On September 21, 2023, the Mississippi Board of Pharmacy (the “Board”) voted to approve and finalize modifications to its proposed rule on shared services. The Board had initially published the proposed rule on June 10, 2022. After a heavily attended public hearing on the proposed rule, multiple comments from stakeholders, and more than 15 months of review and deliberation, the Board only made slight modifications to the rule and approved for final review by the state’s Occupational Licensing Review Commission (“OLRC”). If approved by the OLRC, the rule will be filed with the Secretary of State as final.                         

As noted, much of the verbiage from the hotly debated proposed rule remains intact. Major highlights from the final rule include the following:

• The definition of “shared pharmacy services” was expanded and now includes “a system that allows a participating Pharmacist or Pharmacy pursuant to a request from another participating Pharmacist or Pharmacy to process or fill a Prescription Drug Order, which may include preparing, packaging, labeling, compounding for specific patients, dispensing, performing drug utilization reviews, conducting claims adjudication, obtaining refill authorizations, reviewing therapeutic interventions, and/or reviewing institutional facility orders.”
• Despite the expanded definition, the final rule requires that the originating pharmacy be the filling and dispensing pharmacy – effectively prohibiting central fill arrangements.
• Pharmacies participating in shared services must have the same owner or “common practice setting,” an undefined term.
• Pharmacies in a shared services arrangement must be permitted and comply with Board regulations, including the 3:1 technician to pharmacist ratio.
• Any pharmacist participating in shared pharmacy services must be individually licensed in Mississippi unless they are working onsite at a Mississippi permitted non-resident facility.
• As in the proposed rule, patients must be notified that their orders may be accessed, and non-filling functions may be performed by another pharmacy. Pharmacies must permit patients to opt-out of the arrangement.

The finalization of the shared services rule comes as pharmacies are currently engaged in submitting permit renewals. On the renewal applications, the Board is requiring applicants to expressly identify whether the entity is engaged in central fill services – a process that will be prohibited by the final rule should it be approved by OLRC and go into effect.