2016 -- S 2946

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LC005939

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2016

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A N   A C T

RELATING TO FOOD AND DRUGS - UNIFORMED CONTROLLED SUBSTANCES ACT

     

     Introduced By: Senator Louis P. DiPalma

     Date Introduced: May 10, 2016

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

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     SECTION 1. Section 21-28-3.32 of the General Laws in Chapter 21-28 entitled "Uniform

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Controlled Substances Act" is hereby amended to read as follows:

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     21-28-3.32. Electronic prescription database. -- (a) The information contained in any

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prescription drug monitoring database maintained by the department of health pursuant to § 21-

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28-3.18 of this chapter shall be disclosed only:

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      (1) To a practitioner who certifies that the requested information is for the purpose of

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evaluating the need for, or providing medical treatment to, a current patient to whom the

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practitioner is prescribing or considering prescribing a controlled substance;

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      (2) To a pharmacist who certifies that the requested information is for a current client to

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whom the pharmacist is dispensing, or considering dispensing, a controlled substance;

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      (3) To an authorized designee of the practitioner and/or pharmacist to consult the

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prescription drug monitoring database on the practitioner's and/or pharmacist's behalf, provided

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that:

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      (i) The designee so authorized is employed by the same professional practice or

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pharmacy;

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      (ii) The practitioner or pharmacist takes reasonable steps to ensure that such designee is

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sufficiently competent in the use of the database;

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      (iii) The practitioner or pharmacist remains responsible for ensuring that access to the

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database by the designee is limited to authorized purposes as provided for in subsections (a)(1)

 

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and (a)(2) of this section;

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      (iv) The practitioner or pharmacist remains responsible for ensuring access to the

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database by the designee occurs in a manner that protects the confidentiality of information

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obtained from the database and remains responsible for any breach of confidentiality;

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      (v) The practitioner or pharmacist terminates the designee's access to the database at the

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termination of the designee's employment; and

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      (vi) The ultimate decision as to whether or not to prescribe or dispense a controlled

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substance remains with the practitioner or pharmacist and is reasonably informed by the relevant

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controlled substance history information obtained from the database.

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      (4) Pursuant to a valid search warrant based on probable cause to believe a violation of

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federal or state criminal law has occurred and that specified information contained in the database

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would assist in the investigation of the crime;

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      (5) To a patient who requests his or her own prescription information, or the parent or

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legal guardian of a minor child who requests the minor child's prescription information;

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      (6) To a health professional regulatory board that documents, in writing, that the

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requested information is necessary for an investigation related to licensure, renewal, or

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disciplinary action involving the applicant, licensee, or registrant to whom the requested

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information pertains;

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      (7) To any vendor or contractor with whom the department has contracted, pursuant to

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state purchasing law and regulations in the contracting of vendors, to establish or maintain the

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electronic system of the prescription drug monitoring database; or

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      (8) To public or private entities for statistical, research, or educational purposes, after

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removing the patient and prescriber information that could be used to identify individual patients.

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This shall not include entities receiving a waiver from the institutional review board.

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      (b) Information stored in the prescription drug monitoring database shall include only the

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following:

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      (1) Patient's first and last name, and/or patient identification number; provided, however,

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the patient's social security number shall not be recorded in whole or in part, patient sex, patient

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date of birth, and patient address;

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      (2) Prescribing practitioner's name and drug enforcement administration prescriber

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information number;

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      (3) Prescribing practitioner's office or hospital contact information;

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      (4) Prescription name, prescription number, prescription species code, national drug code

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number, prescription dosage, prescription quantity, days' supply, new-refill code, number of

 

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refills authorized, date the prescription was written, date the prescription was filled, payment

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type; provided, however, no credit card number shall be recorded in whole or in part; and

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      (5) The drug enforcement administration pharmacy number of the pharmacy filling the

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prescription.

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      (c) The department shall disclose any information relating to a patient maintained in the

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prescription drug monitoring database to that patient, at no cost to the patient, within thirty (30)

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business days after the department receives a written request from the patient for the information.

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This information shall include the records maintained by the department pursuant to subsection

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(e). Notwithstanding the above, the department may, at the request of the law enforcement

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agency, withhold for up to sixty (60) days following the conclusion of a law enforcement

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investigation, the disclosure to the patient that information has been obtained pursuant to

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subdivision (a)(3).

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      (d) A patient may request, from the dispensing pharmacy, correction of any inaccurate

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information contained within the prescription drug monitoring database in accordance with the

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procedure specified by § 5-37.3-5(c).

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      (e) The department shall, for the period of time that prescription information is

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maintained, maintain records of the information disclosed through the prescription drug

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monitoring database, including, but not limited to:

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      (1) The identity of each person who requests or receives information from the

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prescription drug monitoring database and the organization, if any, the person represents;

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      (2) The information released to each person or organization and the basis for its release

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under subsection (a); and

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      (3) The dates the information was requested and provided.

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      (f) Prescription information contained within the prescription drug monitoring database

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shall be removed no later than five (5) years from the date the information is entered into the

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database. Records in existence prior to the enactment of this section shall be removed no later

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than ten (10) years from the date the information is entered into the database.

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      (g) The department shall promptly notify any affected individual of an improper

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disclosure of information from the prescription drug monitoring database or a breach in the

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security of the prescription drug monitoring database that poses a significant risk of disclosure of

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patient information to an unauthorized individual.

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      (h) At the time of signing a prescription that is required by the department to be entered

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into the prescription drug monitoring database, the prescribing practitioner shall inform the

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patient in writing of the existence of the prescription drug monitoring database, the patient's right

 

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to access their own prescription information, and the name and contact information of the agency

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operating the program.

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      (i) No person shall access information in the prescription monitoring database except to

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the extent and for the purposes authorized by subsection (a).

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      (j) In any civil action allowing a violation of this chapter, the court may award damages,

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including punitive damages, and reasonable attorneys' fees and costs to a prevailing plaintiff, and

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injunctive and any other appropriate relief.

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      (k) Any pharmacist who, in his or her professional judgment, refuses to fill a prescription

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based on information contained within the prescription drug monitoring database shall inform the

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prescribing physician within twenty-four (24) hours.

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      (l) All practitioners shall, as a condition of the initial registration or renewal of the

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practitioner's authority to prescribe controlled substances, register with the prescription drug

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monitoring database maintained by the department of health.

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     (m) The department shall seek federal funding to improve the usefulness and value of the

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prescription drug monitoring database program by increasing its analytical functionality,

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timeliness, and scope, pursuant to the following:

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     (1) Utilizing data from additional data sources as permissible under state and federal

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statutes; and

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     (2) Analyzing information submitted to the prescription drug monitoring database to

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ensure that prescription data collected from dispensing pharmacists is readily accessible for a

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given patient; to identify unusual or aberrant patterns of prescribing, dispensing or receiving

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controlled substances; and to generate an automatic alert when such patterns arise.

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     (3) Developing regulations to ensure that prescription drug monitoring analyses are

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updated and disseminated regularly to appropriate officials and that summary reports are provided

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to the general assembly at least annually. In the development of said regulations, the department

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may include any of the following analytical functions, within the boundaries of patient

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confidentiality rights under state and federal law:

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     (i) Consolidate raw prescription data collected from dispensing pharmacists into a single

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view of all prescriptions filled for a given patient;

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     (ii) Identify unusual or aberrant patterns of prescribing controlled substances, by relevant

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prescriber attributes, and generate an automatic alert when such patterns arise;

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     (iii) Identify unusual or aberrant patterns of receiving prescriptions for controlled

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substances, by relevant patient attributes, and generate an automatic alert when such patterns

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arise;

 

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     (iv) Identify unusual or aberrant patterns of dispensing controlled substances, by relevant

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dispenser attributes, and generate an automatic alert when such patterns arise; and

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     (v) Identify and visually display linkages among prescribers, patients, and dispensers that

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can be used to detect any collusive behaviors.

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     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO FOOD AND DRUGS - UNIFORMED CONTROLLED SUBSTANCES ACT

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     This act would improve the usefulness and value of the prescription drug monitoring

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database program by adding analytical functions, requiring program updates at least weekly, and

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incorporating data from similar programs in other states.

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     This act would take effect upon passage.

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