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SENATE AMENDED
PRIOR PRINTER'S NOS. 3008, 3533, 3587
PRINTER'S NO. 4044
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
1699
Session of
2015
INTRODUCED BY R. BROWN, COHEN, CORBIN, DAVIS, DeLUCA,
DiGIROLAMO, GINGRICH, HARHAI, HEFFLEY, KAUFER, KLUNK,
MARSHALL, MASSER, D. PARKER, READSHAW, ROTHMAN, SNYDER,
TAYLOR, FARRY, WARNER AND SANTARSIERO, MARCH 22, 2016
SENATOR VANCE, PUBLIC HEALTH AND WELFARE, IN SENATE, AS AMENDED,
OCTOBER 18, 2016
AN ACT
Providing for limitations on the dispensing of opioid drug
products in hospital emergency departments and urgent care
centers AND TO PATIENTS IN OBSERVATION STATUS and for duties
of the Department of Health; and imposing a penalty.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Short title.
This act shall be known and may be cited as the Safe
Emergency Prescribing Act.
Section 2. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Emergency department." An entity within a hospital that is
organizationally distinct from other outpatient facilities and
whose primary function is to provide emergency accident or
emergency medical or surgical care.
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"Health care practitioner." As defined in section 103 of the
act of July 19, 1979 (P.L.130, No.48), known as the Health Care
Facilities Act, including a practitioner who provides services
in an emergency department at a hospital or urgent care center
and is authorized to prescribe medication under the laws of this
Commonwealth.
"Hospital." As defined in section 802.1 of the Health Care
Facilities Act.
"Opioid drug product." A drug product that contains an
opioid agonist and is designated by the United States Food and
Drug Administration for the treatment of pain.
"OBSERVATION STATUS." WHEN A PATIENT RECEIVES ONSITE
SERVICES FROM A HOSPITAL FOR MORE THAN 23 CONSECUTIVE HOURS,
INCLUDING A HOSPITAL BED AND MEALS THAT HAVE BEEN PROVIDED IN AN
AREA OF THE HOSPITAL OTHER THAN THE HOSPITAL EMERGENCY ROOM, AND
THE PATIENT HAS NOT BEEN FORMALLY ADMITTED AS AN INPATIENT AT
THE HOSPITAL.
"OPIOID DRUG PRODUCT." ANY OF THE FOLLOWING:
(1) A PREPARATION OR DERIVATIVE OF OPIUM.
(2) A SYNTHETIC NARCOTIC THAT HAS OPIATE-LIKE EFFECTS,
BUT IS NOT DERIVED FROM OPIUM.
(3) A GROUP OF NATURALLY OCCURRING PEPTIDES THAT BIND AT
OR OTHERWISE INFLUENCE OPIATE RECEPTORS, INCLUDING AN OPIOID
AGONIST.
"Urgent care center." An organization or business entity
that provides outpatient treatment to patients with urgent
medical conditions, illnesses or injuries on an unscheduled
basis but that is not licensed as a hospital or an ambulatory
surgical facility. THE TERM DOES NOT INCLUDE THE OFFICES OF
PRIVATE PHYSICIANS, WHETHER FOR INDIVIDUAL OR GROUP PRACTICE.
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Section 3. Prescribing practices.
(a) Limitation on quantity of opioid drug products.--
(1) Except as set forth in paragraph (2), a health care
practitioner may not prescribe an opioid drug product to an
individual seeking treatment in an emergency department or
urgent care center, OR WHO IS IN OBSERVATION STATUS IN A
HOSPITAL, in a quantity sufficient to treat that individual
for more than seven days.
(2) Notwithstanding paragraph (1), if, in the
professional medical judgment of a health care practitioner,
more than a seven-day supply of an opioid drug product is
required to treat a patient's acute medical condition or is
necessary for the treatment of pain associated with a cancer
diagnosis or for palliative care, then the health care
practitioner may issue a prescription for the quantity needed
to treat such acute medical condition or pain associated with
a cancer diagnosis or for palliative care. The condition
triggering prescription of the opioid drug product under this
paragraph shall be documented in the patient's medical
record, and the health care practitioner must indicate that a
non-opioid drug product alternative was not appropriate to
treat the medical condition and that the health care
practitioner provided the patient with a pain management
referral.
(b) Refills.--A health care practitioner in an emergency
department or urgent care center may not authorize the refilling
of a prescription for an opioid drug product that has been lost,
stolen or destroyed., OR WHO IS CARING FOR A PATIENT IN
OBSERVATION STATUS, MAY NOT WRITE A PRESCRIPTION REFILL FOR AN
OPIOID DRUG PRODUCT.
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Section 4. Referral to treatment.
A health care practitioner shall refer an individual for
treatment if the individual is believed to be at risk for
substance abuse while seeking treatment in an emergency
department or urgent care center OR WHEN IN OBSERVATION STATUS
IN A HEALTH CARE FACILITY.
Section 5. Use of prescription drug monitoring program.
To determine whether a patient may be under treatment with an
opioid drug product by another health care practitioner, the
prescribing health care practitioner shall access the
prescription drug monitoring program in accordance with section
8 of the act of October 27, 2014 (P.L.2911, No.191), known as
the Achieving Better Care By Monitoring All Prescriptions
Program (ABC-MAP) Act. This section shall not apply to any
medication provided to a patient in the course of treatment
while the patient is admitted to a hospital or under the care of
UNDERGOING CARE IN an emergency department.
Section 6. Regulations.
The Department of Health shall promulgate regulations to
carry out this act.
Section 7. Penalty.
A health care practitioner who violates any provision of this
act commits unprofessional conduct and shall be subject to
REVIEW AND disciplinary action under the licensure,
certification, registration or permit provisions of law and
regulation governing the respective health care practitioner.
SECTION 8. LIABILITY.
A HEALTH CARE PRACTITIONER WHO COMPLIES WITH THE PROVISIONS
OF THIS ACT SHALL BE PRESUMED TO BE ACTING IN GOOD FAITH AND
SHALL HAVE IMMUNITY FROM CIVIL LIABILITY.
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Section 8 9. Effective date.
This act shall take effect in 60 days.
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