Rhode Island 2025 Regular Session

Rhode Island House Bill H5866 Latest Draft

Bill / Comm Sub Version Filed 04/01/2025

                             
 
 
 
2025 -- H 5866 SUBSTITUTE A 
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LC001584/SUB A 
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S T A T E O F R H O D E I S L A N D 
IN GENERAL ASSEMBLY 
JANUARY SESSION, A.D. 2025 
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A N   A C T 
RELATING TO FOOD AND DRUGS -- UNIFORM CONTROLLED SUBSTANCES A CT 
Introduced By: Representatives McGaw, Boylan, Furtado, Caldwell, Casimiro, Stewart, 
Voas, Fogarty, Solomon, and Cotter 
Date Introduced: February 28, 2025 
Referred To: House Health & Human Services 
 
 
It is enacted by the General Assembly as follows: 
SECTION 1. Section 21-28-3.18 of the General Laws in Chapter 21-28 entitled "Uniform 1 
Controlled Substances Act" is hereby amended to read as follows: 2 
21-28-3.18. Prescriptions. 3 
(a) An apothecary in good faith may sell and dispense controlled substances in schedules 4 
II, III, IV, and V to any person upon a valid prescription by a practitioner licensed by law to 5 
prescribe or administer those substances; dated and signed by the person prescribing on the day 6 
when issued and bearing the full name and address of the patient to whom, or of the owner of the 7 
animal for which, the substance is dispensed; and the full name, address, and registration number 8 
under the federal law of the person prescribing, if he or she is required by that law to be registered. 9 
If the prescription is for an animal, it shall state the species of the animal for which the substance 10 
is prescribed. 11 
(b) When filling a hard-copy prescription for a schedule II controlled substance, the 12 
apothecary filling the prescription shall sign his or her full name and shall write the date of filling 13 
on the face of the prescription. 14 
(c) The prescription shall be retained on file by the proprietor of the pharmacy in which it 15 
was filled for a period of two (2) years so as to be readily accessible for inspection by any public 16 
officer or employee engaged in the enforcement of this chapter. 17 
(d)(1) Hard-copy prescriptions for controlled substances in schedule II shall be filed 18 
separately and shall not be refilled. 19   
 
 
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(2) The director of health shall, after appropriate notice and hearing pursuant to § 42-35-3, 1 
promulgate rules and regulations for the purpose of adopting a system for electronic data 2 
transmission of prescriptions for controlled substances in schedules II, III, IV, and V. Opioid 3 
antagonists, including, but not limited to, naloxone, as may be further determined by rules and 4 
regulations, shall be transmitted with controlled substances in schedules II, III, IV, and V. Provided, 5 
information collected regarding dispensing of opioid antagonists shall be for statistical, research, 6 
or educational purposes only. The department’s rules and regulations shall require the removal of 7 
patient, recipient, or prescriber information that could be used to identify individual patients or 8 
recipients of opioid antagonists. 9 
(3) A practitioner shall sign and transmit electronic prescriptions for controlled substances 10 
in schedules II, III, IV, and V to a pharmacy in accordance with rules and regulations as shall be 11 
promulgated by the department and which shall require electronic transmission no sooner than 12 
January 1, 2020, and a pharmacy may dispense an electronically transmitted prescription for these 13 
controlled substances in accordance with the code of federal regulations, 21 C.F.R., pt. 1300, et 14 
seq. 15 
(e) Subject to the rules and regulations promulgated by the department pursuant to 16 
subsection (d)(3) of this section, a prescription for a schedule II narcotic substance to be 17 
compounded for the direct administration to a patient by parenteral, intravenous, intramuscular, 18 
subcutaneous, or intraspinal infusion may be transmitted by the practitioner, or practitioner’s agent, 19 
to the pharmacy by facsimile. The facsimile will serve as the original prescription. 20 
(f) Subject to the rules and regulations promulgated by the department pursuant to 21 
subsection (d)(3) of this section, a prescription for a schedule II substance for a resident of a long-22 
term-care facility may be transmitted by the practitioner, or the practitioner’s agent, to the 23 
dispensing pharmacy by facsimile. The facsimile serves as the original prescription. 24 
(g) Subject to the rules and regulations promulgated by the department pursuant to 25 
subsection (d)(3) of this section, a prescription for a schedule II narcotic substance for a patient 26 
residing in a hospice certified by Medicare under title XVIII of the Social Security Act, 42 U.S.C. 27 
§ 1395 et seq., or licensed by the state, may be transmitted by the practitioner, or practitioner’s 28 
agent, to the dispensing pharmacy by facsimile. The practitioner, or the practitioner’s agent, will 29 
note on the prescription that the patient is a hospice patient. The facsimile serves as the original, 30 
written prescription. 31 
(h) An apothecary, in lieu of a written prescription, may sell and dispense controlled 32 
substances in schedules III, IV, and V to any person upon an oral prescription of a practitioner. In 33 
issuing an oral prescription, the prescriber shall furnish the apothecary with the same information 34   
 
 
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as is required by subsection (a) of this section and the apothecary who fills the prescription shall 1 
immediately reduce the oral prescription to writing and shall inscribe the information on the written 2 
record of the prescription made. This record shall be filed and preserved by the proprietor of the 3 
pharmacy in which it is filled in accordance with the provisions of subsection (c) of this section. In 4 
no case may a prescription for a controlled substance listed in schedules III, IV, or V be filled or 5 
refilled more than six (6) months after the date on which the prescription was issued and no 6 
prescription shall be authorized to be refilled more than five (5) times. Each refilling shall be 7 
entered on the face or back of the prescription and note the date and amount of controlled substance 8 
dispensed and the initials or identity of the dispensing apothecary. 9 
(i) In the case of an emergency situation as defined in federal law, an apothecary may 10 
dispense a controlled substance listed in schedule II upon receiving an oral authorization of a 11 
prescribing practitioner provided that: 12 
(1) The quantity prescribed and dispensed is limited to the amount adequate to treat the 13 
patient during the emergency period and dispensing beyond the emergency period must be pursuant 14 
to a written prescription signed by the prescribing practitioner. 15 
(2) The prescription shall be immediately reduced to writing and shall contain all the 16 
information required in subsection (a). 17 
(3) The prescription must be dispensed in good faith in the normal course of professional 18 
practice. 19 
(4) Within seven (7) days after authorizing an emergency oral prescription, the prescribing 20 
practitioner shall cause a prescription for the emergency quantity prescribed to be delivered to the 21 
dispensing apothecary. The prescription shall have written on its face “authorization for emergency 22 
dispensing” and the date of the oral order. The prescription, upon receipt by the apothecary, shall 23 
be attached to the oral emergency prescription that had earlier been reduced to writing. 24 
(j)(1) The partial filling of a prescription for a controlled substance listed in schedule II is 25 
permissible, if the apothecary is unable to supply the full quantity called for in a prescription or 26 
emergency oral prescription and he or she makes a notation of the quantity supplied on the face of 27 
the prescription or oral emergency prescription that has been reduced to writing. The remaining 28 
portion of the prescription may be filled within seventy-two (72) hours of the first partial filling, 29 
however, if the remaining portion is not, or cannot be, filled within seventy-two (72) hours, the 30 
apothecary shall notify the prescribing practitioner. No further quantity may be supplied beyond 31 
seventy-two (72) hours without a new prescription. 32 
(2)(i) A prescription for a schedule II controlled substance written for a patient in a long-33 
term-care facility (LTCF), or for a patient with a medical diagnosis documenting a terminal illness, 34   
 
 
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may be filled in partial quantities to include individual dosage units. If there is a question whether 1 
a patient may be classified as having a terminal illness, the pharmacist must contact the practitioner 2 
prior to partially filling the prescription. Both the pharmacist and the prescribing practitioner have 3 
a corresponding responsibility to assure that the controlled substance is for a terminally ill patient. 4 
(ii) The pharmacist must record on the prescription whether the patient is “terminally ill” 5 
or an “LTCF patient.” A prescription that is partially filled, and does not contain the notation 6 
“terminally ill” or “LTCF patient,” shall be deemed to have been filled in violation of this chapter. 7 
(iii) For each partial filling, the dispensing pharmacist shall record on the back of the 8 
prescription (or on another appropriate record, uniformly maintained, and readily retrievable), the: 9 
(A) Date of the partial filling; 10 
(B) Quantity dispensed; 11 
(C) Remaining quantity authorized to be dispensed; and 12 
(D) Identification of the dispensing pharmacist. 13 
(iv) The total quantity of schedule II controlled substances dispensed in all partial fillings 14 
must not exceed the total quantity prescribed. 15 
(v) Schedule II prescriptions for patients in a LTCF, or patients with a medical diagnosis 16 
documenting a terminal illness, are valid for a period not to exceed sixty (60) days from the issue 17 
date, unless sooner terminated by the discontinuance of medication. 18 
(k) Automated data-processing systems. As an alternative to the prescription record-19 
keeping provision of subsection (h) of this section, an automated data-processing system may be 20 
employed for the record-keeping system if the following conditions have been met: 21 
(1) The system shall have the capability of producing sight-readable documents of all 22 
original and refilled prescription information. The term “sight readable” means that an authorized 23 
agent shall be able to examine the record and read the information. During the course of an on-site 24 
inspection, the record may be read from the CRT, microfiche, microfilm, printout, or other method 25 
acceptable to the director. In the case of administrative proceedings, records must be provided in a 26 
paper printout form. 27 
(2) The information shall include, but not be limited to, the prescription requirements and 28 
records of dispensing as indicated in subsection (h) of this section. 29 
(3) The individual pharmacist responsible for completeness and accuracy of the entries to 30 
the system must provide documentation of the fact that prescription information entered into the 31 
computer is correct. In documenting this information, the pharmacy shall have the option to either: 32 
(i) Maintain a bound logbook, or separate file, in which each individual pharmacist 33 
involved in the dispensing shall sign a statement each day attesting to the fact that the prescription 34   
 
 
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information entered into the computer that day has been reviewed and is correct as shown. The 1 
book or file must be maintained at the pharmacy employing that system for a period of at least two 2 
(2) years after the date of last dispensing; or 3 
(ii) Provide a printout of each day’s prescription information. That printout shall be 4 
verified, dated, and signed by the individual pharmacist verifying that the information indicated is 5 
correct. The printout must be maintained at least two (2) years from the date of last dispensing. 6 
(4) An auxiliary, record-keeping system shall be established for the documentation of 7 
refills if the automated data-processing system is inoperative for any reason. The auxiliary system 8 
shall ensure that all refills are authorized by the original prescription and that the maximum number 9 
of refills is not exceeded. When this automated data-processing system is restored to operation, the 10 
information regarding prescriptions filled and refilled during the inoperative period shall be entered 11 
into the automated data-processing system within ninety-six (96) hours. 12 
(5) Any pharmacy using an automated data-processing system must comply with all 13 
applicable state and federal laws and regulations. 14 
(6) A pharmacy shall make arrangements with the supplier of data-processing services or 15 
materials to ensure that the pharmacy continues to have adequate and complete prescription and 16 
dispensing records if the relationship with the supplier terminates for any reason. A pharmacy shall 17 
ensure continuity in the maintenance of records. 18 
(7) The automated data-processing system shall contain adequate safeguards for security 19 
of the records to maintain the confidentiality and accuracy of the prescription information. 20 
Safeguards against unauthorized changes in data after the information has been entered and verified 21 
by the registered pharmacist shall be provided by the system. 22 
(l) Prescriptions for controlled substances as found in schedule II will become void unless 23 
dispensed within ninety (90) days of the original date of the prescription and in no event shall more 24 
than a thirty-day (30) supply be dispensed at any one time, with the exception of prescriptions for 25 
non-opioid, non-narcotic controlled substances found in schedule II, where a sixty-day (60) supply 26 
but in no event more than a sixty-day (60) supply, may be dispensed at any one time. 27 
(1) In prescribing controlled substances in schedule II, practitioners may write up to three 28 
(3) separate prescriptions, each for up to a one-month supply, each signed and dated on the date 29 
written. For those prescriptions for the second and/or third month, the practitioner must write the 30 
earliest date each of those subsequent prescriptions may be filled, with directions to the pharmacist 31 
to fill no earlier than the date specified on the face of the prescription. 32 
(m) The prescriptions in schedules III, IV, and V will become void unless dispensed within 33 
one hundred eighty (180) days of the original date of the prescription. For purposes of this section, 34   
 
 
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a “dosage unit” shall be defined as a single capsule, tablet, or suppository, or not more than one 1 
five (5) ml. of an oral liquid. 2 
(1) Prescriptions in schedule III cannot be written for more than one hundred (100) dosage 3 
units and not more than one hundred (100) dosage units may be dispensed at one time. Provided, 4 
however, manufacturer prepackaged steroids and hormones in schedule III shall be exempt from 5 
this subsection. 6 
(2) Prescriptions in schedules IV and V may be written for up to a ninety-day (90) supply 7 
based on directions. No more than three hundred and sixty (360) dosage units may be dispensed at 8 
one time. 9 
(n) A pharmacy shall transmit prescription information to the prescription-monitoring 10 
database at the department of health within one business day following the dispensing of an opioid 11 
prescription. 12 
(o) The pharmacist shall inform patients verbally or in writing about the proper disposal of 13 
expired, unused, or unwanted medications, including the location of local disposal sites as listed on 14 
the department of health website. 15 
(p) The pharmacist shall inform patients verbally or in writing in the proper use of any 16 
devices necessary for the administration of controlled substances. 17 
(q)(1) A healthcare professional authorized to issue prescriptions shall, prior to issuing an 18 
initial prescription for an opioid drug, specifically discuss with the patient who is eighteen (18) 19 
years of age or older, or the patient’s parent or guardian if the patient is under eighteen (18) years 20 
of age, the risks of developing a dependence or addiction to the prescription opioid drug and 21 
potential of overdose or death; the adverse risks of concurrent use of alcohol or other psychoactive 22 
medications and the patient’s or the minor patient’s parent or guardian’s responsibility to safeguard 23 
all medications; and, if the prescriber deems it appropriate, discuss such alternative treatments as 24 
may be available. For patients in recovery from substance dependence, education shall be focused 25 
on relapse risk factors. This discussion shall be noted in the patient’s record. 26 
(2) The director of the department of health shall develop and make available to prescribers 27 
guidelines for the discussion required pursuant to this subsection. 28 
(3) The discussion required under this subsection shall not be required prior to issuing a 29 
prescription to any patient who is currently receiving hospice care from a licensed hospice. 30 
(r) Effective January 1, 2025, in recognition of the United States Drug Enforcement 31 
Agency (DEA) revised regulations regarding electronic prescription refills permitting DEA 32 
registered pharmacies to transfer electronic prescriptions at a patient’s request, the department of 33 
health shall amend its regulations to reflect this change following the Centers for Medicare and 34   
 
 
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Medicaid’s designation for the standard the pharmacy industry must use to support Medicare 1 
electronic prescribing and related transactions to permit the transfer of electronic prescriptions. 2 
SECTION 2. This act shall take effect upon passage. 3 
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EXPLANATION 
BY THE LEGISLATIVE COUNCIL 
OF 
A N   A C T 
RELATING TO FOOD AND DRUGS -- UNIFORM CONTROLLED SUBSTANCES ACT 
***
This act would increase the maximum fill for non-opioid, non-narcotic controlled 1 
substances found in schedule II, so that a sixty-day (60) supply may be dispensed at any one time. 2 
This act would take effect upon passage. 3 
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LC001584/SUB A 
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