Bill Text: CA AB1998 | 2017-2018 | Regular Session | Introduced


Bill Title: Opioids: prescription limitations.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2018-02-12 - Referred to Coms. on HEALTH and B. & P. [AB1998 Detail]

Download: California-2017-AB1998-Introduced.html


CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Assembly Bill No. 1998


Introduced by Assembly Member Rodriguez

February 01, 2018


An act to amend Sections 11158 and 11190 of, and to add Section 11154.5 to, the Health and Safety Code, relating to controlled substances.


LEGISLATIVE COUNSEL'S DIGEST


AB 1998, as introduced, Rodriguez. Opioids: prescription limitations.
Existing law, the Uniform Controlled Substances Act, classifies opioids as Schedule II controlled substances and places restrictions on the prescription of those drugs, including prohibiting refills and specifying the requirements of a prescription for these drugs. Under existing law a practitioner may dispense directly to an ultimate user a Schedule II controlled substance in an amount not to exceed a 72-hour supply when the patient is not expected to require any additional amount of the controlled substance beyond the 72 hours. Violation of these provisions is a misdemeanor.
This bill would prohibit a practitioner from prescribing an opioid in an amount greater that the patient needs for a 3-day period unless the practitioner believes, in his or her professional judgment, that a larger prescription is needed to treat a medical condition or that a larger prescription is necessary for the treatment of chronic pain. The bill would require a practitioner who writes a prescription for an opioid that is either larger than the 3-day supply or that is the 4th prescription without the dosage decreasing to include in the patient’s record why the excess or additional prescription was needed, what other medications were considered, the patient’s injury or illness, and the milligram dosage of the prescription. The bill would require the practitioner to take specified actions prior to prescribing an opioid, including informing the patient of the risks and treatment options for opioid addiction. By creating new crimes, this bill would impose a state-mandated local program.
The bill would remove the ability of a practitioner to dispense a 72-hour supply of a Schedule II controlled substance directly to the patient when the patient is not expected to require any additional amount of the controlled substance beyond the 72 hours.
Existing law imposes reporting requirements on practitioners prescribing Schedule II controlled substances and makes a violation of those reporting requirements a misdemeanor.
This bill would require, when a prescription is for an amount larger than that needed for 3 days or when the prescription is the 4th prescription without the dosage decreasing, the practitioner to report, in detail, why the excess or additional prescription was needed, what other medications were considered, the patient’s injury or illness, and the milligram dosage of the prescription. The bill would also require a practitioner who fails to submit the report required to be referred to the appropriate licensing board for administrative action, as deemed appropriate by that board. By creating a new crime, this bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: YES  

The people of the State of California do enact as follows:


SECTION 1.

 Section 11154.5 is added to the Health and Safety Code, to read:

11154.5.
 (a) A practitioner shall not prescribe an opioid listed in subdivision (b) or (c) of Section 11055 in an amount greater that the patient needs for a three-day period unless the practitioner believes, in his or her professional judgment, that a larger prescription is needed to treat a medical condition or that a larger prescription is necessary for the treatment of chronic pain. If a prescription is written for more than a three-day supply, the practitioner shall include in the patient’s record, in detail, why the excess prescription was needed, what other medications were considered, the patient’s injury or illness, and the milligram dosage of the prescription.
(b) When a practitioner writes a fourth prescription for an opioid listed in subdivision (b) or (c) of Section 11055 where the dosage of the prescription has not decreased, the practitioner shall include in the patient’s record, in detail, why the additional prescription is needed, what other medications were considered, the patient’s injury or illness, and the milligram dosage of the prescription.
(c) Prior to prescribing an opioid listed in subdivision (b) or (c) of Section 11055, a practitioner shall do all of the following:
(1) Consult with the patient regarding the quantity of the prescription and the option for a partial fill pursuant to Section 4052.10 of the Business and Professions Code.
(2) Inform the patient of the risks of opioid addiction and overdose.
(3) Inform the patient of the treatment options for opioid addiction, including medication-assisted therapy.
(4) Offer the patient a referral to psychological counseling and behavioral therapy.
(d) This section shall not apply to a patient with a cancer diagnosis or who is in hospice care.

SEC. 2.

 Section 11158 of the Health and Safety Code is amended to read:

11158.
 (a)  Except as provided in Section 11159 or in subdivision (b) of this section, no 11159, a controlled substance classified in Schedule II shall not be dispensed without a prescription meeting the requirements of this chapter. Except as provided in Section 11159 or when dispensed directly to an ultimate user by a practitioner, other than a pharmacist or pharmacy, no a controlled substance classified in Schedule III, IV, or V may shall not be dispensed without a prescription meeting the requirements of this chapter.

(b) A practitioner specified in Section 11150 may dispense directly to an ultimate user a controlled substance classified in Schedule II in an amount not to exceed a 72-hour supply for the patient in accordance with directions for use given by the dispensing practitioner only where the patient is not expected to require any additional amount of the controlled substance beyond the 72 hours. Practitioners dispensing drugs pursuant to this subdivision shall meet the requirements of subdivision (f) of Section 11164.

(c)

(b) Except as otherwise prohibited or limited by law, a practitioner specified in Section 11150, may administer controlled substances in the regular practice of his or her profession.

SEC. 3.

 Section 11190 of the Health and Safety Code is amended to read:

11190.
 (a)  Every practitioner, other than a pharmacist, who prescribes or administers a controlled substance classified in Schedule II shall make a record that, as to the transaction, shows all of the following:
(1) The name and address of the patient.
(2) The date.
(3) The character, including the name and name, strength, and quantity of controlled substances involved.
(b) The prescriber’s practitioner’s record shall show the pathology and purpose for which the controlled substance was administered or prescribed.
(c) (1)  For each prescription for a Schedule II, Schedule III, or Schedule IV controlled substance that is dispensed by a prescriber pursuant to Section 4170 of the Business and Professions Code, the prescriber shall record and maintain the following information:
(A) Full name, address, and the telephone number of the ultimate user or research subject, or contact information as determined by the Secretary of the United States Department of Health and Human Services, and the gender, gender and date of birth of the patient.
(B) The prescriber’s category of licensure and license number; federal controlled substance registration number; and the state medical license number of any prescriber using the federal controlled substance registration number of a government-exempt facility.
(C) NDC (National Drug Code) number of the controlled substance dispensed.
(D) Quantity of the controlled substance dispensed.
(E) ICD-9 (diagnosis code), if available.
(F) Number of refills ordered.
(G) Whether the drug was dispensed as a refill of a prescription or as a first-time request.
(H) Date of origin of the prescription.
(2) (A) Each prescriber practitioner that dispenses controlled substances shall provide the Department of Justice the information required by this subdivision on a weekly basis in a format set by the Department of Justice pursuant to regulation.
(B) The reporting requirement in this section shall not apply to the direct administration of a controlled substance to the body of an ultimate user.

(d)This section shall become operative on January 1, 2005.

(d) (1) For an opioid listed in subdivision (b) or (c) of Section 11055, when a prescription is for an amount larger than that needed for three days or when the prescription is the fourth prescription without the dosage decreasing, the practitioner shall report, in detail, why the longer or additional prescription was needed, what other medications were considered, the patient’s injury or illness, and the milligram dosage of the prescription.
(2) In addition to the penalties authorized by Section 11191, a practitioner who fails to submit the report required pursuant to this subdivision shall be referred to the appropriate licensing board for administrative action, as deemed appropriate by that board.
(e) The reporting requirement in this section for Schedule IV controlled substances shall not apply to any of the following:
(1) The dispensing of a controlled substance in a quantity limited to an amount adequate to treat the ultimate user involved for 48 hours or less.
(2) The administration or dispensing of a controlled substance in accordance with any other exclusion identified by the United States Health and Human Service Secretary for the National All Schedules Prescription Electronic Reporting Act of 2005.
(f) Notwithstanding paragraph (2) of subdivision (c), the reporting requirement of the information required by this section for a Schedule II or Schedule III controlled substance, in a format set by the Department of Justice pursuant to regulation, shall be on a monthly basis for all of the following:
(1) The dispensing of a controlled substance in a quantity limited to an amount adequate to treat the ultimate user involved for 48 hours or less.
(2) The administration or dispensing of a controlled substance in accordance with any other exclusion identified by the United States Health and Human Service Secretary for the National All Schedules Prescription Electronic Reporting Act of 2005.

SEC. 4.

 No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.
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