12RS HB4
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HB4

12RS

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HB 4/LM/CI (BR 171) - G. Stumbo, L. Clark, R. Adkins, L. Belcher, T. Burch, H. Collins, L. Combs, R. Damron, D. Keene, M. King, C. Miller, R. Nelson, R. Palumbo, T. Pullin, J. Richards, T. Riner, F. Steele, W. Stone, T. Thompson, J. Tilley, B. Yonts

     AN ACT relating to controlled substances and making an appropriation therefor.
     Create a new section of KRS Chapter 218A to require licensing boards, the Attorney General, and the Department of Kentucky State Police to share information regarding drug diversion and improper prescribing, and specify action to be taken upon receipt of a report; create a new section of KRS Chapter 218A to describe required actions prior to and after a person with prescribing authority prescribes or dispenses a controlled substance to a patient and to require registration with and the use of the Kentucky All Schedule Prescription Reporting (KASPER) system prior to prescribing or dispensing a controlled substance to a patient; create a new section of KRS Chapter 218A to define "pain management facility" and require the facility to be owned by a person licensed by a professional licensing board; create a new section of KRS Chapter 15 to create the Attorney General's drug diversion prevention trust and agency fund and specify its uses; amend KRS 218A.202, relating to the KASPER controlled substance monitoring program, to require licensed medical professionals who use the system to pay a fee of $100 per year for the use of the system; specify information to be entered into the system; specify persons and agencies who may use the system; specify to whom information with the system may be disclosed; specify that if the Attorney General finds that a prescriber is not using the system the Attorney General must report the matter to the prescriber's licensing board; amend KRS 218A.240, relating to powers of the Attorney General and licensing board employees to specify how the Attorney General is to use the KASPER data; require the development and publication of drug prescribing and diversion trend reports; specify that information from the system is confidential and specify to whom the information may be revealed; permit hospitals to request prescribing information about their employees; amend KRS 218A.245, relating to reciprocal agreements with other states for prescription monitoring programs, to transfer functions from the Cabinet for Health and Family Services to the Office of the Attorney General; create a new section of KRS Chapter 218A to require the Boards of Medical Licensure, Nursing, Dentistry and other boards to develop a procedure for suspending, limiting, or restricting a license where the licensee's practice may endanger the health and welfare of patients or the public; amend KRS 72.045, relating to coroner's cases, to specify when a coroner is to take a blood sample from a deceased to determine the presence of controlled substances; create a new section of KRS Chapter 72 to require coroners to report to the state registrar of vital statistics and the Department of Kentucky State Police all deaths due to drug overdoses and provide relevant information to licensing boards; amend KRS 72.080, relating to the State Medical Examiners Office publishing an annual report of drug related deaths, to require the registrar of vital statistics to report information to the state medical examiner for the report; create a new section of KRS Chapter 218A to require licensees with prescribing authority to report convictions, license suspensions, surrender of licenses and other disciplinary actions to their licensing boards in Kentucky, whether or not the underlying action occurred in Kentucky or another jurisdiction; provide for suspension or permanent revocation of license for specified acts; provide penalties for failure to report, late reporting, and lying on an application for a license; create a new section of KRS Chapter 15 to specify duties of the Attorney General with regard to monitoring and enforcing drug monitoring, prescribing, and drug diversion statutes and permit the Attorney General to take action against persons and agencies; create a new section of KRS Chapter 218A to specify complaint handling procedures for boards which license persons to prescribe or dispense controlled substances; amend KRS 311.530, relating to the Board of Medical Licensure, to require one member to be a board-certified pain management specialist, and one to be a board-certified physiatrist certified in addiction medicine; amend KRS 311.591, relating to complaints against persons licensed by the Board of Medical Licensure, to prohibit requiring complaints to be sworn and permit the board to accept anonymous complaints under limited circumstances; amend KRS 314.011, relating to the Board of Nursing, to place controlled substance prescribing and dispensing limits on advanced practice registered nurses; amend KRS 314.042 to require advanced practice registered nurses to register with and use the KASPER system prior to and after the prescribing of Schedule II or III controlled substances to a patient; amend KRS 314.121, relating to the membership of the Board of Nursing, to require one member to be a certified addiction specialist and one member to be a certified pain management specialist; create a new section of KRS Chapter 218A to require boards which license persons to prescribe or dispense controlled substances to promulgate administrative regulations relating to mandatory prescribing and dispensing standards; create a new section of KRS Chapter 315, relating to pharmacies, to require that they not accept prescriptions for Schedule II or III controlled substances for more than a 90-day supply, that they ship not more than a 30-day supply in one shipment, and that they not make the next shipment until near exhaustion of the previous shipment; create a new section of KRS Chapter 218A to prohibit any board licensing persons to prescribe or dispense controlled substances to require complaints to be sworn or notarized; permit the filing of an anonymous complaint under limited circumstances; require transfer of the KASPER drug monitoring system from the Cabinet for Health and Family Services to the Office of the Attorney General; specify when the Governor shall appoint pain management specialist and addiction specialist members to the Board of Medical Licensure and the Board of Nursing.

HB 4 - AMENDMENTS


     HCS/LM/CI - Retain most original provisions; clarify which law enforcement agencies and licensing boards have to share information; require practitioners to register with KASPER; eliminate requirement for prescribers to report prescriptions to KASPER; exempt dispensing controlled substance at scene of emergency, in ground or air ambulance, emergency department or intensive care unit of licensed hospital, licensed pharmacist, and hospice programs; require a pain management facility to be owned by a physician or advanced practice registered nurse; exempt hospital, critical access hospital, educational institutions, ambulatory care facility, and hospice program from definition of pain management facility; require Attorney General to report on use of KASPER fees annually to Legislative Research Commission; permit Attorney General to charge fee for use of KASPER; eliminate requirement for prescribers to make report to KASPER; specify which information shall be reported to KASPER; permit Commonwealth's and county attorneys and their assistants to access KASPER; require Attorney General to promulgate administrative regulations relating to the use of KASPER; add patient's legal guardian and health care surrogate to persons to whom patient treatment may be discussed; permit KASPER information to be placed in patient's medical record and make release subject to HIPAA regulations; clarify to whom KASPER information may be released; clarify procedures for gathering information for and publication of trend reports for controlled substance prescribing and misuse; delete former Section 9; amend KRS 72.405 relating to coroners; clarify coroner reporting responsibilities with regard to drug related deaths; require Office of Drug Control Policy to cooperate with medical examiner and Office of Vital Statistics in the preparation and publication of annual drug death information; require agencies licensing practitioners to do criminal record checks and license suspension checks; require practitioners to report felony convictions to licensing board; require practitioners to report permanent revocations of licenses or suspensions from other states to Kentucky licensing boards; require practitioners to report other disciplinary suspensions or actions by other states to Kentucky licensing boards; require applicant to disclose information which would cause their application for a license in Kentucky to be denied; specify what a board may do if a person is convicted of a felony offense may do when that person conviction is reversed; specify that the Attorney General may require licensing boards and agencies to comply with controlled substances laws with regard to licensees; require licensing boards to cooperate with law enforcement agencies in deterring illegal and unsafe controlled substance prescribing and dispensing practices; clarify appointment of pain management and addiction specialists to Board of Medical Licensure; clarify appointment of pain management and addiction specialists to the Board of Nursing; require licensing boards to promulgate administrative regulations to implement mandatory prescribing and dispensing practices for persons licensed by the board; clarify requirement for shipping only 30 days of Schedule II or III controlled substances from a pharmacy to a patient; relate to handling of grievances and complaints by licensing boards and permits anonymous grievances; clarify transfer of responsibility for the KASPER program from the Cabinet for Health and Family Services to the Attorney General; delete Section 16 amending KRS 311.591, relating to grievances filed with Board of Medical Licensure; delete Section 17 amending KRS 314.011, relating to advanced practice registered nurses; delete Section 18 amending KRS 314.042, relating to advanced practice registered nurses.
     HFA (1/Title, J. Fischer) - Make a title amendment.
     HFA (2, J. Fischer) - Require that a patient's medical records, which shall be maintained in a format that is readily available for review, be released only to those persons entitled by law to the information.
     HFA (3, J. Fischer) - Retain original provisions; create a new section of KRS 311.710 to 311.820 to require an ultrasound prior to an abortion; amend KRS 311.990 to provide a criminal penalty for a physician violating the new section.
     HFA (4, D. Owens) - Delete subsection requiring investigation of illegal drug seeking by Medicaid recipient.
     HFA (5/P, J. Fischer) - Retain original provisions; create a new section of KRS Chapter 311 to specify the interpretation of the phrase "individual private setting" in informed consent situations.
     HFA (6, G. Stumbo) - Delete all provisions of original bill; retain most provisions of committee substitute; require sharing of reports to the extent permitted by law; require licensing board which receives a report to provide specified due process; expand period for board action from 60 to 120 days; permit sharing of patient records maintained by a practitioner to patient and persons authorized by law to view them; limit most practitioners to dispensing a 48 hours supply of a Schedule II or III controlled substance, exempt licensed Narcotic Treatment programs; permit optometrist to prescribe controlled substance in conformity to optometry law; permit dentist to prescribe a 3 day supply of controlled substance following oral surgery; clarify provisions relating to making material false statement in application for a practitioner license.
     HFA (7/P, J. Fischer) - Retain original provisions; create a new section of KRS Chapter 311 to specify the interpretation of the phrase "individual private setting" in informed consent situations; amend Section 2 to provide that physician's discussion with patient regarding use of controlled substances is to be in an individual and private setting.
     HFA (8/P, J. Fischer) - Retain original provisions; create a new section of KRS Chapter 311 to specify the interpretation of the phrase "individual private setting" in informed consent situations; amend Section 2 to provide that physician's discussion with patient regarding use of controlled substances is to be in an individual and private setting.
     HFA (9, G. Stumbo) - Retain most provisions of committee substitute; require sharing of reports to the extent permitted by law; require licensing board which receives a report to provide specified due process; require licensing board to withhold action against a licensee upon request of a law enforcement agency if board action might jeopardize a law enforcement investigation; expand period for board action from 60 to 120 days; permit sharing of patient records maintained by a practitioner to patient and persons authorized by law to view them; limit most practitioners to dispensing a 48-hour supply of a Schedule II or III controlled substance, exempt licensed Narcotic Treatment programs; permit optometrist to prescribe controlled substance in conformity to optometry law; permit dentist to prescribe a three day supply of controlled substance following oral surgery; exempt a primary care center licensed pursuant to KRS Chapter 216B from definition of pain clinic; replace felony penalties for failure to report to KASPER with misdemeanor penalties; clarify provisions relating to making material false statement in application for a practitioner license.
     SCS/LM/CI - Create a new section of KRS Chapter 218A to establish standards for the ownership and operation of pain clinics; amend KRS 218A.202 to transfer operation of the KASPER system to the Attorney General, to allow a private company to operate KASPER if certain safeguards are met, and allow doctors and patient to see their own KASPER reports; amend KRS 218A.240 to reflect KASPER's transfer to the Attorney General; amend KRS 218A.245 to allow for a private entity to provide for interstate KASPER connectivity; create a new section of KRS Chapter 218A to require boards that license prescribers or dispensers of controlled substances to establish regulations addressing controlled substance prescribing and dispensing standards, KASPER checks on patients, continuing education, suboxone and methadone protocols, expedited licensure review and license suspension, interstate background checks and data sharing, disciplinary benchmarks for controlled substance offenses or misconduct, and interagency cooperation; create a new section of KRS Chapter 218A to allow a licensing board to accept an anonymous complaint if accompanied by corroborating evidence; amend KRS 311.530 and 314.121 to place addiction and pain management specialists on the Board of Medical Licensure and the Board of Nursing; amend KRS 72.280 to increase drug overdose death reporting and require an annual drug death report be done by the Office of Drug Control Policy; create a new section of KRS Chapter 315 to require reporting of lost or stolen shipments of certain controlled substances; create a new section of KRS Chapter 15 to allow the Attorney General to establish a controlled substance investigation clearinghouse allowing law enforcement and licensing boards to share reports of complaints and investigations; create a new section of KRS Chapter 15 to establish a KASPER unit in the AG's office responsible for administering the KASPER system and conducting limited searches of its data; amend KRS 15.010 to place the KASPER unit with the AG's organization structure; create a new section of KRS Chapter 218A to adopt the Interstate Prescription Monitoring Compact; create a new section of KRS Chapter 218A to provide that the Governor appoints Kentucky's representatives to the Interstate Prescription Monitoring Compact, subject to Senate confirmation; include non-codified transitional provisions.
     SFA (1, J. Higdon) - Retain most provisions of committee substitute; transfer operation of the KASPER system from the Attorney General back to the Cabinet for Health and Family Services; and create a new section of KRS Chapter 218A to allow the cabinet to establish a controlled substance investigation clearinghouse allowing law enforcement and licensing boards to share reports of complaints and investigations and require the cabinet to develop objective search criteria for limited searches of KASPER data.
     CCR - Cannot agree.

     Feb 2-introduced in House
     Feb 6-to Judiciary (H)
     Feb 8-taken from Judiciary (H); 1st reading; returned to Judiciary (H)
     Feb 13-posted in committee
     Feb 29-reported favorably, 2nd reading, to Rules with Committee Substitute
     Mar 1-floor amendments (2) (3) (4) and (5) filed to Committee Substitute, floor amendment (1-title) filed
     Mar 5-posted for passage in the Regular Orders of the Day for Tuesday, March 6, 2012; floor amendment (6) filed
     Mar 6-floor amendment (7) filed to Committee Substitute, floor amendment (8) filed
     Mar 7-floor amendment (9) filed to Committee Substitute
     Mar 8-3rd reading; floor amendment (8) withdrawn ; floor amendment (7) ruled not germane ; passed 81-7 with Committee Substitute, floor amendment (9)
     Mar 9-received in Senate
     Mar 13-to Judiciary (S)
     Mar 23-taken from Judiciary (S); 1st reading; returned to Judiciary (S)
     Mar 26-taken from Judiciary (S); 2nd reading; returned to Judiciary (S)
     Mar 27-reported favorably, to Rules with Committee Substitute ; floor amendment (1) filed to Committee Substitute
     Mar 28-posted for passage in the Regular Orders of the Day for Wednesday, March 28, 2012; 3rd reading; floor amendment (1) defeated ; passed 26-9 with Committee Substitute ; received in House; to Rules (H)
     Mar 29-posted for passage for concurrence in Senate Committee Substitute ; House refused to concur in Senate Committee Substitute ; Conference Committee appointed in House; received in Senate
     Mar 30-posted for passage for receding from Senate Committee Substitute, floor amendment (1) ; Senate refused to recede from Committee Substitute ; Conference Committee appointed in Senate; Conference Committee report filed in House; Conference Committee report adopted in House; Free Conference Committee appointed in House; Conference Committee report filed in Senate; Conference Committee report adopted in Senate; motion to adopt Conference Committee report reconsidered; passed over and retained in the Orders of the Day; Free Conference Committee appointed in Senate
     Apr 12-Conference Committee report adopted in Senate

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