Regular Session 2015-2016 Senate Bill 1202 P.N. 2199

HOUSE AMENDED

PRIOR PRINTER'S NOS. 1741, 1912, 2177

PRINTER'S NO. 2199

THE GENERAL ASSEMBLY OF PENNSYLVANIA

SENATE BILL

No.

1202

Session of

2015

INTRODUCED BY YAW, WOZNIAK, SABATINA, VOGEL, FARNESE, RAFFERTY,

HUTCHINSON, BLAKE, BARTOLOTTA, MENSCH, YUDICHAK, WAGNER,

FOLMER, VULAKOVICH, WARD, STEFANO, HUGHES, BROWNE, SCARNATI,

WILLIAMS, SCHWANK AND SCAVELLO, MAY 2, 2016

AS AMENDED ON SECOND CONSIDERATION, HOUSE OF REPRESENTATIVES,

OCTOBER 25, 2016

AN ACT

Amending the act of October 27, 2014 (P.L.2911, No.191),

entitled "An act providing for prescription drug monitoring;

creating the ABC-MAP Board; establishing the Achieving Better

Care by Monitoring All Prescriptions Program; and providing

for unlawful acts and penalties," providing for licensing

boards to require education in pain management and dispensing

and prescribing practices of opioids FURTHER PROVIDING FOR

DEFINITIONS, FOR POWERS AND DUTIES OF BOARD, FOR REQUIREMENTS

FOR DISPENSERS AND PHARMACIES AND FOR REQUIREMENTS FOR

PRESCRIBERS; AND PROVIDING FOR LICENSING BOARDS TO REQUIRE

EDUCATION IN PAIN MANAGEMENT, ADDICTION AND PRESCRIBING AND

DISPENSING PRACTICES FOR OPIOIDS.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1. 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, is amended by adding a

section to read:

Section 9.1. Licensing boards to require education in pain

management and dispensing and prescribing practices

of opioids.

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(a) General rule.--Except as otherwise provided for in

subsection (c), each licensing board in the Department of State

jurisdiction over professional licensees who are dispensers or

prescribers shall require:

(1) Individuals applying for an initial license or

certification issued by the licensing board, which license or

certification authorizes the licensee to be a dispenser or

prescriber, shall submit, no later than 12 months after

obtaining an initial license or certification, documentation

acceptable to the licensing board of the completion of at

least two hours of education in pain management and at least

two hours of education in the dispensing or prescribing

practices of opioids. The education may occur as part of the

applicants' professional degree educational program.

(2) Dispensers and prescribers applying for the renewal

of a license or certification issued by the licensing board

to complete at least two hours of education in pain

management or two hours of education in the dispensing or

prescribing practices of opioids as a portion of the total

continuing education required for biennial renewal.

(b) Consultation with department.--Each licensing board

shall, in consultation with the department, approve the

curricula for the pain management and prescribing practices of

opioids education.

not apply to a dispenser or prescriber who is exempt from the

Drug Enforcement Administration's requirements for a

registration number under 21 CFR Ch. II (relating to Drug

Enforcement Administration, Department of Justice) and

applicable State law.

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SECTION 1. SECTION 3 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, IS AMENDED BY ADDING

DEFINITIONS TO READ:

SECTION 3. 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:

* * *

"BENZODIAZEPINE." A PSYCHOACTIVE DRUG WHOSE CORE CHEMICAL

STRUCTURE IS THE FUSION OF A BENZENE RING AND A DIAZEPINE RING

AND WORKS ON THE CENTRAL NERVOUS SYSTEM, ACTING SELECTIVELY ON

GAMMA-AMINOBUTYRIC ACID TYPE A (GABA(A)) RECEPTORS IN THE BRAIN.

* * *

"OBSERVATION STATUS." WHEN A PATIENT RECEIVES ONSITE

SERVICES FROM THE HOSPITAL FOR MORE THAN 23 CONSECUTIVE HOURS,

THE ONSITE SERVICES RECEIVED BY THE PATIENT INCLUDE 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 OPIOID

AGONIST.

* * *

SECTION 2. SECTION 5(5) OF THE ACT IS AMENDED BY ADDING A

SUBPARAGRAPH TO READ:

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SECTION 5. POWERS AND DUTIES OF BOARD.

THE BOARD SHALL HAVE THE FOLLOWING POWERS AND DUTIES:

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(5) DEVELOP POLICIES AND PROCEDURES TO:

* * *

(XVI) REQUIRE AND ENSURE REGISTRATION OF ALL

PRESCRIBERS AND DISPENSERS WITH THE PROGRAM.

SECTION 3. SECTIONS 7(C) AND 8(A) OF THE ACT ARE AMENDED AND

THE SECTIONS ARE AMENDED BY ADDING SUBSECTIONS TO READ:

SECTION 7. REQUIREMENTS FOR DISPENSERS AND PHARMACIES.

* * *

INFORMATION REQUIRED UNDER SUBSECTION (B) TO THE SYSTEM NO LATER

THAN [72 HOURS] THE CLOSE OF THE SUBSEQUENT BUSINESS DAY AFTER

DISPENSING A CONTROLLED SUBSTANCE.

* * *

(E) SYSTEM QUERY.--

(1) A DISPENSER SHALL QUERY THE SYSTEM BEFORE DISPENSING

AN OPIOID DRUG PRODUCT OR A BENZODIAZEPINE PRESCRIBED TO A

PATIENT IF ANY OF THE FOLLOWING APPLY:

(I) THE PATIENT IS A NEW PATIENT OF THE DISPENSER.

(II) THE PATIENT PAYS CASH WHEN THEY HAVE INSURANCE.

(III) THE PATIENT REQUESTS A REFILL EARLY.

(IV) THE PATIENT IS GETTING OPIOID DRUG PRODUCTS OR

BENZODIAZEPINES FROM MORE THAN ONE PRESCRIBER.

(2) FOR THE PURPOSES OF THIS SUBSECTION, A NEW PATIENT

DOES NOT INCLUDE AN INDIVIDUAL GOING TO THE SAME PHARMACY, OR

A DIFFERENT PHYSICAL LOCATION OF THAT PHARMACY, IF THE

PATIENT'S RECORD IS AVAILABLE TO THE DISPENSER.

SECTION 8. REQUIREMENTS FOR PRESCRIBERS.

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(A) SYSTEM QUERY.--A PRESCRIBER SHALL QUERY THE SYSTEM:

(1) FOR EACH PATIENT THE FIRST TIME THE PATIENT IS

PRESCRIBED A CONTROLLED SUBSTANCE BY THE PRESCRIBER FOR

PURPOSES OF ESTABLISHING A BASELINE AND A THOROUGH MEDICAL

RECORD; [OR]

(2) IF A PRESCRIBER BELIEVES OR HAS REASON TO BELIEVE,

USING SOUND CLINICAL JUDGMENT, THAT A PATIENT MAY BE ABUSING

OR DIVERTING DRUGS[.]; OR

(3) EACH TIME A PATIENT IS PRESCRIBED AN OPIOID DRUG

PRODUCT OR BENZODIAZEPINE BY THE PRESCRIBER.

(A.1) QUERY NOT REQUIRED.--IF A PATIENT HAS BEEN ADMITTED TO

A LICENSED HEALTH CARE FACILITY OR IS IN OBSERVATION STATUS IN A

LICENSED HEALTH CARE FACILITY, THE PRESCRIBER DOES NOT NEED TO

QUERY THE SYSTEM AFTER THE INITIAL QUERY UNDER SUBSECTION (A)(1)

AS LONG AS THE PATIENT REMAINS ADMITTED TO THE LICENSED HEALTH

CARE FACILITY OR REMAINS IN OBSERVATION STATUS IN A LICENSED

HEALTH CARE FACILITY.

* * *

SECTION 4. THE ACT IS AMENDED BY ADDING A SECTION TO READ:

SECTION 9.1. LICENSING BOARDS TO REQUIRE EDUCATION IN PAIN

MANAGEMENT, ADDICTION AND PRESCRIBING AND DISPENSING

PRACTICES FOR OPIOIDS.

(A) GENERAL RULE.--EXCEPT AS OTHERWISE PROVIDED FOR IN

SUBSECTION (C), EACH LICENSING BOARD SHALL REQUIRE:

(1) INDIVIDUALS APPLYING FOR AN INITIAL LICENSE OR

CERTIFICATION ISSUED BY THE LICENSING BOARD, WHICH LICENSE OR

CERTIFICATION AUTHORIZES THE LICENSEE OR CERTIFICATE HOLDER

TO BE A DISPENSER OR PRESCRIBER, TO SUBMIT, NO LATER THAN 12

MONTHS AFTER OBTAINING AN INITIAL LICENSE OR CERTIFICATION,

DOCUMENTATION ACCEPTABLE TO THE LICENSING BOARD OF THE

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COMPLETION OF AT LEAST TWO HOURS OF EDUCATION IN PAIN

MANAGEMENT OR IDENTIFICATION OF ADDICTION AND AT LEAST TWO

HOURS OF EDUCATION IN THE PRACTICES OF PRESCRIBING OR

DISPENSING OF OPIOIDS. THE EDUCATION MAY OCCUR AS PART OF THE

INDIVIDUAL'S PROFESSIONAL DEGREE EDUCATIONAL PROGRAM OR

CONTINUING EDUCATION PROGRAM.

(2) DISPENSERS AND PRESCRIBERS APPLYING FOR THE RENEWAL

OF A LICENSE OR CERTIFICATION TO COMPLETE AT LEAST TWO HOURS

OF CONTINUING EDUCATION IN PAIN MANAGEMENT, IDENTIFICATION OF

ADDICTION OR THE PRACTICES OF PRESCRIBING OR DISPENSING OF

OPIOIDS AS A PORTION OF THE TOTAL CONTINUING EDUCATION

REQUIRED FOR BIENNIAL RENEWAL.

(B) CONSULTATION WITH DEPARTMENT.--EACH LICENSING BOARD

SHALL, IN CONSULTATION WITH THE DEPARTMENT, APPROVE THE

CURRICULA FOR THE PAIN MANAGEMENT, IDENTIFICATION OF ADDICTION

AND THE PRACTICES OF PRESCRIBING AND DISPENSING OF OPIOIDS

EDUCATION.

NOT APPLY TO A PRESCRIBER WHO IS EXEMPT FROM THE DRUG

ENFORCEMENT ADMINISTRATION'S REQUIREMENTS FOR A REGISTRATION

NUMBER UNDER 21 CFR CH. II (RELATING TO DRUG ENFORCEMENT

ADMINISTRATION, DEPARTMENT OF JUSTICE) AND APPLICABLE STATE LAW

AND DOES NOT USE THE REGISTRATION NUMBER OF ANOTHER PERSON OR

ENTITY AS PERMITTED BY LAW TO PRESCRIBE CONTROLLED SUBSTANCES IN

ANY MANNER.

(D) DEFINITION.--AS USED IN THIS SECTION, THE TERM

"LICENSING BOARD" MEANS A LICENSING BOARD UNDER THE BUREAU OF

PROFESSIONAL AND OCCUPATIONAL AFFAIRS IN THE DEPARTMENT OF STATE

WITH JURISDICTION OVER PROFESSIONAL LICENSEES OR CERTIFICATE

HOLDERS WHO ARE DISPENSERS OR PRESCRIBERS.

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Section 2 5. This act shall take effect in 60 days.

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