2017-2018 Regular Session HB 1712 PN 2297 Bill Text (HTM)

PRINTER'S NO. 2297

THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

No.

1712

Session of

2017

INTRODUCED BY NEILSON, READSHAW, SANTORA, TAYLOR, DRISCOLL,

PASHINSKI, O'BRIEN, McNEILL, A. HARRIS, DONATUCCI, W. KELLER

AND KAUFER, AUGUST 16, 2017

REFERRED TO COMMITTEE ON HEALTH, AUGUST 16, 2017

AN ACT

Amending Title 35 (Health and Safety) of the Pennsylvania

Consolidated Statutes, in prescribing opioids to minors,

providing for prescribing opioids to individuals and further

providing for definitions, for prohibition and for procedure.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1. The heading of Chapter 52A of Title 35 of the

Pennsylvania Consolidated Statutes is amended to read:

CHAPTER 52A

PRESCRIBING OPIOIDS TO [MINORS] INDIVIDUALS

Section 2. The definition of "medical emergency" in section

52A01 of Title 35 is amended and the section is amended by

adding definitions to read:

§ 52A01. Definitions.

The following words and phrases when used in this chapter

shall have the meanings given to them in this section unless the

context clearly indicates otherwise:

* * *

"Conservative care management." An approach to treating back

pain, neck pain and related spinal conditions utilizing

nonpharmacological and nonsurgical treatment options.

"Conservative care management specialist." A medical

professional that administers conservative care management

treatment that is either licensed by the State Board of Medicine

or the State Board of Chiropractic.

* * *

"Medical emergency." A situation which, in a prescriber's

good faith professional judgment, creates an immediate threat of

serious risk to the life or physical health of [a minor] an

individual.

* * *

Section 3. Sections 52A03 and 52A04 of Title 35 are amended

to read:

§ 52A03. Prohibition.

(a) Proscription.--A prescriber may not do any of the

following:

(1) Prescribe to [a minor] an individual a controlled

substance containing an opioid unless the prescriber complies

with section 52A04 (relating to procedure).

(2) Except as set forth in subsection (b) and subject to

section 52A04(c)(1), prescribe to [a minor] an individual

more than a seven-day supply of a controlled substance

containing an opioid.

(b) Exception.--Notwithstanding subsection (a)(1), a

prescriber may prescribe to [a minor] an individual more than a

seven-day supply of a controlled substance containing an opioid

if any of the following apply:

(1) In the professional medical judgment of the

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prescriber, more than a seven-day supply of a controlled

substance containing an opioid is required to stabilize the

[minor's] individual's acute medical condition. In order for

this paragraph to apply, the prescriber must:

(i) document the acute medical condition in the

[minor's] individual's record with the prescriber; and

(ii) indicate the reason why a non-opioid

alternative is not appropriate to address the acute

medical condition.

(2) The prescription is for:

(i) management of pain associated with cancer;

(ii) use in palliative or hospice care; or

(iii) management of chronic pain not associated with

cancer.

§ 52A04. Procedure.

(a) Requirements.--Except as set forth in subsection (b),

before issuing [a minor] an individual the first prescription in

a single course of treatment for a controlled substance

containing an opioid, regardless of whether the dosage is

modified during that course of treatment, a prescriber shall do

all of the following:

(1) Assess whether the [minor] individual has taken or

is currently taking prescription drugs for treatment of a

substance use disorder.

(1.1) Assess whether or not the individual has completed

a 12-week conservative care management treatment regimen

administered by a doctor of chiropractic or other licensed

physical medicine and rehabilitation professional. The

following shall apply:

(i) If it is determined that the individual has not

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completed a 12-week conservative care management

treatment regimen, the prescriber shall refer the

individual to a conservative care management treatment

specialist to complete a 12-week conservative care

management treatment regimen before issuing a

prescription.

(ii) If the individual has completed a 12-week

conservative care management treatment regimen, the

prescriber shall consult with the individual's

conservative care management treatment specialist as soon

as practicable to determine if a prescription should be

issued. The reasons provided by the conservative care

management treatment specialist as to why a prescription

should be issued shall be documented by the prescriber.

(2) Discuss with the [minor and] individual or, if the

individual is a minor, with the minor's parent or guardian or

with an authorized adult, all of the following:

(i) The risks of addiction and overdose associated

with the controlled substance containing an opioid.

(ii) The increased risk of addiction to controlled

substances to individuals suffering from mental or

substance use disorders.

(iii) The dangers of taking a controlled substance

containing an opioid with benzodiazepines, alcohol or

other central nervous system depressants.

(iv) Other information in the patient counseling

information section of the labeling for controlled

substances containing an opioid required under 21 C.F.R.

201.57(c)(18) (relating to specific requirements on

content and format of labeling for human prescription

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drug and biological products described in § 201.56(b)(1))

deemed necessary by the prescriber.

(3) Obtain written consent for the prescription from the

[minor's] individual or, if the individual is a minor, from

the minor's parent or guardian or from an authorized adult.

The prescriber shall record the consent on the form under

section 52A02(b)(1) (relating to administration). The

following apply:

(i) The form must contain all of the following:

(A) The brand name or generic name and quantity

of the controlled substance containing an opioid

being prescribed and the amount of the initial dose.

(B) A statement indicating that a controlled

substance is a drug or other substance that the

United States Drug Enforcement Administration has

identified as having a potential for abuse.

engaged in the discussion under paragraph (2).

(D) The number of refills authorized by the

prescription under section 52A03(b) (relating to

prohibition).

(E) The signature of the [minor's] individual

or, if the individual is a minor, the signature of

the parent or guardian or of an authorized adult, and

the date of signing.

(ii) The form shall be maintained in the [minor's]

individual's record with the prescriber.

(b) Exception.--Subsection (a) does not apply if the

[minor's] individual's treatment with a controlled substance

containing an opioid meets any of the following criteria:

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(1) The treatment is associated with or incident to a

medical emergency as documented in the [minor's] individual's

medical record.

(2) In the prescriber's professional judgment, complying

with subsection (a) with respect to the [minor's]

individual's treatment would be detrimental to the [minor's]

individual's health or safety. The prescriber shall document

in the [minor's] individual's medical record the factor or

factors which the prescriber believed constituted cause for

not fulfilling the requirements of subsection (a).

(3) A conservative care management specialist recommends

to the prescriber the issuance of a prescription for an

individual under subsection (a)(1.1)(ii).

consent form under subsection (a)(3) is an authorized adult, the

prescriber:

(1) may prescribe not more than a single, 72-hour

supply; and

(2) shall indicate on the prescription the quantity that

is to be dispensed pursuant to the prescription.

Section 4. This act shall take effect in 180 days.

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