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HD 1365

An Act relative to opioid reversal drugs

194th Legislature (2025-2026) Introduced by Sally Kerans

Authorizes a statewide standing order for licensed pharmacists to dispense opioid antagonists (naloxone) with good-faith immunity and data reporting, billed like prescriptions.

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Bill Summary · HD 1365

Summary: An Act relative to opioid reversal drugs (HD 1365)

Overview

HD 1365, titled An Act relative to opioid reversal drugs, is a proposed bill introduced in the Massachusetts General Court in January 2025 by Representative Sally P. Kerans. The bill seeks to improve access to opioid antagonists (e.g., naloxone) by authorizing a statewide standing order that allows licensed pharmacists to dispense opioid antagonists and by providing liability protections and reporting requirements. It is part of the 194th General Court (2025-2026). The status is that it is a proposed bill; no final enactment status is provided in the text.

Purpose and intent

  • Enhance access to opioid reversal drugs across the Commonwealth.
  • Normalize and simplify the dispensing process for pharmacists through a statewide standing order.
  • Provide protections for individuals who dispense or administer opioid antagonists in good faith.
  • Establish data collection to monitor distribution and usage while protecting patient confidentiality.
  • Align pricing/billing practices with standard prescription processes for insurance purposes.

Key provisions

1) Definitions
- “Opioid antagonist” means any FDA-approved competitive narcotic antagonist used to reverse opioid overdoses (e.g., naloxone).

2) Statewide standing order
- The Department of Public Health (through the commissioner or a physician designated by the commissioner) must issue a statewide standing order authorizing licensed pharmacists to dispense opioid antagonists.
- The standing order includes standardized procedures or protocols for dispensing.

3) Dispensing authority and protections
- Pharmacists may dispense an opioid antagonist under the statewide standing order, notwithstanding other laws.
- Pharmacists acting in good faith are immunity-protected from criminal, civil liability or professional disciplinary action related to dispensing, except in cases of gross negligence or willful misconduct.

4) Reporting and data
- Pharmacists who dispense opioid antagonists must annually report the number of doses dispensed to the Department.
- Reports are confidential and do not identify individual patients.
- The Department must publish an annual aggregate report on dispensing of opioid antagonists.

5) Billing and insurance
- Transactions are treated as prescription dispensing for health insurance billing and cost-sharing purposes.
- Pharmacists must attempt to identify the purchaser’s insurance and submit a claim prior to dispensing, unless the purchaser pays out-of-pocket.

6) Broader immunity
- Immunity applies to the commissioner or physician issuing the standing order and to practitioners who prescribe or dispense an opioid antagonist in good faith.
- Individuals who administer an opioid antagonist in good faith to someone experiencing an overdose are immune from criminal/civil liability and professional discipline.
- The immunity framework references and aligns with existing immunity provisions (e.g., Section 34A).

7) Regulation and implementation
- The Department of Public Health, along with the Board of Registration in Medicine and the Board of Registration in Pharmacy, must adopt regulations to implement the section.

Who is affected

  • Licensed pharmacists: can dispense opioid antagonists under the statewide standing order; subject to reporting and billing requirements; protected by broad immunity.
  • Purchasers of opioid antagonists: may obtain these drugs from pharmacists; interactions with insurers/billing will be processed similarly to prescriptions.
  • Healthcare professionals: physicians issuing the standing order and prescribers/dispensers of antagonists gain immunities when acting in good faith.
  • Public health and regulatory bodies: Department of Public Health and the state boards will implement and regulate the program and publish aggregate dispensing data.

Implementation and timeline

  • No specific effective date is provided in the text excerpt; implementation hinges on regulatory rulemaking by the Department and Boards.
  • Regulations to implement the section must be adopted.
  • An annual aggregate report on dispensing must be published by the Department.

Potential impact and considerations

  • Positive impacts: expanded access to overdose reversal drugs, clearer dispensing authority for pharmacists, stronger protections for those who dispense or administer antagonists, better data on usage.
  • Considerations: cost implications for insurers and pharmacies, ensuring privacy in reporting, and monitoring for unintended misuse or misallocation of funds.

Compiled from official sources — confirm details with the bill’s official record.

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