Bill Summary for H 243 (2017-2018)

Printer-friendly: Click to view

Summary date: 

Jun 15 2017

Bill Information:

View NCGA Bill Details2017-2018 Session
House Bill 243 (Public) Filed Thursday, March 2, 2017
AN ACT STRENGTHENING OPIOID MISUSE PREVENTION BY EXTENDING STANDING ORDERS FOR OPIOID ANTAGONIST TO COMMUNITY HEALTH GROUPS; REQUIRING SUPERVISING PHYSICIANS TO PERSONALLY CONSULT WITH PHYSICIAN ASSISTANTS AND NURSE PRACTITIONERS WHO PRESCRIBE CERTAIN SCHEDULE II OR III CONTROLLED SUBSTANCES FOR LONG-TERM USE; REQUIRING ELECTRONIC PRESCRIBING OF CERTAIN SCHEDULE II AND III CONTROLLED SUBSTANCES; ESTABLISHING MAXIMUM LIMITS FOR INITIAL PRESCRIPTIONS OF SCHEDULE II AND III CONTROLLED SUBSTANCES; REQUIRING HOSPICE AND PALLIATIVE CARE PROVIDERS TO PROVIDE EDUCATION REGARDING PROPER DISPOSAL OF CERTAIN UNUSED CONTROLLED SUBSTANCES; CLARIFYING ALLOWABLE FUNDS FOR SYRINGE EXCHANGE PROGRAMS; REQUIRING VETERINARIAN PARTICIPATION IN THE CONTROLLED SUBSTANCES REPORTING SYSTEM; ESTABLISHING CIVIL PENALTIES FOR PHARMACIES THAT EMPLOY DISPENSERS WHO IMPROPERLY REPORT INFORMATION TO THE CONTROLLED SUBSTANCES REPORTING SYSTEM (CSRS); EXPANDING THE ROLE OF THE DEPARTMENTS OF HEALTH AND HUMAN SERVICES (DHHS) IN USING CSRS DATA TO DETECT AND PREVENT FRAUD AND MISUSE; MANDATING DISPENSER REGISTRATION FOR ACCESS TO THE CSRS; MANDATING DISPENSER AND PRACTITIONER USE OF THE CSRS; REQUIRING DHHS TO REPORT PRACTITIONERS WHO FAIL TO PROPERLY USE THE CSRS; CREATING A SPECIAL REVENUE FUND TO SUPPORT THE CSRS; AND REQUIRING AN ANNUAL REPORT FROM DHHS ON THE CSRS.
Intro. by Murphy, Davis, Malone, Horn.

View: All Summaries for BillTracking:

Bill summary

Senate committee substitute makes the following changes to the 3rd edition.

Adds whereas clauses concerning the impact of the opioid epidemic in North Carolina.

Part III

Deletes the previous language of proposed GS 90-18.1(b) and now provides the following. Requires a physician assistant to personally consult with the supervising physician before prescribing a targeted controlled substance as defined in Article 5 of GS Chapter 90 when: (1) the patient is being treated by a facility that primarily engages in the treatment of pain by prescribing narcotic medications or advertises in any medium for any type of pain management services and (2) the therapeutic use of the targeted controlled substance will or is expected to exceed a period of 30 days. Requires the physician assistant to consult with the supervising physician at least once every 90 days when a targeted controlled substance prescribed in accordance with this subdivision is continuously prescribed to the same patient in order to verify that the prescription remains medically appropriate for the patient. Deletes the previous language of proposed GS 90-18.2(b), concerning nurse practitioners, and instead provides identical language as just described for proposed GS 90-18.1(b) concerning physician assistants, making the same requirements applicable for nurse practitioners. 

Amends the proposed new language in GS 90-106 concerning prescriptions and labeling. Adds two new exemptions to those set out in new subsection (a1), exempting a practitioner who orders a controlled substance to be administered in an outpatient dialysis facility as well as a person licensed to practice veterinary medicine pursuant to Article 11 of GS Chapter 90 from the requirement that practitioners electronically prescribe all targeted controlled substances. Adds to new subsection (a3), establishing immunity for a practitioner who acts in accordance with the limitation on prescriptions set forth in the subsection for acting in accordance with the subsection. Deletes proposed subsection (a4), concerning pain management agreement plans for extended therapeutic use of a targeted controlled substance. Makes conforming changes to the effective date provisions in Part VI.

Part V

Deletes the proposed changes to GS 90-113.73(b)(2), which make the required patient information that a dispenser must report for whom a controlled substance is dispensed also applicable to the owner of an animal to whom the controlled substance for the animal is dispensed. Also deletes proposed subdivision (b)(12), requiring the dispenser to report the name of a prescribing physician assistant or nurse practitioner's supervising physician. Adds to proposed subsection (e), prohibiting the assessment of any civil penalty upon a pharmacy acting in good faith that attempts to report the information required by the statute as amended. 

Provides that the effective date for the proposed changes to GS 90-113.73(e) (concerning penalties for failure to report)  are effective when the act becomes law (previously included in the provisions that become effective 30 days after the date the Chief Information Officer notifies the Revisor of Statutes that the CSRS database has the capability to record the described information).

Further amends GS 90-113.74, now amending subsection (c). Requires the administrator of a hospital emergency department or hospital acute care facility to provide the Department of Health and Human Services (Department) with a list of prescribers who are authorized to prescribe controlled substances for the purpose of providing medical care for patients of the hospital emergency department or hospital acute care facility and a list of delegates who are authorized to receive data on behalf of the providers listed. Requires the administrator to submit the lists to the Department by December 1 of the calendar year preceding the year during which the delegates are to receive data. Permits the administrator to provide updated lists at any time during the course of the year. Directs the Department to establish, within one week of receiving the initial or updated lists, all of the delegate accounts necessary to enable each delegate listed by the administrator of the hospital emergency department or hospital acute care facility to receive data on behalf of the listed prescribers. Adds that delegations made pursuant to this provision are valid during the calendar year for which submitted by the administrator. 

Modifies proposed GS 90-113.75B, concerning the annual report by the Department of Health and Human Services to the General Assembly and licensing boards. Amends the required content of the report to also include any other data deemed appropriate and requested by the North Carolina Board of Podiatry Examiners. 

Modifies the proposed changes to Section 12F.16(h) of SL 2015-241, deleting the requirement that the Department of Health and Human Services apply for grant funding from the National Association of Boards of Pharmacy to establish interstate connectivity for the Controlled Substances Reporting System (CSRS) as specified.

Modifies the proposed changes to Section 12F.16(i)(3) of SL 2015-241, deleting the requirement that the specified funds be used to establish interstate connectivity for the CSRS for the 2015-16 fiscal year. 

Directs the Department to conduct a study in consultation with the Office of the Attorney General and the NC Veterinary Medical Board on how to implement the provisions of the act pertaining to electronic prescriptions and the submission of data to the CSRS as they relate to the practice of veterinary medicine. Directs the Department to report to the Joint Legislative Oversight Committee on Health and Human Services no later than February 1, 2018.