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                          LEGISLATURE OF NEBRASKA
                       ONE HUNDRED NINTH LEGISLATURE
                                SECOND SESSION
                   LEGISLATIVE BILL 1211
 Introduced by Riepe, 12.
 Read first time January 21, 2026
 Committee: Health and Human Services
1  A BILL FOR AN ACT relating to the Automated Medication Systems Act; to
2amend section 71-2444, Reissue Revised Statutes of Nebraska, and
3section 71-2449, Revised Statutes Cumulative Supplement, 2024; to
4provide requirements for automated medication systems operated by
5certain   pharmacies;   to   harmonize   provisions;   and   to   repeal   the
6original sections.
7    Be it enacted by the people of the State of Nebraska,
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1Section 1. Section 71-2444, Reissue Revised Statutes of Nebraska, is
2 amended to read:
371-2444 Sections 71-2444 to 71-2452 and section 3 of this act shall
4 be known and may be cited as the Automated Medication Systems Act.
5Sec. 2. Section 71-2449, Revised Statutes Cumulative Supplement,
6 2024, is amended to read:
771-2449 (1) An automated medication distribution machine:
8(a) Is subject to the requirements of section 71-2447 and, if it is
9 in a long-term care automated pharmacy, is subject to section 71-2451;
10 and
11(b)     Subject      to   section   71-2451,      may       be   operated    or   used     in   a
12 hospital,      long-term        care   facility,       or     assisted-living  facility    for
13 medication administration pursuant to a chart order or prescription by a
14 licensed health care professional; and .
15(c) Subject to section 71-2447 and section 3 of this act, may be
16 operated in connection with a pharmacy located on property owned or
17 leased by the licensed pharmacy, whether within the interior of the
18 pharmacy building or affixed to, or situated on, the exterior of the
19 building.
20(2) Drugs placed in an automated medication distribution machine
21 shall    be    in    the   manufacturer's      original  packaging   or   in    containers
22 repackaged      in    compliance       with    state        and    federal    laws,     rules,    and
23 regulations relating to repackaging, labeling, and record keeping.
24(3) The inventory which is transferred to an automated medication
25 distribution machine in a hospital shall be excluded from the percent of
26 total prescription drug sales revenue described in section 71-7454.
27Sec. 3.  (1) In order for an automated medication system to be
28 operated by, or under the authority of, a pharmacy licensed under the
29 Health      Care     Facility     Licensure     Act     and        located    in   Nebraska,      the
30 pharmacist in charge of the licensed pharmacy shall annually license the
31 automated medication system when such system is located on property owned
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1    or leased by the licensed pharmacy, whether within the interior of the
2     pharmacy building or affixed to, or situated on, the exterior of the
3  building.
4(2) The pharmacist in charge of a licensed pharmacy shall submit an
5    application for licensure or renewal of licensure to the Division of
6     Public Health of the Department of Health and Human Services with a fee
7    in an amount determined by the Board of Pharmacy, not to exceed fifty
8    dollars. The application shall include:
9(a) The name and location of the licensed pharmacy;
10(b)   The    physical       location     of   the   automated    medication    system,
11    affirming that it is located on property owned or leased by the licensed
12    pharmacy, whether within the interior of the pharmacy building or affixed
13    to, or situated on, the exterior of the building; and
14(c) The name of the pharmacist in charge of the licensed pharmacy.
15(3) As part of the application process, the division shall conduct
16    an inspection of the automated medication system by a pharmacy inspector
17    as   provided     in    section    38-28,101.      The   division    shall   also   conduct
18    inspections      of    the   operation   of    the   automated      medication   system   as
19    necessary.
20(4) The division shall license an automated medication system which
21    meets the licensure requirements of this section.
22(5) A pharmacist in charge of a licensed pharmacy shall apply for a
23    separate license for each location at which it operates one or more
24     automated medication systems. The licensed pharmacy shall be the provider
25 pharmacy for the automated medication system.
26(6) The pharmacist in charge of the licensed pharmacy operating an
27    automated medication system shall:
28(a)     Identify        a    pharmacist       responsible      for   the    operation,
29    supervision, and development of policies and procedures of the automated
30    medication system. Compliance with this subdivision shall be sufficient
31     if the pharmacist monitors the automated medication system electronically
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1 and keeps records of compliance with this requirement for a period of
2 five years;
3(b) Implement the policies and procedures developed to comply with
4 section 71-2447;
5(c) Assure compliance with the prescription drug storage and record
6 keeping requirements of the Pharmacy Practice Act;
7(d) Assure compliance with the labeling requirements described in
8 subsection (7) of this section;
9(e)   Develop       and    implement  policies     for    the      verification  of   a
10 prescription drug by a pharmacist prior to being loaded into an automated
11 medication system or for the verification of a prescription drug by a
12 pharmacist prior to being released to a patient or caregiver; and
13(f) Assure that each prescription drug is reviewed by a pharmacist
14 prior to the release of a drug by an automated medication system;
15(7) Each prescription drug dispensed from an automated medication
16     system shall meet the labeling requirements applicable to prescription
17 drugs dispensed by a licensed pharmacist pursuant to section 71-2479.
18(8)   An    automated       medication  system    shall      not    dispense  or   make
19 available      prescription  medication  to   a    patient     or    caregiver  unless
20 pharmacist  care    has    been     offered       and     made    available       in     a    manner
21 consistent with section 38-2869.
22(9) An automated medication system that is located outside a fully
23 enclosed       building  shall     not   be     placed     in    a    manner      that       exposes
24 medications to adverse environmental conditions or to security risks,
25 unless the Board of Pharmacy determines, through rule or case-specific
26 approval,      that       the    automated      medication       system     employs      environmental
27 controls and physical security measures sufficient to protect medication
28 integrity and prevent diversion.
29(10) An automated medication system operated in accordance with this
30 section       shall       not    store,    dispense,        or    otherwise       make    available  a
31  controlled substance as defined under state or federal law.
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1(11) This section does not apply to a long-term care automated
2  pharmacy or an automated medication system operated in a long-term care
3  facility under section 71-2451.
4Sec.   4.   Original   section    71-2444,   Reissue   Revised   Statutes   of
5 Nebraska, and section 71-2449, Revised Statutes Cumulative Supplement,
6    2024, are repealed.
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