Rep. Norm Thurston — Voting Record

Bill

Number

H.B. 177 (2020GS)

Sponsor

Rep. Harrison, S.

Final action

Governor Signed 3/24/2020

Outcome

Became law — signed by Gov. Gary R. Herbert

Summary

What it does

• This bill:
• requires, with some exceptions, that prescriptions for controlled substances be issued electronically;
• authorizes the division to create rules for certain aspects of prescribing controlled substances;
• amends the protocol for the dispensing of drugs by practitioners in the emergency room; and
• repeals Title 58, Chapter 82, Electronic Prescribing Act.

Every vote on this bill

Bill text

PRESCRIPTION REVISIONS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Suzanne Harrison
Senate Sponsor: 
Evan J. Vickers
Cosponsors:
Cheryl K. Acton
Joel K. Briscoe
Marsha Judkins
Steve Waldrip
LONG TITLE
General Description:
This bill amends provisions relating to prescriptions for controlled substances.
Highlighted Provisions:
This bill:
▸ requires, with some exceptions, that prescriptions for controlled substances be
issued electronically;
▸ authorizes the division to create rules for certain aspects of prescribing controlled
substances;
▸ amends the protocol for the dispensing of drugs by practitioners in the emergency
room; and
▸ repeals Title 58, Chapter 82, Electronic Prescribing Act.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
58-17b-610.5
, as last amended by Laws of Utah 2016, Chapter 238
58-37-6
, as last amended by Laws of Utah 2018, Chapter 318
REPEALS:
58-82-101
, as enacted by Laws of Utah 2009, Chapter 47
58-82-102
, as last amended by Laws of Utah 2010, Chapter 276
58-82-201
, as last amended by Laws of Utah 2012, Chapter 160
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
58-17b-610.5
 is amended to read:
58-17b-610.5.
Dispensing in emergency department -- Patient's immediate need.
(1) As used in this section, "controlled substance" means a substance classified as a
controlled substance by the federal Controlled Substances Act, Title II, Pub. L. No. 91-513 et
seq., or by Chapter 37, Utah Controlled Substances Act.
[
(1)
] 
(2)
 The division shall adopt administrative rules in accordance with Title 63G,
Chapter 3, Utah Administrative Rulemaking Act, in consultation with hospital pharmacies and
the boards of practitioners authorized to prescribe prescription drugs to establish guidelines
under which a practitioner may dispense prescription drugs to a patient in a hospital emergency
department if:
(a) the hospital pharmacy is closed;
(b) in the professional judgment of the practitioner, dispensing the drug is necessary for
the patient's immediate needs; [
and
]
(c) dispensing the prescription drug meets protocols established by the hospital
pharmacy[
.
]
; and
(d) the practitioner dispenses only a sufficient amount of the prescription drug as
necessary to last until a pharmacy can fill the prescription.
[
(2)
] 
(3)
 A practitioner in an emergency department may dispense a prescription drug
in accordance with Subsection [
(1)
] 
(2)
.
(4) Under Subsection (2), a practitioner may not dispense more than a two-day supply
of a controlled substance.
Section 2. Section 
58-37-6
 is amended to read:
58-37-6.
License to manufacture, produce, distribute, dispense, administer, or
conduct research -- Issuance by division -- Denial, suspension, or revocation -- Records
required -- Prescriptions.
(1) (a) The division may adopt rules relating to the licensing and control of the
manufacture, distribution, production, prescription, administration, dispensing, conducting of
research with, and performing of laboratory analysis upon controlled substances within this
state.
(b) The division may assess reasonable fees to defray the cost of issuing original and
renewal licenses under this chapter pursuant to Section 
63J-1-504
.
(2) (a) (i) Every person who manufactures, produces, distributes, prescribes, dispenses,
administers, conducts research with, or performs laboratory analysis upon any controlled
substance in Schedules I through V within this state, or who proposes to engage in
manufacturing, producing, distributing, prescribing, dispensing, administering, conducting
research with, or performing laboratory analysis upon controlled substances included in
Schedules I through V within this state shall obtain a license issued by the division.
(ii) The division shall issue each license under this chapter in accordance with a
two-year renewal cycle established by rule. The division may by rule extend or shorten a
renewal period by as much as one year to stagger the renewal cycles it administers.
(b) Persons licensed to manufacture, produce, distribute, prescribe, dispense,
administer, conduct research with, or perform laboratory analysis upon controlled substances in
Schedules I through V within this state may possess, manufacture, produce, distribute,
prescribe, dispense, administer, conduct research with, or perform laboratory analysis upon
those substances to the extent authorized by their license and in conformity with this chapter.
(c) The following persons are not required to obtain a license and may lawfully possess
controlled substances included in Schedules II through V under this section:
(i) an agent or employee, except a sales representative, of any registered manufacturer,
distributor, or dispenser of any controlled substance, if the agent or employee is acting in the
usual course of the [
person's
] 
agent or employee's
 business or employment; however, nothing
in this subsection shall be interpreted to permit an agent, employee, sales representative, or
detail man to maintain an inventory of controlled substances separate from the location of the
person's employer's registered and licensed place of business;
(ii) a motor carrier or warehouseman, or an employee of a motor carrier or
warehouseman, who possesses [
any
] 
a
 controlled substance in the usual course of the person's
business or employment; and
(iii) an ultimate user, or [
any
] 
a
 person who possesses any controlled substance
pursuant to a lawful order of a practitioner.
(d) The division may enact rules waiving the license requirement for certain
manufacturers, producers, distributors, prescribers, dispensers, administrators, research
practitioners, or laboratories performing analysis if 
waiving the license requirement is
consistent with [
the
] public health and safety.
(e) A separate license is required at each principal place of business or professional
practice where the applicant manufactures, produces, distributes, dispenses, conducts research
with, or performs laboratory analysis upon controlled substances.
(f) The division may enact rules providing for the inspection of a licensee or applicant's
establishment, and may inspect the establishment according to those rules.
(3) (a) (i) Upon proper application, the division shall license a qualified applicant to
manufacture, produce, distribute, conduct research with, or perform laboratory analysis upon
controlled substances included in Schedules I through V, unless it determines that issuance of a
license is inconsistent with the public interest.
(ii) The division may not issue a license to any person to prescribe, dispense, or
administer a Schedule I controlled substance except under Subsection (3)(a)(i).
(iii) In determining public interest under this Subsection (3)(a), the division shall
consider whether [
or not
] the applicant has:
(A) maintained effective controls against diversion of controlled substances and any
Schedule I or II substance compounded from any controlled substance into 
channels
 other than
legitimate medical, scientific, or industrial channels;
(B) complied with applicable state and local law;
(C) been convicted under federal or state laws relating to the manufacture, distribution,
or dispensing of substances;
(D) past experience in the manufacture of controlled dangerous substances;
(E) established effective controls against diversion; and
(F) complied with any other factors that the division establishes that promote the public
health and safety.
(b) Licenses granted under Subsection (3)(a) do not entitle a licensee to manufacture,
produce, distribute, conduct research with, or perform laboratory analysis upon controlled
substances in Schedule I other than those specified in the license.
(c) (i) Practitioners shall be licensed to administer, dispense, or conduct research with
substances in Schedules II through V if they are authorized to administer, dispense, or conduct
research under the laws of this state.
(ii) The division need not require a separate license for practitioners engaging in
research with nonnarcotic controlled substances in Schedules II through V where the licensee is
already licensed under this chapter in another capacity.
(iii) With respect to research involving narcotic substances in Schedules II through V,
or where the division by rule requires a separate license for research of nonnarcotic substances
in Schedules II through V, a practitioner shall apply to the division prior to conducting
research.
(iv) Licensing for purposes of bona fide research with controlled substances by a
practitioner considered qualified may be denied only on a ground specified in Subsection (4),
or upon evidence that the applicant will abuse or unlawfully transfer or fail to safeguard
adequately the practitioner's supply of substances against diversion from medical or scientific
use.
(v) Practitioners registered under federal law to conduct research in Schedule I
substances may conduct research in Schedule I substances within this state upon [
furnishing
]
providing
 the division 
with
 evidence of federal registration.
(d) Compliance by manufacturers, producers, and distributors with the provisions of
federal law respecting registration, excluding fees, entitles them to be licensed under this
chapter.
(e) The division shall initially license those persons who own or operate an
establishment engaged in the manufacture, production, distribution, dispensation, or
administration of controlled substances prior to April 3, 1980, and who are licensed by the
state.
(4) (a) Any license 
issued
 pursuant to Subsection (2) or (3) may be denied, suspended,
placed on probation, or revoked by the division upon finding that the applicant or licensee has:
(i) materially falsified any application filed or required pursuant to this chapter;
(ii) been convicted of an offense under this chapter or any law of the United States, or
any state, relating to any substance defined as a controlled substance;
(iii) been convicted of a felony under any other law of the United States or any state
within five years of the date of the issuance of the license;
(iv) had a federal registration or license denied, suspended, or revoked by competent
federal authority and is no longer authorized to manufacture, distribute, prescribe, or dispense
controlled substances;
(v) had the licensee's license suspended or revoked by competent authority of another
state for violation of laws or regulations comparable to those of this state relating to the
manufacture, distribution, or dispensing of controlled substances;
(vi) violated any division rule that reflects adversely on the licensee's reliability and
integrity with respect to controlled substances;
(vii) refused inspection of records required to be maintained under this chapter by a
person authorized to inspect them; or
(viii) prescribed, dispensed, administered, or injected an anabolic steroid for the
purpose of manipulating human hormonal structure so as to:
(A) increase muscle mass, strength, or weight without medical necessity and without a
written prescription by any practitioner in the course of the practitioner's professional practice;
or
(B) improve performance in any form of human exercise, sport, or game.
(b) The division may limit revocation or suspension of a license to a particular
controlled substance with respect to which grounds for revocation or suspension exist.
(c) (i) Proceedings to deny, revoke, or suspend a license shall be conducted pursuant to
this section and in accordance with the procedures set forth in Title 58, Chapter 1, Division of
Occupational and Professional Licensing Act, and conducted in conjunction with the
appropriate representative committee designated by the director of the department.
(ii) Nothing in this Subsection (4)(c) gives the Division of Occupational and
Professional Licensing exclusive authority in proceedings to deny, revoke, or suspend licenses,
except where the division is designated by law to perform those functions, or, when not
designated by law, is designated by the executive director of the Department of Commerce to
conduct the proceedings.
(d) (i) The division may suspend any license simultaneously with the institution of
proceedings under this section if it finds there is an imminent danger to the public health or
safety.
(ii) Suspension shall continue in effect until the conclusion of proceedings, including
judicial review, unless withdrawn by the division or dissolved by a court of competent
jurisdiction.
(e) (i) If a license is suspended or revoked under this Subsection (4), all controlled
substances owned or possessed by the licensee may be placed under seal in the discretion of the
division.
(ii) Disposition may not be made of substances under seal until the time for taking an
appeal has lapsed, or until all appeals have been concluded, unless a court, upon application,
orders the sale of perishable substances and the proceeds deposited with the court.
(iii) If a revocation order becomes final, all controlled substances shall be forfeited.
(f) The division shall notify promptly the Drug Enforcement Administration of all
orders suspending or revoking a license and all forfeitures of controlled substances.
(g) If an individual's Drug Enforcement Administration registration is denied, revoked,
surrendered, or suspended, the division shall immediately suspend the individual's controlled
substance license, which shall only be reinstated by the division upon reinstatement of the
federal registration, unless the division has taken further administrative action under
Subsection (4)(a)(iv), which would be grounds for the continued denial of the controlled
substance license.
(5) (a) [
Persons
] 
A person
 licensed under Subsection (2) or (3) shall maintain records
and inventories in conformance with the record keeping and inventory requirements of federal
and state law and any additional rules issued by the division.
(b) (i) [
Every
] 
A
 physician, dentist, naturopathic physician, veterinarian, practitioner,
or other [
person
] 
individual
 who is authorized to administer or professionally use a controlled
substance shall keep a record of the drugs received by [
him
] 
the individual
 and a record of all
drugs administered, dispensed, or professionally used by [
him
] 
the individual
 otherwise than by
a prescription.
(ii) [
A person
] 
An individual
 using small quantities or solutions or other preparations
of those drugs for local application has complied with this Subsection (5)(b) if the [
person
]
individual
 keeps a record of the quantity, character, and potency of those solutions or
preparations purchased or prepared by [
him
] 
the individual
, and of the dates when purchased or
prepared.
(6) Controlled substances in Schedules I through V may be distributed only by a
licensee and pursuant to an order form prepared in compliance with division rules or a lawful
order under the rules and regulations of the United States.
(7) (a) [
A person
] 
An individual
 may not write or authorize a prescription for a
controlled substance unless the [
person
] 
individual
 is:
(i) a practitioner authorized to prescribe drugs and medicine under the laws of this state
or under the laws of another state having similar standards; and
(ii) licensed under this chapter or under the laws of another state having similar
standards.
(b) [
A person
] 
An individual
 other than a pharmacist licensed under the laws of this
state, or the pharmacist's licensed intern, as required by Sections 
58-17b-303
 and 
58-17b-304
,
may not dispense a controlled substance.
(c) (i) A controlled substance may not be dispensed without the written prescription of
a practitioner, if the written prescription is required by the federal Controlled Substances Act.
(ii) That written prescription shall be made in accordance with Subsection (7)(a) and in
conformity with Subsection (7)(d).
(iii) In emergency situations, as defined by division rule, controlled substances may be
dispensed upon oral prescription of a practitioner, if reduced promptly to writing on forms
designated by the division and filed by the pharmacy.
(iv) Prescriptions reduced to writing by a pharmacist shall be in conformity with
Subsection (7)(d).
(d) Except for emergency situations designated by the division, [
a person
] 
an
individual
 may not issue, fill, compound, or dispense a prescription for a controlled substance
unless the prescription is signed by the prescriber in ink or indelible pencil or is signed with an
electronic signature of the prescriber as authorized by division rule, and contains the following
information:
(i) the name, address, and registry number of the prescriber;
(ii) the name, address, and age of the person to whom or for whom the prescription is
issued;
(iii) the date of issuance of the prescription; and
(iv) the name, quantity, and specific directions for use by the ultimate user of the
controlled substance.
(e) A prescription may not be written, issued, filled, or dispensed for a Schedule I
controlled substance unless:
(i) the [
person
] 
individual
 who writes the prescription is licensed under Subsection (2);
and
(ii) the prescribed controlled substance is to be used in research.
(f) Except when administered directly to an ultimate user by a licensed practitioner,
controlled substances are subject to the restrictions of this Subsection (7)(f).
(i) A prescription for a Schedule II substance may not be refilled.
(ii) A Schedule II controlled substance may not be filled in a quantity to exceed a
one-month's supply, as directed on the daily dosage rate of the prescriptions.
(iii) (A) Except as provided in Subsection (7)(f)(iii)(B), a prescription for a Schedule II
or Schedule III controlled substance that is an opiate and that is issued for an acute condition
shall be completely or partially filled in a quantity not to exceed a seven-day supply as directed
on the daily dosage rate of the prescription.
(B) Subsection (7)(f)(iii)(A) does not apply to a prescription issued for a surgery when
the practitioner determined that a quantity exceeding seven days is needed, in which case the
practitioner may prescribe up to a 30-day supply, with a partial fill at the discretion of the
practitioner.
(C) Subsection (7)(f)(iii)(A) does not apply to prescriptions issued for complex or
chronic conditions which are documented as being complex or chronic in the medical record.
(D) A pharmacist is not required to verify that a prescription is in compliance with
Subsection (7)(f)(iii).
(iv) A Schedule III or IV controlled substance may be filled only within six months of
issuance, and may not be refilled more than six months after the date of its original issuance or
be refilled more than five times after the date of the prescription unless renewed by the
practitioner.
(v) All other controlled substances in Schedule V may be refilled as the prescriber's
prescription directs, but they may not be refilled one year after the date the prescription was
issued unless renewed by the practitioner.
(vi) Any prescription for a Schedule II substance may not be dispensed if it is not
presented to a pharmacist for dispensing by a pharmacist or a pharmacy intern within 30 days
after the date the prescription was issued, or 30 days after the dispensing date, if that date is
specified separately from the date of issue.
(vii) A practitioner may issue more than one prescription at the same time for the same
Schedule II controlled substance, but only under the following conditions:
(A) no more than three prescriptions for the same Schedule II controlled substance may
be issued at the same time;
(B) no one prescription may exceed a 30-day supply; and
(C) a second or third prescription shall include the date of issuance and the date for
dispensing.
(g) (i) Beginning January 1, 2022, each prescription issued for a controlled substance
shall be transmitted electronically as an electronic prescription unless the prescription is:
(A) for a patient residing in an assisted living facility as that term is defined in Section
26-21-2
, a long-term care facility as that term is defined in Section 
58-31b-102
, or a
correctional facility as that term is defined in Section 
64-13-1
;
(B) issued by a veterinarian licensed under Title 58, Chapter 28, Veterinary Practice
Act;
(C) dispensed by a Department of Veterans Affairs pharmacy;
(D) issued during a temporary technical or electronic failure at the practitioner's or
pharmacy's location; or
(E) issued in an emergency situation.
(ii) The division, in collaboration with the appropriate boards that govern the licensure
of the licensees who are authorized by the division to prescribe or to dispense controlled
substances, shall make rules in accordance with Title 63G, Chapter 3, Utah Administrative
Rulemaking Act to:
(A) require that controlled substances prescribed or dispensed under Subsection
(7)(g)(i)(D) indicate on the prescription that the prescribing practitioner or the pharamacy is
experiencing a technical difficulty or an electronic failure;
(B) define an emergency situation for purposes of Subsection (7)(g)(i)(E);
(C) establish additional exemptions to the electronic prescription requirements
established in this Subsection (7)(g);
(D) establish guidelines under which a prescribing practitioner or a pharmacy may
obtain an extension of up to two additional years to comply with Subsection (7)(g)(i);
(E) establish a protocol to follow if the pharmacy that receives the electronic
prescription is not able to fill the prescription; and
(F) establish requirements that comply with federal laws and regulations for software
used to issue and dispense electronic prescriptions.
[
(g)
] 
(h)
 An order for a controlled substance in Schedules II through V for use by an
inpatient or an outpatient of a licensed hospital is exempt from all requirements of this
Subsection (7) if the order is:
(i) issued or made by a prescribing practitioner who holds an unrestricted registration
with the federal Drug Enforcement Administration, and an active Utah controlled substance
license in good standing issued by the division under this section, or a medical resident who is
exempted from licensure under Subsection 
58-1-307
(1)(c);
(ii) authorized by the prescribing practitioner treating the patient and the prescribing
practitioner designates the quantity ordered;
(iii) entered upon the record of the patient, the record is signed by the prescriber
affirming the prescriber's authorization of the order within 48 hours after filling or
administering the order, and the patient's record reflects the quantity actually administered; and
(iv) filled and dispensed by a pharmacist practicing the pharmacist's profession within
the physical structure of the hospital, or the order is taken from a supply lawfully maintained by
the hospital and the amount taken from the supply is administered directly to the patient
authorized to receive it.
[
(h)
] 
(i)
 A practitioner licensed under this chapter may not prescribe, administer, or
dispense a controlled substance to a child, without first obtaining the consent required in
Section 
78B-3-406
 of a parent, guardian, or person standing in loco parentis of the child except
in cases of an emergency. For purposes of [
this
] Subsection (7)[
(h)
]
(i)
, "child" has the same
meaning as defined in Section 
78A-6-105
, and "emergency" means any physical condition
requiring the administration of a controlled substance for immediate relief of pain or suffering.
[
(i)
] 
(j)
 A practitioner licensed under this chapter may not prescribe or administer
dosages of a controlled substance in excess of medically recognized quantities necessary to
treat the ailment, malady, or condition of the ultimate user.
[
(j)
] 
(k)
 A practitioner licensed under this chapter may not prescribe, administer, or
dispense any controlled substance to another person knowing that the other person is using a
false name, address, or other personal information for the purpose of securing the controlled
substance.
[
(k)
] 
(l)
 A person who is licensed under this chapter to manufacture, distribute, or
dispense a controlled substance may not manufacture, distribute, or dispense a controlled
substance to another licensee or any other authorized person not authorized by this license.
[
(l)
] 
(m)
 A person licensed under this chapter may not omit, remove, alter, or obliterate
a symbol required by this chapter or by a rule issued under this chapter.
[
(m)
] 
(n)
 A person licensed under this chapter may not refuse or fail to make, keep, or
furnish any record notification, order form, statement, invoice, or information required under
this chapter.
[
(n)
] 
(o)
 A person licensed under this chapter may not refuse entry into any premises
for inspection as authorized by this chapter.
[
(o)
] 
(p)
 A person licensed under this chapter may not furnish false or fraudulent
material information in any application, report, or other document required to be kept by this
chapter or willfully make any false statement in any prescription, order, report, or record
required by this chapter.
(8) (a) (i) Any person licensed under this chapter who is found by the division to have
violated any of the provisions of Subsections (7)(k) through (o) or Subsection (10) is subject to
a penalty not to exceed $5,000. The division shall determine the procedure for adjudication of
any violations in accordance with Sections 
58-1-106
 and 
58-1-108
.
(ii) The division shall deposit all penalties collected under Subsection (8)(a)(i) in the
General Fund as a dedicated credit to be used by the division under Subsection 
58-37f-502
(1).
(iii) The director may collect a penalty that is not paid by:
(A) referring the matter to a collection agency; or
(B) bringing an action in the district court of the county where the person against
whom the penalty is imposed resides or in the county where the office of the director is located.
(iv) A county attorney or the attorney general of the state shall provide legal assistance
and advice to the director in an action to collect a penalty.
(v) A court shall award reasonable attorney fees and costs to the prevailing party in an
action brought by the division to collect a penalty.
(b) Any person who knowingly and intentionally violates Subsections (7)(h) through (j)
or Subsection (10) is:
(i) upon first conviction, guilty of a class B misdemeanor;
(ii) upon second conviction, guilty of a class A misdemeanor; and
(iii) on third or subsequent conviction, guilty of a third degree felony.
(c) Any person who knowingly and intentionally violates Subsections (7)(k) through
(o) shall upon conviction be guilty of a third degree felony.
(9) Any information communicated to any licensed practitioner in an attempt to
unlawfully procure, or to procure the administration of, a controlled substance is not considered
to be a privileged communication.
(10) A person holding a valid license under this chapter who is engaged in medical
research may produce, possess, administer, prescribe, or dispense a controlled substance for
research purposes as licensed under Subsection (2) but may not otherwise prescribe or dispense
a controlled substance listed in Section 
58-37-4.2
.
Section 3. 
Repealer.
This bill repeals:
Section 
58-82-101
,
Title.
Section 
58-82-102
,
Definitions.
Section 
58-82-201
,
Electronic prescriptions -- Restrictions -- Rulemaking
authority.