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SUBSTANCE ABUSE DISORDER TREATMENT AMENDMENTS

2     
2019 GENERAL SESSION

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STATE OF UTAH

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Chief Sponsor: Jennifer Dailey-Provost

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Senate Sponsor: ____________

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7     LONG TITLE
8     General Description:
9          This bill amends provisions relating to utilization of the controlled substance database.
10     Highlighted Provisions:
11          This bill:
12          ▸     exempts a prescriber from the requirement to check the controlled substance
13     database when prescribing buprenorphine to a patient.
14     Money Appropriated in this Bill:
15          None
16     Other Special Clauses:
17          None
18     Utah Code Sections Affected:
19     AMENDS:
20          58-37f-304, as last amended by Laws of Utah 2018, Chapters 281 and 327
21     

22     Be it enacted by the Legislature of the state of Utah:
23          Section 1. Section 58-37f-304 is amended to read:
24          58-37f-304. Database utilization.
25          (1) As used in this section:
26          (a) "Dispenser" means a licensed pharmacist, as described in Section 58-17b-303, or
27     the pharmacist's licensed intern, as described in Section 58-17b-304, who is also licensed to

28     dispense a controlled substance under Title 58, Chapter 37, Utah Controlled Substances Act.
29          (b) "Outpatient" means a setting in which an individual visits a licensed healthcare
30     facility or a healthcare provider's office for a diagnosis or treatment but is not admitted to a
31     licensed healthcare facility for an overnight stay.
32          (c) "Prescriber" means an individual authorized to prescribe a controlled substance
33     under Title 58, Chapter 37, Utah Controlled Substances Act.
34          (d) "Schedule II opioid" means those substances listed in Subsection 58-37-4(2)(b)(i)
35     or (2)(b)(ii).
36          (e) "Schedule III opioid" means those substances listed in Subsection 58-37-4(2)(c)
37     that are opioids.
38          (2) (a) A prescriber shall check the database for information about a patient before the
39     first time the prescriber gives a prescription to a patient for a Schedule II opioid or a Schedule
40     III opioid.
41          (b) If a prescriber is repeatedly prescribing a Schedule II opioid or Schedule III opioid
42     to a patient, the prescriber shall periodically review information about the patient in:
43          (i) the database; or
44          (ii) other similar records of controlled substances the patient has filled.
45          (c) A prescriber is not subject to the requirements in Subsection (2)(a) or (b) when
46     prescribing buprenorphine to a patient.
47          [(c)] (d) A prescriber may assign the access and review required under Subsection
48     (2)(a) to one or more employees in accordance with Subsections 58-37f-301(2)(i) and (j).
49          [(d)] (e) (i) A prescriber may comply with the requirements in Subsections (2)(a) and
50     (b) by checking an electronic health record system if the electronic health record system:
51          (A) is connected to the database through a connection that has been approved by the
52     division; and
53          (B) displays the information from the database in a prominent manner for the
54     prescriber.
55          (ii) The division may not approve a connection to the database if the connection does
56     not satisfy the requirements established by the division under Section 58-37f-301.
57          [(e)] (f) A prescriber is not in violation of the requirements of Subsection (2)(a) or (b)
58     if the failure to comply with Subsection (2)(a) or (b):

59          (i) is necessary due to an emergency situation;
60          (ii) is caused by a suspension or disruption in the operation of the database; or
61          (iii) is caused by a failure in the operation or availability of the Internet.
62          [(f)] (g) The division may not take action against the license of a prescriber for failure
63     to comply with this Subsection (2) unless the failure occurs after the earlier of:
64          (i) December 31, 2018; or
65          (ii) the date that the division has the capability to establish a connection that meets the
66     requirements established by the division under Section 58-37f-301 between the database and an
67     electronic health record system.
68          (3) The division shall, in collaboration with the licensing boards for prescribers and
69     dispensers:
70          (a) develop a system that gathers and reports to prescribers and dispensers the progress
71     and results of the prescriber's and dispenser's individual access and review of the database, as
72     provided in this section; and
73          (b) reduce or waive the division's continuing education requirements regarding opioid
74     prescriptions, described in Section 58-37-6.5, including the online tutorial and test relating to
75     the database, for prescribers and dispensers whose individual utilization of the database, as
76     determined by the division, demonstrates substantial compliance with this section.
77          (4) If the dispenser's access and review of the database suggest that the individual
78     seeking an opioid may be obtaining opioids in quantities or frequencies inconsistent with
79     generally recognized standards as provided in this section and Section 58-37f-201, the
80     dispenser shall reasonably attempt to contact the prescriber to obtain the prescriber's informed,
81     current, and professional decision regarding whether the prescribed opioid is medically
82     justified, notwithstanding the results of the database search.
83          (5) (a) The division shall review the database to identify any prescriber who has a
84     pattern of prescribing opioids not in accordance with the recommendations of:
85          (i) the CDC Guideline for Prescribing Opioids for Chronic Pain, published by the
86     Centers for Disease Control and Prevention;
87          (ii) the Utah Clinical Guidelines on Prescribing Opioids for Treatment of Pain,
88     published by the Department of Health; or
89          (iii) other publications describing best practices related to prescribing opioids as

90     identified by division rule in accordance with Title 63G, Chapter 3, Utah Administrative
91     Rulemaking Act, and in consultation with the Physicians Licensing Board.
92          (b) The division shall offer education to a prescriber identified under this Subsection
93     (5) regarding best practices in the prescribing of opioids.
94          (c) A decision by a prescriber to accept or not accept the education offered by the
95     division under this Subsection (5) is voluntary.
96          (d) The division may not use an identification the division has made under this
97     Subsection (5) or the decision by a prescriber to accept or not accept education offered by the
98     division under this Subsection (5) in a licensing investigation or action by the division.
99          (e) Any record created by the division as a result of this Subsection (5) is a protected
100     record under Section 63G-2-305.