2020 Kentucky Revised Statutes Chapter 218A - Controlled substances 218A.205 Reports of improper, inappropriate, or illegal prescribing or dispensing of controlled substances -- Administrative regulations for prescribing and dispensing protocols and licensure actions and requirements -- Presumption of medical necessity -- Complaint procedure -- Criminal record check.
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218A.205 Reports of improper, inappropriate, or illegal prescribing or dispensing
of controlled substances -- Administrative regulations for prescribing and
dispensing protocols and licensure actions and requirements -- Presumption of
medical necessity -- Complaint procedure -- Criminal record check.
(1)
(2)
(3)
As used in this section:
(a) "Reporting agency" includes:
1.
The Department of Kentucky State Police;
2.
The Office of the Attorney General;
3.
The Cabinet for Health and Family Services; and
4.
The applicable state licensing board; and
(b) "State licensing board" means:
1.
The Kentucky Board of Medical Licensure;
2.
The Kentucky Board of Nursing;
3.
The Kentucky Board of Dentistry;
4.
The Kentucky Board of Optometric Examiners;
5.
The State Board of Podiatry; and
6.
Any other board that licenses or regulates a person who is entitled to
prescribe or dispense controlled substances to humans.
(a) When a reporting agency or a law enforcement agency receives a report of
improper, inappropriate, or illegal prescribing or dispensing of a controlled
substance it may, to the extent otherwise allowed by law, send a copy of the
report within three (3) business days to every other reporting agency.
(b) A county attorney or Commonwealth's attorney shall notify the Office of the
Attorney General and the appropriate state licensing board within three (3)
business days of an indictment or a waiver of indictment becoming public in
his or her jurisdiction charging a licensed person with a felony offense relating
to the manufacture of, trafficking in, prescribing, dispensing, or possession of
a controlled substance.
Each state licensing board shall, in consultation with the Kentucky Office of Drug
Control Policy, establish the following by administrative regulation for those
licensees authorized to prescribe or dispense controlled substances:
(a) Mandatory prescribing and dispensing standards related to controlled
substances, the requirements of which shall include the diagnostic, treatment,
review, and other protocols and standards established for Schedule II
controlled substances and Schedule III controlled substances containing
hydrocodone under KRS 218A.172 and which may include the exemptions
authorized by KRS 218A.172(4);
(b) In accord with the CDC Guideline for Prescribing Opioids for Chronic Pain
published in 2016, a prohibition on a practitioner issuing a prescription for a
Schedule II controlled substance for more than a three (3) day supply of a
Schedule II controlled substance if the prescription is intended to treat pain as
(c)
(d)
(e)
an acute medical condition, with the following exceptions:
1.
The practitioner, in his or her professional judgment, believes that more
than a three (3) day supply of a Schedule II controlled substance is
medically necessary to treat the patient's pain as an acute medical
condition and the practitioner adequately documents the acute medical
condition and lack of alternative treatment options which justifies
deviation from the three (3) day supply limit established in this
subsection in the patient's medical records;
2.
The prescription for a Schedule II controlled substance is prescribed to
treat chronic pain;
3.
The prescription for a Schedule II controlled substance is prescribed to
treat pain associated with a valid cancer diagnosis;
4.
The prescription for a Schedule II controlled substance is prescribed to
treat pain while the patient is receiving hospice or end-of-life treatment
or is receiving care from a certified community based palliative care
program;
5.
The prescription for a Schedule II controlled substance is prescribed as
part of a narcotic treatment program licensed by the Cabinet for Health
and Family Services;
6.
The prescription for a Schedule II controlled substance is prescribed to
treat pain following a major surgery or the treatment of significant
trauma, as defined by the state licensing board in consultation with the
Kentucky Office of Drug Control Policy;
7.
The Schedule II controlled substance is dispensed or administered
directly to an ultimate user in an inpatient setting; or
8.
Any additional treatment scenario deemed medically necessary by the
state licensing board in consultation with the Kentucky Office of Drug
Control Policy.
Nothing in this paragraph shall authorize a state licensing board to promulgate
regulations which expand any practitioner's prescriptive authority beyond that
which existed prior to June 29, 2017;
A prohibition on a practitioner dispensing greater than a forty-eight (48) hour
supply of any Schedule II controlled substance or a Schedule III controlled
substance containing hydrocodone unless the dispensing is done as part of a
narcotic treatment program licensed by the Cabinet for Health and Family
Services;
A procedure for temporarily suspending, limiting, or restricting a license held
by a named licensee where a substantial likelihood exists to believe that the
continued unrestricted practice by the named licensee would constitute a
danger to the health, welfare, or safety of the licensee's patients or of the
general public;
A procedure for the expedited review of complaints filed against their
licensees pertaining to the improper, inappropriate, or illegal prescribing or
(4)
(5)
dispensing of controlled substances that is designed to commence an
investigation within seven (7) days of a complaint being filed and produce a
charging decision by the board on the complaint within one hundred twenty
(120) days of the receipt of the complaint, unless an extension for a definite
period of time is requested by a law enforcement agency due to an ongoing
criminal investigation;
(f) The establishment and enforcement of licensure standards that conform to the
following:
1.
A permanent ban on licensees and applicants convicted after July 20,
2012, in this state or any other state of any felony offense relating to
controlled substances from prescribing or dispensing a controlled
substance;
2.
Restrictions short of a permanent ban on licensees and applicants
convicted in this state or any other state of any misdemeanor offense
relating to prescribing or dispensing a controlled substance;
3.
Restrictions mirroring in time and scope any disciplinary limitation
placed on a licensee or applicant by a licensing board of another state if
the disciplinary action results from improper, inappropriate, or illegal
prescribing or dispensing of controlled substances; and
4.
A requirement that licensees and applicants report to the board any
conviction or disciplinary action covered by this subsection with
appropriate sanctions for any failure to make this required report;
(g) A procedure for the continuous submission of all disciplinary and other
reportable information to the National Practitioner Data Bank of the United
States Department of Health and Human Services;
(h) If not otherwise required by other law, a process for submitting a query on
each applicant for licensure to the National Practitioner Data Bank of the
United States Department of Health and Human Services to retrieve any
relevant data on the applicant; and
(i) Continuing education requirements beginning with the first full educational
year occurring after July 1, 2012, that specify that at least seven and one-half
percent (7.5%) of the continuing education required of the licensed
practitioner relate to the use of the electronic monitoring system established in
KRS 218A.202, pain management, or addiction disorders.
For the purposes of pharmacy dispensing, the medical necessity for a Schedule II
controlled substance as documented by the practitioner in the patient's medical
record and the prescription for more than a three (3) day supply of that controlled
substance are presumed to be valid.
A state licensing board shall employ or obtain the services of a specialist in the
treatment of pain and a specialist in drug addiction to evaluate information received
regarding a licensee's prescribing or dispensing practices related to controlled
substances if the board or its staff does not possess such expertise, to ascertain if the
licensee under investigation is engaging in improper, inappropriate, or illegal
(6)
(7)
(8)
practices.
Any statute to the contrary notwithstanding, no state licensing board shall require
that a grievance or complaint against a licensee relating to controlled substances be
sworn to or notarized, but the grievance or complaint shall identify the name and
address of the grievant or complainant, unless the board by administrative
regulation authorizes the filing of anonymous complaints. Any such authorizing
administrative regulation shall require that an anonymous complaint or grievance be
accompanied by sufficient corroborating evidence as would allow the board to
believe, based upon a totality of the circumstances, that a reasonable probability
exists that the complaint or grievance is meritorious.
Every state licensing board shall cooperate to the maximum extent permitted by law
with all state, local, and federal law enforcement agencies, and all professional
licensing boards and agencies, state and federal, in the United States or its territories
in the coordination of actions to deter the improper, inappropriate, or illegal
prescribing or dispensing of a controlled substance.
Each state licensing board shall require a fingerprint-supported criminal record
check by the Department of Kentucky State Police and the Federal Bureau of
Investigation of any applicant for initial licensure to practice any profession
authorized to prescribe or dispense controlled substances.
Effective: June 27, 2019
History: Amended 2019 Ky. Acts ch. 84, sec. 5, effective June 27, 2019. -- Amended
2017 Ky. Acts ch. 168, sec. 7, effective June 29, 2017. -- Amended 2013 Ky. Acts
ch. 2, sec. 4, effective March 4, 2013. -- Created 2012 (1st Extra. Sess.) Ky. Acts ch.
1, sec. 2, effective July 20, 2012.
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