LB86 LB86
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LEGISLATURE OF NEBRASKA
ONE HUNDRED SEVENTH LEGISLATURE
FIRST SESSION
LEGISLATIVE BILL 86
Introduced by Bostelman, 23.
Read first time January 07, 2021
Committee: Health and Human Services
1 A BILL FOR AN ACT relating to public health and welfare; to amend
2 sections 38-101 and 71-2454, Revised Statutes Cumulative Supplement,
3 2020; to require certain credential holders to register for the
4 prescription drug monitoring system; to harmonize provisions; and to
5 repeal the original sections.
6 Be it enacted by the people of the State of Nebraska,
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1 Section 1. Section 38-101, Revised Statutes Cumulative Supplement,
2 2020, is amended to read:
3 38-101 Sections 38-101 to 38-1,145 and section 2 of this act and the
4 following practice acts shall be known and may be cited as the Uniform
5 Credentialing Act:
6 (1) The Advanced Practice Registered Nurse Practice Act;
7 (2) The Alcohol and Drug Counseling Practice Act;
8 (3) The Athletic Training Practice Act;
9 (4) The Audiology and Speech-Language Pathology Practice Act;
10 (5) The Certified Nurse Midwifery Practice Act;
11 (6) The Certified Registered Nurse Anesthetist Practice Act;
12 (7) The Chiropractic Practice Act;
13 (8) The Clinical Nurse Specialist Practice Act;
14 (9) The Cosmetology, Electrology, Esthetics, Nail Technology, and
15 Body Art Practice Act;
16 (10) The Dentistry Practice Act;
17 (11) The Dialysis Patient Care Technician Registration Act;
18 (12) The Emergency Medical Services Practice Act;
19 (13) The Environmental Health Specialists Practice Act;
20 (14) The Funeral Directing and Embalming Practice Act;
21 (15) The Genetic Counseling Practice Act;
22 (16) The Hearing Instrument Specialists Practice Act;
23 (17) The Licensed Practical Nurse-Certified Practice Act until
24 November 1, 2017;
25 (18) The Massage Therapy Practice Act;
26 (19) The Medical Nutrition Therapy Practice Act;
27 (20) The Medical Radiography Practice Act;
28 (21) The Medicine and Surgery Practice Act;
29 (22) The Mental Health Practice Act;
30 (23) The Nurse Practice Act;
31 (24) The Nurse Practitioner Practice Act;
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1 (25) The Nursing Home Administrator Practice Act;
2 (26) The Occupational Therapy Practice Act;
3 (27) The Optometry Practice Act;
4 (28) The Perfusion Practice Act;
5 (29) The Pharmacy Practice Act;
6 (30) The Physical Therapy Practice Act;
7 (31) The Podiatry Practice Act;
8 (32) The Psychology Practice Act;
9 (33) The Respiratory Care Practice Act;
10 (34) The Surgical First Assistant Practice Act;
11 (35) The Veterinary Medicine and Surgery Practice Act; and
12 (36) The Water Well Standards and Contractors' Practice Act.
13 If there is any conflict between any provision of sections 38-101 to
14 38-1,145 and section 2 of this act and any provision of a practice act,
15 the provision of the practice act shall prevail.
16 The Revisor of Statutes shall assign the Uniform Credentialing Act,
17 including the practice acts enumerated in subdivisions (1) through (35)
18 of this section, to articles within Chapter 38.
19 Sec. 2. (1) Except as otherwise provided in subsection (3) of this
20 section, beginning October 1, 2021, each credential holder under the
21 Uniform Credentialing Act and each applicant for a credential under the
22 act shall register with the department for the prescription drug
23 monitoring system established pursuant to section 71-2454 if the
24 credential holder is, or applicant will be, a dispenser or prescriber as
25 defined in section 71-2454.
26 (2) The department shall establish a system of registration for each
27 such credential holder. The registration shall be valid for the term of
28 the credential, and renewal of the registration shall be a condition of
29 renewal of the credential. There shall be no fee charged for
30 registration.
31 (3) The following credential holders and applicants for a credential
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1 are not required to register pursuant to this section:
2 (a) A credential holder who is not a dispenser or prescriber as
3 defined in section 71-2454;
4 (b) A veterinarian;
5 (c) A credential holder who is on active duty in the armed forces of
6 the United States and who does not practice in Nebraska;
7 (d) A credential holder who is retired and who does not treat
8 patients;
9 (e) A credential holder who is a researcher and who does not treat
10 patients;
11 (f) A credential holder who is a faculty member at a college or
12 university and who does not treat patients; and
13 (g) Any other credential holder who does not treat patients.
14 Sec. 3. Section 71-2454, Revised Statutes Cumulative Supplement,
15 2020, is amended to read:
16 71-2454 (1) An entity described in section 71-2455 shall establish a
17 system of prescription drug monitoring for the purposes of (a) preventing
18 the misuse of controlled substances that are prescribed, (b) allowing
19 prescribers and dispensers to monitor the care and treatment of patients
20 for whom such a prescription drug is prescribed to ensure that such
21 prescription drugs are used for medically appropriate purposes, (c)
22 providing information to improve the health and safety of patients, and
23 (d) ensuring that the State of Nebraska remains on the cutting edge of
24 medical information technology.
25 (2) Such system of prescription drug monitoring shall be implemented
26 as follows: Except as provided in subsection (4) of this section, all
27 prescription drug information shall be reported to the prescription drug
28 monitoring system. The prescription drug monitoring system shall include,
29 but not be limited to, provisions that:
30 (a) Prohibit any patient from opting out of the prescription drug
31 monitoring system;
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1 (b) Require any prescription drug that is dispensed in this state or
2 to an address in this state to be entered into the system by the
3 dispenser or his or her delegate no less frequently than daily after such
4 prescription drug is sold, including prescription drugs for patients
5 paying cash or otherwise not relying on a third-party payor for payment;
6 (c) Allow all prescribers or dispensers of prescription drugs to
7 access the system at no cost to such prescriber or dispenser;
8 (d) Ensure that such system includes information relating to all
9 payors, including, but not limited to, the medical assistance program
10 established pursuant to the Medical Assistance Act; and
11 (e) Make the prescription drug information available to the
12 statewide health information exchange described in section 71-2455 for
13 access by its participants if such access is in compliance with the
14 privacy and security protections set forth in the provisions of the
15 federal Health Insurance Portability and Accountability Act of 1996,
16 Public Law 104-191, and regulations promulgated thereunder, except that
17 if a patient opts out of the statewide health information exchange, the
18 prescription drug information regarding that patient shall not be
19 accessible by the participants in the statewide health information
20 exchange.
21 (3) Except as provided in subsection (4) of this section,
22 prescription drug information that shall be submitted electronically to
23 the prescription drug monitoring system shall be determined by the entity
24 described in section 71-2455 and shall include, but not be limited to:
25 (a) The patient's name, address, telephone number, if a telephone
26 number is available, gender, and date of birth;
27 (b) A patient identifier such as a military identification number,
28 driver's license number, state identification card number, or other valid
29 government-issued identification number, insurance identification number,
30 pharmacy software-generated patient-specific identifier, or other
31 identifier associated specifically with the patient;
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1 (c) The name and address of the pharmacy dispensing the prescription
2 drug;
3 (d) The date the prescription is issued;
4 (e) The date the prescription is filled;
5 (f) The date the prescription is sold to the patient;
6 (g) The number of refills authorized;
7 (h) The prescription number of the prescription drug;
8 (i) The National Drug Code number as published by the federal Food
9 and Drug Administration of the prescription drug;
10 (j) The strength of the prescription drug prescribed;
11 (k) The quantity of the prescription drug prescribed and the number
12 of days' supply;
13 (l) The prescriber's name and National Provider Identifier number or
14 Drug Enforcement Administration number when reporting a controlled
15 substance; and
16 (m) Additional information as determined by the Health Information
17 Technology Board and as published in the submitter guide for the
18 prescription drug monitoring system.
19 (4) Beginning July 1, 2018, a veterinarian licensed under the
20 Veterinary Medicine and Surgery Practice Act shall be required to report
21 the dispensing of prescription drugs which are controlled substances
22 listed on Schedule II, Schedule III, Schedule IV, or Schedule V pursuant
23 to section 28-405. Each such veterinarian shall indicate that the
24 prescription is an animal prescription and shall include the following
25 information in such report:
26 (a) The first and last name and address, including city, state, and
27 zip code, of the individual to whom the prescription drug is dispensed in
28 accordance with a valid veterinarian-client-patient relationship;
29 (b) Reporting status;
30 (c) The first and last name of the prescribing veterinarian and his
31 or her federal Drug Enforcement Administration number;
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1 (d) The National Drug Code number as published by the federal Food
2 and Drug Administration of the prescription drug and the prescription
3 number;
4 (e) The date the prescription is written and the date the
5 prescription is filled;
6 (f) The number of refills authorized, if any; and
7 (g) The quantity of the prescription drug and the number of days'
8 supply.
9 (5)(a) All prescription drug information submitted pursuant to this
10 section, all data contained in the prescription drug monitoring system,
11 and any report obtained from data contained in the prescription drug
12 monitoring system are confidential, are privileged, are not public
13 records, and may be withheld pursuant to section 84-712.05 except for
14 information released as provided in subsection (9) or (10) of this
15 section.
16 (b) No patient-identifying data as defined in section 81-664,
17 including the data collected under subsection (3) of this section, shall
18 be disclosed, made public, or released to any public or private person or
19 entity except to the statewide health information exchange described in
20 section 71-2455 and its participants, to prescribers and dispensers as
21 provided in subsection (2) of this section, or as provided in subsection
22 (7), (9), or (10) of this section.
23 (c) All other data is for the confidential use of the department and
24 the statewide health information exchange described in section 71-2455
25 and its participants. The department, or the statewide health information
26 exchange in accordance with policies adopted by the Health Information
27 Technology Board and in collaboration with the department, may release
28 such information in accordance with the privacy and security provisions
29 set forth in the federal Health Insurance Portability and Accountability
30 Act of 1996, Public Law 104-191, and regulations promulgated thereunder,
31 as Class I, Class II, or Class IV data in accordance with section 81-667,
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1 except for purposes in accordance with subsection (9) or (10) of this
2 section, to the private or public persons or entities that the department
3 or the statewide health information exchange, in accordance with policies
4 adopted by the Health Information Technology Board, determines may view
5 such records as provided in sections 81-663 to 81-675. In addition, the
6 department, or the statewide health information exchange in accordance
7 with policies adopted by the Health Information Technology Board and in
8 collaboration with the department, may release such information as
9 provided in subsection (9) or (10) of this section.
10 (6) The statewide health information exchange described in section
11 71-2455, in accordance with policies adopted by the Health Information
12 Technology Board and in collaboration with the department, shall
13 establish the minimum administrative, physical, and technical safeguards
14 necessary to protect the confidentiality, integrity, and availability of
15 prescription drug information.
16 (7) If the entity receiving the prescription drug information has
17 privacy protections at least as restrictive as those set forth in this
18 section and has implemented and maintains the minimum safeguards required
19 by subsection (6) of this section, the statewide health information
20 exchange described in section 71-2455, in accordance with policies
21 adopted by the Health Information Technology Board and in collaboration
22 with the department, may release the prescription drug information and
23 any other data collected pursuant to this section to:
24 (a) Other state prescription drug monitoring programs;
25 (b) State and regional health information exchanges;
26 (c) The medical director and pharmacy director of the Division of
27 Medicaid and Long-Term Care of the department, or their designees;
28 (d) The medical directors and pharmacy directors of medicaid-managed
29 care entities, the state's medicaid drug utilization review board, and
30 any other state-administered health insurance program or its designee if
31 any such entities have a current data-sharing agreement with the
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1 statewide health information exchange described in section 71-2455, and
2 if such release is in accordance with the privacy and security provisions
3 of the federal Health Insurance Portability and Accountability Act of
4 1996, Public Law 104-191, and all regulations promulgated thereunder;
5 (e) Organizations which facilitate the interoperability and mutual
6 exchange of information among state prescription drug monitoring programs
7 or state or regional health information exchanges; or
8 (f) Electronic health record systems or pharmacy-dispensing software
9 systems for the purpose of integrating prescription drug information into<