2015 Kentucky Revised Statutes CHAPTER 218A - CONTROLLED SUBSTANCES 218A.202 Electronic system for monitoring controlled substances -- Required registration and reporting -- Penalty for illegal use of system -- Pilot or continuing project -- Continuing education programs -- Reports of failure to comply with section -- Administrative regulations.
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218A.202
Electronic system for monitoring controlled substances -- Required
registration and reporting -- Penalty for illegal use of system -- Pilot or
continuing project -- Continuing education programs -- Reports of failure to
comply with section -- Administrative regulations.
(1)
(2)
(3)
(4)
The Cabinet for Health and Family Services shall establish an electronic system for
monitoring Schedules II, III, IV, and V controlled substances that are dispensed
within the Commonwealth by a practitioner or pharmacist or dispensed to an
address within the Commonwealth by a pharmacy that has obtained a license,
permit, or other authorization to operate from the Kentucky Board of Pharmacy.
The cabinet may contract for the design, upgrade, or operation of this system if the
contract preserves all of the rights, privileges, and protections guaranteed to
Kentucky citizens under this chapter and the contract requires that all other aspects
of the system be operated in conformity with the requirements of this or any other
applicable state or federal law.
A practitioner or a pharmacist authorized to prescribe or dispense controlled
substances to humans shall register with the cabinet to use the system provided for
in this section and shall maintain such registration continuously during the
practitioner's or pharmacist's term of licensure and shall not have to pay a fee or tax
specifically dedicated to the operation of the system.
Every dispenser within the Commonwealth who is licensed, permitted, or otherwise
authorized to prescribe or dispense a controlled substance to a person in Kentucky
shall report to the Cabinet for Health and Family Services the data required by this
section, except that reporting shall not be required for:
(a) A drug administered directly to a patient in a hospital, a resident of a health
care facility licensed under KRS Chapter 216B, a resident of a child-caring
facility as defined by KRS 199.011, or an individual in a jail, correctional
facility, or juvenile detention facility;
(b) A drug, other than any Schedule II controlled substance or a Schedule III
controlled substance containing hydrocodone, dispensed by a practitioner at a
facility licensed by the cabinet, provided that the quantity dispensed is limited
to an amount adequate to treat the patient for a maximum of forty-eight (48)
hours; or
(c) A drug administered or dispensed to a research subject enrolled in a research
protocol approved by an institutional review board that has an active
federalwide assurance number from the United States Department of Health
and Human Services, Office for Human Research Protections, where the
research involves single, double, or triple blind drug administration or is
additionally covered by a certificate of confidentiality from the National
Institutes of Health.
Data for each controlled substance that is dispensed shall include but not be limited
to the following:
(a) Patient identifier;
(b) National drug code of the drug dispensed;
(5)
(6)
(c) Date of dispensing;
(d) Quantity dispensed;
(e) Prescriber; and
(f) Dispenser.
The data shall be provided in the electronic format specified by the Cabinet for
Health and Family Services unless a waiver has been granted by the cabinet to an
individual dispenser. The cabinet shall establish acceptable error tolerance rates for
data. Dispensers shall ensure that reports fall within these tolerances. Incomplete or
inaccurate data shall be corrected upon notification by the cabinet if the dispenser
exceeds these error tolerance rates.
The Cabinet for Health and Family Services shall only disclose data to persons and
entities authorized to receive that data under this section. Disclosure to any other
person or entity, including disclosure in the context of a civil action where the
disclosure is sought either for the purpose of discovery or for evidence, is prohibited
unless specifically authorized by this section. The Cabinet for Health and Family
Services shall be authorized to provide data to:
(a) A designated representative of a board responsible for the licensure,
regulation, or discipline of practitioners, pharmacists, or other person who is
authorized to prescribe, administer, or dispense controlled substances and who
is involved in a bona fide specific investigation involving a designated person;
(b) Employees of the Office of the Inspector General of the Cabinet for Health
and Family Services who have successfully completed training for the
electronic system and who have been approved to use the system, Kentucky
Commonwealth's attorneys and assistant Commonwealth's attorneys, county
attorneys and assistant county attorneys, a peace officer certified pursuant to
KRS 15.380 to 15.404, a certified or full-time peace officer of another state,
or a federal peace officer whose duty is to enforce the laws of this
Commonwealth, of another state, or of the United States relating to drugs and
who is engaged in a bona fide specific investigation involving a designated
person;
(c) A state-operated Medicaid program in conformity with subsection (7) of this
section;
(d) A properly convened grand jury pursuant to a subpoena properly issued for the
records;
(e) A practitioner or pharmacist, or employee of the practitioner's or pharmacist's
practice acting under the specific direction of the practitioner or pharmacist,
who requests information and certifies that the requested information is for the
purpose of:
1.
Providing medical or pharmaceutical treatment to a bona fide current or
prospective patient; or
2.
Reviewing and assessing the individual prescribing or dispensing
patterns of the practitioner or pharmacist or to determine the accuracy
and completeness of information contained in the monitoring system;
(f)
(7)
The chief medical officer of a hospital or long-term-care facility, an employee
of the hospital or long-term-care facility as designated by the chief medical
officer and who is working under his or her specific direction, or a physician
designee if the hospital or facility has no chief medical officer, if the officer,
employee, or designee certifies that the requested information is for the
purpose of providing medical or pharmaceutical treatment to a bona fide
current or prospective patient or resident in the hospital or facility;
(g) In addition to the purposes authorized under paragraph (a) of this subsection,
the Kentucky Board of Medical Licensure, for any physician who is:
1.
Associated in a partnership or other business entity with a physician who
is already under investigation by the Board of Medical Licensure for
improper prescribing or dispensing practices;
2.
In a designated geographic area for which a trend report indicates a
substantial likelihood that inappropriate prescribing or dispensing may
be occurring; or
3.
In a designated geographic area for which a report on another physician
in that area indicates a substantial likelihood that inappropriate
prescribing or dispensing may be occurring in that area;
(h) In addition to the purposes authorized under paragraph (a) of this subsection,
the Kentucky Board of Nursing, for any advanced practice registered nurse
who is:
1.
Associated in a partnership or other business entity with a physician who
is already under investigation by the Kentucky Board of Medical
Licensure for improper prescribing or dispensing practices;
2.
Associated in a partnership or other business entity with an advanced
practice registered nurse who is already under investigation by the Board
of Nursing for improper prescribing practices;
3.
In a designated geographic area for which a trend report indicates a
substantial likelihood that inappropriate prescribing or dispensing may
be occurring; or
4.
In a designated geographic area for which a report on a physician or
another advanced practice registered nurse in that area indicates a
substantial likelihood that inappropriate prescribing or dispensing may
be occurring in that area;
(i) A judge or a probation or parole officer administering a diversion or probation
program of a criminal defendant arising out of a violation of this chapter or of
a criminal defendant who is documented by the court as a substance abuser
who is eligible to participate in a court-ordered drug diversion or probation
program; or
(j) A medical examiner engaged in a death investigation pursuant to KRS 72.026.
The Department for Medicaid Services shall use any data or reports from the system
for the purpose of identifying Medicaid providers or recipients whose prescribing,
dispensing, or usage of controlled substances may be:
(a)
Appropriately managed by a single outpatient pharmacy or primary care
physician; or
(b) Indicative of improper, inappropriate, or illegal prescribing or dispensing
practices by a practitioner or drug seeking by a Medicaid recipient.
(8) A person who receives data or any report of the system from the cabinet shall not
provide it to any other person or entity except as provided in this section, in another
statute, or by order of a court of competent jurisdiction and only to a person or
entity authorized to receive the data or the report under this section, except that:
(a) A person specified in subsection (6)(b) of this section who is authorized to
receive data or a report may share that information with any other persons
specified in subsection (6)(b) of this section authorized to receive data or a
report if the persons specified in subsection (6)(b) of this section are working
on a bona fide specific investigation involving a designated person. Both the
person providing and the person receiving the data or report under this
paragraph shall document in writing each person to whom the data or report
has been given or received and the day, month, and year that the data or report
has been given or received. This document shall be maintained in a file by
each agency engaged in the investigation;
(b) A representative of the Department for Medicaid Services may share data or
reports regarding overutilization by Medicaid recipients with a board
designated in subsection (6)(a) of this section, or with a law enforcement
officer designated in subsection (6)(b) of this section;
(c) The Department for Medicaid Services may submit the data as evidence in an
administrative hearing held in accordance with KRS Chapter 13B;
(d) If a state licensing board as defined in KRS 218A.205 initiates formal
disciplinary proceedings against a licensee, and data obtained by the board is
relevant to the charges, the board may provide the data to the licensee and his
or her counsel, as part of the notice process required by KRS 13B.050, and
admit the data as evidence in an administrative hearing conducted pursuant to
KRS Chapter 13B, with the board and licensee taking all necessary steps to
prevent further disclosure of the data; and
(e) A practitioner, pharmacist, or employee who obtains data under subsection
(6)(e) of this section may share the report with the patient or person authorized
to act on the patient's behalf and place the report in the patient's medical
record, with that individual report then being deemed a medical record subject
to disclosure on the same terms and conditions as an ordinary medical record
in lieu of the disclosure restrictions otherwise imposed by this section.
(9) The Cabinet for Health and Family Services, all peace officers specified in
subsection (6)(b) of this section, all officers of the court, and all regulatory agencies
and officers, in using the data for investigative or prosecution purposes, shall
consider the nature of the prescriber's and dispenser's practice and the condition for
which the patient is being treated.
(10) The data and any report obtained therefrom shall not be a public record, except that
(11)
(12)
(13)
(14)
(15)
(16)
the Department for Medicaid Services may submit the data as evidence in an
administrative hearing held in accordance with KRS Chapter 13B.
Intentional failure by a dispenser to transmit data to the cabinet as required by
subsection (3), (4), or (5) of this section shall be a Class B misdemeanor for the first
offense and a Class A misdemeanor for each subsequent offense.
Intentional disclosure of transmitted data to a person not authorized by subsection
(6) to subsection (8) of this section or authorized by KRS 315.121, or obtaining
information under this section not relating to a bona fide specific investigation, shall
be a Class B misdemeanor for the first offense and a Class A misdemeanor for each
subsequent offense.
(a) The Commonwealth Office of Technology, in consultation with the Cabinet
for Health and Family Services, may submit an application to the United
States Department of Justice for a drug diversion grant to fund a pilot or
continuing project to study, create, or maintain a real-time electronic
monitoring system for Schedules II, III, IV, and V controlled substances.
(b) The pilot project shall:
1.
Be conducted in two (2) rural counties that have an interactive real-time
electronic information system in place for monitoring patient utilization
of health and social services through a federally funded community
access program; and
2.
Study the use of an interactive system that includes a relational data base
with query capability.
(c) Funding to create or maintain a real-time electronic monitoring system for
Schedules II, III, IV, and V controlled substances may be sought for a
statewide system or for a system covering any geographic portion or portions
of the state.
Provisions in this section that relate to data collection, disclosure, access, and
penalties shall apply to the pilot project authorized under subsection (13) of this
section.
The Cabinet for Health and Family Services may, by promulgating an
administrative regulation, limit the length of time that data remain in the electronic
system. Any data removed from the system shall be archived and subject to retrieval
within a reasonable time after a request from a person authorized to review data
under this section.
(a) The Cabinet for Health and Family Services shall work with each board
responsible for the licensure, regulation, or discipline of practitioners,
pharmacists, or other persons who are authorized to prescribe, administer, or
dispense controlled substances for the development of a continuing education
program about the purposes and uses of the electronic system for monitoring
established in this section.
(b) The cabinet shall work with the Kentucky Bar Association for the
development of a continuing education program for attorneys about the
purposes and uses of the electronic system for monitoring established in this
section.
(c) The cabinet shall work with the Justice and Public Safety Cabinet for the
development of a continuing education program for law enforcement officers
about the purposes and uses of the electronic system for monitoring
established in this section.
(17) If the cabinet becomes aware of a prescriber's or dispenser's failure to comply with
this section, the cabinet shall notify the licensing board or agency responsible for
licensing the prescriber or dispenser. The licensing board shall treat the notification
as a complaint against the licensee.
(18) The cabinet shall promulgate administrative regulations to implement the provisions
of this section. Included in these administrative regulations shall be:
(a) An error resolution process allowing a patient to whom a report had been
disclosed under subsection (8) of this section to request the correction of
inaccurate information contained in the system relating to that patient; and
(b) Beginning July 1, 2013, a requirement that data be reported to the system
under subsection (3) of this section within one (1) day of dispensing.
Effective: March 4, 2013
History: Amended 2013 Ky. Acts ch. 2, sec. 3, effective March 4, 2013. -- Amended
2012 (1st Extra. Sess.) Ky. Acts ch. 1, sec. 4, effective July 20, 2012. -- Amended
2010 Ky. Acts ch. 85, sec. 43, effective July 15, 2010. -- Amended 2007 Ky. Acts ch.
85, sec. 252, effective June 26, 2007; and ch. 124, sec. 4, effective June 26, 2007. -Amended 2006 Ky. Acts ch. 5, sec. 5, effective July 12, 2006. -- Amended 2005 Ky.
Acts ch. 85, sec. 627, effective June 20, 2005; and ch. 99, sec. 543, effective June 20,
2005. -- Amended 2004 Ky. Acts ch. 68, sec. 1, effective July 13, 2004; and ch. 107,
sec. 1, effective July 13, 2004. -- Amended 2002 Ky. Acts ch. 295, sec. 1, effective
April 9, 2002. -- Created 1998 Ky. Acts ch. 301, sec. 13, effective July 15, 1998.
Legislative Research Commission Note (7/13/2004). This section was amended by
2004 Ky. Acts chs. 68 and 107. Where these Acts are not in conflict, they have been
codified together. Where a conflict exists, Acts ch. 107, which was last enacted by
the General Assembly, prevails under KRS 446.250.
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