HB 217 builds on last year's landmark HB 1, which gave the state's licensing boards the authority to expand the list of drugs for which doctors are required to check KASPER and to modify pharmacy reporting requirements.
KASPER is the Kentucky All Schedule Prescription Electronic Reporting system. The state requires doctors to check KASPER before prescribing drugs on Schedule II and drugs containing hydrocodone on Schedule III of the U.S. Drug Enforcement Administration's controlled substances list and required Kentucky pharmacies to upload data on all prescriptions for controlled substances every seven days.
HB 217 codifies a regulation adopted by the state Board of Pharmacy that will require pharmacies to report the filling of all controlled-substance prescriptions once every business day beginning on July 1, 2013.
In addition HB 217:
- Requires doctors to obtain 12 months of history from KASPER before prescribing Schedule II drugs and Schedule III drugs containing hydrocodone to a patient on the first visit and every three months thereafter.
- Removes Schedule V drugs from those for which doctors must check the database. Doctors still would be required to check the database before prescribing some Schedule III and IV drugs.
- Removes a requirement by the Board of Medical Licensure that physicians conduct random urine tests for all patients receiving controlled substances. Doctors, instead, would be required to conduct the random tests they deem appropriate to check for abuse of each specific drug being prescribed.
- A doctor prescribing a controlled substance within 14 days following surgery.
- A doctor prescribing drugs in a hospital or long-term care facility, as long as the facility has obtained a 12-month drug history on the patient within 12 hours of the patient's admission to the facility.
- Prescriptions of controlled substances for hospice or other end-of-life care.
- Prescriptions for the treatment of pain associated with cancer.
The bill mandates that all state licensing boards require fingerprint-supported criminal record checks conducted by the Kentucky State Police and the FBI of anyone applying for a license to prescribe or dispense controlled substances.
The International Association of Industrial Accidents Boards & Commissions (IAIABC) earlier this year ultimately declined to publish its model law for the control of prescription drugs but the National Organization of Insurance Legislators (NCOIL) has taken up the task. It seems that what Kentucky has done is a good model to start from.
And it also seems that the states that have database systems established for doctors and pharmacists to report to and check likewise have something to model after.
As in any legislation there are some who are not quite thrilled with the laws, but at least according to WorkCompCentral news on the bill the major players are, if not happy with the end result, at least are not unhappy with it.
The Kentucky Medical Association, Kentucky Pharmacy Association and Board of Medical Licensure have indicated that the changes made by HB 217 are workable.
And that is a pretty good endorsement for a law that has such broad and sweeping impact.