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First Substitute H.B. 119

Representative Bradley M. Daw proposes the following substitute bill:


             1     
CONTROLLED SUBSTANCE DATABASE

             2     
AMENDMENTS

             3     
2008 GENERAL SESSION

             4     
STATE OF UTAH

             5     
Chief Sponsor: Bradley M. Daw

             6     
Senate Sponsor: Curtis S. Bramble

             7     
             8      LONG TITLE
             9      General Description:
             10          This bill amends provisions of the Utah Controlled Substances Act relating to the
             11      controlled substance database and establishes a pilot program for real-time reporting of
             12      data to, and access from, the controlled substance database.
             13      Highlighted Provisions:
             14          This bill:
             15          .    defines terms;
             16          .    makes it a third degree felony to obtain or attempt to obtain information from the
             17      controlled substances database for a purpose other than a purpose authorized by
             18      statute or rule;
             19          .    prohibits access to, and use of, identifying information in the controlled substance
             20      database, by discovery, subpoena, or similar process, in certain civil, judicial,
             21      administrative, or legislative proceedings;
             22          .    establishes a pilot program, beginning on July 1, 2008, and ending on July 1, 2010,
             23      for the real-time reporting of, and access to, controlled substance database
             24      information by pharmacies, pharmaceutical facilities, and physicians;
             25          .    grants rulemaking authority to the Division of Occupational and Professional


             26      Licensing in relation to the pilot program;
             27          .    requires the Division of Occupational and Professional Licensing to report on the
             28      pilot program and the advisability and cost of implementing the pilot program on a
             29      statewide basis;
             30          .    requires the Division of Occupational and Professional Licensing to implement the
             31      pilot program established in this bill as a permanent program on a statewide basis,
             32      on or before July 1, 2010; and
             33          .    makes technical changes.
             34      Monies Appropriated in this Bill:
             35          This bill appropriates:
             36          .    $175,000 as an ongoing appropriation from the General Fund, for the fiscal year
             37      2008-09, to the Division of Occupational and Professional Licensing; and
             38          .    $650,000 from the General Fund, for the fiscal year 2008-09 only, to the Division of
             39      Occupational and Professional Licensing, as nonlapsing funds.
             40      Other Special Clauses:
             41          This bill takes effect on July 1, 2008.
             42      Utah Code Sections Affected:
             43      AMENDS:
             44          58-37-7.5, as last amended by Laws of Utah 2007, Chapter 293
             45      ENACTS:
             46          58-37-7.8, Utah Code Annotated 1953
             47     
             48      Be it enacted by the Legislature of the state of Utah:
             49          Section 1. Section 58-37-7.5 is amended to read:
             50           58-37-7.5. Controlled substance database -- Pharmacy reporting requirements --
             51      Access -- Penalties.
             52          (1) As used in this section:
             53          (a) "Board" means the Utah State Board of Pharmacy created in Section 58-17b-201 .
             54          [(a)] (b) "Database" means the controlled substance database created in this section.
             55          [(b)] (c) "Database manager" means the person responsible for operating the database,
             56      or [his] the person's designee.


             57          [(c)] (d) "Division" means the Division of Occupational and Professional Licensing
             58      created in Section 58-1-103 .
             59          [(d)] (e) "Health care facility" [has the same definition as] is as defined in Section
             60      26-21-2 .
             61          [(e)] (f) "Pharmacy" or "pharmaceutical facility" [has the same definition as] is as
             62      defined in Section 58-17b-102 .
             63          (2) (a) There is created within the division a controlled substance database.
             64          (b) The division shall administer and direct the functioning of the database in
             65      accordance with this section. The division may under state procurement laws contract with
             66      another state agency or private entity to establish, operate, or maintain the database. The
             67      division in collaboration with the board shall determine whether to operate the database within
             68      the division or contract with another entity to operate the database, based on an analysis of
             69      costs and benefits.
             70          (c) The purpose of the database is to contain data as described in this section regarding
             71      every prescription for a controlled substance dispensed in the state to any person other than an
             72      inpatient in a licensed health care facility.
             73          (d) Data required by this section shall be submitted in compliance with this section to
             74      the manager of the database by the pharmacist in charge of the drug outlet where the controlled
             75      substance is dispensed.
             76          (3) The [Utah State Board of Pharmacy created in Section 58-17b-201 ] board shall
             77      advise the division regarding:
             78          (a) establishing, maintaining, and operating the database;
             79          (b) access to the database and how access is obtained; and
             80          (c) control of information contained in the database.
             81          (4) The pharmacist in charge shall, regarding each controlled substance dispensed by a
             82      pharmacist under [his] the pharmacist's supervision other than those dispensed for an inpatient
             83      at a health care facility, submit to the manager of the database the following information, by a
             84      procedure and in a format established by the division:
             85          (a) name of the prescribing practitioner;
             86          (b) date of the prescription;
             87          (c) date the prescription was filled;


             88          (d) name of the person for whom the prescription was written;
             89          (e) positive identification of the person receiving the prescription, including the type of
             90      identification and any identifying numbers on the identification;
             91          (f) name of the controlled substance;
             92          (g) quantity of controlled substance prescribed;
             93          (h) strength of controlled substance;
             94          (i) quantity of controlled substance dispensed;
             95          (j) dosage quantity and frequency as prescribed;
             96          (k) name of drug outlet dispensing the controlled substance;
             97          (l) name of pharmacist dispensing the controlled substance; and
             98          (m) other relevant information as required by division rule.
             99          (5) The division shall maintain the database in an electronic file or by other means
             100      established by the division to facilitate use of the database for identification of:
             101          (a) prescribing practices and patterns of prescribing and dispensing controlled
             102      substances;
             103          (b) practitioners prescribing controlled substances in an unprofessional or unlawful
             104      manner;
             105          (c) individuals receiving prescriptions for controlled substances from licensed
             106      practitioners, and who subsequently obtain dispensed controlled substances from a drug outlet
             107      in quantities or with a frequency inconsistent with generally recognized standards of dosage for
             108      that controlled substance; and
             109          (d) individuals presenting forged or otherwise false or altered prescriptions for
             110      controlled substances to a pharmacy.
             111          (6) (a) The division shall by rule establish the electronic format in which the
             112      information required under this section shall be submitted to the administrator of the database.
             113          (b) The division shall ensure the database system records and maintains for reference:
             114          (i) identification of each person who requests or receives information from the
             115      database;
             116          (ii) the information provided to each person; and
             117          (iii) the date and time the information is requested or provided.
             118          (7) The division shall make rules to:


             119          (a) effectively enforce the limitations on access to the database as described in
             120      Subsection (8); and
             121          (b) establish standards and procedures to ensure accurate identification of individuals
             122      requesting information or receiving information without request from the database.
             123          (8) The manager of the database shall make information in the database available only
             124      to the following persons, and in accordance with the limitations stated and division rules:
             125          (a) personnel of the division specifically assigned to conduct investigations related to
             126      controlled substances laws under the jurisdiction of the division;
             127          (b) authorized division personnel engaged in analysis of controlled substance
             128      prescription information as a part of the assigned duties and responsibilities of their
             129      employment;
             130          (c) employees of the Department of Health whom the director of the Department of
             131      Health assigns to conduct scientific studies regarding the use or abuse of controlled substances,
             132      provided that the identity of the individuals and pharmacies in the database are confidential and
             133      are not disclosed in any manner to any individual who is not directly involved in the scientific
             134      studies;
             135          (d) a licensed practitioner having authority to prescribe controlled substances, to the
             136      extent:
             137          (i) the information relates specifically to a current patient of the practitioner, to whom
             138      the practitioner is prescribing or considering prescribing any controlled substance;
             139          (ii) the information relates specifically to an individual who has access to the
             140      practitioner's Drug Enforcement Administration number, and the practitioner suspects that the
             141      individual may have used the practitioner's Drug Enforcement Administration identification
             142      number to fraudulently acquire or prescribe controlled substances; or
             143          (iii) the information relates to the practitioner's own prescribing practices, except when
             144      specifically prohibited by the division by administrative rule;
             145          (e) a licensed pharmacist having authority to dispense controlled substances to the
             146      extent the information relates specifically to a current patient to whom that pharmacist is
             147      dispensing or considering dispensing any controlled substance;
             148          (f) federal, state, and local law enforcement authorities, and state and local prosecutors,
             149      engaged as a specified duty of their employment in enforcing laws:


             150          (i) regulating controlled substances; or
             151          (ii) investigating insurance fraud, Medicaid fraud, or Medicare fraud; and
             152          (g) an individual who is the recipient of a controlled substance prescription entered into
             153      the database, upon providing evidence satisfactory to the database manager that the individual
             154      requesting the information is in fact the person about whom the data entry was made.
             155          (9) Any person who knowingly and intentionally releases any information in the
             156      database in violation of the limitations under Subsection (8) is guilty of a third degree felony.
             157          (10) (a) Any person who obtains or attempts to obtain information from the database
             158      by misrepresentation or fraud is guilty of a third degree felony.
             159          (b) Any person who obtains or attempts to obtain information from the database for a
             160      purpose other than a purpose authorized by this section or by rule is guilty of a third degree
             161      felony.
             162          (11) (a) A person may not knowingly and intentionally use, release, publish, or
             163      otherwise make available to any other person or entity any information obtained from the
             164      database for any purpose other than those specified in Subsection (8). Each separate violation
             165      of this Subsection (11) is a third degree felony and is also subject to a civil penalty not to
             166      exceed $5,000.
             167          (b) The procedure for determining a civil violation of this Subsection (11) shall be in
             168      accordance with Section 58-1-108 , regarding adjudicative proceedings within the division.
             169          (c) Civil penalties assessed under this Subsection (11) shall be deposited in the General
             170      Fund as a dedicated credit to be used by the division under Subsection 58-37-7.7 (1).
             171          (12) (a) The failure of a pharmacist in charge to submit information to the database as
             172      required under this section after the division has submitted a specific written request for the
             173      information or when the division determines the individual has a demonstrable pattern of
             174      failing to submit the information as required is grounds for the division to take the following
             175      actions in accordance with Section 58-1-401 :
             176          (i) refuse to issue a license to the individual;
             177          (ii) refuse to renew the individual's license;
             178          (iii) revoke, suspend, restrict, or place on probation the license;
             179          (iv) issue a public or private reprimand to the individual;
             180          (v) issue a cease and desist order; and


             181          (vi) impose a civil penalty of not more than $1,000 for each dispensed prescription
             182      regarding which the required information is not submitted.
             183          (b) Civil penalties assessed under Subsection (12)(a)(vi) shall be deposited in the
             184      General Fund as a dedicated credit to be used by the division under Subsection 58-37-7.7 (1).
             185          (c) The procedure for determining a civil violation of this Subsection (12) shall be in
             186      accordance with Section 58-1-108 , regarding adjudicative proceedings within the division.
             187          (13) An individual who has submitted information to the database in accordance with
             188      this section may not be held civilly liable for having submitted the information.
             189          (14) All department and the division costs necessary to establish and operate the
             190      database shall be funded by appropriations from:
             191          (a) the Commerce Service Fund; and
             192          (b) the General Fund.
             193          (15) All costs associated with recording and submitting data as required in this section
             194      shall be assumed by the submitting pharmacy.
             195          (16) (a) Except as provided in Subsection (16)(b), data provided to, maintained in, or
             196      accessed from the database that may be identified to, or with, a particular person is not subject
             197      to discovery, subpoena, or similar compulsory process in any civil, judicial, administrative, or
             198      legislative proceeding, nor shall any individual or organization with lawful access to the data
             199      be compelled to testify with regard to the data.
             200          (b) The restrictions in Subsection (16)(a) do not apply to:
             201          (i) a criminal proceeding; or
             202          (ii) a civil, judicial, or administrative action brought to enforce the provisions of this
             203      section, Section 58-37-7.7 , or Section 58-37-7.8 .
             204          Section 2. Section 58-37-7.8 is enacted to read:
             205          58-37-7.8. Pilot program for real time reporting for controlled substance database
             206      -- Statewide implementation.
             207          (1) (a) As used in this section:
             208          (i) "Pilot area" means the areas of the state that the division determines to operate the
             209      pilot program in, under Subsection (3), which may include:
             210          (A) the entire state; or
             211          (B) geographical areas within the state.


             212          (ii) "Pilot program" means the pilot program described in this section.
             213          (b) The definitions in Subsection 58-37-7.5 (1) apply to this section.
             214          (2) There is established a pilot program for real-time reporting of data to, and access to
             215      data from, the database by a pharmacy, a pharmaceutical facility, or a physician beginning on
             216      July 1, 2008, and ending on July 1, 2010.
             217          (3) In addition to fulfilling the requirements of Sections 58-37-7.5 and 58-37-7.7 on a
             218      statewide basis, the division shall, in accordance with Subsection (4), upgrade, administer, and
             219      direct the functioning of the database in geographical areas specified by the division, or on a
             220      statewide basis, in a manner that provides for real-time reporting of information entered into,
             221      and accessed from, the database by a pharmacy or pharmaceutical facility.
             222          (4) The division shall, under state procurement laws, and with the technical assistance
             223      of the Department of Technology Services, contract with a private entity to upgrade, operate,
             224      and maintain the database in the pilot area.
             225          (5) (a) All provisions and requirements of the state-wide database, described in
             226      Sections 58-37-7.5 and 58-37-7.7 , are applicable to the database in the pilot area, to the extent
             227      that they do not conflict with the requirements of this section.
             228          (b) For purposes of Section 58-37-7.5 , Section 58-37-7.7 , and this section, the database
             229      in the pilot area is considered part of the statewide database.
             230          (6) A pharmacy or pharmaceutical facility shall cooperate with the division, or the
             231      division's designee, to provide real-time submission of, and access to, information for the
             232      database:
             233          (a) in the pilot area; and
             234          (b) when the division implements the pilot program as a permanent program under
             235      Subsection (10), on a statewide basis.
             236          (7) The penalties and enforcement provisions described in Sections 58-37-7.5 and
             237      58-37-7.7 apply to enforce the provisions of this section in relation to a pharmacy or
             238      pharmaceutical facility that is located in, or operates in, the pilot area.
             239          (8) The division may make rules, in accordance with Title 63, Chapter 46a, Utah
             240      Administrative Rulemaking Act, to provide for the real-time reporting of, and access to,
             241      information in accordance with the requirements of this section.
             242          (9) During the Legislature's 2009 interim, the division shall report to the Health and


             243      Human Services Interim Committee regarding:
             244          (a) the implementation, operation, and impact of the pilot program established in this
             245      section;
             246          (b) the progress made by the division in implementing the pilot program on a statewide
             247      basis; and
             248          (c) the advisability of, and projected costs of, implementing the pilot program on a
             249      statewide basis.
             250          (10) The division shall, on or before July 1, 2010, implement the pilot program as a
             251      permanent program on a statewide basis.
             252          (11) (a) The division shall, through the private entity contracted with under Subsection
             253      (4), provide, free of charge, to a pharmacy or pharmaceutical facility that is required to comply
             254      with Subsection (6), software, software installation assistance, and training, that will enable the
             255      pharmacy or pharmaceutical facility to comply with Subsection (6).
             256          (b) Notwithstanding Subsection (11)(a), a pharmacy or pharmaceutical facility required
             257      to comply with Subsection (6) may, instead of accepting installation of the software provided
             258      by the division under Subsection (11)(a), modify its own software in order to comply with the
             259      requirements of Subsection (6), if the modification is made:
             260          (i) at the expense of the pharmacy or pharmaceutical facility;
             261          (ii) in consultation with the division; and
             262          (iii) within six months after the division notifies the pharmacy or pharmaceutical
             263      facility, in writing, of the division's intention to install the software described in Subsection
             264      (11)(a).
             265          (c) The division shall, through the private entity contracted with under Subsection (4),
             266      cooperate with a pharmacy or pharmaceutical facility that is required to comply with
             267      Subsection (6), to ensure that the installation and operation of the software described in
             268      Subsection (11)(a), or the provision of information from the pharmacy or pharmaceutical
             269      facility to the database:
             270          (i) is secure; and
             271          (ii) does not interfere with the proper functioning of the pharmacy's or pharmaceutical
             272      facility's software or computer system.
             273          Section 3. Appropriation.


             274          There is appropriated:
             275          (1) as an ongoing appropriation, subject to future budget constraints, $175,000 from
             276      the General Fund for the fiscal year 2008-09, to the Division of Occupational and Professional
             277      Licensing to maintain and operate the controlled substance database; and
             278          (2) $650,000 from the General Fund, for the fiscal year 2008-09 only, to the Division
             279      of Occupational and Professional Licensing to implement and operate the pilot program
             280      described in this bill.
             281          (3) The $650,000 appropriated from the General Fund, under Subsection (2), shall be
             282      nonlapsing.
             283          Section 4. Effective date.
             284          This bill takes effect on July 1, 2008.


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