2011, amending
the education law relating to authorizing pharmacists to perform colla-
borative, drug therapy management with physicians in hospital facilities
to remove the sunset and make the law permanent.
Section 4 establishes the effective date.
 
JUSTIFICATION:
Collaborative Practice Medication Adherence (CPMA) has been accepted by
the NYS Health Department as a policy recommendation from a Value-Based
Payment stakeholder workgroup. CPMA is a professional service provided
by qualified pharmacists to patients who are referred by their treating
physicians for extra medication support services. The service represents
a targeted strategy developed to reduce avoidable hospitalizations and
healthcare costs resulting from the exacerbation of chronic diseases due
to sub-optimal medication use. With expertise in pharmacotherapy and
pharmacokinetics, pharmacists are uniquely positioned healthcare provid-
ers to address medication-related problems. One key aspect of profes-
sional practice is patient counseling which includes an assessment of a
patient's understanding of how to use the medication, what side-effects
to expect, how to manage them, what side-effects are dangerous and
should be reported, etc. Patients are not compliant for many reasons,
and pharmacists are well equipped for effective one-to-one discussions
that produce positive results. Peer-reviewed studies in published liter-
ature consistently document the effectiveness of increasing direct
interactions between pharmacists and patients. I n fact, the evidence
was so compelling that the Centers for Medicaid and Medicare included
Medication Therapy Management as a mandatory element in Medicare Part
1-) Prescription Drug Plans. CPMA represents a logica l progression.
Under CPMA, only at-risk patients receive the additional service.
Patients are identified by their treating physicians and referred to an
individual pharmacist with whom the treating physician has developed a
written protocol for a particular patient related to a particular
disease or diseases. As Value-Based payment methodologies evolve and
quality is increasingly measured by therapeutic outcomes in defined
patient populations, the need for CPMA services by pharmacists will
become more and more apparent. In fact, QARR and HEDIS measures current-
ly include many directly concerned with medication adherence, for exam-
ple: medication management for people with asthma, statin therapy for
patients with diabetes, persistence of beta-blocker treatment after a
heart attack, antidepressant medication management, and adherence to
antipsychotic medications for people with schizophrenia. CPMA as
described in the bill applies to pharmacists in community settings as
well as patients with chronic medical conditions and their treating
physicians who have relationships with local pharmacists. The protocols
envisioned in this proposal will deal with common conditions such as
asthma, diabetes, hypertension and hypercholesterolemia. This legis-
lation represents a modest and logical extension to the services that
pharmacists in community practice settings can provide if they meet the
additional qualifications included in the bill. Finally, under current
Education Law pharmacists employed in hospitals who meet additional
qualification requirements receive a credential from the Education
Department authorizing them to enter into collaborative agreements with
physicians in hospitals. This bill removes the sunset on this section of
law which has been in place since 2011, making it permanent.
 
PRIOR LEGISLATIVE HISTORY:
2017-2018 A.8664-A/S.7682
2019-2020 A.3849/S.5296
2021-2022 A.6699/S.6110
2023: S.3591
 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
This legislation is expected to result in a savings for the State under
Medicaid and other public programs.
 
EFFECTIVE DATE:
This act shall take effect immediately, provided that sections one and
two of this act shall take effect on the one hundred eightieth day after
it shall have become a law provided, that, effective immediately, the
addition, amendment and/or repeal of any rule or regulation necessary
for the implementation of this act on its effective date is authorized
and directed to be made and completed on or before such effective date.