Connecticut 2024 2024 Regular Session

Connecticut Senate Bill SB00202 Comm Sub / Bill

Filed 03/21/2024

                     
 
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General Assembly  Substitute Bill No. 202  
February Session, 2024 
 
 
 
 
 
AN ACT CONCERNING THE DEPARTMENT OF CONSUMER 
PROTECTION'S RECOMMENDATIONS REGARDING PRESCRIPTION 
DRUG CONTROL.  
Be it enacted by the Senate and House of Representatives in General 
Assembly convened: 
 
Section 1. Subsection (a) of section 21a-65 of the 2024 supplement to 1 
the general statutes is repealed and the following is substituted in lieu 2 
thereof (Effective from passage): 3 
(a) A licensed manufacturer or licensed wholesaler may sell 4 
hypodermic needles and syringes only to the following: (1) To a licensed 5 
manufacturer, licensed wholesaler or licensed pharmacy; (2) to [a] an 6 
advanced practice registered nurse, dentist, embalmer, optometrist, 7 
physician, [dentist,] physician assistant, podiatrist, scientific 8 
investigator or veterinarian [, embalmer, podiatrist or scientific 9 
investigator] licensed to practice in this state; (3) to a person in charge of 10 
a care-giving institution, as defined in section 20-571, incorporated 11 
college or scientific institution, but only for use by or in such care-giving 12 
institution, college or institution for medical or scientific purposes; (4) 13 
to a person in charge of a licensed or registered laboratory, but only for 14 
use in that laboratory for scientific and medical purposes; (5) to a farmer 15 
but only for use on the farmer's own animals or poultry; (6) to a business 16 
authorized in accordance with the regulations adopted under section 17  Substitute Bill No. 202 
 
 
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21a-66 to purchase hypodermic needles and syringes but only for 18 
legitimate industrial or medical use within that business; and (7) to a 19 
syringe services program established pursuant to section 19a-124. 20 
Sec. 2. Section 21a-70h of the 2024 supplement to the general statutes 21 
is repealed and the following is substituted in lieu thereof (Effective from 22 
passage): 23 
For the purposes of this section and sections 21a-70i to 21a-70k, as 24 
amended by this act: 25 
(1) "Commissioner" means the Commissioner of Consumer 26 
Protection or the commissioner's authorized representative; 27 
(2) "Contact" means any communication transmitted in person or by 28 
telephone, electronic mail, text message or other electronic means 29 
between a pharmaceutical representative and a prescribing practitioner 30 
or pharmacist, to promote or provide information relating to a legend 31 
drug; 32 
(3) "Department" means the Department of Consumer Protection; 33 
(4) "Legend drug" has the same meaning as provided in section 20-34 
571; 35 
(5) "Pharmaceutical manufacturer" (A) means a [(A)] (i) person, 36 
whether within or without the boundaries of the state of Connecticut, 37 
that (I) produces, prepares, cultivates, grows, propagates, compounds, 38 
converts or processes a drug, [device or cosmetic,] directly or indirectly, 39 
by extraction from substances of natural origin, by means of chemical 40 
synthesis or by a combination of extraction and chemical synthesis, or 41 
[that] (II) packages, repackages, labels or relabels a drug container under 42 
such manufacturer's own trademark or label, or any other trademark or 43 
label, [or a drug, device or cosmetic] for the purpose of selling the drug, 44 
[device or cosmetic,] or [(B)] (ii) sterile compounding pharmacy, as 45 
defined in section 20-633b that dispenses sterile pharmaceuticals 46 
without a prescription or a patient-specific medical order intended for 47  Substitute Bill No. 202 
 
 
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use in humans, and (B) includes, but is not limited to, a virtual 48 
manufacturer, as defined in section 20-571; 49 
[(6) "Pharmaceutical manufacturer" includes a virtual manufacturer, 50 
as defined in section 20-571;] 51 
[(7)] (6) "Pharmaceutical marketing firm" means a pharmaceutical 52 
manufacturer that employs or compensates pharmaceutical 53 
representatives; 54 
[(8)] (7) "Pharmaceutical representative" means any person, 55 
including, but not limited to, a sales representative, who markets, 56 
promotes or provides information regarding a legend drug for human 57 
use to a prescribing practitioner and is employed or compensated by a 58 
pharmaceutical manufacturer; 59 
[(9)] (8) "Pharmacist" has the same meaning as provided in section 20-60 
571; and 61 
[(10)] (9) "Prescribing practitioner" has the same meaning as provided 62 
in section 20-571. 63 
Sec. 3. Section 21a-70i of the 2024 supplement to the general statutes 64 
is repealed and the following is substituted in lieu thereof (Effective from 65 
passage): 66 
(a) On and after October 1, 2023, a pharmaceutical manufacturer that 67 
employs [an individual to perform the duties of] a pharmaceutical 68 
[sales] representative shall register annually with the department as a 69 
pharmaceutical marketing firm, in a form and manner prescribed by the 70 
commissioner. No pharmaceutical manufacturer shall authorize an 71 
individual to perform [such] the duties of a pharmaceutical 72 
representative on such manufacturer's behalf unless such manufacturer 73 
has obtained a pharmaceutical marketing firm registration from the 74 
department pursuant to this section. Registrations issued pursuant to 75 
this section shall expire annually on June thirtieth. 76  Substitute Bill No. 202 
 
 
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(b) The nonrefundable fee for registration as a pharmaceutical 77 
marketing firm and for annual renewal of such registration shall be one 78 
hundred fifty dollars. Any pharmaceutical marketing firm that fails to 79 
renew its registration on or before June thirtieth shall pay a late fee of 80 
one hundred dollars for each year that such firm did not renew, in 81 
addition to the annual renewal fee required under this section. 82 
(c) On the date of its initial registration, and annually thereafter, each 83 
pharmaceutical marketing firm shall provide to the department a list of 84 
all [individuals] pharmaceutical representatives employed or 85 
compensated by such firm. [as a pharmaceutical sales representative.] 86 
Each pharmaceutical marketing firm shall notify the department, in a 87 
form and manner prescribed by the commissioner, of each individual 88 
who is no longer employed or compensated as a pharmaceutical [sales] 89 
representative or who was hired or compensated as a pharmaceutical 90 
representative after the date on which such firm provided such annual 91 
list, not later than two weeks after such individual leaves employment 92 
or was hired or otherwise compensated. 93 
(d) The department shall prominently post on its Internet web site the 94 
most recent list provided by each pharmaceutical marketing firm 95 
pursuant to subsection (c) of this section. 96 
(e) Any person who is not identified to the department pursuant to 97 
subsection (c) of this section shall not perform the duties of a 98 
pharmaceutical [sales] representative on behalf of the pharmaceutical 99 
marketing firm. [for any prescribing practitioner in this state.] 100 
(f) Not later than July 1, 2024, and annually thereafter, each 101 
pharmaceutical marketing firm shall provide the commissioner with the 102 
following information regarding the performance for the previous 103 
calendar year of each of its pharmaceutical [sales] representatives 104 
identified to the department pursuant to subsection (c) of this section at 105 
any time during the previous calendar year, in a form and manner 106 
prescribed by the commissioner: 107  Substitute Bill No. 202 
 
 
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(1) The aggregate number of contacts such pharmaceutical [sales] 108 
representative had with prescribing practitioners and pharmacists; 109 
(2) The specialty of [each] such prescribing practitioner and each 110 
pharmacist with whom such pharmaceutical [sales] representative 111 
made contact; 112 
(3) Whether product samples, materials or gifts of any value were 113 
provided to a prescribing practitioner or such practitioner's staff in a 114 
prescribing practitioner's office or to a pharmacist; and 115 
(4) An aggregate report of all free samples, by drug name and 116 
strength, in a form and manner prescribed by the commissioner. 117 
(g) The department shall annually [analyze the information 118 
submitted pursuant to this section and] compile a report on the activities 119 
of pharmaceutical [sales representatives] marketing firms in the state. 120 
Not later than December [1] 31, 2024, and annually thereafter, the 121 
department shall post such report on its Internet web site and submit 122 
such report to the Secretary of the Office of Policy and Management. 123 
Sec. 4. Section 21a-70j of the 2024 supplement to the general statutes 124 
is repealed and the following is substituted in lieu thereof (Effective from 125 
passage): 126 
Each pharmaceutical marketing firm that employs or compensates a 127 
pharmaceutical representative who is engaged in marketing, promoting 128 
or providing information regarding a legend drug [marketing] for 129 
human use in this state shall [disclose] ensure that such pharmaceutical 130 
representative discloses, in writing, to a prescribing practitioner or 131 
pharmacist, [at the] each time [of each] such pharmaceutical 132 
representative makes contact with [such] the prescribing practitioner or 133 
pharmacist: [, the following information:] 134 
(1) The list price of a legend drug when such pharmaceutical 135 
representative provides information concerning [such] the legend drug 136 
to [the] such prescribing practitioner or pharmacist based on the dose 137  Substitute Bill No. 202 
 
 
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and quantity of such legend drug as described in the medication 138 
package insert; and 139 
(2) Information on the variation efficacy of the legend drug marketed 140 
to different racial and ethnic groups, if such information is available. 141 
Sec. 5. Section 19a-17d of the 2024 supplement to the general statutes 142 
is repealed and the following is substituted in lieu thereof (Effective from 143 
passage): 144 
If a [pharmacist or] health care professional who is currently licensed 145 
or was previously licensed in another state or jurisdiction is subject to 146 
automatic reciprocal discipline for a disciplinary action in such state or 147 
jurisdiction, such automatic reciprocal discipline shall be automatically 148 
rescinded and shall not be entered into the licensing record of the 149 
[pharmacist or] health care professional if the discipline was based 150 
solely on the termination of pregnancy under conditions that would not 151 
violate the general statutes or the regulations of Connecticut state 152 
agencies. The provisions of this section shall not preclude or affect the 153 
ability of an agency or board of the state to seek or impose any discipline 154 
pursuant to the general statutes against a [pharmacist or other] health 155 
care professional licensed by the state. 156 
Sec. 6. Subsection (a) of section 21a-70k of the 2024 supplement to the 157 
general statutes is repealed and the following is substituted in lieu 158 
thereof (Effective from passage): 159 
(a) The commissioner may (1) refuse to authorize the issuance or 160 
renewal of a registration to operate as a pharmaceutical marketing firm, 161 
(2) revoke, suspend or place conditions on a registration to operate as a 162 
pharmaceutical marketing firm, and (3) assess a penalty of up to one 163 
thousand dollars for each violation of any provision of section 21a-70i, 164 
as amended by this act, or 21a-70j, as amended by this act, or take other 165 
action permitted by [subdivision (7) of subsection (a) of section 21a-7] 166 
section 21a-11, if the applicant or holder of the registration fails to 167 
comply with the requirements set forth in section 21a-70i, as amended 168  Substitute Bill No. 202 
 
 
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by this act, or 21a-70j, as amended by this act. 169 
Sec. 7. Section 21a-322 of the general statutes is repealed and the 170 
following is substituted in lieu thereof (Effective from passage): 171 
(a) The [commissioner] Commissioner of Consumer Protection may 172 
suspend, revoke or refuse to renew a registration, place a registration on 173 
probation, place conditions on a registration and assess a civil penalty 174 
of not more than one thousand dollars per violation of this chapter, for 175 
sufficient cause. Any of the following shall be sufficient cause for such 176 
action by the commissioner: (1) The furnishing of false or fraudulent 177 
information in any application filed under this chapter; (2) conviction of 178 
a crime under any state or federal law relating to the registrant's 179 
profession, controlled substances or drugs or fraudulent practices, 180 
including, but not limited to, fraudulent billing practices; (3) failure to 181 
maintain effective controls against diversion of controlled substances 182 
into other than duly authorized legitimate medical, scientific, or 183 
commercial channels; (4) the suspension, revocation, expiration or 184 
surrender of the practitioner's federal controlled substance registration; 185 
(5) prescribing, distributing, administering or dispensing a controlled 186 
substance in schedules other than those specified in the practitioner's 187 
state or federal registration or in violation of any condition placed on 188 
the practitioner's registration; (6) suspension, revocation, expiration, 189 
surrender or other disciplinary action taken against any professional 190 
license or registration held by the practitioner; (7) abuse or excessive use 191 
of drugs; (8) possession, use, prescription for use or distribution of 192 
controlled substances or legend drugs, except for therapeutic or other 193 
proper medical or scientific purpose; (9) a practitioner's failure to 194 
account for disposition of controlled substances as determined by an 195 
audit of the receipt and disposition records of said practitioner; (10) 196 
failure to keep records of medical evaluations of patients and all 197 
controlled substances dispensed, administered or prescribed to patients 198 
by a practitioner; (11) failure to establish and implement administrative 199 
safeguards for the protection of electronic protected health information 200 
pursuant to 45 CFR 164.308, as amended from time to time; and (12) 201  Substitute Bill No. 202 
 
 
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breach of any such safeguards by a prescribing practitioner's authorized 202 
agent. 203 
(b) If a practitioner dispenses, administers or prescribes any 204 
controlled substance to a patient, the practitioner shall make available 205 
to the Department of Consumer Protection, for inspection by the 206 
department, records of medical evaluations associated with dispensing, 207 
administering or prescribing such controlled substance. Such records 208 
shall be confidential and not be subject to disclosure under the Freedom 209 
of Information Act, as defined in section 1-200. The department may 210 
inspect such records solely for the purpose of investigating any violation 211 
or suspected violation, or enforcing any provision, of this chapter or any 212 
regulation promulgated under this chapter. Nothing in this subsection 213 
shall be construed to require disclosure of any substance abuse 214 
treatment record that is protected from disclosure under 42 USC 290dd-215 
2, as amended from time to time, or other applicable federal law. 216 
Sec. 8. Subparagraphs (A) and (B) of subdivision (10) of subsection (j) 217 
of section 21a-254 of the general statutes are repealed and the following 218 
is substituted in lieu thereof (Effective from passage): 219 
(10) (A) A prescribing practitioner may designate an authorized 220 
agent to review the electronic prescription drug monitoring program 221 
and patient controlled substance prescription information on behalf of 222 
the prescribing practitioner. The prescribing practitioner shall ensure 223 
that any authorized agent's access to such program and patient 224 
controlled substance prescription information is limited to the purposes 225 
described in this section and occurs in a manner that protects the 226 
confidentiality of information that is accessed through such program. 227 
The prescribing practitioner and any authorized agent shall be subject 228 
to the provisions of 45 CFR 164.308, as amended from time to time, 229 
concerning administrative safeguards for the protection of electronic 230 
protected health information. A prescribing practitioner may be subject 231 
to disciplinary action for acts of the authorized agent as provided in 232 
subsection (a) of section 21a-322, as amended by this act. 233  Substitute Bill No. 202 
 
 
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(B) Notwithstanding the provisions of subparagraph (A) of this 234 
subdivision, a prescribing practitioner who is employed by or provides 235 
professional services to a hospital shall, prior to designating an 236 
authorized agent to review the electronic prescription drug monitoring 237 
program and patient controlled substance prescription information on 238 
behalf of the prescribing practitioner, (i) submit a request to designate 239 
one or more authorized agents for such purposes and a written protocol 240 
for oversight of the authorized agent or agents to the commissioner, in 241 
the form and manner prescribed by the commissioner, and (ii) receive 242 
the commissioner's approval to designate such authorized agent or 243 
agents and of such written protocol. Such written protocol shall 244 
designate either the hospital's medical director, a hospital department 245 
head, who is a prescribing practitioner, or another prescribing 246 
practitioner as the person responsible for ensuring that the authorized 247 
agent's or agents' access to such program and patient controlled 248 
substance prescription information is limited to the purposes described 249 
in this section and occurs in a manner that protects the confidentiality 250 
of information that is accessed through such program. A hospital 251 
medical director, a hospital department head, who is a prescribing 252 
practitioner, or another prescribing practitioner designated as the 253 
person responsible for overseeing an authorized agent's or agents' 254 
access to such program and information in the written protocol 255 
approved by the commissioner may be subject to disciplinary action for 256 
acts of the authorized agent or agents as provided in subsection (a) of 257 
section 21a-322, as amended by this act. The commissioner may inspect 258 
hospital records to determine compliance with written protocols 259 
approved in accordance with this section. 260 
This act shall take effect as follows and shall amend the following 
sections: 
 
Section 1 from passage 21a-65(a) 
Sec. 2 from passage 21a-70h 
Sec. 3 from passage 21a-70i 
Sec. 4 from passage 21a-70j 
Sec. 5 from passage 19a-17d  Substitute Bill No. 202 
 
 
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Sec. 6 from passage 21a-70k(a) 
Sec. 7 from passage 21a-322 
Sec. 8 from passage 21a-254(j)(10)(A) and (B) 
 
Statement of Legislative Commissioners:   
In Section 7(b), ", as amended from time to time," was added for 
consistency with standard drafting conventions. 
 
GL Joint Favorable Subst.