PRIOR PRINTER'S NO. 2067

PRINTER'S NO.  2830

  

THE GENERAL ASSEMBLY OF PENNSYLVANIA

  

HOUSE BILL

 

No.

1651

Session of

2011

  

  

INTRODUCED BY DiGIROLAMO, COHEN, BAKER, BISHOP, BOYD, BRENNAN, R. BROWN, CALTAGIRONE, CLYMER, DAVIS, J. EVANS, GEIST, GINGRICH, GROVE, HAHN, HARHAI, HARKINS, HEFFLEY, HELM, HENNESSEY, HESS, HORNAMAN, KILLION, KOTIK, KULA, MANN, MICOZZIE, MURPHY, MURT, MYERS, PYLE, QUINN, REICHLEY, SAYLOR, SCAVELLO, CULVER, K. SMITH, TAYLOR, THOMAS, VULAKOVICH AND DONATUCCI, JUNE 8, 2011

  

  

AS REPORTED FROM COMMITTEE ON HUMAN SERVICES, HOUSE OF REPRESENTATIVES, AS AMENDED, DECEMBER 6, 2011   

  

  

  

AN ACT

  

1

Amending Title 44 (Law and Justice) of the Pennsylvania

2

Consolidated Statutes, establishing the Pharmaceutical

3

Accountability Monitoring System; and imposing penalties.

4

The General Assembly of the Commonwealth of Pennsylvania

5

hereby enacts as follows:

6

Section 1.  Title 44 of the Pennsylvania Consolidated

7

Statutes is amended by adding a chapter to read:

8

CHAPTER 27

<--

9

PHARMACEUTICAL ACCOUNTABILITY MONITORING SYSTEM

10

Sec.

11

2701.  Short title of chapter.

12

2702.  Scope of chapter.

13

2703.  Definitions.

14

2704.  Establishment of Pharmaceutical Accountability Monitoring

15

System.

 


1

2705.  Requirements for Pharmaceutical Accountability Monitoring

2

System.

3

2706.  Access to prescription information.

4

2707.  Unlawful acts and penalties.

5

2708.  Education and treatment.

6

2709.  Immunity.

7

2710.  Additional provisions.

8

2711.  Use of money collected.

9

2712.  Rules and regulations.

10

2713.  Evaluation, data analysis and reporting.

11

2714.  Severability.

12

§ 2701.  Short title of chapter.

13

This chapter shall be known and may be cited as the

14

Pharmaceutical Accountability Monitoring System Act.

15

§ 2702.  Scope of chapter.

16

This chapter is intended to improve the Commonwealth's

17

ability to enable informed and responsible prescribing and

18

dispensing of controlled substances and to reduce diversion and

19

misuse of such drugs in an efficient and cost-effective manner

20

that will not impede the appropriate medical utilization of

21

licit controlled substances.

22

§ 2703.  Definitions.

23

The following words and phrases when used in this chapter

24

shall have the meanings given to them in this section unless the

25

context clearly indicates otherwise:

26

"Alcohol and other drug addiction treatment program."  Any

27

facility or treatment program that is licensed, certified or

28

approved by the Commonwealth to provide alcohol and other drug

29

addiction treatment on a hospital, nonhospital, residential or

30

outpatient basis.

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1

"Controlled substance."  A drug, substance or immediate

2

precursor included in Schedule II, III, IV or V of the act of

3

April 14, 1972 (P.L.233, No.64), known as The Controlled

4

Substance, Drug, Device and Cosmetic Act, or the Controlled

5

Substances Act (Public Law 91-513, 84 Stat. 1236).

6

"Database."  The Pharmaceutical Accountability Monitoring

7

System established in section 2704 (relating to establishment of

8

Pharmaceutical Accountability Monitoring System).

9

"Department."  The Department of Drug and Alcohol Programs.

10

"Dispenser."  A provider who dispenses a scheduled drug to a

11

patient in this Commonwealth but does not include any of the

12

following:

13

(1)  A licensed health care facility or long-term care

14

pharmacy that distributes such substances for the purpose of

15

inpatient hospital or long-term care facility administration.

16

(2)  A practitioner or other authorized person who

17

administers such a substance.

18

(3)  A wholesale distributor of a scheduled drug.

19

(4)  A hospice care provider.

20

"Licensed health care facility."  A health care facility that

21

is licensed under Article X of the act of June 13, 1967 (P.L.

22

31, No.21), known as the Public Welfare Code, or the act of July

23

19, 1979 (P.L.130, No.48), known as the Health Care Facilities

24

Act.

25

"PAMS."  The Pharmaceutical Accountability Monitoring System

26

established in section 2704.

27

"Patient."  The person who has lawfully obtained and who

28

possesses any scheduled drug for the person's own use.

29

"Practitioner."  The term shall mean:

30

(1)  a physician, osteopath, dentist, veterinarian,

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1

pharmacist, podiatrist, nurse, scientific investigator or

2

other person licensed, registered or otherwise permitted to

3

distribute, dispense, conduct research with respect to or to

4

administer a controlled substance, other drug or device in

5

the course of professional practice or research in this

6

Commonwealth; or

7

(2)  a pharmacy, hospital, clinic or other institution

8

licensed, registered or otherwise permitted to distribute,

9

dispense, conduct research with respect to or to administer a

10

controlled substance, other drug or device in the course of

11

professional practice or research in this Commonwealth.

12

§ 2704.  Establishment of Pharmaceutical Accountability

13

Monitoring System.

14

(a)  General rule.--The department shall establish and

15

maintain an electronic system for monitoring all scheduled drugs

16

that are dispensed within this Commonwealth by all professionals

17

licensed to prescribe or dispense such substances in this

18

Commonwealth, including, but not limited to, a practitioner or

19

pharmacist or dispensed to an address within this Commonwealth

20

by a pharmacy that has obtained a license, permit or other

21

authorization to operate by the Pennsylvania Board of Pharmacy.

22

(b)  Duties of department.--The department shall administer

23

PAMS.

24

(c)  Purpose.--The purpose of PAMS is to contain data as

25

described in this section regarding every prescription for a

26

controlled substance dispensed in this Commonwealth to any

27

person other than an inpatient in a licensed health care

28

facility or by a hospice care provider.

29

(d)  Data compliance.--Data required by this section shall be

30

submitted in compliance with this section to the department by

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1

the pharmacy or other dispensing entity.

2

(e)  Data input.--A dispenser shall input data as required by

3

the department.

4

(f)  Queries.--A practitioner may query such data.

5

(g)  Registration.--Each dispenser and practitioner licensed

6

to practice in this Commonwealth shall register with and

7

establish a user name and personal identification number that

8

permits access to the secure website housing PAMS established by

9

this act.

10

(h)  Dispenser access.--Each dispenser required to report

11

electronically pursuant to this act shall have online access to

12

PAMS at all times when the dispenser provides pharmaceutical

13

care to a patient potentially receiving a controlled substance.

14

§ 2705.  Requirements for Pharmaceutical Accountability

15

Monitoring System.

16

(a)  Submission.--The dispenser shall, regarding each

17

controlled substance dispensed, submit by electronic means to

18

the department the following information by transmission

19

methods, protocols and in a format established by the

20

department:

21

(1)  Full name of the prescribing practitioner.

22

(2)  Prescriber Drug Enforcement Agency (DEA)

23

registration number.

24

(3)  Date the prescription was written.

25

(4)  Date the prescription was dispensed.

26

(5)  Patient information of the person for whom the

27

prescription was written and dispensed, including full name,

28

date of birth, gender and address.

29

(6)  Positive identification of the person receiving the

30

prescription, including the type of identification.

- 5 -

 


1

(7)  Name of the controlled substance.

2

(8)  Quantity of the controlled substance prescribed.

3

(9)  Strength of the controlled substance.

4

(10)  Quantity of the controlled substance dispensed.

5

(11)  Dosage quantity and frequency prescribed.

6

(12)  Name of the pharmacy or other entity dispensing the

7

controlled substance.

8

(13)  Name of the pharmacist dispensing the controlled

9

substance.

10

(14)  Dispensing entity's DEA registration number and

11

NPI.

12

(15)  Source of payment for the prescription.

13

(16)  Other relevant information as established by

14

department regulations.

15

(b)  Frequency.--Each dispenser shall submit the information

16

required by this act as frequently as specified by the

17

department, but not later than two days after the dispensing of

18

a controlled substance monitored by PAMS. The department shall

19

implement a real-time reporting requirement as expeditiously as

20

possible.

21

(c)  Maintenance.--The department shall maintain PAMS in an

22

electronic file or by other means established by the department

23

to facilitate use of the database for identification of:

24

(1)  Prescribing and dispensing practices and patterns

25

for controlled substances.

26

(2)  An individual patient's patterns of obtaining

27

controlled substances from licensed practitioners and who

28

subsequently obtain dispensed controlled substances from a

29

drug outlet in quantities or with a frequency inconsistent

30

with generally recognized standards of dosage for that

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1

controlled substance.

2

(3)  Individuals presenting forged or otherwise false or

3

altered prescriptions for controlled substances to a

4

pharmacy.

5

(d)  Recordkeeping.--The department shall maintain a record

6

of PAMS queries for reference, including:

7

(1)  Identification of each person who requests or

8

receives information from PAMS.

9

(2)  The information provided to each person.

10

(3)  The date and time the information is requested or

11

provided.

12

§ 2706.  Access to prescription information.

13

(a)  General rule.--Except as set forth in subsection (c),

14

prescription information submitted to the department shall be

15

confidential and not subject to disclosure under the act of

16

February 14, 2008 (P.L.6, No.3), known as the Right-to-Know Law.  

17

(b)  Privacy procedures.--The department shall maintain

18

procedures to ensure that the privacy and confidentiality of

19

patients and patient information collected, recorded,

20

transmitted and maintained is not disclosed to persons except

21

those enumerated in subsection (c).

22

(c)  Limited availability.--The manager of PAMS shall make

23

information in PAMS available only to the following persons and

24

in accordance with the limitations stated in the department

25

regulations:

26

(1)  Personnel of the department specifically assigned to

27

conduct investigations related to controlled substances laws

28

under the jurisdiction of the department.

29

(2)  Authorized department personnel engaged in analysis

30

of controlled substance prescription information as a part of

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1

the assigned duties and responsibilities of their employment.

2

(3)  Qualified personnel for the purpose of bona fide

3

research or education. Data elements that would reasonably

4

identify a specific recipient, prescriber or dispenser shall

5

be deleted or redacted from such information prior to

6

disclosure. Release of the information shall only be made

7

pursuant to a written agreement between such qualified

8

personnel and the department in order to ensure compliance

9

with this chapter.

10

(4)  A licensed practitioner, or a representative

11

employed by the practitioner, designated by the practitioner

12

pursuant to criteria established by the department, having

13

authority to prescribe controlled substances, to the extent

14

of one of the following:

15

(i)  The information relates to a current patient of

16

the practitioner to whom the practitioner is prescribing

17

or considering prescribing any controlled substance.

18

(ii)  The information relates specifically to an

19

individual who has access to the practitioner's DEA

20

number, and the practitioner suspects that the individual

21

may use the practitioner's DEA identification number to

22

fraudulently acquire or prescribe controlled substances.

23

(iii)  The information relates to the practitioner's

24

own prescribing practices, except when specifically

25

prohibited by department regulations.

26

(5)  A licensed pharmacist, or a designee employed by the

27

pharmacist, designated by the pharmacist pursuant to criteria

28

established by the department, having authority to dispense

29

controlled substances to the extent the information relates

30

specifically to a current patient to whom that pharmacist is

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1

dispensing or considering dispensing any controlled

2

substance.

3

(6)  Federal or State law enforcement authorities engaged

4

in the administration, investigation or enforcement of the

5

laws governing controlled substances and who are involved in

6

one of the following:

7

(i)  A bona fide specific drug-related investigation

8

involving a designated person.

9

(ii)  Investigating insurance fraud, Medicaid fraud

10

or Medicare fraud.

11

(7)  A designated representative from the Commonwealth or

12

out-of-State agency or board responsible for licensing or

13

certifying prescribers or dispensers who is involved in a

14

bona fide investigation of a prescriber or dispenser whose

15

professional practice was or is regulated by that agency or

16

board.

17

(8)  A medical examiner or county coroner for the purpose

18

of investigating the death of an individual.

19

(9)  A designated prescription monitoring official of a

20

state with which this Commonwealth has an interoperability

21

agreement may access prescription monitoring information in

22

accordance with procedures adopted by the department.

23

(10)  An individual who is the recipient of a controlled

24

substance prescription entered into PAMS upon providing

25

evidence satisfactory to the PAMS manager that the individual

26

requesting the information is in fact the person about whom

27

the data entry was made.

28

(11)  A judicial authority under grand jury subpoena or

29

court order or equivalent judicial process for investigation

30

of a criminal violation of law governing controlled

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1

substances may access prescription monitoring information.

2

§ 2707.  Unlawful acts and penalties.

3

(a)  Knowing and intentional release.--Any person who

4

knowingly and intentionally releases any information in PAMS in

5

violation of the limitations under section 2706(c) (relating to

6

access to prescription information) commits a felony of the

7

third degree.

8

(b)  Misrepresentation or fraud.--Any person who obtains or

9

attempts to obtain information from PAMS by misrepresentation or

10

fraud commits a felony of the third degree.

11

(c)  Unauthorized purpose.--Any person who obtains or

12

attempts to obtain information from PAMS for a purpose other

13

than a purpose authorized by this section or by department

14

regulations commits a felony of the third degree.

15

(d)  Other person.--A person may not knowingly and

16

intentionally use, release, publish or otherwise make available

17

to any other person or entity any information obtained from PAMS

18

for any purpose other than those specified in section 2706(c).

19

Each separate violation of this subsection is a felony of the

20

third degree and is subject to a civil penalty not to exceed

21

$5,000.

22

(e)  Civil violation.--The procedure for determining a civil

23

violation of this subsection shall be in accordance with

24

department regulations. Civil penalties assessed under this

25

subsection shall be deposited in the General Fund, appropriated

26

to the department and dedicated to the controlled substance PAMS

27

operations.

28

(f)  Failure to submit.--The failure of a dispenser to submit

29

information to PAMS as required under this section, after the

30

department has submitted a specific written request for the

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1

information or when the department determines the individual has

2

a demonstrable pattern of knowing that failure to submit the

3

information as required, is grounds for the pharmacy board to

4

take the following action in accordance with the act of

5

September 27, 1961 (P.L.1700, No.699), known as the Pharmacy

6

Act.

7

(1)  Refuse to issue a license to the individual.

8

(2)  Refuse to renew the individual's license.

9

(3)  Revoke, suspend, restrict or place on probation the

10

license.

11

(4)  Issue a public or private reprimand to the

12

individual.

13

(5)  Issue a cease and desist order.

14

(6)  Impose a civil penalty of not more than $1,000 for

15

each dispensed prescription for which the required

16

information was not submitted.

17

(g)  A person authorized to have prescription monitoring

18

information under this act who knowingly uses such information

19

in violation of this act shall, upon conviction, be fined not

20

less than $5,000, be sentenced to imprisonment of not more than

21

90 days, or both, for each offense.

22

§ 2708.  Education and treatment.

23

(a)  General rule.--The department shall:

24

(1)  assist the appropriate agency, board or association

25

for each category of authorized user in this act to

26

incorporate the appropriate information regarding PAMS into

27

the training, education or instruction provided to each

28

category of authorized user;

29

(2)  assist the State or regional chapter of the American

30

Society of Addiction Medicine, or comparable association in

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1

this Commonwealth, and the medical society to develop a

2

continuing education course for health care professionals on

3

prescribing practices, pharmacology and identification,

4

referral and treatment of patients addicted to or abusing

5

controlled substances monitored by PAMS; and

6

(3)  implement, or assist other appropriate agencies to

7

implement, an educational program to inform the public about

8

the use, diversion and abuse of, addiction to and treatment

9

for the addiction to the controlled substances monitored by

10

PAMS.

11

(b)  Referral.--The department shall refer prescribers and

12

dispensers it has reason to believe may be impaired to the

13

appropriate professional licensing or certification agency, and

14

to the appropriate impaired professionals associations, to

15

provide intervention, assessment and referral to alcohol and

16

other drug addiction treatment programs, and ongoing monitoring

17

and follow-up.

18

(c)  Identification.--The department shall work with the

19

appropriate alcohol and other drug addiction treatment

20

professionals to provide that patients identified through PAMS

21

as potentially addicted to a controlled substance are assessed

22

and referred to alcohol and other drug addiction treatment

23

programs.

24

§ 2709.  Immunity.

25

An individual who has submitted information to PAMS in

26

accordance with this section may not be held civilly liable for

27

having submitted the information.

28

§ 2710.  Additional provisions.

29

(a)  Funding.--A practitioner or a pharmacist shall not be

30

required to pay a fee or tax specifically dedicated to

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1

establishment, operation or maintenance of the system.

2

(b)  Costs.--All costs associated with recording and

3

submitting data as required in this section shall be assumed by

4

the submitting pharmacy.

5

(c)  Use of data.--Except as provided in subsection (d), data

6

provided to, maintained in or accessed from PAMS that may be

7

identified to, or with, a particular person is not subject to

8

discovery, subpoena or similar compulsory process in any civil,

9

judicial, administrative or legislative proceeding, nor shall

10

any individual or organization with lawful access to the data be

11

compelled to testify with regard to the data.

12

(d)  Exceptions.--The restrictions in subsection (c) do not

13

apply to:

14

(1)  A criminal proceeding.

15

(2)  A civil, judicial or administrative action brought

16

to enforce the provisions of this section.

17

§ 2711.  Use of money collected.

18

(a)  General rule.--The department may use the moneys

19

deposited in the General Fund and appropriated to the department

20

for the following purposes:

21

(1)  Maintenance and replacement of PAMS equipment,

22

including hardware and software.

23

(2)  Training of staff.

24

(3)  Pursuit of grants and matching funds.

25

(b)  Collections.--The department may collect any penalty

26

imposed under section 2707 (relating to unlawful acts and

27

penalties) and which is not paid by bringing an action in the

28

court of common pleas of the county in which the person owing

29

the debt resides or in the county where the department is

30

located.

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1

(c)  Legal assistance.--The department may seek legal

2

assistance from the Attorney General or the county or district

3

attorney of the county in which the action is brought to collect

4

the fine.

5

(d)  Attorney fees and costs.--The court shall award

6

reasonable attorney fees and costs to the department for

7

successful collection actions under section 2707.

8

§ 2712.  Rules and regulations.

9

The department shall promulgate rules and regulations setting

10

forth the procedures and methods for implementing this chapter.

11

At a minimum, the rules and regulations shall include the

12

following:

13

(1)  Effectively enforce the limitations on access to

14

PAMS prescribed in section 2706 (relating to access to

15

prescription information).

16

(2)  Establish standards and procedures to ensure

17

accurate identification of individuals requesting information

18

or receiving information from PAMS.

19

§ 2713.  Evaluation, data analysis and reporting.

20

(a)  General rule.--The department shall design and implement

21

an evaluation component to identify:

22

(1)  cost benefits of PAMS;

23

(2)  the impact on efforts to reduce misuse, abuse,

24

overdose and diversion of, or addiction to, controlled

25

substances;

26

(3)  the impact on prescribing practices for controlled

27

substances;

28

(4)  the number of patients identified through PAMS as

29

potentially addicted to a controlled substance that were

30

assessed for alcohol and other drug addictions;

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1

(5)  the number of patients in paragraph (4) that

2

received alcohol and other drug addiction treatment and the

3

names of the licensed, certified or approved alcohol and

4

other drug addiction treatment facilities in which the

5

patients were treated;

6

(6)  the progress made in implementing real-time

7

reporting; and

8

(7)  other information relevant to policy, research and

9

education involving controlled substances and drugs of

10

concern monitored by PAMS.

11

(b)  Annual report.--The department shall annually report the

12

information specified in subsection (a) to the Public Health and

13

Welfare Committee of the Senate, the Human Services Committee of

14

the House of Representatives, the United States Department of

15

Justice, the Substance Abuse and Mental Health Services

16

Administration of the Office of National Drug Control Policy and

17

members of Pennsylvania's United States Congressional

18

delegation. Additionally, the department shall make the annual

19

report available to the public on its publicly accessible

20

Internet website.

21

§ 2714.  Severability.

22

The provisions of this act are severable. If any provision of

23

this act or its application to any person or circumstance is

24

held invalid, the invalidity shall not affect other provisions

25

or applications of this act which can be given effect without

26

the invalid provision or application.

27

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

28

CHAPTER 27

<--

29

PHARMACEUTICAL ACCOUNTABILITY MONITORING SYSTEM

30

Sec.

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1

2701.  Short title of chapter.

2

2702.  Purpose.

3

2703.  Scope of chapter.

4

2704.  Definitions.

5

2705.  Advisory committee.

6

2706.  Establishment of Pharmaceutical Accountability Monitoring

7

System.

8

2707.  Requirements for Pharmaceutical Accountability Monitoring

9

System.

10

2708.  Access to prescription information.

11

2709.  Unlawful acts and penalties.

12

2710.  Education and treatment.

13

2711.  Immunity.

14

2712.  Additional provisions.

15

2713.  Use of money collected.

16

2714.  Rules and regulations.

17

2715.  Evaluation, data analysis and reporting.

18

2716.  Concurrent jurisdiction.

19

§ 2701.  Short title of chapter.

20

This chapter shall be known and may be cited as the

21

Pharmaceutical Accountability Monitoring System Act.

22

§ 2702.  Purpose.

23

The purpose of this chapter is to reduce the abuse of

24

controlled substances and fraud by providing a tool that will

25

ensure that practitioners making prescribing decisions have

26

complete and reliable information about what, if any, other

27

prescription drugs have recently been prescribed to their

28

patients. It is the purpose of this act to provide reporting

29

mechanisms, with full confidentiality protections, in which

30

dispensers report prescription information to a central

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1

repository, in order to identify patient and practitioner

2

behaviors that give rise to a reasonable suspicion that

3

prescription drugs are being inappropriately obtained or

4

prescribed, so that appropriate ameliorative and corrective

5

action, including treatment for individuals suffering from drug

6

and alcohol addiction, may be taken. This chapter is further

7

intended to help detect, refer to law enforcement and regulatory

8

agencies and deter prescription drug fraud and diversion.

9

§ 2703.  Scope of chapter.

10

This chapter is intended to improve the Commonwealth's

11

ability to enable informed and responsible prescribing and

12

dispensing of controlled substances and to reduce diversion and

13

misuse of such drugs in an efficient and cost-effective manner

14

that will not impede the appropriate medical utilization of

15

licit controlled substances.

16

§ 2704.  Definitions.

17

The following words and phrases when used in this chapter

18

shall have the meanings given to them in this section unless the

19

context clearly indicates otherwise:

20

"Alcohol and other drug addiction treatment program."  Any

21

facility or treatment program that is licensed by the

22

Commonwealth to provide alcohol and other drug addiction

23

treatment on a hospital, nonhospital residential or outpatient

24

basis.

25

"Bona fide investigation."  An investigation that is entered

26

into in good faith against a specific individual and based on

27

information secured outside of the PAMS except in circumstances

28

where a person with lawful access to the information contained

29

in the PAMS brings a report of that information to the attention

30

of law enforcement.

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1

"Controlled substance."  A drug, substance or immediate

2

precursor included in Schedule II, III, IV or V of the act of

3

April 14, 1972 (P.L.233, No.64), known as The Controlled

4

Substance, Drug, Device and Cosmetic Act, or the Controlled

5

Substances Act (Public Law 91-513, 84 Stat. 1236).

6

"Database."  The Pharmaceutical Accountability Monitoring

7

System established in section 2706 (relating to establishment of

8

Pharmaceutical Accountability Monitoring System).

9

"Department."  The Department of Drug and Alcohol Programs.

10

"Dispense."  To deliver a controlled substance, other drug or

11

device to an ultimate user by or pursuant to the lawful order of

12

a practitioner.

13

"Dispenser."  A practitioner who dispenses in this

14

Commonwealth, including mail order and Internet sales of

15

pharmaceuticals. The term does not include any of the following:

16

(1)  A licensed health care facility or long-term care

17

pharmacy that distributes such substances for the purpose of

18

inpatient hospital or long-term care facility administration.

19

(2)  A practitioner or other authorized person who

20

administers such a substance.

21

(3)  A wholesale distributor of a controlled substance.

22

(4)  A hospice care provider.

23

(5)  A medical practitioner at a health care facility

24

licensed by this Commonwealth if the quantity of controlled

25

substances dispensed is limited to an amount adequate to

26

treat the patient for a maximum of 24 hours with not more

27

than two 24-hour cycles within any 15-day period.

28

"Internet pharmacy."  A person, entity or Internet site,

29

whether in the United States or abroad, that knowingly or

30

intentionally delivers, distributes or dispenses, or offers or

- 18 -

 


1

attempts to deliver, distribute or dispense, a controlled

2

substance by means of the Internet, including a pharmacy.

3

"Licensed health care facility."  A health care facility that

4

is licensed under Article X of the act of June 13, 1967 (P.L.

5

31, No.21), known as the Public Welfare Code, or the act of July

6

19, 1979 (P.L.130, No.48), known as the Health Care Facilities

7

Act.

8

"Mail-order pharmacy."  A pharmacy that dispenses controlled

9

substances using the United States Postal Service or any express

10

delivery service.

11

"PAMS."  The Pharmaceutical Accountability Monitoring System

12

established in section 2706 (relating to establishment of

13

Pharmaceutical Accountability Monitoring System).

14

"Practitioner."  The term shall mean:

15

(1)  a physician, dentist, veterinarian, pharmacist,

16

podiatrist, physician assistant, certified registered nurse

17

practitioner or other person licensed, registered or

18

otherwise permitted to distribute, dispense or to administer

19

a controlled substance, other drug or device in the course of

20

professional practice or research in this Commonwealth; or

21

(2)  a pharmacy, hospital, clinic or other institution

22

licensed, registered or otherwise permitted to distribute,

23

dispense, conduct research with respect to or to administer a

24

controlled substance, other drug or device in the course of

25

professional practice or research in this Commonwealth.

26

"Ultimate user."  A person who lawfully possesses a

27

controlled substance, other drug, device or cosmetic for his own

28

use or for the use of a member of his household or for

29

administering to an animal in his care.

30

§ 2705.  Advisory committee.

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1

(a)  Establishment.--An advisory committee is established to

2

provide input and advice to the department regarding the

3

establishment and maintenance of PAMS, including, but not

4

limited to:

5

(1)  Use of PAMS to improve patient care, to identify and

6

address addiction and to facilitate the goal of reducing

7

misuse, abuse, overdose, addiction to and diversion of

8

controlled substances and drugs of concern.

9

(2)  Safeguards for the release of information to

10

authorized users.

11

(3)  The confidentiality of prescription monitoring

12

information and the integrity of the patient's relationship

13

with the patient's health care provider.

14

(4)  Development of criteria for referring prescription

15

monitoring information to a law enforcement or professional

16

licensing agency.

17

(5)  Development of criteria for referring a prescriber

18

or dispenser to a professional licensing agency or impaired

19

professionals association.

20

(6)  The design and implementation of training, education

21

or instruction.

22

(7)  The provision of assessment and referral to alcohol

23

and other drug addiction treatment as part of any other

24

requirements of this chapter.

25

(8)  Technical standards for electronic reporting of

26

prescription monitoring information.

27

(9)  Technological improvements to facilitate the

28

interoperability of PAMS with other State prescription drug

29

monitoring programs and electronic health information systems

30

and to facilitate prescribers' and dispensers' access to and

- 20 -

 


1

use of PAMS.

2

(10)  Proper analysis and interpretation of prescription

3

monitoring information.

4

(11)  Design and implementation of an evaluation

5

component.

6

(12)  Recommended appointments to the advisory committee.

7

(b)  Confidentiality.--For the purpose of providing input and

8

advice pursuant to subsection (a), no advisory committee member

9

shall receive prescription monitoring information which

10

identifies, or could reasonably be used to identify, the

11

patient, prescriber, dispenser or other person who is the

12

subject of the information.

13

(c)  Membership.--

14

(1)  The department shall establish an advisory committee

15

comprised of the following:

16

(i)  A representative recommended by the Department

17

of State representing the State Board of Medicine and the

18

State Board of Nursing.

19

(ii)  A representative recommended by the State Board

20

of Pharmacy.

21

(iii)  A representative recommended by the Attorney

22

General.

23

(iv)  Two physicians recommended by the Pennsylvania

24

Medical Society, one of whom holds membership in the

25

American Society of Addiction Medicine and the other who

26

is a physician with expertise in chronic pain management

27

and treatment.

28

(v)  A representative recommended by the Pennsylvania

29

District Attorneys Association.

30

(vi)  A representative recommended by the

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1

Pennsylvania Coroners Association.

2

(vii)  A representative recommended by the Drug and

3

Alcohol Service Providers Organization of Pennsylvania.

4

(viii)  A representative of chronic pain patients

5

recommended by a physician with expertise in chronic pain

6

management.

7

(2)  The department may also appoint persons with

8

recognized expertise, knowledge and experience in the

9

establishment and maintenance of prescription monitoring

10

programs, skills and expertise in alcohol and other drug

11

addiction assessment and referral to addiction treatment or

12

issues involving the misuse, abuse or diversion of, or the

13

addiction to, controlled substances or drugs of concern.

14

(d)  Quorum.--Nine members of the advisory committee shall

15

constitute a quorum for the transaction of all business. The

16

members shall elect a chairman and such other officers as deemed

17

necessary whose duties shall be established by the advisory

18

committee. The department shall convene the advisory committee

19

at least quarterly using telecommunication whenever possible.

20

(e)  Staff assistance.--The department shall provide the

21

advisory committee with any staff services which may be

22

necessary for the advisory committee to carry out its duties

23

under this chapter.

24

§ 2706.  Establishment of Pharmaceutical Accountability

25

Monitoring System.

26

(a)  General rule.--The department shall establish and

27

administer the Pharmaceutical Accountability Monitoring System

28

(PAMS) for monitoring all controlled substances that are

29

dispensed within this Commonwealth by all practitioners or

30

dispensers, including, but not limited to, a practitioner or

- 22 -

 


1

dispenser that dispenses to a person or ships to an address

2

within this Commonwealth.

3

(b)  Data compliance.--Data required by this section shall be

4

submitted in compliance with this section to the department by

5

the pharmacy or other dispensing entity.

6

(c)  Registration.--Each dispenser and practitioner

7

dispensing or prescribing controlled substances shall register

8

with and establish a user name and personal identification

9

number that permits access to the secure website housing PAMS

10

established by this chapter.

11

(d)  Queries.--A practitioner may query data through the

12

department. A Federal or State law enforcement official whose

13

duties include enforcing laws relating to controlled substances

14

and prescription drugs shall be provided access to the

15

information from PAMS relating to the person who is the subject

16

of a bona fide investigation of a drug abuse offense, including,

17

but not limited to, violations of the act of April 14, 1972

18

(P.L.233, No.64), known as The Controlled Substance, Drug,

19

Device and Cosmetic Act, insurance fraud, Medicare fraud or

20

Medicaid fraud pursuant to a bona fide investigation.

21

§ 2707.  Requirements for Pharmaceutical Accountability

22

Monitoring System.

23

(a)  Submission.--The dispenser shall, regarding each

24

controlled substance dispensed, submit by electronic means to

25

the department the following information using methods of

26

transmission protocols and in a format established by the

27

department:

28

(1)  Full name of the prescribing practitioner.

29

(2)  Prescriber Drug Enforcement Agency (DEA)

30

registration number.

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1

(3)  Date the prescription was written.

2

(4)  Date the prescription was dispensed.

3

(5)  Full name, date of birth, gender and address of the

4

person for whom the prescription was written and dispensed.

5

(6)  Name of the controlled substance.

6

(7)  Quantity of the controlled substance prescribed.

7

(8)  Strength of the controlled substance.

8

(9)  Quantity of the controlled substance dispensed.

9

(10)  Dosage quantity and frequency prescribed.

10

(11)  Name of the pharmacy or other entity dispensing the

11

controlled substance.

12

(12)  Dispensing entity's DEA registration number and

13

NPI.

14

(13)  Source of payment for the prescription.

15

(14)  Other relevant information as established by

16

department regulations.

17

(b)  Frequency.--Each dispenser shall submit the information

18

required by this chapter as frequently as specified by the

19

department, but not later than seven days after the dispensing

20

of a controlled substance monitored by PAMS. The department

21

shall implement a real-time reporting requirement as

22

expeditiously as possible.

23

(c)  Maintenance.--The department shall maintain PAMS in an

24

electronic file or by other means established by the department

25

to facilitate use of the database.

26

(d)  Recordkeeping.--The department shall maintain a record

27

of PAMS queries for reference, including:

28

(1)  Identification of each person who requests or

29

receives information from PAMS.

30

(2)  The information provided to each person.

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1

(3)  The date and time the information is requested and

2

provided.

3

(e)  Expungement.--The department shall remove from PAMS all

4

identifying information more than six years old from the date of

5

collection. Such information shall then be destroyed unless a

6

law enforcement agency or a professional licensing or

7

certification agency or board for prescribers or dispensers has

8

submitted a written request to the department for retention of

9

specific information. All requests shall comply with procedures

10

adopted by the department.

11

§ 2708.  Access to prescription information.

12

(a)  General rule.--Except as set forth in subsection (c),

13

prescription information submitted to the department and records

14

of requests to query the data shall be confidential and not

15

subject to disclosure under the act of February 14, 2008 (P.L.6,

16

No.3), known as the Right-to-Know Law.

17

(b)  Privacy procedures.--The department shall maintain

18

procedures to ensure that the privacy and confidentiality of

19

patients and patient information collected, recorded,

20

transmitted and maintained is not disclosed to persons except

21

those enumerated in subsection (c).

22

(c)  Limited availability.--The department shall make

23

information in PAMS available only to the following persons and

24

in accordance with department regulations:

25

(1)  Personnel of the department specifically assigned to

26

conduct internal reviews related to controlled substances

27

laws under the jurisdiction of the department.

28

(2)  Authorized department personnel engaged in analysis

29

of controlled substance prescription information as a part of

30

the assigned duties and responsibilities of their employment.

- 25 -

 


1

(3)  Qualified personnel for the purpose of bona fide

2

research or education. Data elements that would reasonably

3

identify a specific recipient, prescriber or dispenser shall

4

be deleted or redacted from such information prior to

5

disclosure. Release of the information shall only be made

6

pursuant to a written agreement between such qualified

7

personnel and the department in order to ensure compliance

8

with this chapter.

9

(4)  A practitioner, or a representative employed by the

10

practitioner, designated by the practitioner pursuant to

11

criteria established by the department, having authority to

12

prescribe controlled substances, to the extent that the

13

information relates to a current patient of the practitioner

14

to whom the practitioner is prescribing or considering

15

prescribing any controlled substance.

16

(5)  A pharmacist, or a designee employed by the

17

pharmacist, designated by the pharmacist pursuant to criteria

18

established by the department, having authority to dispense

19

controlled substances to the extent the information relates

20

specifically to a current patient to whom that pharmacist is

21

dispensing or considering dispensing any controlled

22

substance.

23

(6)  A designated representative from the Commonwealth or

24

out-of-State agency or board responsible for licensing or

25

certifying prescribers or dispensers who is involved in a

26

bona fide investigation of a prescriber or dispenser whose

27

professional practice was or is regulated by that agency or

28

board.

29

(7)  A medical examiner or county coroner for the purpose

30

of investigating the death of an individual.

- 26 -

 


1

(8)  A designated prescription monitoring official of a

2

state with which this Commonwealth has an interoperability

3

agreement may access prescription monitoring information in

4

accordance with the provisions of this chapter and procedures

5

adopted by the department.

6

(9)  An individual who is the recipient of a controlled

7

substance prescription entered into PAMS upon providing

8

evidence satisfactory to the PAMS manager that the individual

9

requesting the information is in fact the person about whom

10

the data entry was made.

11

(10)  The Office of Attorney General of Pennsylvania or

12

the equivalent law enforcement officer of another state may

13

access information from the PAMS for a bona fide

14

investigation of a criminal violation of law governing

15

controlled substances.

16

(d)  Dispenser access.--No person shall knowingly hinder a

17

pharmacist or practitioner who dispenses who is eligible to

18

receive information from PAMS from requesting and receiving such

19

information in a timely fashion.

20

§ 2709.  Unlawful acts and penalties.

21

(a)  Knowing and intentional release or use.--A person may

22

not knowingly and intentionally use, release, publish or

23

otherwise make available any information obtained from PAMS for

24

any purpose other than those specified in section 2708(c)

25

(relating to access to prescription information). A person who

26

does knowingly and intentionally release or use information from

27

PAMS that is not authorized in section 2708(c) commits a felony

28

of the third degree and is subject to a civil penalty of not

29

less than $5,000, or shall be sentenced to imprisonment of not

30

more than 90 days, or both, for each offense.

- 27 -

 


1

(b)  Misrepresentation or fraud.--Any person who obtains or

2

attempts to obtain information from PAMS by misrepresentation or

3

fraud commits a felony of the third degree.

4

(c)  Unauthorized purpose.--Any person who obtains or

5

attempts to obtain information from PAMS for a purpose other

6

than a purpose authorized by this section or by department

7

regulations commits a felony of the third degree.

8

(d)  Civil violation.--The procedure for determining a civil

9

violation of this subsection shall be in accordance with

10

department regulations. Civil penalties assessed under this

11

subsection shall be deposited in the General Fund, appropriated

12

to the department and dedicated to the controlled substance PAMS

13

operations.

14

(e)  Failure to submit.--The failure of a dispenser to submit

15

information to PAMS as required under this section, after the

16

department has submitted a specific written request for the

17

information or when the department determines the individual has

18

a demonstrable pattern of knowing that failure to submit the

19

information as required, is grounds for the appropriate

20

licensing board to take the following action in accordance with

21

the appropriate licensing act.

22

(1)  Prohibit an Internet pharmacy from conducting

23

business in this Commonwealth.

24

(2)  Refuse to issue a license to the individual.

25

(3)  Refuse to renew the individual's license.

26

(4)  Revoke, suspend, restrict or place on probation the

27

license.

28

(5)  Issue a public or private reprimand to the

29

individual.

30

(6)  Issue a cease and desist order.

- 28 -

 


1

(7)  Impose a civil penalty of not more than $1,000 for

2

each failure to submit information required by this act.

3

§ 2710.  Education and treatment.

4

(a)  General rule.--With the input and advice of the advisory

5

committee, the department shall:

6

(1)  assist the appropriate agency, board or association

7

for each category of authorized user in this act to

8

incorporate the appropriate information regarding PAMS into

9

the training, education or instruction provided to each

10

category of authorized user;

11

(2)  assist the State or regional chapter of the American

12

Society of Addiction Medicine, the Pennsylvania Medical

13

Society, the Pennsylvania Academy of Family Physicians and

14

the Pennsylvania Coalition of Nurse Practitioners to develop

15

a continuing education course for health care professionals

16

on prescribing practices, pharmacology and identification,

17

referral and treatment of patients addicted to or abusing

18

controlled substances monitored by PAMS; and

19

(3)  implement, or assist other appropriate agencies to

20

implement, an educational program to inform the public about

21

the use, diversion and abuse of, addiction to and treatment

22

for the addiction to the controlled substances monitored by

23

PAMS, including the nature and scope of PAMS.

24

(b)  Referral.--With the input and advice of the advisory

25

committee, the department shall refer prescribers and dispensers

26

it has reason to believe may be impaired to the appropriate

27

professional licensing or certification agency, and to the

28

appropriate impaired professionals associations, to provide

29

intervention, assessment and referral to alcohol and other drug

30

addiction treatment programs, and ongoing monitoring and follow-

- 29 -

 


1

up.

2

(c)  Identification.--With the input and advice of the

3

advisory committee, the department shall work with the patient's

4

individual practitioner and the appropriate alcohol and other

5

drug addiction treatment professionals to provide that patients

6

identified through PAMS as potentially addicted to a controlled

7

substance are assessed and referred to alcohol and other drug

8

addiction treatment programs.

9

§ 2711.  Immunity.

10

An individual who has submitted to or received information

11

from PAMS in accordance with this section may not be held

12

civilly liable or disciplined in a licensing board action for

13

having submitted the information or for not seeking or obtaining

14

information from the prescription monitoring program prior to

15

prescribing or dispensing a controlled substance to a patient.

16

§ 2712.  Additional provisions.

17

(a)  Funding.--A practitioner or a pharmacist shall not be

18

required to pay a fee or tax specifically dedicated to

19

establishment, operation or maintenance of the system.

20

(b)  Costs.--All costs associated with recording and

21

submitting data as required in this section shall be assumed by

22

the submitting dispenser.

23

(c)  Use of data.--Except as provided in subsection (d), data

24

provided to, maintained in or accessed from PAMS that may be

25

identified to, or with, a particular person is not subject to

26

discovery, subpoena or similar compulsory process in any civil,

27

judicial, administrative or legislative proceeding, nor shall

28

any individual or organization with lawful access to the data be

29

compelled to testify with regard to the data.

30

(d)  Exceptions.--The restrictions in subsection (c) do not

- 30 -

 


1

apply to:

2

(1)  A criminal proceeding.

3

(2)  A civil, judicial or administrative action brought

4

to enforce the provisions of this section.

5

§ 2713.  Use of money collected.

6

(a)  General rule.--The department may use the moneys

7

deposited in the General Fund and appropriated to the department

8

for the following purposes:

9

(1)  Maintenance and replacement of PAMS equipment,

10

including hardware and software.

11

(2)  Training of staff.

12

(3)  Pursuit of grants and matching funds.

13

(b)  Collections.--The department may collect any penalty

14

imposed under section 2707 (relating to unlawful acts and

15

penalties) and which is not paid by bringing an action in the

16

court of common pleas of the county in which the person owing

17

the debt resides or in the county where the department is

18

located.

19

(c)  Legal assistance.--The department may seek legal

20

assistance from the Attorney General or the county or district

21

attorney of the county in which the action is brought to collect

22

the fine.

23

(d)  Attorney fees and costs.--The court shall award

24

reasonable attorney fees and costs to the department for

25

successful collection actions under section 2707.

26

§ 2714.  Rules and regulations.

27

The department shall promulgate rules and regulations setting

28

forth the procedures and methods for implementing this chapter.

29

At a minimum, the rules and regulations shall include the

30

following:

- 31 -

 


1

(1)  Effectively enforce the limitations on access to

2

PAMS prescribed in section 2708 (relating to access to

3

prescription information).

4

(2)  Establish standards and procedures to ensure

5

accurate identification of individuals requesting information

6

or receiving information from PAMS.

7

(3)  Allow adequate time following implementation of this

8

chapter for dispensers and practitioners to make the changes

9

to their operational systems necessary to comply with this

10

chapter.

11

(4)  Allow for dispensers to have ease of transition to

12

comply with the requirements of the Pharmaceutical

13

Accountability Monitoring System.

14

(5)  Not place an undue burden on law enforcement seeking

15

information related to an investigation.

16

(6)  Dispensers and practitioners licensed to practice in

17

this Commonwealth shall not be held liable for failure to

18

comply with PAMS requirements until all changes are fully

19

operational and dispensers and practitioners have had

20

adequate time to make necessary adjustments to operating

21

systems and to receive training to fully accommodate such

22

changes upon promulgation of the regulations, but not later

23

than one year after the effective date of this chapter.

24

(7)  Dispensers who can show good cause for not

25

submitting data electronically may be authorized to submit

26

data manually if they lack Internet access.

27

§ 2715.  Evaluation, data analysis and reporting.

28

(a)  General rule.--The department shall design and implement

29

an evaluation component to identify:

30

(1)  cost benefits of PAMS;

- 32 -

 


1

(2)  the impact on efforts to reduce misuse, abuse,

2

overdose and diversion of, or addiction to, controlled

3

substances;

4

(3)  the impact on prescribing practices for controlled

5

substances;

6

(4)  the number of patients identified through PAMS as

7

potentially addicted to a controlled substance that were

8

assessed for alcohol and other drug addictions;

9

(5)  the number of patients in paragraph (4) that

10

received alcohol and other drug addiction treatment and the

11

names of the licensed alcohol and other drug addiction

12

treatment facilities in which the patients were treated;

13

(6)  the progress made in implementing real-time

14

reporting; and

15

(7)  other information relevant to policy, research and

16

education involving controlled substances and drugs of

17

concern monitored by PAMS.

18

(b)  Annual report.--The department shall annually report the

19

information specified in subsection (a) to the Public Health and

20

Welfare Committee of the Senate, the Human Services Committee of

21

the House of Representatives, the United States Department of

22

Justice, the Substance Abuse and Mental Health Services

23

Administration of the Office of National Drug Control Policy and

24

members of Pennsylvania's United States Congressional

25

delegation. Additionally, the department shall make the annual

26

report available to the public on its publicly accessible

27

Internet website.

28

§ 2716.  Concurrent jurisdiction.

29

The Attorney General shall have concurrent prosecutorial

30

jurisdiction with the county district attorney for violations of

- 33 -

 


1

this chapter. No person charged with a violation of this chapter

2

by the Attorney General shall have standing to challenge the

3

authority of the Attorney General to prosecute the case and, if

4

any such challenge is made, the challenge shall be dismissed and

5

no relief shall be available in the courts of this Commonwealth

6

to the person making the challenge.

7

Section 2.  The provisions of this act are severable. If any

8

provision of this act or its application to any person or

9

circumstance is held invalid, the invalidity shall not affect

10

other provisions or applications of this act which can be given

11

effect without the invalid provision or application.

12

Section 3.  This act shall take effect in 60 days.

- 34 -