July 15, 2020
IMPORTANT EXECUTIVE ORDER UPDATE
Executive Order 2020-124, the EO which MPA helped to create, has been rescinded. It allowed the following:

  1. Allows for pharmacists to dispense emergency refills up to a sixty day supply of non-controlled maintenance medication. When filling an emergency refill the pharmacist must a. inform the patient they are doing so under EO 2020-93, b. inform the prescriber in writing within a reasonable time of refills dispensed, c. make a reasonable effort to communicate with the prescriber regarding the refill, and make note of efforts to reach prescriber, d. prescriber will not incur any criminal or civil liability as a result of filled prescriptions.
  2. Pharmacists may operate in an area that is not designated on the pharmacy license, but may not prepare sterile drugs in this area.
  3. Pharmacists may dispense and/or administer drugs to treat COVID pursuant to protocols established by the CDC or the Chief Medical Examiner of the Department of Health and Human Services (DHHS).
  4. Substitution of therapeutically equivalent medication is allowed when a critical shortage exists without authorization of a prescriber. Again, a pharmacist must inform a prescriber if such a substitution happens.
  5. Preceptors may supervise student pharmacists remotely to fulfill eligibility for licensure and to avoid delaying graduation.
  6. Insurers and HMOs must cover any emergency refills of covered prescription drugs dispensed by a pharmacist. Contract provisions governing out-of-network benefits and cost-sharing may still apply.
  7. Pharmacists may supervise technicians and other staff remotely through a real time audiovisual camera system (telepharmacy) there must be a pharmacist present in the pharmacy during this time.
  8. Pharmacists holding a license in good standing in a different state will be deemed to be licensed in this state to do business, they may not deliver controlled substances.
  9. Wholesale Distributors holding a license in good standing in a different state will be deemed to be licensed in this state to do business, they may not deliver controlled substances.

This Executive Order has been rescinded and is no longer in effect as of 8:31 p.m. July 14, 2020. MPA strongly urges its members to halt any activities that were allowed under EO 2020-124.

There are still three Executive Orders in place that affect pharmacy and they are below.

Executive Order 2020-104 – In order to increase testing in the state of Michigan EO 104 authorizes licensed pharmacists, physician assistants and nurse practitioners the authority to establish and administer a COVID testing service in the state, using FDA approved tests, without an additional state license or permit at any site. The EO also temporarily suspends regulations for strict compliance with the scope-of-practice, supervision, and delegation provisions. This will EO will expire at the end of the state of emergency. 

Licensees administering a COVID-19 testing service or testing laboratory shall comply with the following:
  1. Any specimen collected at a COVID-19 testing service shall be tested at a laboratory or entity in accordance with federal CLIA regulations as facilitated by the Department of Licensing and Regulatory Affairs. High-complexity tests, including PCR tests, must be tested at a laboratory that is CLIA certified. Waived tests, including rapid point-of-care diagnostic tests, must be tested at an entity that has obtained a CLIA waiver.
  2. The licensee shall provide personnel with any training necessary to operate a COVID-19 testing service.
  3. The licensee shall comply with any reporting requirements issued by DHHS.
  4. COVID-19 testing service personnel shall use proper personal protective equipment when administering and conducting specimen collection and testing.
  5. A licensee collecting specimens for testing who does not perform testing shall securely store specimens pending retrieval by the entity that will test the specimens.
  6. A licensee shall refer patients to appropriate medical providers for follow up, if not available through the entity conducting testing.

Note that unlicensed personnel working at one of these testing sites would have to be trained by the licensee, and can perform any of the tasks and functions of COVID-19 testing services, including screening of patients, observing self-swabbing, temporarily storing specimens pending transmittal to a laboratory, transmitting specimens to a laboratory, reporting test results to the Michigan Disease Surveillance System, and referring patients to appropriate medical providers for follow-up. EO 2020-104 can be read in full here.

Executive Order 2020-149 - Any individual who enters a pharmacy who is able to medically tolerate a face covering must wear a covering over his or her nose and mouth, such as a homemade mask, scarf, bandanna or handkerchief. Additionally, pharmacies must create at least two hours per week of dedicated shopping time for vulnerable populations, which for purposes of this order are people over 60, pregnant people, and those with chronic conditions, including heart disease, diabetes and lung disease. This executive order is in effect until Aug. 10 at 11:59 p.m. EO 202-149 can be read in full here.

Executive Order 2020-152 – To increase the number of pharmacists who can serve patients during this time of need, preceptors may supervise student pharmacists remotely to fulfill eligibility for licensure and avoid delaying graduation. This executive order is in effect until the end of the state of emergency. EO 2020-152 can be read in full here.