Session of 2021
HOUSE BILL No. 2253
By Committee on Appropriations
2-5

1 AN ACT concerning health professions and practices; relating to the board
2 of pharmacy; prescription monitoring program act; pertaining to
3 persons permitted to receive program data; data security; user and
4 delegate access; increasing the number of members of the prescription
5 monitoring program advisory committee; providing for initial setup and
6 annual maintenance fees to be charged for program data integration
7 into any other electronic health or pharmacy record system approved by
8 the board; amending K.S.A. 65-1682, 65-1683, 65-1684, 65-1685, 65-
9 1687 and 65-1689 and repealing the existing sections.
10
11 Be it enacted by the Legislature of the State of Kansas:
12 Section 1. K.S.A. 65-1682 is hereby amended to read as follows: 65-
13 1682. As used in this act, unless the context otherwise requires:
14 (a) "Audit trail information" means information produced regarding
15 requests for prescription monitoring program data that the board and
16 advisory committee use to monitor compliance with this act.
17 (b) "Board" means the state board of pharmacy.
18 (c) "Delegate" means:
19 (1) A registered nurse, licensed practical nurse, respiratory therapist,
20 emergency medical responder, paramedic, dental hygienist, pharmacy
21 technician or pharmacy intern who has registered for access to the
22 program database as an agent of a practitioner or pharmacist to request
23 program data on behalf of the practitioner or pharmacist;
24 (2) a death investigator who has registered for limited access to the
25 program database as an agent of a medical examiner, coroner or another
26 person authorized under law to investigate or determine causes of death;
27 or
28 (3) an individual authorized to access the program database by the
29 board in rules and regulations.
30 (b)(d) "Dispenser" means a practitioner, pharmacy or pharmacist who
31 delivers a scheduled substance or drug of concern to an ultimate user, but
32 does not include:
33 (1) A licensed hospital pharmacy that distributes such substances for
34 the purpose of inpatient hospital care;
35 (2) a medical care facility as defined in K.S.A. 65-425, and
36 amendments thereto, practitioner or other authorized person who
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1 administers such a substance;
2 (3) a registered wholesale distributor of such substances;
3 (4) a veterinarian licensed by the Kansas board of veterinary
4 examiners who dispenses or prescribes a scheduled substance or drug of
5 concern; or
6 (5) a practitioner who has been exempted from the reporting
7 requirements of this act in rules and regulations promulgated by the board.
8 (c)(e) "Drug of concern" means any drug that demonstrates a
9 potential for abuse and is designated as a drug of concern in rules and
10 regulations promulgated by the board.
11 (d)(f) "Patient" means the person individual who is the ultimate user
12 of a drug for whom a prescription is issued or for whom a drug is
13 dispensed, or both.
14 (e)(g) "Pharmacist" means an individual currently licensed by the
15 board to practice the profession of pharmacy in this state.
16 (h) "Pharmacy" means a premises, laboratory, area or other place
17 currently registered with the board where scheduled substances or drugs
18 of concern are offered for sale or dispensed in this state.
19 (f)(i) "Practitioner" means a person an individual licensed to practice
20 medicine and surgery, dentist, podiatrist, optometrist or other person
21 individual authorized by law to prescribe or dispense scheduled substances
22 and drugs of concern.
23 (g)(j) "Program" means the prescription monitoring program.
24 (k) "Scheduled substance" means controlled substances included in
25 schedules II, III or IV of the schedules designated in K.S.A. 65-4107, 65-
26 4109 and 65-4111, and amendments thereto, respectively, or the federal
27 controlled substances act (,21 U.S.C. ยง 812).
28 Sec. 2. K.S.A. 65-1683 is hereby amended to read as follows: 65-
29 1683. (a) The board shall establish and maintain a prescription monitoring
30 program for the monitoring of scheduled substances and drugs of concern
31 dispensed in this state or dispensed to an address in this state.
32 (b) Each dispenser shall submit to the board by electronic means
33 information required by the board regarding each prescription dispensed
34 for a substance included under subsection (a). The board shall promulgate
35 rules and regulations specifying the nationally recognized
36 telecommunications format to be used for submission of information that
37 each dispenser shall submit to the board. Such information may include,
38 but not be limited to:
39 (1) The dispenser identification number;
40 (2) the date the prescription is filled;
41 (3) the prescription number;
42 (4) whether the prescription is new or is a refill;
43 (5) the national drug code for the drug dispensed;
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1 (6) the quantity dispensed;
2 (7) the number of days' supply of the drug;
3 (8) the patient identification number;
4 (9) the patient's name;
5 (10) the patient's address;
6 (11) the patient's date of birth;
7 (12) the prescriber identification number;
8 (13) the date the prescription was issued by the prescriber; and
9 (14) the source of payment for the prescription; and
10 (15) the diagnosis code.
11 (c) The board shall promulgate rules and regulations specifying the
12 transmission methods and frequency of the dispenser submissions required
13 under subsection (b).
14 (d) The board may issue a waiver to a dispenser that is unable to
15 submit prescription information by electronic means. Such waiver may
16 permit the dispenser to submit prescription information by paper form or
17 other means, provided that all information required by rules and
18 regulations is submitted in this alternative format. The board may, in
19 consultation with the advisory committee, enable features and include
20 additional information to enhance the program database. Such
21 information may include, but not be limited to:
22 (1) The date or fact of death;
23 (2) the dispensation or administration of emergency opioid
24 antagonists, as defined by K.S.A. 65-16,127, and amendments thereto; and
25 (3) the data related to an overdose event.
26 (e) The board is hereby authorized to apply for and to accept grants
27 and may accept any donation, gift or bequest made to the board for
28 furthering any phase of the prescription monitoring program.
29 (f) The board shall remit all moneys received by it under subsection
30 (e) to the state treasurer in accordance with the provisions of K.S.A. 75-
31 4215, and amendments thereto. Upon receipt of such remittance, the state
32 treasurer shall deposit the entire amount in the state treasury to the credit
33 of the non-federal gifts and grants fund. All expenditures from such fund
34 shall be made in accordance with appropriation acts upon warrants of the
35 director of accounts and reports issued pursuant to vouchers approved by
36 the president of the board or a person designated by the president.
37 Sec. 3. K.S.A. 65-1684 is hereby amended to read as follows: 65-
38 1684. The board shall not impose any charge for the establishment or
39 maintenance of the prescription monitoring program database on a
40 registered wholesale distributor, pharmacist, dispenser or other person
41 authorized to prescribe or dispense scheduled substances and drugs of
42 concern. The board shall not charge any fees for the transmission of data to
43 the database or for the receipt of information from the database, except
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1 that as provided in this section:
2 (a) The board may charge a fee to an individual who requests the
3 individual's own prescription monitoring information in accordance with
4 procedures adopted by the board; and
5 (b)(1) in consultation with the advisory committee, the board may
6 adopt rules and regulations necessary to establish and charge to each
7 integrated entity an initial setup fee and an annual maintenance fee for the
8 integration of program data in any electronic health record or pharmacy
9 management system approved by the board. If the board deems such rules
10 and regulations necessary, such rules and regulations shall be adopted not
11 later than July 1, 2022.
12 (2) All moneys collected under this subsection shall be remitted to the
13 state treasurer in accordance with the provisions of K.S.A. 75-4215, and
14 amendments thereto. Upon receipt of each such remittance, the state
15 treasurer shall deposit the entire amount in the state treasury to the credit
16 of the state board of pharmacy fee fund.
17 Sec. 4. K.S.A. 65-1685 is hereby amended to read as follows: 65-
18 1685. (a) The prescription monitoring program database, all information
19 contained therein and any records maintained by the board, or by any
20 entity contracting with the board, submitted to, maintained or stored as a
21 part of the database, including audit trail information, shall be privileged
22 and confidential, shall not be subject to subpoena or discovery in civil
23 proceedings and may only be used for investigatory or evidentiary
24 purposes related to violations of state or federal law and regulatory
25 activities of entities charged with administrative oversight of those persons
26 individuals engaged in the prescribing or dispensing of scheduled
27 substances and drugs of concern, shall not be a public record and shall not
28 be subject to the Kansas open records act, K.S.A. 45-215 et seq., and
29 amendments thereto, except as provided in subsections (c) and (d).
30 (b) The board shall maintain procedures to ensure that the privacy
31 and confidentiality of patients and patient information collected, recorded,
32 transmitted and maintained is not disclosed to persons individuals except
33 as provided in subsections (c) and (d).
34 (c) The board is hereby authorized to provide data in the prescription
35 monitoring program to the following persons individuals:
36 (1) PersonsIndividuals authorized to prescribe or dispense scheduled
37 substances and drugs of concern, for the purpose of providing medical or
38 pharmaceutical care for their patients;
39 (2) an individual who requests the individual's own prescription
40 monitoring information in accordance with procedures established by the
41 board;
42 (3) designated representatives from the professional licensing,
43 certification or regulatory agencies charged with administrative oversight
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1 of those persons individuals engaged in the prescribing or dispensing of
2 scheduled substances and drugs of concern;
3 (4) local, state and federal law enforcement or prosecutorial officials
4 engaged in the administration, investigation or enforcement of the laws
5 governing scheduled substances and drugs of concern subject to the
6 requirements in K.S.A. 22-2502, and amendments thereto;
7 (5) designated representatives from the department of health and
8 environment regarding authorized medicaid program recipients;
9 (6) personsindividuals authorized by a grand jury subpoena,
10 inquisition subpoena or court order in a criminal action;
11 (7) personnel of the prescription monitoring program advisory
12 committee for the purpose of operation of the program;
13 (8) personnel of the board for purposes of operation of the program
14 and administration and enforcement of this act or the uniform controlled
15 substances act, K.S.A. 65-4101 et seq., and amendments thereto;
16 (9) personsindividuals authorized to prescribe or dispense scheduled
17 substances and drugs of concern, when an individual is obtaining
18 prescriptions in a manner that appears to be misuse, abuse or diversion of
19 scheduled substances or drugs of concern; and
20 (10) medical examiners, coroners or other persons individuals
21 authorized under law to investigate or determine causes of death.;
22 (11) persons operating a practitioner or pharmacist impaired
23 provider program in accordance with K.S.A. 65-4924, and amendments
24 thereto, for the purpose of reviewing drugs dispensed to a practitioner or
25 pharmacist enrolled in the program;
26 (12) delegates of individuals authorized by paragraphs (1), (9) and
27 (10);
28 (13) individuals or organizations notified by the advisory committee
29 as provided in subsection (g);
30 (14) practitioners or pharmacists conducting research approved by
31 an institutional review board who have obtained patient consent for the
32 release of program data; and
33 (15) an overdose fatality review board established by the state of
34 Kansas.
35 (d) An individual registered for access to the program database shall
36 notify the board in writing within 30 calendar days of any action that
37 would disqualify the individual from being authorized to receive program
38 data as provided in subsection (c).
39 (e) The state board of healing arts, board of nursing, Kansas dental
40 board and board of examiners in optometry shall notify the board in
41 writing within 30 calendar days of any denial, suspension, revocation or
42 other administrative limitation of a practitioner's license or registration
43 that would disqualify the practitioner from being authorized to receive
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1 program data as provided in subsection (c).
2 (f) A practitioner or pharmacist shall notify the board in writing
3 within 30 calendar days of any action that would disqualify a delegate
4 from being authorized to receive program data on behalf of the
5 practitioner or pharmacist.
6 (d)(g) The prescription monitoring program advisory committee
7 established pursuant to K.S.A. 65-1689, and amendments thereto, is
8 authorized to review and analyze the program data for purposes of
9 identifying patterns and activity of concern.
10 (1) If a review of information appears to indicate a person an
11 individual may be obtaining prescriptions in a manner that may represent
12 misuse or abuse of controlled scheduled substances and drugs of concern,
13 the advisory committee is authorized to notify the prescribers and
14 dispensers who prescribed or dispensed the prescriptions. If the review
15 does not identify a recent prescriber as a point of contact for potential
16 clinical intervention, the advisory committee is authorized to notify the
17 disability and behavioral health services section of the Kansas department
18 for aging and disability services for the purpose of offering confidential
19 treatment services. Further disclosure of information is prohibited. If the
20 review identifies patterns or other evidence sufficient to create a
21 reasonable suspicion of criminal activity, the advisory committee is
22 authorized to notify the appropriate law enforcement agency.
23 (2) If a review of information appears to indicate that a violation of
24 state or federal law relating to prescribing controlled scheduled substances
25 and drugs of concern may have occurred, or that a prescriber or dispenser
26 has knowingly prescribed, dispensed or obtained controlled scheduled
27 substances and drugs of concern in a manner that is inconsistent with
28 recognized standards of care for the profession, the advisory committee
29 shall determine whether a report to the professional licensing, certification
30 or regulatory agencies charged with administrative oversight of those
31 persons individuals engaged in prescribing or dispensing of controlled
32 scheduled substances and drugs of concern or to the appropriate law
33 enforcement agency is warranted.
34 (A) For purposes of such determination the advisory committee may,
35 in consultation with the appropriate regulatory agencies and professional
36 organizations, establish criteria regarding appropriate standards and utilize
37 volunteer peer review committees of professionals with expertise in the
38 particular practice to create such standards and review individual cases.
39 (B) The peer review committee or committees appointed herein shall
40 have authority to request and receive information in the prescription
41 monitoring program database from the director of the prescription
42 monitoring program.
43 (C) If the determination is made that a referral to a regulatory or law
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1 enforcement agency is not warranted but educational or professional
2 advising might be appropriate, the advisory committee may refer the
3 prescribers or dispensers to other such resources.
4 (3) If a review of information appears to indicate that program data
5 has been accessed or used in violation of state or federal law, the advisory
6 committee shall determine whether a report to the professional licensing,
7 certification or regulatory agencies charged with administrative oversight
8 of those individuals engaged in prescribing or dispensing of scheduled
9 substances and drugs of concern is warranted and may make such report.
10 (e) The board is hereby authorized to provide data in the prescription
11 monitoring program data to public or private entities for statistical,
12 research or educational purposes after removing information that could be
13 used to identify individual practitioners, dispensers, patients or persons
14 ind