HB2307 - 531R

Be it enacted by the Legislature of the State of Arizona:

Section 1. Section 32-1907, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1907. Arizona state board of pharmacy fund

A. Except as provided in section 32‑1939, the executive director shall receive and receipt for all fees and other monies provided for in this chapter and shall deposit, pursuant to sections 35‑146 and 35‑147, ten per cent percent of such monies in the state general fund and ninety per cent percent in the Arizona state board of pharmacy fund. All monies derived from civil penalties collected pursuant to this chapter shall be deposited, pursuant to sections 35‑146 and 35‑147, in the state general fund.

B. Except as provided in subsection C of this section, monies deposited in the Arizona state board of pharmacy fund shall be subject to section 35‑143.01.

C. From monies deposited in the Arizona state board of pharmacy fund pursuant to subsection A of this section, the executive director may transfer up to three hundred ninety-five thousand seven hundred ninety‑five five hundred thousand dollars annually to the controlled substances prescription monitoring program fund established by section 36‑2605 for expenses related to the controlled substances prescription monitoring program as required by title 36, chapter 28.

D. From monies deposited in the Arizona state board of pharmacy fund pursuant to subsection A of this section, the executive director may transfer up to one million dollars annually to the Arizona poison and drug information center for the purposes specified in section 36‑1161 to supplement, and not supplant, any state general fund appropriation for those purposes.END_STATUTE

Sec. 2. Section 32-3219, Arizona Revised Statutes, is amended to read:

START_STATUTE32-3219. Licensure; renewal; notification; definitions

A. A medical practitioner regulatory board shall notify the Arizona state board of pharmacy once each month of any initial licensures for medical practitioners who intend to apply for registration under the controlled substances act (21 United States Code sections 801 through 904) and licensure renewals for medical practitioners who hold active licenses in this state for the purpose of registering the medical practitioner and providing the person access to the controlled substances prescription monitoring program database. The medical practitioner regulatory board shall provide to the Arizona state board of pharmacy any information necessary to register and provide access to the medical practitioner. The medical practitioner regulatory board shall notify each medical practitioner receiving an initial license who intends to apply for registration under the controlled substances act (21 United States Code sections 801 through 904) of the person's responsibility to register with the Arizona state board of pharmacy and be granted access to the program's central database tracking system.

A. A medical practitioner regulatory board shall notify each medical practitioner who receives an initial or renewal license and who intends to apply for registration or has an active registration under the controlled substances act (21 United States Code section 801 through 904) of the medical practitioner's responsibility to register with the Arizona state board of pharmacy and be granted access to the controlled substances prescription monitoring program's central database tracking system. The Arizona state board of pharmacy shall provide access to the central database tracking system to each medical practitioner who has a valid license pursuant to this title and who possesses an Arizona registration under the controlled substances act (21 United States Code section 801 through 904).

B. For the purposes of this section:

1. "Medical practitioner" means any person who is licensed and authorized by law to use and prescribe drugs and devices for the treatment of sick and injured human beings or for the diagnosis or prevention of sickness in human beings in this state or any state, territory or district of the United States and who possesses an Arizona registration under the controlled substances act (21 United States Code sections 801 through 904).

2. "Medical practitioner regulatory board" means any board established pursuant to title 32, chapter 7, 11, 13, 14, 15, 16, 17, 25 or 29 of this title that regulates one or more medical practitioners in this state. END_STATUTE

Sec. 3. Section 36-2602, Arizona Revised Statutes, is amended to read:

START_STATUTE36-2602. Controlled substances prescription monitoring program; contracts; retention and maintenance of records

A. The board shall adopt rules to establish a controlled substances prescription monitoring program. The program shall:

1. Be operated, monitored and maintained by the board.

2. Be staffed by the board.

1. 3. Include a computerized central database tracking system to track the prescribing, dispensing and consumption of schedule II, III and IV controlled substances that are dispensed by a medical practitioner or by a pharmacy that holds a valid license or permit issued pursuant to title 32. The database shall include data from the department of health services that identifies residents of this state who possess a registry identification card issued pursuant to chapter 28.1 of this title. The tracking system shall not interfere with the legal use of a controlled substance for the management of severe or intractable pain.

2. 4. Assist law enforcement to identify illegal activity related to the prescribing, dispensing and consumption of schedule II, III and IV controlled substances.

3. 5. Provide information to patients, medical practitioners and pharmacists to help avoid the inappropriate use of schedule II, III and IV controlled substances.

4. 6. Be designed to minimize inconvenience to patients, prescribing medical practitioners and pharmacies while effectuating the collection and storage of information.

B. The board may enter into private or public contracts, including intergovernmental agreements pursuant to title 11, chapter 7, article 3, to ensure the effective operation of the program. Each contractor must comply with the confidentiality requirements prescribed in this article and is subject to the criminal penalties prescribed in section 36‑2610.

C. The board shall maintain medical records information in the program pursuant to the standards prescribed in section 12‑2297. END_STATUTE

Sec. 4. Section 36-2606, Arizona Revised Statutes, is amended to read:

START_STATUTE36-2606. Registration; access; requirements; mandatory use; annual user satisfaction survey; report; definition

A. Beginning November 1, 2007 and pursuant to rules adopted by the board, each medical practitioner who is issued a license pursuant to title 32 and who possesses an Arizona registration under the controlled substances act (21 United States Code sections 801 through 904) must have a current controlled substances prescription monitoring program registration issued by the board and be granted access to the program's central database tracking system. The Arizona state board of pharmacy, on receipt of licensure and license renewal confirmation from a medical practitioner regulatory board established pursuant to title 32, chapter 7, 11, 13, 14, 15, 16, 17, 25 or 29, shall register each medical practitioner who possesses an Arizona registration under the controlled substances act (21 United States Code sections 801 through 904) and provide the medical practitioner access to the program's central database tracking system. The Arizona state board of pharmacy shall notify each medical practitioner of the person's registration and access to the database tracking system and how to use the system. The Arizona state board of pharmacy shall notify each medical practitioner receiving an initial license who intends to apply for registration under the controlled substances act (21 United States Code sections 801 through 904) of the person's responsibility and the process to register with the Arizona state board of pharmacy and be granted access to the program's central database tracking system.

B. The registration is:

1. Until January 1, 2020, subject to biennial renewal as specified in this article, except for medical practitioners whose registration and renewal are provided pursuant to subsection A of this section.

1. Valid in conjunction with a valid United States drug enforcement administration registration number and a valid license issued by a medical practitioner regulatory board established pursuant to title 32, chapter 7, 11, 13, 14, 15, 16, 17, 25 or 29.

2. Not transferable or assignable.

3. Valid only in conjunction with a valid license issued by a medical practitioner regulatory board established pursuant to title 32, chapter 7, 11, 13, 14, 15, 16, 17, 25 or 29.

C. An applicant for registration pursuant to this section must submit an application as prescribed by the board unless the medical practitioner's registration and renewal are provided pursuant to subsection A of this section.

D. Until January 1, 2020, the board shall assign all persons registered under this article to one of two registration renewal groups. The holder of a registration ending in an even number must renew the registration biennially on or before May 1 of the next even‑numbered year. The holder of a registration ending in an odd number must renew the registration biennially on or before May 1 of the next odd-numbered year. The board shall automatically suspend the registration of any registrant who fails to renew the registration on or before May 1 of the year in which the renewal is due. The board shall vacate a suspension if the registrant submits a renewal application. A suspended registrant is prohibited from accessing information in the prescription monitoring program database tracking system. This subsection does not apply to medical practitioners whose registration and renewal are provided pursuant to subsection A of this section.

E. A registrant shall not apply for registration renewal more than sixty days before the expiration date of the registration.

F. An applicant for registration renewal pursuant to this section must submit a renewal application prescribed by the board by rule unless the medical practitioner's registration and renewal are provided pursuant to subsection A of this section.

G. D. Pursuant to a fee prescribed by the board by rule, the board may issue a replacement registration to a registrant who requests a replacement because the original was damaged or destroyed, because of a change of name or for any other good cause as prescribed by the board.

H. E. Beginning the later of October 1, 2017 or sixty days after the statewide health information exchange has integrated the controlled substances prescription monitoring program data into the exchange, a medical practitioner, before prescribing an opioid analgesic or benzodiazepine controlled substance listed in schedule II, III or IV for a patient, shall obtain a patient utilization report regarding the patient for the preceding twelve months from the controlled substances prescription monitoring program's central database tracking system at the beginning of each new course of treatment and at least quarterly while that prescription remains a part of the treatment. Each medical practitioner regulatory board shall notify the medical practitioners licensed by that board of the applicable date. A medical practitioner may be granted a one‑year waiver from the requirement in this subsection due to technological limitations that are not reasonably within the control of the practitioner or other exceptional circumstances demonstrated by the practitioner, pursuant to a process established by rule by the Arizona state board of pharmacy.

I. F. The medical practitioner is not required to obtain a patient utilization report from the central database tracking system pursuant to subsection H E of this section if any of the following applies:

1. The patient is receiving hospice care or palliative care for a serious or chronic illness.

2. The patient is receiving care for cancer, a cancer‑related illness or condition or dialysis treatment.

3. A medical practitioner will administer the controlled substance.

4. The patient is receiving the controlled substance during the course of inpatient or residential treatment in a hospital, nursing care facility, assisted living facility, correctional facility or mental health facility.

5. The medical practitioner is prescribing the controlled substance to the patient for no more than a ten‑day period for an invasive medical or dental procedure or a medical or dental procedure that results in acute pain to the patient.

6. The medical practitioner is prescribing the controlled substance to the patient for no more than a ten‑day period for a patient who has suffered an acute injury or a medical or dental disease process that is diagnosed in an emergency department setting and that results in acute pain to the patient. An acute injury or medical disease process does not include back pain.

7. The medical practitioner is prescribing no more than a five‑day prescription and has reviewed the program's central database tracking system for that patient within the last thirty days, and the system shows that no other prescriber has prescribed a controlled substance in the preceding thirty‑day period.

J. G. If a medical practitioner uses electronic medical records that integrate data from the controlled substances prescription monitoring program, a review of the electronic medical records with the integrated data shall be deemed compliant with the review of the program's central database tracking system as required in subsection H E of this section.

K. H. The board shall promote and enter into data sharing agreements for the purpose of integrating the controlled substances prescription monitoring program into electronic medical records.

L. I. By complying with this section, a medical practitioner acting in good faith, or the medical practitioner's employer, is not subject to liability or disciplinary action arising solely from either:

1. Requesting or receiving, or failing to request or receive, prescription monitoring data from the program's central database tracking system.

2. Acting or failing to act on the basis of the prescription monitoring data provided by the program's central database tracking system.

M. J. Notwithstanding any provision of this section to the contrary, medical practitioners and their delegates are not in violation of this section during any time period in which the controlled substances prescription monitoring program's central database tracking system is suspended or is not operational or available in a timely manner. If the program's central database tracking system is not accessible, the medical practitioner or the medical practitioner's delegate shall document the date and time the practitioner or delegate attempted to use the central database tracking system pursuant to a process established by board rule.

N. K. The board shall conduct an annual voluntary survey of program users to assess user satisfaction with the program's central database tracking system. The survey may be conducted electronically. On or before December 1 of each year, the board shall provide a report of the survey results to the president of the senate, the speaker of the house of representatives and the governor and shall provide a copy of this report to the secretary of state.

O. L. This section does not prohibit a medical practitioner regulatory board from obtaining and using information from the program's central database tracking system.

P. M. For the purposes of this section, "emergency department" means the unit within a hospital that is designed for the provision of emergency services.END_STATUTE