Bill > AB474

Introduced Session

Legislative Counsel's Digest: Existing law requires certain providers of health care to report to the local health authority if a person has or is suspected of having a communicable disease. (NRS 441A.150) Each health authority is required to make a weekly report to the Chief Medical Officer of all cases or suspected cases of communicable diseases reported to the health authority. (NRS 441A.170) Sections 1-6 of this bill require similar reports to be made concerning cases or suspected cases of drug overdose. Section 6 makes it a misdemeanor for a provider of health care to willfully fail, neglect or refuse to make such a report. Existing law requires the State Board of Pharmacy and the Investigation Division of the Department of Public Safety to cooperatively develop a computerized program to track each prescription for a controlled substance listed in schedule II, III or IV. (NRS 453.162) Section 7 of this bill requires that program to include certain information relating to each prescription of such a controlled substance. Existing law requires any practitioner or person who dispenses a controlled substance or proposes to engage in such dispensing to obtain a registration from the State Board of Pharmacy. (NRS 453.226) Existing law requires each registered person to upload certain information to the database of the computerized program after dispensing a controlled substance listed in schedule II, III or IV. (NRS 453.163) Sections 8 and 9 of this bill clarify that the requirement to upload such information applies to a controlled substance listed in schedule II, III or IV that is dispensed for human consumption. Section 9 also authorizes: (1) certain occupational licensing boards to access the database to investigate the fraudulent, illegal, unauthorized or otherwise inappropriate prescribing, dispensing or use of a controlled substance; and (2) paramedics to access the database to determine if the symptoms of a person the paramedic is treating may be caused by a controlled substance listed in schedule II, III or IV. Section 11 of this bill requires a person to present proof that he or she has access to the database of the program before the Board may issue or renew a registration to prescribe a controlled substance. Existing law prescribes certain criminal penalties for persons who knowingly or intentionally sell, manufacture, deliver, bring into this State or possess a controlled substance listed in schedule II based on the quantity of the controlled substance involved. (NRS 453.3395) Section 12 of this bill provides that such penalties instead depend on the aggregate quantity involved or collected by the investigating law enforcement agency over the course of an investigation. Sections 13 and 62 of this bill revise provisions governing the accessibility of health care records in certain investigations. Sections 15, 22, 28, 33, 40 and 45 of this bill require certain occupational licensing boards that receive a complaint or information that indicates the fraudulent, illegal, unauthorized or inappropriate prescribing or use of a controlled substance listed in schedule II, III or IV to take certain measures to review and evaluate the information and impose disciplinary action upon a licensee if it determines that a violation has occurred. Sections 20, 26, 38 and 49 of this bill clarify that such measures must be taken before a formal investigation commences. Sections 16, 23, 29, 34, 41 and 46 of this bill establish procedures by which such occupational licensing boards may summarily suspend a licensee s authority to prescribe, administer or dispense a controlled substance listed in schedule II, III or IV. Existing law authorizes certain occupational licensing boards to require licensees who are registered to dispense controlled substances to complete at least 1 hour of training relating specifically to the misuse and abuse of controlled substances. (NRS 630.2535, 631.344, 632.2375, 633.473, 635.116, 636.2881) Sections 17, 24, 30, 35, 42 and 47 of this bill instead: (1) increase the required training to 2 hours; and (2) add to the list of authorized topics for training to satisfy that requirement training relating specifically to the prescribing of opioids or addiction. Section 52 of this bill requires a practitioner who intends to prescribe or dispense more than certain quantities of a controlled substance listed in schedule II, III or IV for the treatment of pain to document in the medical record of the patient the reasons for prescribing or dispensing that quantity. Section 53 of this bill requires a practitioner to have established a bona fide relationship with a patient and to take certain actions, including performing an evaluation and risk assessment, creating a treatment plan and obtaining the informed written consent of the patient, before initiating a prescription for a controlled substance listed in schedule II, III or IV for the treatment of pain for the patient. Section 54 of this bill prescribes requirements concerning such an evaluation and risk assessment and for obtaining the informed written consent. Section 55 of this bill requires a practitioner to take certain actions before issuing a prescription for a controlled substance listed in schedule II, III or IV to continue the treatment of pain of a patient who has used the controlled substance for 90 consecutive days or longer. Section 56 of this bill requires a practitioner who intends to prescribe a controlled substance listed in schedule II, III or IV for more than 30 days for the treatment of pain to enter into a prescription medication agreement with the patient. Section 57 of this bill requires a practitioner to consider certain factors before prescribing a controlled substance listed in schedule II, III or IV. Section 58 of this bill authorizes the State Board of Pharmacy to adopt any regulations necessary to enforce the provisions of this bill concerning the prescription of a controlled substance listed in schedule II, III or IV for the treatment of pain. Section 58 also provides that a person who violates those provisions or regulations is not guilty of a misdemeanor but is subject to professional discipline. Sections 15, 22, 28, 33, 40 and 45 require an occupational licensing board that licenses practitioners who prescribe controlled substances listed in schedule II, III or IV to adopt regulations establishing disciplinary action for prescribing such a controlled substance inappropriately or in violation of the provisions of this bill concerning the prescribing of such a controlled substance for the treatment of pain. Sections 18, 25, 31, 36, 43 and 48 of this bill authorize the imposition of disciplinary action in such circumstances. Existing law requires a practitioner to obtain a patient utilization report from the computerized program established by the Board and the Investigation Division before initiating a prescription for a controlled substance listed in schedule II, III or IV. (NRS 639.23507) Section 60 of this bill: (1) additionally requires a practitioner to obtain such a report at least every 90 days for the duration of the prescription; and (2) requires a practitioner to make certain determinations based on the report. Section 61 of this bill revises the required contents of a written prescription.

AI Summary

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Other Sponsors (1)

Approved by the Governor. Chapter 605. (on 06/16/2017)

Official Document