SLS 17RS-189 ORIGINAL 2017 Regular Session SENATE BILL NO. 55 BY SENATOR MILLS Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana. HEALTH CARE. Provides relative to prescribers of controlled dangerous substances. (See Act) 1 AN ACT 2 To amend and reenact R.S. 40:973(A) and 978(F) and to enact R.S. 40:978.3, relative to 3 prescribing controlled dangerous substances; to provide for automatic renewal in the 4 prescription monitoring program; to provide for mandated access of the program by 5 prescribers; to provide for exceptions; to provide for continuing education 6 requirements; to provide for rulemaking; to provide for effective dates; and to 7 provide for related matters. 8 Be it enacted by the Legislature of Louisiana: 9 Section 1. R.S. 40:973(A) and 978(F) are hereby amended and reenacted to read as 10 follows: 11 §973. Licensing requirements 12 A.(1) Every person who conducts research with, manufactures, distributes, 13 procures, possesses, prescribes or dispenses any controlled dangerous substance 14 within this state or who proposes to engage in the research of, manufacture, 15 distribution, procurement, possession, prescribing or dispensing of any controlled 16 dangerous substance within this state, shall obtain a controlled dangerous 17 substance license issued by the Board of Pharmacy in accordance with the rules and Page 1 of 5 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 55 SLS 17RS-189 ORIGINAL 1 regulations promulgated by it prior to engaging in such activity. 2 (2) Upon initial application or upon renewal of a controlled dangerous 3 substance license from the Board of Pharmacy, a prescribing practitioner shall 4 automatically and without further action be registered as a participant in the 5 Prescription Monitoring Program established in R.S. 40:1001 et seq. For 6 purposes of this Subsection, a practitioner shall include those with prescription 7 authority for controlled substances in Louisiana, excluding veterinarians. 8 * * * 9 §978. Prescriptions 10 * * * 11 F.(1) A prescriber shall access and review the patient's record in the 12 Prescription Monitoring Program prior to initially prescribing any Schedule II 13 controlled dangerous substance to a patient and shall access the Prescription 14 Monitoring Program and review the patient's record at least every ninety days 15 if the patient's course of treatment continues for more than ninety days for the 16 treatment of non-cancer-related chronic or intractable pain. The requirement 17 established in this Subsection shall not apply in the following instances: 18 (a) The drug is prescribed or administered to a hospice patient or to any 19 other patient who has been diagnosed as terminally ill. 20 (b) The drug is prescribed or administered for the treatment of 21 cancer-related chronic or intractable pain. 22 (c) The drug is ordered or administered to a hospital inpatient. 23 (d) The Prescription Monitoring Program is inaccessible or not 24 functioning properly due to an internal or external electronic issue. However, 25 the prescriber or his delegate must check the Prescription Monitoring Program 26 once electronic accessability has been restored and note the cause for the delay 27 in the patient's chart. 28 (2) The provisions of this Subsection shall be enforced by the health 29 profession licensing board that regulates the prescriber. Each health profession Page 2 of 5 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 55 SLS 17RS-189 ORIGINAL 1 licensing board that regulates prescribers shall promulgate rules and 2 regulations in accordance with the Administrative Procedure Act to comply 3 with the mandate in this Subsection. If a health profession licensing board 4 becomes aware of a prescriber's failure to comply with this Subsection, they 5 shall treat the notification as a complaint against the licensee, but shall not 6 consider such notice as evidence of deviation from standard of care. 7 Section 2. R.S. 40:978.3 is hereby enacted to read as follows: 8 §978.3. Continuing education for the prescribing of controlled substances 9 A. The continuing education requirement established in this Section shall 10 apply to all practitioners with prescriptive authority in Louisiana that have a 11 controlled dangerous substance license in Louisiana. 12 B. Each licensing board that regulates practitioners with prescriptive 13 authority in Louisiana shall establish continuing education requirements as a 14 prerequisite to license renewal. Each board shall develop continuing education 15 criteria, to include drug diversion training, best practice prescribing of 16 controlled substances, appropriate treatment for addiction, and any other 17 matters regarding the prescribing of controlled dangerous substances that are 18 deemed appropriate by the board. Rules and regulations to implement this 19 Section shall be promulgated in accordance with the Administrative Procedure 20 Act. Such rules shall include the following: 21 (1) Each practitioner with prescriptive authority in Louisiana who 22 receives his initial controlled dangerous substance license shall obtain three 23 credit hours of continuing education as a prerequisite to license renewal. 24 (2) Each practitioner with prescriptive authority in Louisiana who has 25 held his controlled dangerous substance license for longer than one year shall 26 obtain three credit hours of continuing education as a prerequisite to license 27 renewal. 28 (3) After a practitioner with prescriptive authority in Louisiana satisfies 29 the requirements in Paragraphs (1) or (2) of this Subsection, he shall thereafter Page 3 of 5 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 55 SLS 17RS-189 ORIGINAL 1 obtain three credit hours of continuing education over the duration of a 2 three-year time period as a prerequisite to license renewal. 3 (4) A practitioner with prescriptive authority in Louisiana who has a 4 controlled dangerous substance license shall be exempt from the continuing 5 education requirements for license renewal established in this Section if he 6 completes and submits to his licensing board a certification form developed by 7 his licensing board attesting that he has not prescribed, administered, or 8 dispensed a controlled dangerous substance during the entire applicable 9 reporting period. The licensing board shall verify the attestation of the 10 prescriber through the Prescription Monitoring Program. 11 C. The licensing board shall provide its members with information on 12 how to access the continuing education courses as required by this Section and 13 shall retain annual compliance documentation that shall be submitted to the 14 Senate and House committees on health and welfare to demonstrate aggregate 15 prescriber compliance. No license shall be renewed for an individual who fails 16 to comply with the provisions of this Section. 17 D. The continuing education hours required by this Section shall be 18 considered among the credit hours required of the prescriber by the licensing 19 board on and after August 1, 2017, and shall not be considered an additional 20 requirement to be met by a prescriber. 21 Section 3. Section 1 of this Act shall become effective upon signature by the 22 governor or, if not signed by the governor, upon expiration of the time for bills to become 23 law without signature by the governor, as provided by Article III, Section 18 of the 24 Constitution of Louisiana. If vetoed by the governor and subsequently approved by the 25 legislature, this Act shall become effective on the day following such approval. 26 Section 4. Section 2 of this Act shall become effective on January 1, 2018. Page 4 of 5 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 55 SLS 17RS-189 ORIGINAL The original instrument and the following digest, which constitutes no part of the legislative instrument, were prepared by Christine Arbo Peck. DIGEST SB 55 Original 2017 Regular Session Mills Present law provides for who must obtain a controlled dangerous substance license in Louisiana. Proposed law clarifies that individuals who conduct research with, procure, possess, or prescribe controlled dangerous substances in Louisiana must also obtain a license to do so in Louisiana prior to engaging in any such activity. Present law provides enrollment access to the Prescription Monitoring Program for prescribing practitioners. Proposed law establishes a process for automatic enrollment into the Prescription Monitoring Program upon initial licensure or upon annual renewal of a prescriber's controlled dangerous substance license. Present law provides for when a prescriber shall access the Prescription Monitoring Program. Proposed law expands the mandate to access the program prior to initially prescribing any Schedule II controlled dangerous substance or if the patient's course of treatment continues for more than 90 days. It further provides for exceptions of when a prescriber does not have to check the program. Proposed law requires all prescribers in Louisiana to obtain three continuing education credit hours as a prerequisite of license renewal in the first annual renewal cycle after January 1, 2018, and three course hours in a three year period prior to subsequent renewals. Continuing education shall be in drug diversion training, best practice prescribing of controlled substances, and appropriate treatment for addiction. Proposed law requires the health profession licensing boards that regulate prescribing practitioners to promulgate rules and regulations to implement the continuing education requirements established by this law, requires the boards to collect and maintain data on compliance and submit aggregate data to the Senate and House committees on health and welfare regarding compliance, and clarifies that these continuing education hours shall be considered among those already required at the time of passage of this law and not be in addition to what is already required. Proposed law provisions relative to licensing requirements and prescription requirements are effective upon signature of the governor or upon lapse of gubernatorial action. Proposed law provisions relative to continuing education are effective January 1, 2018. (Amends R.S. 40:973(A) and 978(F); adds R.S. 40:978.3) Page 5 of 5 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions.