This document includes House Committee Amendments incorporated into the bill on Wed, Jan 27, 2016 at 4:29 PM by gvanwagenen.
This document includes House Floor Amendments incorporated into the bill on Mon, Feb 8, 2016 at 3:57 PM by cynthiahopkin.
1     
CONTROLLED SUBSTANCE PRESCRIPTION

2     
NOTIFICATION

3     
2016 GENERAL SESSION

4     
STATE OF UTAH

5     
Chief Sponsor: Brad M. Daw

6     
Senate Sponsor: Curtis S. Bramble

7     

8     LONG TITLE
9     General Description:
10          This bill modifies provisions regarding controlled substances.
11     Highlighted Provisions:
12          This bill:
13          ▸     amends the Controlled Substance Database Act to allow a person for whom a
14     controlled substance is prescribed to designate a third party who is to be notified
15     when a controlled substance prescription is dispensed to the person;
15a      Ĥ→ ▸ allows the person to direct the division to discontinue providing the information;
15b      ▸ requires that the division advise the person that if the person discontinues the
15c     notification, the third party will be advised of the discontinuance;
15d          ▸ requires that the division comply with the direction and also notify the third party of
15e     the discontinuation; ←Ĥ and
16          ▸     authorizes the division to make administrative rules to facilitate implementation of
17     this provision.
18     Money Appropriated in this Bill:
19          None
20     Other Special Clauses:
21          None
22     Utah Code Sections Affected:
23     AMENDS:
24          58-37f-301, as last amended by Laws of Utah 2015, Chapters 89, 326, and 336
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 and information obtained from
36     other state or federal prescription monitoring programs by means of the database available only
37     to the following individuals, in accordance with the requirements of this chapter and division
38     rules:
39          (a) personnel of the division specifically assigned to conduct investigations related to
40     controlled substance laws under the jurisdiction of the division;
41          (b) authorized division personnel engaged in analysis of controlled substance
42     prescription information as a part of the assigned duties and responsibilities of their
43     employment;
44          (c) in accordance with a written agreement entered into with the department,
45     employees of the Department of Health:
46          (i) whom the director of the Department of Health assigns to conduct scientific studies
47     regarding the use or abuse of controlled substances, if the identity of the individuals and
48     pharmacies in the database are confidential and are not disclosed in any manner to any
49     individual who is not directly involved in the scientific studies; or
50          (ii) when the information is requested by the Department of Health in relation to a
51     person or provider whom the Department of Health suspects may be improperly obtaining or
52     providing a controlled substance;
53          (d) in accordance with a written agreement entered into with the department, a
54     designee of the director of the Department of Health, who is not an employee of the
55     Department of Health, whom the director of the Department of Health assigns to conduct
56     scientific studies regarding the use or abuse of controlled substances pursuant to an application
57     process established in rule by the Department of Health, if:
58          (i) the designee provides explicit information to the Department of Health regarding

59     the purpose of the scientific studies;
60          (ii) the scientific studies to be conducted by the designee:
61          (A) fit within the responsibilities of the Department of Health for health and welfare;
62          (B) are reviewed and approved by an Institutional Review Board that is approved for
63     human subject research by the United States Department of Health and Human Services; and
64          (C) are not conducted for profit or commercial gain; and
65          (D) are conducted in a research facility, as defined by division rule, that is associated
66     with a university or college in the state accredited by one or more regional or national
67     accrediting agencies recognized by the United States Department of Education;
68          (iii) the designee protects the information as a business associate of the Department of
69     Health; and
70          (iv) the identity of the prescribers, patients, and pharmacies in the database are
71     de-identified, confidential, not disclosed in any manner to the designee or to any individual
72     who is not directly involved in the scientific studies;
73          (e) in accordance with the written agreement entered into with the department and the
74     Department of Health, authorized employees of a managed care organization, as defined in 42
75     C.F.R. Sec. 438, if:
76          (i) the managed care organization contracts with the Department of Health under the
77     provisions of Section 26-18-405 and the contract includes provisions that:
78          (A) require a managed care organization employee who will have access to information
79     from the database to submit to a criminal background check; and
80          (B) limit the authorized employee of the managed care organization to requesting either
81     the division or the Department of Health to conduct a search of the database regarding a
82     specific Medicaid enrollee and to report the results of the search to the authorized employee;
83     and
84          (ii) the information is requested by an authorized employee of the managed care
85     organization in relation to a person who is enrolled in the Medicaid program with the managed
86     care organization, and the managed care organization suspects the person may be improperly
87     obtaining or providing a controlled substance;
88          (f) a licensed practitioner having authority to prescribe controlled substances, to the
89     extent the information:

90          (i) (A) relates specifically to a current or prospective patient of the practitioner; and
91          (B) is provided to or sought by the practitioner for the purpose of:
92          (I) prescribing or considering prescribing any controlled substance to the current or
93     prospective patient;
94          (II) diagnosing the current or prospective patient;
95          (III) providing medical treatment or medical advice to the current or prospective
96     patient; or
97          (IV) determining whether the current or prospective patient:
98          (Aa) is attempting to fraudulently obtain a controlled substance from the practitioner;
99     or
100          (Bb) has fraudulently obtained, or attempted to fraudulently obtain, a controlled
101     substance from the practitioner;
102          (ii) (A) relates specifically to a former patient of the practitioner; and
103          (B) is provided to or sought by the practitioner for the purpose of determining whether
104     the former patient has fraudulently obtained, or has attempted to fraudulently obtain, a
105     controlled substance from the practitioner;
106          (iii) relates specifically to an individual who has access to the practitioner's Drug
107     Enforcement Administration identification number, and the practitioner suspects that the
108     individual may have used the practitioner's Drug Enforcement Administration identification
109     number to fraudulently acquire or prescribe a controlled substance;
110          (iv) relates to the practitioner's own prescribing practices, except when specifically
111     prohibited by the division by administrative rule;
112          (v) relates to the use of the controlled substance database by an employee of the
113     practitioner, described in Subsection (2)(g); or
114          (vi) relates to any use of the practitioner's Drug Enforcement Administration
115     identification number to obtain, attempt to obtain, prescribe, or attempt to prescribe, a
116     controlled substance;
117          (g) in accordance with Subsection (3)(a), an employee of a practitioner described in
118     Subsection (2)(f), for a purpose described in Subsection (2)(f)(i) or (ii), if:
119          (i) the employee is designated by the practitioner as an individual authorized to access
120     the information on behalf of the practitioner;

121          (ii) the practitioner provides written notice to the division of the identity of the
122     employee; and
123          (iii) the division:
124          (A) grants the employee access to the database; and
125          (B) provides the employee with a password that is unique to that employee to access
126     the database in order to permit the division to comply with the requirements of Subsection
127     58-37f-203(5) with respect to the employee;
128          (h) an employee of the same business that employs a licensed practitioner under
129     Subsection (2)(f) if:
130          (i) the employee is designated by the practitioner as an individual authorized to access
131     the information on behalf of the practitioner;
132          (ii) the practitioner and the employing business provide written notice to the division of
133     the identity of the designated employee; and
134          (iii) the division:
135          (A) grants the employee access to the database; and
136          (B) provides the employee with a password that is unique to that employee to access
137     the database in order to permit the division to comply with the requirements of Subsection
138     58-37f-203(5) with respect to the employee;
139          (i) a licensed pharmacist having authority to dispense a controlled substance to the
140     extent the information is provided or sought for the purpose of:
141          (i) dispensing or considering dispensing any controlled substance; or
142          (ii) determining whether a person:
143          (A) is attempting to fraudulently obtain a controlled substance from the pharmacist; or
144          (B) has fraudulently obtained, or attempted to fraudulently obtain, a controlled
145     substance from the pharmacist;
146          (j) in accordance with Subsection (3)(a), a licensed pharmacy technician and pharmacy
147     intern who is an employee of a pharmacy as defined in Section 58-17b-102, for the purposes
148     described in Subsection (2)(h)(i) or (ii), if:
149          (i) the employee is designated by the pharmacist-in-charge as an individual authorized
150     to access the information on behalf of a licensed pharmacist employed by the pharmacy;
151          (ii) the pharmacist-in-charge provides written notice to the division of the identity of

152     the employee; and
153          (iii) the division:
154          (A) grants the employee access to the database; and
155          (B) provides the employee with a password that is unique to that employee to access
156     the database in order to permit the division to comply with the requirements of Subsection
157     58-37f-203(5) with respect to the employee;
158          (k) pursuant to a valid search warrant, federal, state, and local law enforcement
159     agencies and state and local prosecutors that are engaged in an investigation related to:
160          (i) one or more controlled substances; and
161          (ii) a specific person who is a subject of the investigation;
162          (l) employees of the Office of Internal Audit and Program Integrity within the
163     Department of Health who are engaged in their specified duty of ensuring Medicaid program
164     integrity under Section 26-18-2.3;
165          (m) a mental health therapist, if:
166          (i) the information relates to a patient who is:
167          (A) enrolled in a licensed substance abuse treatment program; and
168          (B) receiving treatment from, or under the direction of, the mental health therapist as
169     part of the patient's participation in the licensed substance abuse treatment program described
170     in Subsection (2)(m)(i)(A);
171          (ii) the information is sought for the purpose of determining whether the patient is
172     using a controlled substance while the patient is enrolled in the licensed substance abuse
173     treatment program described in Subsection (2)(m)(i)(A); and
174          (iii) the licensed substance abuse treatment program described in Subsection
175     (2)(m)(i)(A) is associated with a practitioner who:
176          (A) is a physician, a physician assistant, an advance practice registered nurse, or a
177     pharmacist; and
178          (B) is available to consult with the mental health therapist regarding the information
179     obtained by the mental health therapist, under this Subsection (2)(m), from the database;
180          (n) an individual who is the recipient of a controlled substance prescription entered into
181     the database, upon providing evidence satisfactory to the division that the individual requesting
182     the information is in fact the individual about whom the data entry was made;

183          (o) an individual under Subsection (2)(n) for the purpose of obtaining a list of the
184     persons and entities that have requested or received any information from the database
185     regarding the individual, except if the individual's record is subject to a pending or current
186     investigation as authorized under this Subsection (2);
187          (p) the inspector general, or a designee of the inspector general, of the Office of
188     Inspector General of Medicaid Services, for the purpose of fulfilling the duties described in
189     Title 63A, Chapter 13, Part 2, Office and Powers; and
190          (q) the following licensed physicians for the purpose of reviewing and offering an
191     opinion on an individual's request for workers' compensation benefits under Title 34A, Chapter
192     2, Workers' Compensation Act, or Title 34A, Chapter 3, Utah Occupational Disease Act:
193          (i) a member of the medical panel described in Section 34A-2-601;
194          (ii) a physician employed as medical director for a licensed workers' compensation
195     insurer or an approved self-insured employer; or
196          (iii) a physician offering a second opinion regarding treatment.
197          (3) (a) (i) A practitioner described in Subsection (2)(f) may designate up to three
198     employees to access information from the database under Subsection (2)(g), (2)(h), or (4)(c).
199          (ii) A pharmacist described in Subsection (2)(i) who is a pharmacist-in-charge may
200     designate up to five employees to access information from the database under Subsection (2)(j).
201          (b) The division shall make rules, in accordance with Title 63G, Chapter 3, Utah
202     Administrative Rulemaking Act, to:
203          (i) establish background check procedures to determine whether an employee
204     designated under Subsection (2)(g), (2)(h), or (4)(c) should be granted access to the database;
205     [and]
206          (ii) establish the information to be provided by an emergency room employee under
207     Subsection (4)[.]; and
208          (iii) facilitate providing controlled substance prescription information to a third party
209     under Subsection (5).
210          (c) The division shall grant an employee designated under Subsection (2)(g), (2)(h), or
211     (4)(c) access to the database, unless the division determines, based on a background check, that
212     the employee poses a security risk to the information contained in the database.
213          (4) (a) An individual who is employed in the emergency room of a hospital may

214     exercise access to the database under this Subsection (4) on behalf of a licensed practitioner if
215     the individual is designated under Subsection (4)(c) and the licensed practitioner:
216          (i) is employed in the emergency room;
217          (ii) is treating an emergency room patient for an emergency medical condition; and
218          (iii) requests that an individual employed in the emergency room and designated under
219     Subsection (4)(c) obtain information regarding the patient from the database as needed in the
220     course of treatment.
221          (b) The emergency room employee obtaining information from the database shall,
222     when gaining access to the database, provide to the database the name and any additional
223     identifiers regarding the requesting practitioner as required by division administrative rule
224     established under Subsection (3)(b).
225          (c) An individual employed in the emergency room under this Subsection (4) may
226     obtain information from the database as provided in Subsection (4)(a) if:
227          (i) the employee is designated by the practitioner as an individual authorized to access
228     the information on behalf of the practitioner;
229          (ii) the practitioner and the hospital operating the emergency room provide written
230     notice to the division of the identity of the designated employee; and
231          (iii) the division:
232          (A) grants the employee access to the database; and
233          (B) provides the employee with a password that is unique to that employee to access
234     the database in order to permit the division to comply with the requirements of Subsection
235     58-37f-203(5) with respect to the employee.
236          (d) The division may impose a fee, in accordance with Section 63J-1-504, on a
237     practitioner who designates an employee under Subsection (2)(g), (2)(h), or (4)(c) to pay for the
238     costs incurred by the division to conduct the background check and make the determination
239     described in Subsection (3)(b).
240          (5) (a) Ĥ→ (i) ←Ĥ An individual may request that the division Ĥ→ [
send] provide ←Ĥ
240a     the information under
241     Subsection (5)(b) to a third party who is designated by the individual each time a controlled
242     substance prescription for the individual is dispensed.
242a      Ĥ→ (ii) The division shall upon receipt of the request under this Subsection (5)(a)
242b     advise the individual in writing that the individual may direct the division to discontinue
242c     providing the information to a third party and that notice of the individual's direction to
242d     discontinue will be provided to the third party. ←Ĥ
243          (b) The information the division shall provide under Subsection (5)(a) is:
244          (i) the fact a controlled substance has been dispensed to the individual, but without

245     identifying the controlled substance; and
246          (ii) the date the controlled substance was dispensed.
246a      Ĥ→ (c) (i) An individual who has made a request under Subsection (5)(a) may direct that
246b     the division discontinue providing information to the third party.
246c          (ii) The division shall:
246d          (A) notify the third party that the individual has directed the division to no longer
246e     provide information to the third party; and
246f          (B) discontinue providing information to the third party. ←Ĥ
247          [(5)] (6) (a) An individual who is granted access to the database based on the fact that
248     the individual is a licensed practitioner or a mental health therapist shall be denied access to the
249     database when the individual is no longer licensed.
250          (b) An individual who is granted access to the database based on the fact that the
251     individual is a designated employee of a licensed practitioner shall be denied access to the
252     database when the practitioner is no longer licensed.






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