Bill Text: NJ S2795 | 2016-2017 | Regular Session | Amended


Bill Title: Provides Commissioner of Human Services and certain insurers access to Prescription Monitoring Program.*

Spectrum: Partisan Bill (Democrat 3-0)

Status: (Engrossed) 2017-06-26 - Received in the Assembly, Referred to Assembly Health and Senior Services Committee [S2795 Detail]

Download: New_Jersey-2016-S2795-Amended.html

[First Reprint]

SENATE, No. 2795

STATE OF NEW JERSEY

217th LEGISLATURE

INTRODUCED NOVEMBER 21, 2016

 


 

Sponsored by:

Senator  PATRICK J. DIEGNAN, JR.

District 18 (Middlesex)

 

Co-Sponsored by:

Senators Gordon and Vitale

 

 

 

 

SYNOPSIS

      Provides Commissioner of Human Services and certain insurers access to Prescription Monitoring Program.

 

CURRENT VERSION OF TEXT

     As amended by the Senate on May 25, 2017.

 


An Act concerning the Prescription Monitoring Program and amending P.L.2007, c.244.

 

     Be It Enacted by the Senate and General Assembly of the State of New Jersey:

 

      1.   Section 26 of P.L.2007, c.244 (C.45:1-46) is amended to read as follows:

      26.  Access to prescription information. 

      a.   The division shall maintain procedures to ensure privacy and confidentiality of patients and that patient information collected, recorded, transmitted, and maintained is not disclosed, except as permitted in this section, including, but not limited to, the use of a password-protected system for maintaining this information and permitting access thereto as authorized under sections 25 through 30 of P.L.2007, c.244 (C.45:1-45 through C.45:1-50), and a requirement that a person as listed in subsection h. or i. of this section provide affirmation of the person's intent to comply with the provisions of sections 25 through 30 of P.L.2007, c.244 (C.45:1-45 through C.45:1-50) as a condition of accessing the information.

      b.   The prescription monitoring information submitted to the division shall be confidential and not be subject to public disclosure under P.L.1963, c.73 (C.47:1A-1 et seq.), or P.L.2001, c.404 (C.47:1A-5 et al.).

      c.   The division shall review the prescription monitoring information provided by a pharmacy permit holder pursuant to sections 25 through 30 of P.L.2007, c.244 (C.45:1-45 through C.45:1-50).  The review shall include, but not be limited to:

      (1)  a review to identify whether any person is obtaining a prescription in a manner that may be indicative of misuse, abuse, or diversion of a controlled dangerous substance.  The director shall establish guidelines regarding the terms "misuse," "abuse," and "diversion" for the purposes of this review.  When an evaluation of the information indicates that a person may be obtaining a prescription for the same or a similar controlled dangerous substance from multiple practitioners or pharmacists during the same time period, the division may provide prescription monitoring information about the person to practitioners and pharmacists; and

      (2)  a review to identify whether a violation of law or regulation or a breach of the applicable standards of practice by any person may have occurred, including, but not limited to, diversion of a controlled dangerous substance.  If the division determines that such a violation or breach may have occurred, the division shall notify the appropriate law enforcement agency or professional licensing board, and provide the prescription monitoring information required for an investigation.

      d.   (Deleted by amendment, P.L.2015, c.74)

      e.   (Deleted by amendment, P.L.2015, c.74)

      f.    (Deleted by amendment, P.L.2015, c.74)

      g.   (Deleted by amendment, P.L.2015, c.74)

      h.   (1) The division shall register a practitioner to access prescription monitoring information upon issuance or renewal of the practitioner's CDS registration.

      (2)  The division shall provide to a pharmacist who is employed by a current pharmacy permit holder online access to prescription monitoring information for the purpose of providing health care to a current patient or verifying information with respect to a patient or a prescriber.

      (3)  The division shall provide to a practitioner who has a current CDS registration online access to prescription monitoring information for the purpose of providing health care to a current patient or verifying information with respect to a patient or a prescriber.  The division shall also grant online access to prescription monitoring information to as many licensed health care professionals as are authorized by a practitioner to access that information and for whom the practitioner is responsible for the use or misuse of that information, subject to a limit on the number of such health care professionals as deemed appropriate by the division for that particular type and size of professional practice, in order to minimize the burden to practitioners to the extent practicable while protecting the confidentiality of the prescription monitoring information obtained.  The director shall establish, by regulation, the terms and conditions under which a practitioner may delegate that authorization, including procedures for authorization and termination of authorization, provisions for maintaining confidentiality, and such other matters as the division may deem appropriate.

      (4)  The division shall provide online access to prescription monitoring information to as many medical or dental residents as are authorized by a faculty member of a medical or dental teaching facility to access that information and for whom the practitioner is responsible for the use or misuse of that information.  The director shall establish, by regulation, the terms and conditions under which a faculty member of a medical or dental teaching facility may delegate that authorization, including procedures for authorization and termination of authorization, provisions for maintaining confidentiality, provisions regarding the duration of a medical or dental resident's authorization to access prescription monitoring information, and such other matters as the division may deem appropriate.

      (5)  The division shall provide online access to prescription monitoring information to as many certified medical assistants as are authorized by a practitioner to access that information and for whom the practitioner is responsible for the use or misuse of that information.  The director shall establish, by regulation, the terms and conditions under which a practitioner may delegate that authorization, including procedures for authorization and termination of authorization, provisions for maintaining confidentiality, provisions regarding the duration of a certified medical assistant's authorization to access prescription monitoring information, and such other matters as the division may deem appropriate.

      (6)  The division shall provide online access to prescription monitoring information to as many registered dental assistants as are authorized by a licensed dentist to access that information and for whom the licensed dentist is responsible for the use or misuse of that information.  The director shall establish, by regulation, the terms and conditions under which a licensed dentist may delegate that authorization, including procedures for authorization and termination of authorization, provisions for maintaining confidentiality, provisions regarding the duration of a registered dental assistant's authorization to access prescription monitoring information, and such other matters as the division may deem appropriate.

      (7)  1[The division shall provide online access to prescription monitoring information to a designated representative of a carrier, as defined in section 2 of P.L.1997, c.192 (C.26:2S-2), that provides coverage for prescription drugs and any third-party administrator or pharmacy benefit manager that administers a pharmacy benefit, and to the Director of the Division of Medical Assistance and Health Services and the Commissioner of Human Services, or their designees, for the purpose of identifying whether a recipient of benefits under the Medicaid program, established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.) or the NJ FamilyCare program, established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.), or any other person, as applicable, is obtaining a prescription in a manner that may be indicative of misuse, abuse, or diversion of a controlled dangerous substance, as provided for in paragraph (1) of subsection c. of this section, or of a violation of law or regulation or a breach of an applicable standard of practice, as provided for in paragraph (2) of subsection c. of this section.

      (8)]1  A person listed in this subsection, as a condition of accessing prescription monitoring information pursuant thereto, shall certify that the request is for the purpose of providing health care to a current patient or verifying information with respect to a patient or practitioner.  Such certification shall be furnished through means of an online statement or alternate means authorized by the director, in a form and manner prescribed by rule or regulation adopted by the director.

      i.    The division may provide online access to prescription monitoring information, or may provide access to prescription monitoring information through any other means deemed appropriate by the director, to the following persons:

      (1)  authorized personnel of the division or a vendor or contractor responsible for maintaining the Prescription Monitoring Program;

      (2)  authorized personnel of the division responsible for administration of the provisions of P.L.1970, c.226 (C.24:21-1 et seq.);

      (3)  the State Medical Examiner, a county medical examiner, a deputy or assistant county medical examiner, or a qualified designated assistant thereof, who certifies that the request is for the purpose of investigating a death pursuant to P.L.1967, c.234 (C.52:17B-78 et seq.);

      (4)  a controlled dangerous substance monitoring program in another state with which the division has established an interoperability agreement, or which participates with the division in a system that facilitates the secure sharing of information between states;

      (5)  a designated representative of the State Board of Medical Examiners, New Jersey State Board of Dentistry, State Board of Nursing, New Jersey State Board of Optometrists, State Board of Pharmacy, State Board of Veterinary Medical Examiners, or any other board in this State or another state that regulates the practice of persons who are authorized to prescribe or dispense controlled dangerous substances, as applicable, who certifies that the representative is engaged in a bona fide specific investigation of a designated practitioner or pharmacist whose professional practice was or is regulated by that board;

      (6)  a State, federal, or municipal law enforcement officer who is acting pursuant to a court order and certifies that the officer is engaged in a bona fide specific investigation of a designated practitioner, pharmacist, or patient. A law enforcement agency that obtains prescription monitoring information shall comply with security protocols established by the director by regulation;

      (7)  a designated representative of a state Medicaid or other program who certifies that the representative is engaged in a bona fide investigation of a designated practitioner, pharmacist, or patient;

      (8)  a properly convened grand jury pursuant to a subpoena properly issued for the records; 1[and]1

      (9)  a licensed mental health practitioner providing treatment for substance abuse to patients at a residential or outpatient substance abuse treatment center licensed by 1[the Division of Mental Health and Addiction Services in]1 the Department of Human Services, who certifies that the request is for the purpose of providing health care to a current patient or verifying information with respect to a patient or practitioner, and who furnishes the division with the written consent of the patient for the mental health practitioner to obtain prescription monitoring information about the patient.  The director shall establish, by regulation, the terms and conditions under which a mental health practitioner may request and receive prescription monitoring information.  Nothing in sections 25 through 30 of P.L.2007, c.244 (C.45:1-45 through C.45:1-50) shall be construed to require or obligate a mental health practitioner to access or check the prescription monitoring information in the course of treatment beyond that which may be required as part of the mental health practitioner's professional practice 1; or

      (10)  a carrier, as defined in section 2 of P.L.1997, c.192 (C.26:2S-2), that provides coverage for prescription drugs, a third-party administrator or pharmacy benefit manager that administers a pharmacy benefit, or the Commissioner of Human Services, or a designee, provided that:

      (a)  the information is requested for the sole purpose of identifying whether an individual who is covered by a pharmacy benefit administered by the requestor has obtained a prescription in a manner that may be indicative of misuse, abuse, or diversion of a controlled dangerous substance, as provided for in paragraph (1) of subsection c. of this section, or of a violation of law or regulation or a breach of an applicable standard of practice, as provided for in paragraph (2) of subsection c. of this section;

      (b)  the information provided concerns only the period of time in which the requesting carrier, third-party administrator, pharmacy benefit manager, or State program was providing a pharmacy benefit to the individual whose information is requested, and only the specific prescription drugs that were eligible for coverage under the benefit in which the individual was enrolled; and

      (c)  if the requestor is a carrier, third-party administrator, or pharmacy benefit manager, the requestor certifies that all of its activities involving sharing of health information are governed by contracts that are fully compliant with the federal HIPAA requirements under 42 CFR Parts 160 and 1641.

      j.    A person listed in subsection i. of this section, as a condition of obtaining prescription monitoring information pursuant thereto, shall certify the reasons for seeking to obtain that information.  1If the requestor is a carrier, third-party administrator, or pharmacy benefit manager, the requestor shall additionally certify that information shall not be used to evaluate or change coverage, payment policies, provider networks, or any other elements of product design.1  Such certification shall be furnished through means of an online statement or alternate means authorized by the director, in a form and manner prescribed by rule or regulation adopted by the director.

      k.   The division shall offer an online tutorial for those persons listed in subsections h. and i. of this section, which shall, at a minimum, include:  how to access prescription monitoring information; the rights of persons who are the subject of this information; the responsibilities of persons who access this information; a summary of the other provisions of sections 25 through 30 of P.L.2007, c.244 (C.45:1-45 through C.45:1-50) and the regulations adopted pursuant thereto, regarding the permitted uses of that information and penalties for violations thereof; and a summary of the requirements of the federal health privacy rule set forth at 45 CFR Parts 160 and 164 and a hypertext link to the federal Department of Health and Human Services website for further information about the specific provisions of the privacy rule.

      l.    The division may request and receive prescription monitoring information from prescription monitoring programs in other states and may use that information for the purposes of sections 25 through 30 of P.L.2007, c.244 (C.45:1-45 through C.45:1-50).  When sharing data with programs in another state, the division shall not be required to obtain a memorandum of understanding unless required by the other state.

      m.  The director may provide nonidentifying prescription drug monitoring information to public or private entities for statistical, research, or educational purposes, in accordance with the provisions of sections 25 through 30 of P.L.2007, c.244 (C.45:1-45 through C.45:1-50).

      n.   Nothing shall be construed to prohibit the division from obtaining unsolicited automated reports from the program or disseminating such reports to pharmacists, practitioners, mental health care practitioners, and other licensed health care professionals.

      o. (1) A current patient of a practitioner may request from that practitioner that patient's own prescription monitoring information that has been submitted to the division pursuant to sections 25 through 30 of P.L.2007, c.244 (C.45:1-45 through C.45:1-50).  A parent or legal guardian of a child who is a current patient of a practitioner may request from that practitioner the child's prescription monitoring information that has been submitted to the division pursuant to sections 25 through 30 of P.L.2007, c.244 (C.45:1-45 through C.45:1-50).

      (2)  Upon receipt of a request pursuant to paragraph (1) of this subsection, a practitioner or health care professional authorized by that practitioner may provide the current patient or parent or legal guardian, as the case may be, with access to or a copy of the prescription monitoring information pertaining to that patient or child.

      (3)  The division shall establish a process by which a patient, or the parent or legal guardian of a child who is a patient, may request a pharmacy permit holder that submitted prescription monitoring information concerning a prescription for controlled dangerous substances for that patient or child to the division pursuant to sections 25 through 30 of P.L.2007, c.244 (C.45:1-45 through C.45:1-50) to correct information that the person believes to have been inaccurately entered into that patient's or child's prescription profile.  Upon confirmation of the inaccuracy of any such entry into a patient's or child's prescription profile, the pharmacy permit holder shall be authorized to correct any such inaccuracies by submitting corrected information to the division pursuant to sections 25 through 30 of P.L.2007, c.244 (C.45:1-45 through C.45:1-50).  The process shall provide for review by the Board of Pharmacy of any disputed request for correction, which determination shall be appealable to the director.

      p.   The division shall take steps to ensure that appropriate channels of communication exist to enable any licensed health care professional, licensed pharmacist, mental health practitioner, pharmacy permit holder, or other practitioner who has online access to the Prescription Monitoring Program pursuant to this section  to seek or provide information to the division related to the provisions of this section.

(cf:  P.L.2015, c.74, s.4)

 

     2.    This act shall take effect on the first day of the fourth month next following the date of enactment.

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