103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB2046 Introduced , by Rep. Kelly M. Cassidy SYNOPSIS AS INTRODUCED: 720 ILCS 570/315.7 new 720 ILCS 570/318 Amends the Illinois Controlled Substances Act. Provides that all decisions regarding the treatment of patients experiencing pain, including chronic pain, shall be made by the prescriber. Provides that ordering, prescribing, dispensing, administering, or paying for controlled substances, including opioids, shall not in any way be predetermined by specific morphine milligram equivalent guidelines. Provides that, before the Department of Human Services releases confidential information from the central repository, the applicant, in addition to other requirements of the Act, must demonstrate in writing to the Department that the applicant has a valid court order or subpoena for the release of the confidential information requested. LRB103 05014 RLC 51034 b A BILL FOR 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB2046 Introduced , by Rep. Kelly M. Cassidy SYNOPSIS AS INTRODUCED: 720 ILCS 570/315.7 new 720 ILCS 570/318 720 ILCS 570/315.7 new 720 ILCS 570/318 Amends the Illinois Controlled Substances Act. Provides that all decisions regarding the treatment of patients experiencing pain, including chronic pain, shall be made by the prescriber. Provides that ordering, prescribing, dispensing, administering, or paying for controlled substances, including opioids, shall not in any way be predetermined by specific morphine milligram equivalent guidelines. Provides that, before the Department of Human Services releases confidential information from the central repository, the applicant, in addition to other requirements of the Act, must demonstrate in writing to the Department that the applicant has a valid court order or subpoena for the release of the confidential information requested. LRB103 05014 RLC 51034 b LRB103 05014 RLC 51034 b A BILL FOR 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB2046 Introduced , by Rep. Kelly M. Cassidy SYNOPSIS AS INTRODUCED: 720 ILCS 570/315.7 new 720 ILCS 570/318 720 ILCS 570/315.7 new 720 ILCS 570/318 720 ILCS 570/315.7 new 720 ILCS 570/318 Amends the Illinois Controlled Substances Act. Provides that all decisions regarding the treatment of patients experiencing pain, including chronic pain, shall be made by the prescriber. Provides that ordering, prescribing, dispensing, administering, or paying for controlled substances, including opioids, shall not in any way be predetermined by specific morphine milligram equivalent guidelines. Provides that, before the Department of Human Services releases confidential information from the central repository, the applicant, in addition to other requirements of the Act, must demonstrate in writing to the Department that the applicant has a valid court order or subpoena for the release of the confidential information requested. LRB103 05014 RLC 51034 b LRB103 05014 RLC 51034 b LRB103 05014 RLC 51034 b A BILL FOR HB2046LRB103 05014 RLC 51034 b HB2046 LRB103 05014 RLC 51034 b HB2046 LRB103 05014 RLC 51034 b 1 AN ACT concerning criminal law. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 5. The Illinois Controlled Substances Act is 5 amended by changing Section 318 and by adding Section 315.7 as 6 follows: 7 (720 ILCS 570/315.7 new) 8 Sec. 315.7. Chronic pain treatment. 9 (a) In this Section, "opioid" means a narcotic drug or 10 substance that is a Schedule II controlled substance under 11 paragraph (1), (2), (3), or (5) of subsection (b) or under 12 subsection (c) of Section 206. 13 (b) All decisions regarding the treatment of patients 14 experiencing pain, including chronic pain, shall be made by 15 the prescriber. 16 (c) Ordering, prescribing, dispensing, administering, or 17 paying for controlled substances, including opioids, shall not 18 in any way be predetermined by specific morphine milligram 19 equivalent guidelines. 20 (720 ILCS 570/318) 21 Sec. 318. Confidentiality of information. 22 (a) Information received by the central repository under 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB2046 Introduced , by Rep. Kelly M. Cassidy SYNOPSIS AS INTRODUCED: 720 ILCS 570/315.7 new 720 ILCS 570/318 720 ILCS 570/315.7 new 720 ILCS 570/318 720 ILCS 570/315.7 new 720 ILCS 570/318 Amends the Illinois Controlled Substances Act. Provides that all decisions regarding the treatment of patients experiencing pain, including chronic pain, shall be made by the prescriber. Provides that ordering, prescribing, dispensing, administering, or paying for controlled substances, including opioids, shall not in any way be predetermined by specific morphine milligram equivalent guidelines. Provides that, before the Department of Human Services releases confidential information from the central repository, the applicant, in addition to other requirements of the Act, must demonstrate in writing to the Department that the applicant has a valid court order or subpoena for the release of the confidential information requested. LRB103 05014 RLC 51034 b LRB103 05014 RLC 51034 b LRB103 05014 RLC 51034 b A BILL FOR 720 ILCS 570/315.7 new 720 ILCS 570/318 LRB103 05014 RLC 51034 b HB2046 LRB103 05014 RLC 51034 b HB2046- 2 -LRB103 05014 RLC 51034 b HB2046 - 2 - LRB103 05014 RLC 51034 b HB2046 - 2 - LRB103 05014 RLC 51034 b 1 Section 316 and former Section 321 is confidential. 2 (a-1) To ensure the federal Health Insurance Portability 3 and Accountability Act and confidentiality of substance use 4 disorder patient records rules that mandate the privacy of an 5 individual's prescription data reported to the Prescription 6 Monitoring Program received from a retail dispenser under this 7 Act, and in order to execute the duties and responsibilities 8 under Section 316 of this Act and rules for disclosure under 9 this Section, the Clinical Director of the Prescription 10 Monitoring Program or his or her designee shall maintain 11 direct access to all Prescription Monitoring Program data. Any 12 request for Prescription Monitoring Program data from any 13 other department or agency must be approved in writing by the 14 Clinical Director of the Prescription Monitoring Program or 15 his or her designee unless otherwise permitted by law. 16 Prescription Monitoring Program data shall only be disclosed 17 as permitted by law. 18 (a-2) As an active step to address the current opioid 19 crisis in this State and to prevent and reduce addiction 20 resulting from a sports injury or an accident, the 21 Prescription Monitoring Program and the Department of Public 22 Health shall coordinate a continuous review of the 23 Prescription Monitoring Program and the Department of Public 24 Health data to determine if a patient may be at risk of opioid 25 addiction. Each patient discharged from any medical facility 26 with an International Classification of Disease, 10th edition HB2046 - 2 - LRB103 05014 RLC 51034 b HB2046- 3 -LRB103 05014 RLC 51034 b HB2046 - 3 - LRB103 05014 RLC 51034 b HB2046 - 3 - LRB103 05014 RLC 51034 b 1 code related to a sport or accident injury shall be subject to 2 the data review. If the discharged patient is dispensed a 3 controlled substance, the Prescription Monitoring Program 4 shall alert the patient's prescriber as to the addiction risk 5 and urge each to follow the Centers for Disease Control and 6 Prevention guidelines or his or her respective profession's 7 treatment guidelines related to the patient's injury. This 8 subsection (a-2), other than this sentence, is inoperative on 9 or after January 1, 2024. 10 (b) The Department must carry out a program to protect the 11 confidentiality of the information described in subsection 12 (a). The Department may disclose the information to another 13 person only under subsection (c), (d), or (f) and may charge a 14 fee not to exceed the actual cost of furnishing the 15 information. 16 (c) The Department may disclose confidential information 17 described in subsection (a) to any person who is engaged in 18 receiving, processing, or storing the information. 19 (d) The Department may release confidential information 20 described in subsection (a) to the following persons: 21 (1) A governing body that licenses practitioners and 22 is engaged in an investigation, an adjudication, or a 23 prosecution of a violation under any State or federal law 24 that involves a controlled substance. 25 (2) An investigator for the Consumer Protection 26 Division of the office of the Attorney General, a HB2046 - 3 - LRB103 05014 RLC 51034 b HB2046- 4 -LRB103 05014 RLC 51034 b HB2046 - 4 - LRB103 05014 RLC 51034 b HB2046 - 4 - LRB103 05014 RLC 51034 b 1 prosecuting attorney, the Attorney General, a deputy 2 Attorney General, or an investigator from the office of 3 the Attorney General, who is engaged in any of the 4 following activities involving controlled substances: 5 (A) an investigation; 6 (B) an adjudication; or 7 (C) a prosecution of a violation under any State 8 or federal law that involves a controlled substance. 9 (3) A law enforcement officer who is: 10 (A) authorized by the Illinois State Police or the 11 office of a county sheriff or State's Attorney or 12 municipal police department of Illinois to receive 13 information of the type requested for the purpose of 14 investigations involving controlled substances; or 15 (B) approved by the Department to receive 16 information of the type requested for the purpose of 17 investigations involving controlled substances; and 18 (C) engaged in the investigation or prosecution of 19 a violation under any State or federal law that 20 involves a controlled substance. 21 (4) Select representatives of the Department of 22 Children and Family Services through the indirect online 23 request process. Access shall be established by an 24 intergovernmental agreement between the Department of 25 Children and Family Services and the Department of Human 26 Services. HB2046 - 4 - LRB103 05014 RLC 51034 b HB2046- 5 -LRB103 05014 RLC 51034 b HB2046 - 5 - LRB103 05014 RLC 51034 b HB2046 - 5 - LRB103 05014 RLC 51034 b 1 (e) Before the Department releases confidential 2 information under subsection (d), the applicant must 3 demonstrate in writing to the Department that: 4 (1) the applicant has reason to believe that a 5 violation under any State or federal law that involves a 6 controlled substance has occurred; and 7 (2) the requested information is reasonably related to 8 the investigation, adjudication, or prosecution of the 9 violation described in subdivision (1); and 10 (3) the applicant has a valid court order or subpoena 11 for the release of the confidential information requested. 12 (f) The Department may receive and release prescription 13 record information under Section 316 and former Section 321 14 to: 15 (1) a governing body that licenses practitioners; 16 (2) an investigator for the Consumer Protection 17 Division of the office of the Attorney General, a 18 prosecuting attorney, the Attorney General, a deputy 19 Attorney General, or an investigator from the office of 20 the Attorney General; 21 (3) any Illinois law enforcement officer who is: 22 (A) authorized to receive the type of information 23 released; and 24 (B) approved by the Department to receive the type 25 of information released; or 26 (4) prescription monitoring entities in other states HB2046 - 5 - LRB103 05014 RLC 51034 b HB2046- 6 -LRB103 05014 RLC 51034 b HB2046 - 6 - LRB103 05014 RLC 51034 b HB2046 - 6 - LRB103 05014 RLC 51034 b 1 per the provisions outlined in subsection (g) and (h) 2 below; 3 confidential prescription record information collected under 4 Sections 316 and 321 (now repealed) that identifies vendors or 5 practitioners, or both, who are prescribing or dispensing 6 large quantities of Schedule II, III, IV, or V controlled 7 substances outside the scope of their practice, pharmacy, or 8 business, as determined by the Advisory Committee created by 9 Section 320. 10 (f-5) In accordance with a confidentiality agreement 11 entered into with the Department, a medical director, or a 12 public health administrator and their delegated analysts, of a 13 county or municipal health department or the Department of 14 Public Health shall have access to data from the system for any 15 of the following purposes: 16 (1) developing education programs or public health 17 interventions relating to prescribing trends and 18 controlled substance use; or 19 (2) conducting analyses and publish reports on 20 prescribing trends in their respective jurisdictions. 21 At a minimum, the confidentiality agreement entered into 22 with the Department shall: 23 (i) prohibit analysis and reports produced under 24 subparagraph (2) from including information that 25 identifies, by name, license, or address, any 26 practitioner, dispenser, ultimate user, or other person HB2046 - 6 - LRB103 05014 RLC 51034 b HB2046- 7 -LRB103 05014 RLC 51034 b HB2046 - 7 - LRB103 05014 RLC 51034 b HB2046 - 7 - LRB103 05014 RLC 51034 b 1 administering a controlled substance; and 2 (ii) specify the appropriate technical and physical 3 safeguards that the county or municipal health department 4 must implement to ensure the privacy and security of data 5 obtained from the system. The data from the system shall 6 not be admissible as evidence, nor discoverable in any 7 action of any kind in any court or before any tribunal, 8 board, agency, or person. The disclosure of any such 9 information or data, whether proper or improper, shall not 10 waive or have any effect upon its confidentiality, 11 non-discoverability, or non-admissibility. 12 (g) The information described in subsection (f) may not be 13 released until it has been reviewed by an employee of the 14 Department who is licensed as a prescriber or a dispenser and 15 until that employee has certified that further investigation 16 is warranted. However, failure to comply with this subsection 17 (g) does not invalidate the use of any evidence that is 18 otherwise admissible in a proceeding described in subsection 19 (h). 20 (h) An investigator or a law enforcement officer receiving 21 confidential information under subsection (c), (d), or (f) may 22 disclose the information to a law enforcement officer or an 23 attorney for the office of the Attorney General for use as 24 evidence in the following: 25 (1) A proceeding under any State or federal law that 26 involves a controlled substance. HB2046 - 7 - LRB103 05014 RLC 51034 b HB2046- 8 -LRB103 05014 RLC 51034 b HB2046 - 8 - LRB103 05014 RLC 51034 b HB2046 - 8 - LRB103 05014 RLC 51034 b 1 (2) A criminal proceeding or a proceeding in juvenile 2 court that involves a controlled substance. 3 (i) The Department may compile statistical reports from 4 the information described in subsection (a). The reports must 5 not include information that identifies, by name, license or 6 address, any practitioner, dispenser, ultimate user, or other 7 person administering a controlled substance. 8 (j) Based upon federal, initial and maintenance funding, a 9 prescriber and dispenser inquiry system shall be developed to 10 assist the health care community in its goal of effective 11 clinical practice and to prevent patients from diverting or 12 abusing medications. 13 (1) An inquirer shall have read-only access to a 14 stand-alone database which shall contain records for the 15 previous 12 months. 16 (2) Dispensers may, upon positive and secure 17 identification, make an inquiry on a patient or customer 18 solely for a medical purpose as delineated within the 19 federal HIPAA law. 20 (3) The Department shall provide a one-to-one secure 21 link and encrypted software necessary to establish the 22 link between an inquirer and the Department. Technical 23 assistance shall also be provided. 24 (4) Written inquiries are acceptable but must include 25 the fee and the requester's Drug Enforcement 26 Administration license number and submitted upon the HB2046 - 8 - LRB103 05014 RLC 51034 b HB2046- 9 -LRB103 05014 RLC 51034 b HB2046 - 9 - LRB103 05014 RLC 51034 b HB2046 - 9 - LRB103 05014 RLC 51034 b 1 requester's business stationery. 2 (5) As directed by the Prescription Monitoring Program 3 Advisory Committee and the Clinical Director for the 4 Prescription Monitoring Program, aggregate data that does 5 not indicate any prescriber, practitioner, dispenser, or 6 patient may be used for clinical studies. 7 (6) Tracking analysis shall be established and used 8 per administrative rule. 9 (7) Nothing in this Act or Illinois law shall be 10 construed to require a prescriber or dispenser to make use 11 of this inquiry system. 12 (8) If there is an adverse outcome because of a 13 prescriber or dispenser making an inquiry, which is 14 initiated in good faith, the prescriber or dispenser shall 15 be held harmless from any civil liability. 16 (k) The Department shall establish, by rule, the process 17 by which to evaluate possible erroneous association of 18 prescriptions to any licensed prescriber or end user of the 19 Illinois Prescription Information Library (PIL). 20 (l) The Prescription Monitoring Program Advisory Committee 21 is authorized to evaluate the need for and method of 22 establishing a patient specific identifier. 23 (m) Patients who identify prescriptions attributed to them 24 that were not obtained by them shall be given access to their 25 personal prescription history pursuant to the validation 26 process as set forth by administrative rule. HB2046 - 9 - LRB103 05014 RLC 51034 b HB2046- 10 -LRB103 05014 RLC 51034 b HB2046 - 10 - LRB103 05014 RLC 51034 b HB2046 - 10 - LRB103 05014 RLC 51034 b 1 (n) The Prescription Monitoring Program is authorized to 2 develop operational push reports to entities with compatible 3 electronic medical records. The process shall be covered 4 within administrative rule established by the Department. 5 (o) Hospital emergency departments and freestanding 6 healthcare facilities providing healthcare to walk-in patients 7 may obtain, for the purpose of improving patient care, a 8 unique identifier for each shift to utilize the PIL system. 9 (p) The Prescription Monitoring Program shall 10 automatically create a log-in to the inquiry system when a 11 prescriber or dispenser obtains or renews his or her 12 controlled substance license. The Department of Financial and 13 Professional Regulation must provide the Prescription 14 Monitoring Program with electronic access to the license 15 information of a prescriber or dispenser to facilitate the 16 creation of this profile. The Prescription Monitoring Program 17 shall send the prescriber or dispenser information regarding 18 the inquiry system, including instructions on how to log into 19 the system, instructions on how to use the system to promote 20 effective clinical practice, and opportunities for continuing 21 education for the prescribing of controlled substances. The 22 Prescription Monitoring Program shall also send to all 23 enrolled prescribers, dispensers, and designees information 24 regarding the unsolicited reports produced pursuant to Section 25 314.5 of this Act. 26 (q) A prescriber or dispenser may authorize a designee to HB2046 - 10 - LRB103 05014 RLC 51034 b HB2046- 11 -LRB103 05014 RLC 51034 b HB2046 - 11 - LRB103 05014 RLC 51034 b HB2046 - 11 - LRB103 05014 RLC 51034 b 1 consult the inquiry system established by the Department under 2 this subsection on his or her behalf, provided that all the 3 following conditions are met: 4 (1) the designee so authorized is employed by the same 5 hospital or health care system; is employed by the same 6 professional practice; or is under contract with such 7 practice, hospital, or health care system; 8 (2) the prescriber or dispenser takes reasonable steps 9 to ensure that such designee is sufficiently competent in 10 the use of the inquiry system; 11 (3) the prescriber or dispenser remains responsible 12 for ensuring that access to the inquiry system by the 13 designee is limited to authorized purposes and occurs in a 14 manner that protects the confidentiality of the 15 information obtained from the inquiry system, and remains 16 responsible for any breach of confidentiality; and 17 (4) the ultimate decision as to whether or not to 18 prescribe or dispense a controlled substance remains with 19 the prescriber or dispenser. 20 The Prescription Monitoring Program shall send to 21 registered designees information regarding the inquiry system, 22 including instructions on how to log onto the system. 23 (r) The Prescription Monitoring Program shall maintain an 24 Internet website in conjunction with its prescriber and 25 dispenser inquiry system. This website shall include, at a 26 minimum, the following information: HB2046 - 11 - LRB103 05014 RLC 51034 b HB2046- 12 -LRB103 05014 RLC 51034 b HB2046 - 12 - LRB103 05014 RLC 51034 b HB2046 - 12 - LRB103 05014 RLC 51034 b 1 (1) current clinical guidelines developed by health 2 care professional organizations on the prescribing of 3 opioids or other controlled substances as determined by 4 the Advisory Committee; 5 (2) accredited continuing education programs related 6 to prescribing of controlled substances; 7 (3) programs or information developed by health care 8 professionals that may be used to assess patients or help 9 ensure compliance with prescriptions; 10 (4) updates from the Food and Drug Administration, the 11 Centers for Disease Control and Prevention, and other 12 public and private organizations which are relevant to 13 prescribing; 14 (5) relevant medical studies related to prescribing; 15 (6) other information regarding the prescription of 16 controlled substances; and 17 (7) information regarding prescription drug disposal 18 events, including take-back programs or other disposal 19 options or events. 20 The content of the Internet website shall be periodically 21 reviewed by the Prescription Monitoring Program Advisory 22 Committee as set forth in Section 320 and updated in 23 accordance with the recommendation of the advisory committee. 24 (s) The Prescription Monitoring Program shall regularly 25 send electronic updates to the registered users of the 26 Program. The Prescription Monitoring Program Advisory HB2046 - 12 - LRB103 05014 RLC 51034 b HB2046- 13 -LRB103 05014 RLC 51034 b HB2046 - 13 - LRB103 05014 RLC 51034 b HB2046 - 13 - LRB103 05014 RLC 51034 b 1 Committee shall review any communications sent to registered 2 users and also make recommendations for communications as set 3 forth in Section 320. These updates shall include the 4 following information: 5 (1) opportunities for accredited continuing education 6 programs related to prescribing of controlled substances; 7 (2) current clinical guidelines developed by health 8 care professional organizations on the prescribing of 9 opioids or other drugs as determined by the Advisory 10 Committee; 11 (3) programs or information developed by health care 12 professionals that may be used to assess patients or help 13 ensure compliance with prescriptions; 14 (4) updates from the Food and Drug Administration, the 15 Centers for Disease Control and Prevention, and other 16 public and private organizations which are relevant to 17 prescribing; 18 (5) relevant medical studies related to prescribing; 19 (6) other information regarding prescribing of 20 controlled substances; 21 (7) information regarding prescription drug disposal 22 events, including take-back programs or other disposal 23 options or events; and 24 (8) reminders that the Prescription Monitoring Program 25 is a useful clinical tool. 26 (t) Notwithstanding any other provision of this Act, HB2046 - 13 - LRB103 05014 RLC 51034 b HB2046- 14 -LRB103 05014 RLC 51034 b HB2046 - 14 - LRB103 05014 RLC 51034 b HB2046 - 14 - LRB103 05014 RLC 51034 b 1 neither the Prescription Monitoring Program nor any other 2 person shall disclose any information in violation of the 3 restrictions and requirements of paragraph (3.5) of subsection 4 (a) of Section 316 as implemented under Public Act 102-527. 5 (Source: P.A. 102-751, eff. 1-1-23.) HB2046 - 14 - LRB103 05014 RLC 51034 b