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First Substitute H.B. 257

Representative Bradley M. Daw proposes the following substitute bill:


             1     
CONTROLLED SUBSTANCE DATABASE AMENDMENTS

             2     
2012 GENERAL SESSION

             3     
STATE OF UTAH

             4     
Chief Sponsor: Bradley M. Daw

             5     
Senate Sponsor: Curtis S. Bramble

             6     
             7      LONG TITLE
             8      General Description:
             9          This bill modifies Title 58, Chapter 37f, Controlled Substance Database Act, regarding
             10      use of the database to obtain information from other states or the federal government,
             11      access to the database by designated employees and practitioners, and the entering of
             12      pain management contracts in the database.
             13      Highlighted Provisions:
             14          This bill:
             15          .    prohibits unauthorized use of the controlled substance database as a means of
             16      obtaining information from other states or a federal drug monitoring program;
             17          .    provides for the designation by a practitioner of persons who are employed by the
             18      same business as the practitioner to gain access to the database at the request of the
             19      practitioner; and
             20          .    provides a procedure for an emergency room employee to look up information in
             21      the database for a practitioner who is treating an emergency room patient.
             22      Money Appropriated in this Bill:
             23          None
             24      Other Special Clauses:
             25          None


             26      Utah Code Sections Affected:
             27      AMENDS:
             28          58-37f-301, as last amended by Laws of Utah 2011, Chapters 38, 151, and 226
             29          58-37f-601, as enacted by Laws of Utah 2010, Chapter 287
             30     
             31      Be it enacted by the Legislature of the state of Utah:
             32          Section 1. Section 58-37f-301 is amended to read:
             33           58-37f-301. Access to database.
             34          (1) The division shall make rules, in accordance with Title 63G, Chapter 3, Utah
             35      Administrative Rulemaking Act, to:
             36          (a) effectively enforce the limitations on access to the database as described in this
             37      part; and
             38          (b) establish standards and procedures to ensure accurate identification of individuals
             39      requesting information or receiving information without request from the database.
             40          (2) The division shall make information in the database and information obtained from
             41      other state or federal prescription monitoring programs by means of the database available only
             42      to the following individuals, in accordance with the requirements of this chapter and division
             43      rules:
             44          (a) personnel of the division specifically assigned to conduct investigations related to
             45      controlled substance laws under the jurisdiction of the division;
             46          (b) authorized division personnel engaged in analysis of controlled substance
             47      prescription information as a part of the assigned duties and responsibilities of their
             48      employment;
             49          (c) in accordance with a written agreement entered into with the department,
             50      employees of the Department of Health:
             51          (i) whom the director of the Department of Health assigns to conduct scientific studies
             52      regarding the use or abuse of controlled substances, provided that the identity of the individuals
             53      and pharmacies in the database are confidential and are not disclosed in any manner to any
             54      individual who is not directly involved in the scientific studies; or
             55          (ii) when the information is requested by the Department of Health in relation to a
             56      person or provider whom the Department of Health suspects may be improperly obtaining or


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


             88      Subsection (2)(d), for a purpose described in Subsection (2)(d)(i) or (ii), if:
             89          (i) the employee is designated by the practitioner as an individual authorized to access
             90      the information on behalf of the practitioner;
             91          (ii) the practitioner provides written notice to the division of the identity of the
             92      employee; and
             93          (iii) the division:
             94          (A) grants the employee access to the database; and
             95          (B) provides the employee with a password that is unique to that employee to access
             96      the database in order to permit the division to comply with the requirements of Subsection
             97      58-37f-203 (3)(b) with respect to the employee;
             98          (f) an employee of the same business that employs a licensed practitioner under
             99      Subsection (2)(d) if:
             100          (i) the employee is designated by the practitioner as an individual authorized to access
             101      the information on behalf of the practitioner;
             102          (ii) the practitioner and the employing business provide written notice to the division of
             103      the identity of the designated employee; and
             104          (iii) the division:
             105          (A) grants the employee access to the database; and
             106          (B) provides the employee with a password that is unique to that employee to access
             107      the database in order to permit the division to comply with the requirements of Subsection
             108      58-37f-203 (3)(b) with respect to the employee;
             109          [(f)] (g) a licensed pharmacist having authority to dispense a controlled substance to
             110      the extent the information is sought for the purpose of:
             111          (i) dispensing or considering dispensing any controlled substance; or
             112          (ii) determining whether a person:
             113          (A) is attempting to fraudulently obtain a controlled substance from the pharmacist; or
             114          (B) has fraudulently obtained, or attempted to fraudulently obtain, a controlled
             115      substance from the pharmacist;
             116          [(g)] (h) federal, state, and local law enforcement authorities, and state and local
             117      prosecutors, engaged as a specified duty of their employment in enforcing laws:
             118          (i) regulating controlled substances; or


             119          (ii) investigating insurance fraud, Medicaid fraud, or Medicare fraud;
             120          [(h)] (i) employees of the Office of Internal Audit and Program Integrity within the
             121      Department of Health who are engaged in their specified duty of ensuring Medicaid program
             122      integrity under Section 26-18-2.3 ;
             123          [(i)] (j) a mental health therapist, if:
             124          (i) the information relates to a patient who is:
             125          (A) enrolled in a licensed substance abuse treatment program; and
             126          (B) receiving treatment from, or under the direction of, the mental health therapist as
             127      part of the patient's participation in the licensed substance abuse treatment program described
             128      in Subsection (2)[(i)](j)(i)(A);
             129          (ii) the information is sought for the purpose of determining whether the patient is
             130      using a controlled substance while the patient is enrolled in the licensed substance abuse
             131      treatment program described in Subsection (2)[(i)](j)(i)(A); and
             132          (iii) the licensed substance abuse treatment program described in Subsection
             133      (2)[(i)](j)(i)(A) is associated with a practitioner who:
             134          (A) is a physician, a physician assistant, an advance practice registered nurse, or a
             135      pharmacist; and
             136          (B) is available to consult with the mental health therapist regarding the information
             137      obtained by the mental health therapist, under this Subsection (2)[(i)](j), from the database;
             138          [(j)] (k) an individual who is the recipient of a controlled substance prescription
             139      entered into the database, upon providing evidence satisfactory to the division that the
             140      individual requesting the information is in fact the individual about whom the data entry was
             141      made;
             142          [(k)] (l) the inspector general, or a designee of the inspector general, of the Office of
             143      Inspector General of Medicaid Services, for the purpose of fulfilling the duties described in
             144      Title 63J, Chapter 4a, Part 2, Office Duties and Powers; and
             145          [(l)] (m) the following licensed physicians for the purpose of reviewing and offering an
             146      opinion on an individual's request for workers' compensation benefits under Title 34A, Chapter
             147      2, Workers' Compensation Act, or Title 34A, Chapter 3, Utah Occupational Disease Act:
             148          (i) a member of the medical panel described in Section 34A-2-601 ; or
             149          (ii) a physician offering a second opinion regarding treatment.


             150          (3) (a) A practitioner described in Subsection (2)(d) may designate up to three
             151      employees to access information from the database under Subsection (2)(e), (2)(f), or (4)(c).
             152          (b) The division shall make rules, in accordance with Title 63G, Chapter 3, Utah
             153      Administrative Rulemaking Act, to:
             154          (i) establish background check procedures to determine whether an employee
             155      designated under Subsection (2)(e)[(i)], (2)(f), or (4c) should be granted access to the
             156      database[.]; and
             157          (ii) establish the information to be provided by an emergency room employee under
             158      Subsection (4).
             159          (c) The division shall grant an employee designated under Subsection (2)(e)[(i)], (2)(f),
             160      or (4)(c) access to the database, unless the division determines, based on a background check,
             161      that the employee poses a security risk to the information contained in the database.
             162          (4) (a) An individual who is employed in the emergency room of a hospital may
             163      exercise access to the database under this Subsection (4) on behalf of a licensed practitioner if
             164      the individual is designated under Subsection (4)(c) and the licensed practitioner:
             165          (i) is employed in the emergency room;
             166          (ii) is treating an emergency room patient for an emergency medical condition; and
             167          (iii) requests that an individual employed in the emergency room and designated under
             168      Subsection (4)(c) obtain information regarding the patient from the database as needed in the
             169      course of treatment.
             170          (b) The emergency room employee obtaining information from the database shall,
             171      when gaining access to the database, provide to the database the name and any additional
             172      identifiers regarding the requesting practitioner as required by division administrative rule
             173      established under Subsection (3)(b).
             174          (c) An individual employed in the emergency room under this Subsection (4) may
             175      obtain information from the database as provided in Subsection (4)(a) if:
             176          (i) the employee is designated by the practitioner as an individual authorized to access
             177      the information on behalf of the practitioner;
             178          (ii) the practitioner and the hospital operating the emergency room provide written
             179      notice to the division of the identity of the designated employee; and
             180          (iii) the division:


             181          (A) grants the employee access to the database; and
             182          (B) provides the employee with a password that is unique to that employee to access
             183      the database in order to permit the division to comply with the requirements of Subsection
             184      58-37f-203 (3)(b) with respect to the employee.
             185          (d) The division may impose a fee, in accordance with Section 63J-1-504 , on a
             186      practitioner who designates an employee under Subsection (2)(e)[(i)], (2)(f), or (4)(c) to pay for
             187      the costs incurred by the division to conduct the background check and make the determination
             188      described in Subsection (3)(b).
             189          [(4)] (5) (a) An individual who is granted access to the database based on the fact that
             190      the individual is a licensed practitioner or a mental health therapist shall be denied access to the
             191      database when the individual is no longer licensed.
             192          (b) An individual who is granted access to the database based on the fact that the
             193      individual is a designated employee of a licensed practitioner shall be denied access to the
             194      database when the practitioner is no longer licensed.
             195          Section 2. Section 58-37f-601 is amended to read:
             196           58-37f-601. Unlawful release or use of database information -- Criminal and civil
             197      penalties.
             198          (1) Any person who knowingly and intentionally releases any information in the
             199      database or knowingly and intentionally releases any information obtained from other state or
             200      federal prescription monitoring programs by means of the database in violation of the
             201      limitations under Part 3, Access, is guilty of a third degree felony.
             202          (2) (a) Any person who obtains or attempts to obtain information from the database or
             203      from any other state or federal prescription monitoring programs by means of the database by
             204      misrepresentation or fraud is guilty of a third degree felony.
             205          (b) Any person who obtains or attempts to obtain information from the database for a
             206      purpose other than a purpose authorized by this chapter or by rule is guilty of a third degree
             207      felony.
             208          (3) (a) Except as provided in Subsection (3)(e), a person may not knowingly and
             209      intentionally use, release, publish, or otherwise make available to any other person any
             210      information obtained from the database or from any other state or federal prescription
             211      monitoring programs by means of the database for any purpose other than those specified in


             212      Part 3, Access.
             213          (b) Each separate violation of this Subsection (3) is a third degree felony and is also
             214      subject to a civil penalty not to exceed $5,000.
             215          (c) The procedure for determining a civil violation of this Subsection (3) [shall be] is in
             216      accordance with Section 58-1-108 , regarding adjudicative proceedings within the division.
             217          (d) Civil penalties assessed under this Subsection (3) shall be deposited in the General
             218      Fund as a dedicated credit to be used by the division under Subsection 58-37f-502 (1).
             219          (e) [Nothing in this] This Subsection (3) [prohibits] does not prohibit a person who
             220      obtains information from the database under Subsection 58-37f-301 (2)(d) [or], (e), (f), or (4)(c)
             221      from:
             222          (i) including the information in the person's medical chart or file for access by a person
             223      authorized to review the medical chart or file; or
             224          (ii) providing the information to a person in accordance with the requirements of the
             225      Health Insurance Portability and Accountability Act of 1996.


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