Representative Val L. Peterson proposes the following substitute bill:


1     
ONLINE PRESCRIBING AND DISPENSING OF MEDICAL DEVICES

2     
2016 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Val L. Peterson

5     
Senate Sponsor: ____________

6     

7     LONG TITLE
8     General Description:
9          This bill amends the Online Prescribing, Dispensing, and Facilitation Licensing Act.
10     Highlighted Provisions:
11          This bill:
12          ▸     amends definitions;
13          ▸     authorizes an optometrist to engage in the delivery of online pharmaceutical
14     services;
15          ▸     authorizes the online prescribing and dispensing of medical devices;
16          ▸     prohibits the Division of Occupational and Professional Licensing from approving a
17     device for online prescribing and dispensing unless the division provides the
18     respective professional licensing board with an opportunity for input;
19          ▸     establishes specials requirements for the online prescribing of contact lenses,
20     catheters, and devices used by a patient for the care or management of diabetes;
21          ▸     specifies that health insurance is not required to pay for the online prescribing or
22     dispensing of medical devices, including contact lenses; and
23          ▸     makes technical changes.
24     Money Appropriated in this Bill:
25          None

26     Other Special Clauses:
27          None
28     Utah Code Sections Affected:
29     AMENDS:
30          58-83-102, as enacted by Laws of Utah 2010, Chapter 180
31          58-83-301, as enacted by Laws of Utah 2010, Chapter 180
32          58-83-302, as enacted by Laws of Utah 2010, Chapter 180
33          58-83-305, as enacted by Laws of Utah 2010, Chapter 180
34          58-83-306, as last amended by Laws of Utah 2015, Chapter 321
35          58-83-307, as enacted by Laws of Utah 2010, Chapter 180
36          58-83-308, as enacted by Laws of Utah 2010, Chapter 180
37          58-83-401, as last amended by Laws of Utah 2011, Chapter 367
38          58-83-501, as enacted by Laws of Utah 2010, Chapter 180
39          58-83-503, as enacted by Laws of Utah 2010, Chapter 180
40     

41     Be it enacted by the Legislature of the state of Utah:
42          Section 1. Section 58-83-102 is amended to read:
43          58-83-102. Definitions.
44          In addition to the definitions in Section 58-1-102, as used in this chapter:
45          (1) "Board" means the Online Prescribing, Dispensing, and Facilitation Licensing
46     Board created in Section 58-83-201.
47          (2) "Branching questionnaire" means an adaptive and progressive assessment tool
48     approved by the board.
49          (3) "Controlled substance" means the same as that term is defined in Section
50     58-17b-102.
51          [(3)] (4) "Delivery of online pharmaceutical services" means the process in which [a
52     prescribing practitioner] an online prescriber diagnoses a patient and prescribes one or more of
53     the drugs or devices authorized by Section 58-83-306, using:
54          (a) (i) for a drug:
55          (A) a branching questionnaire approved by the division for the purpose of diagnosing
56     and assessing a patient's health status; or [other]

57          (B) another assessment tool approved by the division for the purpose of diagnosing and
58     assessing a patient's health status; or
59          (ii) for a device:
60          (A) a branching questionnaire approved by the division for the purpose of diagnosing
61     and assessing a patient's health status; or
62          (B) another assessment tool that is consistent with industry-recognized, standardized
63     requirements for prescribing the device and is approved by the division, with the opportunity
64     for input from the respective boards, for the purpose of diagnosing and assessing a patient's
65     health status and the propriety of the particular device for the patient;
66          (b) an Internet contract pharmacy to:
67          (i) dispense the prescribed drug or device; or
68          (ii) transfer the prescription to another pharmacy; and
69          (c) an Internet facilitator to facilitate the practices described in Subsections [(3)] (4)(a)
70     and (b).
71          (5) "Device":
72          (a) means the following prescription medical devices:
73          (i) a catheter intended for insertion by the patient;
74          (ii) a contact lens, as that term is defined in Section 58-16a-102;
75          (iii) a device that provides continuous positive airway pressure;
76          (iv) a device used by a patient for the care or management of diabetes; or
77          (v) a hearing aid, as that term is defined in Section 58-41-17; and
78          (b) does not mean a prescription medical device that:
79          (i) requires surgical implantation;
80          (ii) is a Class III medical device, as defined by the United States Food and Drug
81     Administration; or
82          (iii) is intended for use or application by only a licensed healthcare professional.
83          (6) "Dispense" means the same as that term is defined in Section 58-17b-102.
84          [(4)] (7) "Division" means the Utah Division of Occupational and Professional
85     Licensing.
86          (8) "Drug" means the same as that term is defined in Section 58-17b-102.
87          [(5)] (9) "Internet facilitator" means a licensed provider of a web-based system for

88     electronic communication between and among an online prescriber, the online prescriber's
89     patient, and the online contract pharmacy.
90          (10) "Legend drug" means a prescription drug.
91          [(6)] (11) "Online contract pharmacy" means a pharmacy licensed and in good standing
92     under Chapter 17b, Pharmacy Practice Act, as either a [Class A Retail Pharmacy] class A retail
93     pharmacy or a [Class B Closed Door Pharmacy] class B closed-door pharmacy and licensed
94     under this chapter to fulfill prescriptions issued by an online prescriber through a specific
95     Internet facilitator.
96          [(7)] (12) "Online prescriber" means [a person: (a) licensed under another chapter of
97     this title; (b) whose license under another chapter of this title includes assessing, diagnosing,
98     and prescribing authority for humans; and (c)]:
99          (a) a physician licensed under Chapter 67, Utah Medical Practice Act, or Chapter 68,
100     Utah Osteopathic Medical Practice Act, who has obtained a license under [this chapter to
101     engage in online prescribing.] Part 3, Licensing, to prescribe online; or
102          (b) an optometrist licensed under Chapter 16A, Utah Optometry Practice Act, who has
103     obtained a license under Part 3, Licensing, to prescribe online.
104          (13) "Pharmacist" means the same as that term is defined in Section 58-17b-102.
105          (14) "Pharmacy" means the same as that term is defined in Section 58-17b-102.
106          (15) "Prescribe" means the same as that term is defined in Section 58-17b-102.
107          (16) "Prescription" means the same as that term is defined in Section 58-17b-102.
108          (17) "Prescription drug" means the same as that term is defined in Section 58-17b-102.
109          (18) "Respective board":
110          (a) means, for a device, the licensing board in Title 58, Occupations and Professions,
111     for an online prescriber within whose scope of practice it is to prescribe the device; and
112          (b) includes:
113          (i) the Optometrist Licensing Board, created by Section 58-16a-201;
114          (ii) the Utah State Board of Pharmacy, created by Section 58-17b-201;
115          (iii) the Physicians Licensing Board, created by Section 58-67-201; and
116          (iv) the Osteopathic Physician and Surgeon's Licensing Board, created by Section
117     58-68-201.
118          [(8)] (19) "Unlawful conduct" [is as] means the same as that term is defined in Sections

119     58-1-501 [and], 58-83-501, and 58-83-503.
120          [(9)] (20) "Unprofessional conduct" [is as defined in Sections 58-1-203 and 58-83-502,
121     and as further defined by the division in accordance with Title 63G, Chapter 3, Utah
122     Administrative Rulemaking Act] means the same as that term is defined:
123          (a) in Sections 58-1-501, 58-1-203, and 58-83-502; and
124          (b) by rule made pursuant to Section 58-1-203 or 58-83-502.
125          Section 2. Section 58-83-301 is amended to read:
126          58-83-301. Licensure required -- Issuance of licenses.
127          (1) [Beginning July 1, 2010, and except] Except as provided in Section 58-1-307:
128          (a) an optometrist licensed under Chapter 16A, Utah Optometry Practice Act, shall be
129     licensed under this chapter to engage in the delivery of online pharmaceutical services;
130          [(a)] (b) a physician licensed under Chapter 67, Utah Medical Practice Act, or Chapter
131     68, Utah Osteopathic Medical Practice Act, shall be licensed under this chapter to engage in the
132     delivery of online pharmaceutical services;
133          [(b)] (c) an online contract pharmacy shall be licensed under this chapter to engage in
134     the delivery of online pharmaceutical services; and
135          [(c)] (d) an Internet facilitator shall be licensed under this chapter to engage in the
136     delivery of online pharmaceutical services.
137          (2) The division shall issue, to any person who qualifies under this chapter, a license:
138          (a) to prescribe online;
139          (b) to operate as an online contract pharmacy; or
140          (c) to operate as an Internet facilitator.
141          (3) (a) A license under this chapter is not required to engage in electronic prescribing
142     under Chapter 82, Electronic Prescribing Act[; and].
143          (b) Nothing in this chapter shall prohibit [a] an optometrist licensed under Chapter
144     16A, Utah Optometry Practice Act, or physician licensed under Chapter 67, Utah Medical
145     Practice Act, or Chapter 68, Utah Osteopathic Medical Practice Act, from electronic
146     prescribing or Internet prescribing as permitted by Chapter 16A, Utah Optometry Practice Act,
147     Chapter 67, Utah Medical Practice Act, [or] Chapter 68, Utah Osteopathic Medical Practice
148     Act, or other law.
149          Section 3. Section 58-83-302 is amended to read:

150          58-83-302. Qualifications for licensure.
151          (1) Each applicant for licensure as an online prescriber under this chapter shall:
152          (a) submit an application in a form prescribed by the division;
153          (b) pay a fee determined by the department under Section 63J-1-504;
154          (c) be of good moral character;
155          (d) document that the applicant holds a Utah license that is active and in good standing
156     and authorizes the licensee to engage in the assessment, diagnosis, and treatment of human
157     ailments and the [prescription] prescribing of medications or devices;
158          (e) document that any other professional license the applicant possesses from other
159     jurisdictions is in good standing;
160          (f) (i) submit to the division an outline of the applicant's proposed online assessment,
161     diagnosis, and prescribing tool, such as a branching questionnaire; and
162          (ii) demonstrate the proposed online assessment, diagnosis, and prescribing tool to the
163     board and establish to the board's satisfaction that the utilization of that assessment tool to
164     facilitate the [prescription] prescribing of the drugs or devices approved for online prescribing
165     under Section [58-83-305] 58-83-306 does not compromise the public's health, safety, or
166     welfare;
167          (g) submit policies and procedures that address patient confidentiality, including
168     measures that will be taken to ensure that the age and other identifying information of the
169     person completing the online branching questionnaire are accurate;
170          (h) describe the mechanism by which the online prescriber and patient will
171     communicate with one another, including electronic and telephonic communication;
172          (i) describe how the online prescriber/patient relationship will be established and
173     maintained;
174          (j) submit the name, address, and contact person of the Internet facilitator with whom
175     the online prescriber has contracted to provide services that the online prescriber will use to
176     engage in online assessment, diagnosis, and prescribing; and
177          (k) submit documentation satisfactory to the board regarding public health, safety, and
178     welfare demonstrating:
179          (i) how the online prescriber will comply with the requirements of Section 58-83-305;
180          (ii) the contractual services arrangement between the online prescriber and:

181          (A) the Internet facilitator; and
182          (B) the online contract pharmacy; and
183          (iii) how the online prescriber will allow and facilitate the division's ability to conduct
184     audits in accordance with Section 58-83-308.
185          (2) An online prescriber may not use the services of an Internet facilitator or online
186     contract pharmacy whose license is not active and in good standing.
187          (3) Each applicant for licensure as an online contract pharmacy under this chapter
188     shall:
189          (a) be licensed in good standing [in Utah] under Chapter 17b, Pharmacy Practice Act,
190     as a [Class A Retail Pharmacy] class A retail pharmacy or a [Class B Closed Door Pharmacy]
191     class B closed-door pharmacy;
192          (b) submit a written application in the form prescribed by the division;
193          (c) pay a fee as determined by the department under Section 63J-1-504;
194          (d) submit any contract between the applicant and the Internet facilitator with which
195     the applicant is or will be affiliated;
196          (e) submit proof of liability insurance acceptable to the division that expressly covers
197     all activities the online contract pharmacy will engage in under this chapter, which coverage
198     shall be in a minimum amount of $1,000,000 per occurrence with a policy limit of not less than
199     $3,000,000;
200          (f) submit a signed affidavit to the division attesting that the online contract pharmacy
201     will not dispense a drug or device that is prescribed by an online prescriber engaged in the
202     delivery of online pharmaceutical services under the provisions of this chapter unless:
203          (i) the drug or device is specifically approved by the division under Section 58-83-306;
204     and
205          (ii) both the prescribing and the dispensing of the drug or device were facilitated by the
206     Internet facilitator with whom the Internet contract pharmacy is associated under Subsection
207     58-83-302(3)(d);
208          (g) document that any other professional license the applicant possesses from other
209     jurisdictions is active and in good standing; and
210          (h) demonstrate to the division that the applicant has satisfied any background check
211     required by Section 58-17b-307, and each owner, officer, or manager of the applicant online

212     contract pharmacy has not engaged in any act, practice, or omission, which when considered
213     with the duties and responsibilities of a licensee under this chapter indicates there is cause to
214     believe that issuing a license under this chapter is inconsistent with the public's health, safety,
215     or welfare.
216          (4) Each applicant for licensure as an Internet facilitator under this chapter shall:
217          (a) submit a written application in the form prescribed by the division;
218          (b) pay a fee as determined by the department under Section 63J-1-504;
219          (c) submit any contract between the applicant and the following with which the
220     applicant will be affiliated:
221          (i) each online prescriber; and
222          (ii) the single online contract pharmacy;
223          (d) submit written policies and procedures satisfactory to the division that:
224          (i) address patient privacy, including compliance with 45 C.F.R. Parts 160, 162, and
225     164, Health Insurance Portability and Accountability Act of 1996;
226          (ii) ensure compliance with all applicable laws by health care personnel and the online
227     prescriber who will process patient communications;
228          (iii) list the hours of operation;
229          (iv) describe the types of services that will be permitted electronically;
230          (v) describe the required patient information to be included in the communication, such
231     as patient name, identification number, and type of transaction;
232          (vi) establish procedures for archiving and retrieving information; and
233          (vii) establish quality oversight mechanisms;
234          (e) submit written documentation of the applicant's security measures to ensure the
235     confidentiality and integrity of any user-identifiable medical information;
236          (f) submit a description of the mechanism for:
237          (i) patients to access, supplement, and amend patient-provided personal health
238     information;
239          (ii) back-up regarding the Internet facilitator electronic interface;
240          (iii) the quality of information and services provided via the interface; and
241          (iv) patients to register complaints regarding the Internet facilitator, the online
242     prescriber, or the online contract pharmacy;

243          (g) submit a copy of the Internet facilitator's website;
244          (h) sign an affidavit attesting that:
245          (i) the applicant will not access any medical records or information contained in the
246     medical record except as necessary to administer the website and the branching questionnaire;
247     and
248          (ii) the applicant and its principals, and any entities affiliated with them, will only use
249     the services of a single online contract pharmacy named on the license approved by the
250     division; and
251          (i) submit any other information required by the division.
252          Section 4. Section 58-83-305 is amended to read:
253          58-83-305. Duties and responsibilities.
254          (1) The online prescriber shall:
255          (a) be held to the same standards of appropriate practice as those applicable in
256     traditional settings which, for purposes of this chapter, include the delivery of online
257     pharmaceutical services;
258          (b) conduct an assessment and diagnosis based upon a comprehensive health history
259     and an assessment tool such as a branching questionnaire;
260          (c) ensure that a comprehensive health history, assessment, and diagnosis have been
261     made before prescribing [any] a medication or device;
262          (d) conduct the online assessment and diagnosis only through the approved Internet
263     facilitator identified in the online prescriber's application;
264          (e) comply with all applicable state and federal laws, rules, regulations, and orders;
265          (f) inform the patient electronically of the benefits and risks of appropriate treatment;
266          (g) guide the patient regarding the optimal course of action;
267          (h) treat the patient with courtesy, respect, dignity, responsiveness, and timely attention
268     to the patient's needs;
269          (i) comply with the requirements for confidentiality as required by this title and
270     applicable federal law;
271          (j) continue to provide the user with reasonable assistance and sufficient opportunity to
272     make alternative arrangements for care;
273          (k) be available for ongoing consultation with the patient through e-mail or other forms

274     of communication;
275          (l) not delegate to a third party the professional responsibility to:
276          (i) review and evaluate the results of the branching questionnaire;
277          (ii) consult with the patient electronically or through other means about the patient's
278     medical condition; and
279          (iii) diagnose and prescribe [medications] a medication or device to the patient;
280          (m) conduct the online assessment and diagnosis and the electronic communication
281     between the online prescriber and the patient only through the approved Internet facilitator;
282          (n) (i) maintain the online medical records of the patient; and
283          (ii) if maintenance of the records is delegated by the online prescriber, delegate that
284     authority only to the approved Internet facilitator;
285          (o) inform a patient of the patient's freedom of choice to select the pharmacy to
286     dispense the patient's prescription by providing the patient with the phone number of the online
287     contract pharmacy so that the patient may contact the online contract pharmacy and request a
288     transfer of the prescription to another pharmacy; and
289          (p) authorize the Internet facilitator to provide the online contract pharmacy with the
290     patient's:
291          (i) full name;
292          (ii) current address and telephone number;
293          (iii) date of birth or age and gender;
294          (iv) height, weight, and vital signs (if known);
295          (v) medication allergies or drug reactions; and
296          (vi) current medications, including over-the-counter products, and any additional
297     comments relevant to the patient's drug or device use.
298          (2) The online contract pharmacy shall:
299          (a) only dispense a prescription [drugs] drug or device that:
300          (i) [are] is approved by the division in accordance with Section 58-83-306; and
301          (ii) [were] is prescribed by an online prescriber who is using the Internet facilitator that
302     is under contract with the online contract pharmacy;
303          (b) maintain a toll-free number with a pharmacist available for patients using the
304     services of the online contract pharmacy to receive [medications] a medication or device

305     prescribed online;
306          (c) use a tracking identification number system when shipping [medications] a
307     medication or device prescribed for [patients] a patient by an online prescriber; and
308          (d) provide to the division a quarterly report of all drugs and devices dispensed in
309     accordance with this chapter.
310          (3) The Internet facilitator shall:
311          (a) provide services that the online prescriber will use in implementing the branching
312     questionnaire or other assessment tool;
313          (b) provide electronic or telephonic communication between the online prescriber and
314     the patient that:
315          (i) is secure and confidential;
316          (ii) allows the online prescriber to be directly accessible to a patient to answer
317     questions regarding the patient's treatment plan; and
318          (iii) provides privacy and security that complies with the provisions of 45 C.F.R. Parts
319     160, 162, and 164, Health Insurance Portability and Accountability Act of 1996;
320          (c) facilitate secure and confidential communication of the prescription issued by the
321     online prescriber to the online contract pharmacy in accordance with Subsection (1)(p);
322          (d) disclose on its website:
323          (i) the owner of the website;
324          (ii) the specific services provided by any associated online prescribers; and
325          (iii) other information the division may require by rule; and
326          (e) (i) only facilitate the delivery of online pharmaceutical services for the specific
327     legend drugs or devices approved by the division in accordance with Section 58-83-306; or
328          (ii) not facilitate, directly or indirectly, through related entities or affiliates, the
329     dispensing or online prescribing of any drug [whether controlled or legend] or device that is not
330     specifically approved under Section 58-83-306.
331          Section 5. Section 58-83-306 is amended to read:
332          58-83-306. Completion of branching questionnaire required for prescription --
333     Drugs and devices approved for online prescribing, dispensing, and facilitation --
334     Delivery of prescription drugs or devices -- Limit on contact lenses -- Health insurance
335     not required to cover online prescribing and dispensing.

336          (1) An online prescriber may prescribe a device or a legend drug that is not a controlled
337     substance only if the patient has completed, and the online prescriber has evaluated, a
338     branching questionnaire or other assessment, diagnosis, and prescribing tool approved by the
339     division and described by Subsections 58-83-102(3)(a), 58-83(302)(1)(f), and 58-83-305(1)(b)
340     and (c).
341          [(1)] (2) An online prescriber may only prescribe, an online contract pharmacy may
342     only dispense, and an Internet facilitator may only facilitate the prescribing and dispensing of[,
343     non-controlled,] a device or a legend [drugs] drug that is not a controlled substance:
344          (a) that [have] has been approved by the Food and Drug Administration;
345          (b) that [are] is prescribed to treat the condition for which the drug or device was
346     approved, within the drug or device manufacturer's guidelines;
347          (c) that [are] is, subject to Subsection (4), specifically approved by the division for
348     online prescribing by administrative rule adopted in accordance with Title 63G, Chapter 3,
349     Utah Administrative Rulemaking Act[;].
350          (3) An online prescriber may only prescribe, an online contract pharmacy may only
351     dispense, and an Internet facilitator may only facilitate the prescribing and dispensing of a
352     legend drug that is not a controlled substance:
353          [(d)] (a) that [are] is prescribed for a person who is:
354          (i) 18 years of age or older; or
355          (ii) at least 16 years of age:
356          (A) if permitted by the state or country in which the patient will receive the drug;
357          (B) with parental consent, if required by the state or country in which the patient will
358     receive the drug; and
359          (C) only if the prescription is for a hormonal based contraceptive; and
360          [(e)] (b) to a person who is located in another country, if the country is designated by
361     the division, by administrative rule, as a country with a regulatory framework for prescribing
362     and dispensing of drugs.
363          (4) (a) The division may not approve a drug or device under Subsection (2)(c) for
364     online prescribing unless:
365          (i) for a device, the division has provided the respective boards with the opportunity for
366     input as to whether the device should be approved; and

367          (ii) the division determines that online prescribing of the drug or device does not
368     compromise the public's health, safety, or welfare.
369          (b) The division may approve a drug or device for online prescribing by an optometrist
370     only if an optometrist may prescribe the drug or device under Chapter 16a, Utah Optometry
371     Practice Act.
372          [(2)] (5) If[, after January 1, 2010,] the Food and Drug Administration issues a clinical
373     black box warning with respect to any drug or device approved by the board under Subsection
374     (1), the division shall determine what action, if any, is necessary to protect the public health or
375     welfare as a result of the black box warning.
376          (6) An online prescriber may issue an online prescription for contact lenses only if:
377          (a) a branching questionnaire or other assessment, diagnosis, and prescribing tool has
378     been completed as required by Subsection (1);
379          (b) the patient provides the online prescriber with proof of an expired contact lens
380     prescription, as defined in Subsection 58-16a-102(3) and issued in accordance with 15 U.S.C.
381     Sec. 7604; and
382          (c) the prescription issued by the online prescriber is for one renewal of the expired
383     contact lens prescription.
384          (7) An online prescriber may issue an online prescription for a catheter intended for
385     insertion by the patient, or for a device used by the patient for the care or management of
386     diabetes, only if a branching questionnaire or other assessment, diagnosis, and prescribing tool
387     has been completed as required by Subsection (1).
388          (8) Nothing in this chapter requires health insurance, as defined in Section 31A-1-301,
389     to pay for the online prescribing, the online dispensing, or the facilitation of online prescribing
390     or online dispensing of a device, including contact lenses.
391          Section 6. Section 58-83-307 is amended to read:
392          58-83-307. Approval of additional drugs or devices -- Request to facilitate.
393          (1) An Internet facilitator licensed under this chapter may seek the division's approval
394     to facilitate the online prescribing and dispensing of prescriptions for additional drugs or
395     devices.
396          (2) The Internet facilitator shall make a request for approval of additional drugs or
397     devices by petitioning for an amendment to the administrative rule adopted by the division in

398     accordance with Section 58-83-306 and Title 63G, Chapter 3, Utah Administrative Rulemaking
399     Act.
400          Section 7. Section 58-83-308 is amended to read:
401          58-83-308. Audits.
402          (1) Each licensee under this chapter shall allow and facilitate an audit by the division
403     regarding the licensee's delivery of online pharmaceutical services to ensure compliance with
404     state and federal statutes, rules, and regulations including ensuring that:
405          (a) a comprehensive history and assessment have been obtained and a diagnosis has
406     been made for a patient before [any medications are] a medication or device is prescribed; and
407          (b) only [the] approved medications or devices are being prescribed [and] or dispensed.
408          (2) The division shall be provided with the following, in the manner that allows access
409     from the division's office for the purpose of conducting an audit:
410          (a) full remote, read-only access rights to the data related to the online prescribing and
411     dispensing of a drug or device under this chapter and that is used and stored in the Internet
412     facilitator's system; and
413          (b) the information available to the online prescriber.
414          (3) An Internet facilitator licensed under this chapter shall provide to the division, at
415     the times designated by the division by administrative rule, a report containing the following
416     information:
417          (a) the number of prescriptions issued by the online prescribers associated with the
418     Internet facilitator by drug or device name;
419          (b) the number of comprehensive histories/assessments received by the Internet
420     facilitator;
421          (c) the number of comprehensive histories/assessments reviewed by an online
422     prescriber;
423          (d) the demographic data of the patients receiving prescriptions through the Internet
424     facilitator;
425          (e) the number of prescriptions:
426          (i) dispensed by the online contract pharmacy; or
427          (ii) transferred to a different pharmacy at the patient's request; and
428          (f) any other information specified by the division by administrative rule.

429          (4) The division's authority to conduct an audit pursuant to this chapter shall survive
430     any termination or expiration of any prescriptive authority for online prescribing, dispensing, or
431     facilitation.
432          Section 8. Section 58-83-401 is amended to read:
433          58-83-401. Grounds for denial of license -- Disciplinary proceedings --
434     Termination of authority to prescribe -- Immediate and significant danger.
435          (1) Grounds for refusing to issue a license to an applicant, for refusing to renew the
436     license of a licensee, for revoking, suspending, restricting, or placing on probation the license
437     of a licensee, for issuing a public reprimand to a licensee, and for issuing a cease and desist
438     order:
439          (a) shall be in accordance with Section 58-1-401; and
440          (b) includes:
441          (i) prescribing, dispensing, or facilitating the prescribing or dispensing of a drug or
442     device not approved by the board under Section 58-83-306; or
443          (ii) any other violation of this chapter.
444          (2) The termination or expiration of a license under this chapter for any reason does not
445     limit the division's authority to start or continue any investigation or adjudicative proceeding.
446          (3) (a) Because of the working business relationship between and among the online
447     prescriber, the Internet facilitator, and the online contract pharmacy, each entity's ability to
448     comply with this chapter may depend in some respects on the actions of the others.
449          (b) It is possible that a particular action or inaction by the online prescriber, the Internet
450     facilitator, or the online contract pharmacy could have the effect of causing the other licensed
451     entities to be out of compliance with this chapter, and each entity may, therefore, be held
452     accountable for any related party's non-compliance, if the party knew or reasonably should
453     have known of the other person's non-compliance.
454          (4) (a) An online prescriber may lose the [practitioner's] online prescriber's
455     professional license to prescribe [any] a drug or device under this title if the online prescriber
456     knew or reasonably should have known that the provisions of this chapter were violated by the
457     online prescriber, the Internet facilitator, or the online contract pharmacy.
458          (b) It is not a defense to an alleged violation under this chapter that the alleged
459     violation was a result of an action or inaction not by the charged party but by the related online

460     prescriber, the online contract pharmacy, or the Internet facilitator.
461          (5) The following actions may result in an immediate suspension of the online
462     prescriber's license, the online contract pharmacy's license, or the Internet facilitator's license,
463     and each is considered an immediate and significant danger to the public health, safety, or
464     welfare requiring immediate action by the division pursuant to Section 63G-4-502 to terminate
465     the delivery of online pharmaceutical services by the licensee:
466          (a) online prescribing, dispensing, or facilitation with respect to:
467          (i) a person under the age of 18 years;
468          (ii) a legend drug or device not authorized by the division in accordance with Section
469     58-83-306; and
470          (iii) any controlled substance;
471          (b) violating this chapter after having been given reasonable opportunity to cure the
472     violation;
473          (c) using the name or official seal of the state, the Utah Department of Commerce, or
474     the Utah Division of Occupational and Professional Licensing, or their boards, in an
475     unauthorized manner; or
476          (d) failing to respond to a request from the division within the time frame requested
477     for:
478          (i) an audit of the website; or
479          (ii) records of the online prescriber, the Internet facilitator, or the online contract
480     pharmacy.
481          Section 9. Section 58-83-501 is amended to read:
482          58-83-501. Practice without a license.
483          ["Unlawful conduct"] Unlawful conduct includes, in addition to the definition in
484     Section 58-1-501, engaging in the practice of Internet prescribing without a license under this
485     chapter.
486          Section 10. Section 58-83-503 is amended to read:
487          58-83-503. Unlawful conduct.
488          Unlawful conduct includes, in addition to the definition in Section 58-1-501:
489          (1) online prescribing, dispensing, or facilitating of a legend drug or device not
490     authorized by the division in accordance with Section 58-83-306; or

491          (2) online prescribing, dispensing, or facilitating of a controlled substance.