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H.B. 358 Enrolled

             1     

ACCESS TO CONTROLLED SUBSTANCE DATABASE

             2     
REVISIONS

             3     
2011 GENERAL SESSION

             4     
STATE OF UTAH

             5     
Chief Sponsor: Steve Eliason

             6     
Senate Sponsor: Wayne L. Niederhauser

             7     
             8      LONG TITLE
             9      General Description:
             10          This bill modifies the Controlled Substance Database Act regarding parties who have
             11      access to the database.
             12      Highlighted Provisions:
             13          This bill:
             14          .    provides controlled substance database access to employees of the Office of Internal
             15      Audit and Program Integrity within the Department of Health who are engaged in
             16      their specified duty of ensuring Medicaid program integrity.
             17      Money Appropriated in this Bill:
             18          None
             19      Other Special Clauses:
             20          None
             21      Utah Code Sections Affected:
             22      AMENDS:
             23          58-37f-301, as enacted by Laws of Utah 2010, Chapter 287 and last amended by
             24      Coordination Clause, Laws of Utah 2010, Chapter 312
             25     
             26      Be it enacted by the Legislature of the state of Utah:
             27          Section 1. Section 58-37f-301 is amended to read:
             28           58-37f-301. Access to database.
             29          (1) The division shall make rules, in accordance with Title 63G, Chapter 3, Utah


             30      Administrative Rulemaking Act, to:
             31          (a) effectively enforce the limitations on access to the database as described in this
             32      part; and
             33          (b) establish standards and procedures to ensure accurate identification of individuals
             34      requesting information or receiving information without request from the database.
             35          (2) The division shall make information in the database available only to the following
             36      individuals, in accordance with the requirements of this chapter and division rules:
             37          (a) personnel of the division specifically assigned to conduct investigations related to
             38      controlled substance laws under the jurisdiction of the division;
             39          (b) authorized division personnel engaged in analysis of controlled substance
             40      prescription information as a part of the assigned duties and responsibilities of their
             41      employment;
             42          (c) in accordance with a written agreement entered into with the department,
             43      employees of the Department of Health:
             44          (i) whom the director of the Department of Health assigns to conduct scientific studies
             45      regarding the use or abuse of controlled substances, provided that the identity of the individuals
             46      and pharmacies in the database are confidential and are not disclosed in any manner to any
             47      individual who is not directly involved in the scientific studies; or
             48          (ii) when the information is requested by the Department of Health in relation to a
             49      person or provider whom the Department of Health suspects may be improperly obtaining or
             50      providing a controlled substance;
             51          (d) a licensed practitioner having authority to prescribe controlled substances, to the
             52      extent the information:
             53          (i) (A) relates specifically to a current or prospective patient of the practitioner; and
             54          (B) is sought by the practitioner for the purpose of:
             55          (I) prescribing or considering prescribing any controlled substance to the current or
             56      prospective patient;
             57          (II) diagnosing the current or prospective patient;


             58          (III) providing medical treatment or medical advice to the current or prospective
             59      patient; or
             60          (IV) determining whether the current or prospective patient:
             61          (Aa) is attempting to fraudulently obtain a controlled substance from the practitioner;
             62      or
             63          (Bb) has fraudulently obtained, or attempted to fraudulently obtain, a controlled
             64      substance from the practitioner;
             65          (ii) (A) relates specifically to a former patient of the practitioner; and
             66          (B) is sought by the practitioner for the purpose of determining whether the former
             67      patient has fraudulently obtained, or has attempted to fraudulently obtain, a controlled
             68      substance from the practitioner;
             69          (iii) relates specifically to an individual who has access to the practitioner's Drug
             70      Enforcement Administration identification number, and the practitioner suspects that the
             71      individual may have used the practitioner's Drug Enforcement Administration identification
             72      number to fraudulently acquire or prescribe a controlled substance;
             73          (iv) relates to the practitioner's own prescribing practices, except when specifically
             74      prohibited by the division by administrative rule;
             75          (v) relates to the use of the controlled substance database by an employee of the
             76      practitioner, described in Subsection (2)(e); or
             77          (vi) relates to any use of the practitioner's Drug Enforcement Administration
             78      identification number to obtain, attempt to obtain, prescribe, or attempt to prescribe, a
             79      controlled substance;
             80          (e) in accordance with Subsection (3)(a), an employee of a practitioner described in
             81      Subsection (2)(d), for a purpose described in Subsection (2)(d)(i) or (ii), if:
             82          (i) the employee is designated by the practitioner as an individual authorized to access
             83      the information on behalf of the practitioner;
             84          (ii) the practitioner provides written notice to the division of the identity of the
             85      employee; and


             86          (iii) the division:
             87          (A) grants the employee access to the database; and
             88          (B) provides the employee with a password that is unique to that employee to access
             89      the database in order to permit the division to comply with the requirements of Subsection
             90      58-37f-203 (3)(b) with respect to the employee;
             91          (f) a licensed pharmacist having authority to dispense a controlled substance to the
             92      extent the information is sought for the purpose of:
             93          (i) dispensing or considering dispensing any controlled substance; or
             94          (ii) determining whether a person:
             95          (A) is attempting to fraudulently obtain a controlled substance from the pharmacist; or
             96          (B) has fraudulently obtained, or attempted to fraudulently obtain, a controlled
             97      substance from the pharmacist;
             98          (g) federal, state, and local law enforcement authorities, and state and local
             99      prosecutors, engaged as a specified duty of their employment in enforcing laws:
             100          (i) regulating controlled substances; or
             101          (ii) investigating insurance fraud, Medicaid fraud, or Medicare fraud;
             102          (h) employees of the Office of Internal Audit and Program Integrity within the
             103      Department of Health who are engaged in their specified duty of ensuring Medicaid program
             104      integrity under Section 26-18-2.3 ;
             105          [(h)] (i) a mental health therapist, if:
             106          (i) the information relates to a patient who is:
             107          (A) enrolled in a licensed substance abuse treatment program; and
             108          (B) receiving treatment from, or under the direction of, the mental health therapist as
             109      part of the patient's participation in the licensed substance abuse treatment program described
             110      in Subsection (2)[(h)](i)(i)(A);
             111          (ii) the information is sought for the purpose of determining whether the patient is
             112      using a controlled substance while the patient is enrolled in the licensed substance abuse
             113      treatment program described in Subsection (2)[(h)](i)(i)(A); and


             114          (iii) the licensed substance abuse treatment program described in Subsection
             115      (2)[(h)](i)(i)(A) is associated with a practitioner who:
             116          (A) is a physician, a physician assistant, an advance practice registered nurse, or a
             117      pharmacist; and
             118          (B) is available to consult with the mental health therapist regarding the information
             119      obtained by the mental health therapist, under this Subsection (2)[(h)](i), from the database;
             120      and
             121          [(i)] (j) an individual who is the recipient of a controlled substance prescription entered
             122      into the database, upon providing evidence satisfactory to the division that the individual
             123      requesting the information is in fact the individual about whom the data entry was made.
             124          (3) (a) A practitioner described in Subsection (2)(d) may designate up to three
             125      employees to access information from the database under Subsection (2)(e).
             126          (b) The division shall make rules, in accordance with Title 63G, Chapter 3, Utah
             127      Administrative Rulemaking Act, to establish background check procedures to determine
             128      whether an employee designated under Subsection (2)(e)(i) should be granted access to the
             129      database.
             130          (c) The division shall grant an employee designated under Subsection (2)(e)(i) access
             131      to the database, unless the division determines, based on a background check, that the
             132      employee poses a security risk to the information contained in the database.
             133          (d) The division may impose a fee, in accordance with Section 63J-1-504 , on a
             134      practitioner who designates an employee under Subsection (2)(e)(i), to pay for the costs
             135      incurred by the division to conduct the background check and make the determination
             136      described in Subsection (3)(b).
             137          (4) (a) An individual who is granted access to the database based on the fact that the
             138      individual is a licensed practitioner or a mental health therapist shall be denied access to the
             139      database when the individual is no longer licensed.
             140          (b) An individual who is granted access to the database based on the fact that the
             141      individual is a designated employee of a licensed practitioner shall be denied access to the


             142      database when the practitioner is no longer licensed.


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