00 CS FOR HOUSE BILL NO. 344(HSS) 01 "An Act relating to the controlled substance prescription database; relating to the duties 02 of the Board of Pharmacy; relating to the prescription of opiates; relating to the practice 03 of dentistry; relating to the practice of medicine; relating to the practice of nursing; 04 relating to the practice of optometry; relating to the practice of veterinary medicine; and 05 providing for an effective date." 06 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 07 * Section 1. AS 08.36.315 is amended to read: 08 Sec. 08.36.315. Grounds for discipline, suspension, or revocation of license. 09 The board may revoke or suspend the license of a dentist, or may reprimand, censure, 10 or discipline a dentist, or both, if the board finds after a hearing that the dentist 11 (1) used or knowingly cooperated in deceit, fraud, or intentional 12 misrepresentation to obtain a license; 13 (2) engaged in deceit, fraud, or intentional misrepresentation in the 01 course of providing or billing for professional dental services or engaging in 02 professional activities; 03 (3) advertised professional dental services in a false or misleading 04 manner; 05 (4) received compensation for referring a person to another dentist or 06 dental practice; 07 (5) has been convicted of a felony or other crime that affects the 08 dentist's ability to continue to practice dentistry competently and safely; 09 (6) engaged in the performance of patient care, or permitted the 10 performance of patient care by persons under the dentist's supervision, regardless of 11 whether actual injury to the patient occurred, 12 (A) that did not conform to minimum professional standards of 13 dentistry; or 14 (B) when the dentist, or a person under the supervision of the 15 dentist, did not have the permit, registration, or certificate required under 16 AS 08.32 or this chapter; 17 (7) failed to comply with this chapter, with a regulation adopted under 18 this chapter, or with an order of the board; 19 (8) continued to practice after becoming unfit due to 20 (A) professional incompetence; 21 (B) addiction or dependence on alcohol or other drugs that 22 impair the dentist's ability to practice safely; 23 (C) physical or mental disability; 24 (9) engaged in lewd or immoral conduct in connection with the 25 delivery of professional service to patients; 26 (10) permitted a dental hygienist or dental assistant who is employed 27 by the dentist or working under the dentist's supervision to perform a dental procedure 28 in violation of AS 08.32.110 or AS 08.36.346; 29 (11) failed to report to the board a death that occurred on the premises 30 used for the practice of dentistry within 48 hours; 31 (12) falsified or destroyed patient or facility records or failed to 01 maintain a patient or facility record for at least seven years after the date the record 02 was created; 03 (13) prescribed or dispensed an opiate in excess of the maximum 04 dosage authorized under AS 08.36.355; or 05 (14) procured, sold, prescribed, or dispensed drugs in violation of 06 a law, regardless of whether there has been a criminal action. 07 * Sec. 2. AS 08.36 is amended by adding a new section to read: 08 Sec. 08.36.355. Maximum dosage for opiate prescriptions. (a) A licensee 09 may not issue an initial prescription for an opiate that exceeds a seven-day supply to 10 an adult patient for outpatient use. 11 (b) A licensee may not issue a prescription for an opiate that exceeds a seven- 12 day supply to a minor. At the time a licensee writes a prescription for an opiate for a 13 minor, the licensee shall discuss with the parent or guardian of the minor why the 14 prescription is necessary and the risks associated with opiate use. 15 (c) Notwithstanding (a) and (b) of this section, a licensee may issue a 16 prescription for an opiate that exceeds a seven-day supply to an adult or minor patient 17 if, in the professional judgment of the licensee, more than a seven-day supply of an 18 opiate is necessary for 19 (1) the patient's acute medical condition, chronic pain management, 20 pain associated with a cancer diagnosis, or pain experienced while the patient is in 21 palliative care; the licensee may write a prescription for an opiate for the quantity 22 needed to treat the patient's medical condition, chronic pain, pain associated with a 23 cancer diagnosis, or pain experienced while the patient is in palliative care; the 24 licensee shall document in the patient's medical record the condition triggering the 25 prescription of an opiate in a quantity that exceeds a seven-day supply and indicate 26 that a non-opiate alternative was not appropriate to address the medical condition; or 27 (2) a patient who is unable to access a practitioner within the time 28 necessary for a refill of the seven-day supply because of a logistical or travel barrier; 29 the licensee may write a prescription for an opiate for the quantity needed to treat the 30 patient for the time that the patient is unable to access a practitioner; the licensee shall 31 document in the patient's medical record the reason for the prescription of an opiate in 01 a quantity that exceeds a seven-day supply and indicate that a non-opiate alternative 02 was not appropriate to address the medical condition; in this paragraph, "practitioner" 03 has the meaning given in AS 11.71.900. 04 (d) In this section, 05 (1) "adult" means 06 (A) a person who has reached 18 years of age; or 07 (B) an emancipated minor; 08 (2) "emancipated minor" means a minor whose disabilities have been 09 removed for general purposes under AS 09.55.590; 10 (3) "minor" means a person under 18 years of age who is not an 11 emancipated minor. 12 * Sec. 3. AS 08.36.370 is amended by adding a new paragraph to read: 13 (10) "opiate" has the meaning given in AS 11.71.900. 14 * Sec. 4. AS 08.64.326(a) is amended to read: 15 (a) The board may impose a sanction if the board finds after a hearing that a 16 licensee 17 (1) secured a license through deceit, fraud, or intentional 18 misrepresentation; 19 (2) engaged in deceit, fraud, or intentional misrepresentation while 20 providing professional services or engaging in professional activities; 21 (3) advertised professional services in a false or misleading manner; 22 (4) has been convicted, including conviction based on a guilty plea or 23 plea of nolo contendere, of 24 (A) a class A or unclassified felony or a crime in another 25 jurisdiction with elements similar to a class A or unclassified felony in this 26 jurisdiction; 27 (B) a class B or class C felony or a crime in another jurisdiction 28 with elements similar to a class B or class C felony in this jurisdiction if the 29 felony or other crime is substantially related to the qualifications, functions, or 30 duties of the licensee; or 31 (C) a crime involving the unlawful procurement, sale, 01 prescription, or dispensing of drugs; 02 (5) has procured, sold, prescribed, or dispensed drugs in violation of a 03 law regardless of whether there has been a criminal action; 04 (6) intentionally or negligently permitted the performance of patient 05 care by persons under the licensee's supervision that does not conform to minimum 06 professional standards even if the patient was not injured; 07 (7) failed to comply with this chapter, a regulation adopted under this 08 chapter, or an order of the board; 09 (8) has demonstrated 10 (A) professional incompetence, gross negligence, or repeated 11 negligent conduct; the board may not base a finding of professional 12 incompetence solely on the basis that a licensee's practice is unconventional or 13 experimental in the absence of demonstrable physical harm to a patient; 14 (B) addiction to, severe dependency on, or habitual overuse of 15 alcohol or other drugs that impairs the licensee's ability to practice safely; 16 (C) unfitness because of physical or mental disability; 17 (9) engaged in unprofessional conduct, in sexual misconduct, or in 18 lewd or immoral conduct in connection with the delivery of professional services to 19 patients; in this paragraph, "sexual misconduct" includes sexual contact, as defined by 20 the board in regulations adopted under this chapter, or attempted sexual contact with a 21 patient outside the scope of generally accepted methods of examination or treatment of 22 the patient, regardless of the patient's consent or lack of consent, during the term of the 23 physician-patient relationship, as defined by the board in regulations adopted under 24 this chapter, unless the patient was the licensee's spouse at the time of the contact or, 25 immediately preceding the physician-patient relationship, was in a dating, courtship, 26 or engagement relationship with the licensee; 27 (10) has violated AS 18.16.010; 28 (11) has violated any code of ethics adopted by regulation by the 29 board; 30 (12) has denied care or treatment to a patient or person seeking 31 assistance from the physician if the only reason for the denial is the failure or refusal 01 of the patient to agree to arbitrate as provided in AS 09.55.535(a); [OR] 02 (13) has had a license or certificate to practice medicine in another 03 state or territory of the United States, or a province or territory of Canada, denied, 04 suspended, revoked, surrendered while under investigation for an alleged violation, 05 restricted, limited, conditioned, or placed on probation unless the denial, suspension, 06 revocation, or other action was caused by the failure of the licensee to pay fees to that 07 state, territory, or province; or 08 (14) prescribed or dispensed an opiate in excess of the maximum 09 dosage authorized under AS 08.64.363. 10 * Sec. 5. AS 08.64 is amended by adding a new section to article 3 to read: 11 Sec. 08.64.363. Maximum dosage for opiate prescriptions. (a) A licensee 12 may not issue an initial prescription for an opiate that exceeds a seven-day supply to 13 an adult patient for outpatient use. 14 (b) A licensee may not issue a prescription for an opiate that exceeds a seven- 15 day supply to a minor. At the time a licensee writes a prescription for an opiate for a 16 minor, the licensee shall discuss with the parent or guardian of the minor why the 17 prescription is necessary and the risks associated with opiate use. 18 (c) Notwithstanding (a) and (b) of this section, a licensee may issue a 19 prescription for an opiate that exceeds a seven-day supply to an adult or minor patient 20 if, in the professional medical judgment of the licensee, more than a seven-day supply 21 of an opiate is necessary for 22 (1) the patient's acute medical condition, chronic pain management, 23 pain associated with a cancer diagnosis, or pain experienced while the patient is in 24 palliative care; the licensee may write a prescription for an opiate for the quantity 25 needed to treat the patient's medical condition, chronic pain, pain associated with a 26 cancer diagnosis, or pain experienced while the patient is in palliative care; the 27 licensee shall document in the patient's medical record the condition triggering the 28 prescription of an opiate in a quantity that exceeds a seven-day supply and indicate 29 that a non-opiate alternative was not appropriate to address the medical condition; or 30 (2) a patient who is unable to access a practitioner within the time 31 necessary for a refill of the seven-day supply because of a logistical or travel barrier; 01 the licensee may write a prescription for an opiate for the quantity needed to treat the 02 patient for the time that the patient is unable to access a practitioner; the licensee shall 03 document in the patient's medical record the reason for the prescription of an opiate in 04 a quantity that exceeds a seven-day supply and indicate that a non-opiate alternative 05 was not appropriate to address the medical condition; in this paragraph, "practitioner" 06 has the meaning given in AS 11.71.900. 07 (d) In this section, 08 (1) "adult" means 09 (A) a person who has reached 18 years of age; or 10 (B) an emancipated minor; 11 (2) "emancipated minor" means a minor whose disabilities have been 12 removed for general purposes under AS 09.55.590; 13 (3) "minor" means a person under 18 years of age who is not an 14 emancipated minor. 15 * Sec. 6. AS 08.64.380 is amended by adding a new paragraph to read: 16 (7) "opiate" has the meaning given in AS 11.71.900. 17 * Sec. 7. AS 08.68.270 is amended to read: 18 Sec. 08.68.270. Grounds for denial, suspension, or revocation. The board 19 may deny, suspend, or revoke the license of a person who 20 (1) has obtained or attempted to obtain a license to practice nursing by 21 fraud or deceit; 22 (2) has been convicted of a felony or other crime if the felony or other 23 crime is substantially related to the qualifications, functions, or duties of the licensee; 24 (3) habitually abuses alcoholic beverages, or illegally uses controlled 25 substances; 26 (4) has impersonated a registered or practical nurse; 27 (5) has intentionally or negligently engaged in conduct that has 28 resulted in a significant risk to the health or safety of a client or in injury to a client; 29 (6) practices or attempts to practice nursing while afflicted with 30 physical or mental illness, deterioration, or disability that interferes with the 31 individual's performance of nursing functions; 01 (7) is guilty of unprofessional conduct as defined by regulations 02 adopted by the board; 03 (8) has wilfully or repeatedly violated a provision of this chapter or 04 regulations adopted under this chapter or AS 08.01; 05 (9) is professionally incompetent; 06 (10) denies care or treatment to a patient or person seeking assistance 07 if the sole reason for the denial is the failure or refusal of the patient or person seeking 08 assistance to agree to arbitrate as provided in AS 09.55.535(a); 09 (11) prescribed or dispensed an opiate in excess of the maximum 10 dosage authorized under AS 08.68.705; or 11 (12) has procured, sold, prescribed, or dispensed drugs in violation 12 of a law, regardless of whether there has been a criminal action. 13 * Sec. 8. AS 08.68 is amended by adding a new section to article 6 to read: 14 Sec. 08.68.705. Maximum dosage for opiate prescriptions. (a) An advanced 15 nurse practitioner licensed in the state may not issue an initial prescription for an 16 opiate that exceeds a seven-day supply to an adult patient for outpatient use. 17 (b) An advanced nurse practitioner licensed in the state may not issue a 18 prescription for an opiate that exceeds a seven-day supply to a minor. At the time an 19 advanced nurse practitioner writes a prescription for an opiate for a minor, the 20 advanced nurse practitioner shall discuss with the parent or guardian of the minor why 21 the prescription is necessary and the risks associated with opiate use. 22 (c) Notwithstanding (a) and (b) of this section, an advanced nurse practitioner 23 licensed in the state may issue a prescription for an opiate that exceeds a seven-day 24 supply to an adult or minor patient if, in the professional judgment of the advanced 25 nurse practitioner, more than a seven-day supply of an opiate is necessary for 26 (1) the patient's acute medical condition, chronic pain management, 27 pain associated with a cancer diagnosis, or pain experienced while the patient is in 28 palliative care; the advanced nurse practitioner may write a prescription for an opiate 29 for the quantity needed to treat the patient's medical condition, chronic pain, pain 30 associated with a cancer diagnosis, or pain experienced while the patient is in 31 palliative care; the advanced nurse practitioner shall document in the patient's medical 01 record the condition triggering the prescription of an opiate in a quantity that exceeds 02 a seven-day supply and indicate that a non-opiate alternative was not appropriate to 03 address the medical condition; or 04 (2) a patient who is unable to access a practitioner within the time 05 necessary for a refill of the seven-day supply because of a logistical or travel barrier; 06 the advanced nurse practitioner may write a prescription for an opiate for the quantity 07 needed to treat the patient for the time that the patient is unable to access a 08 practitioner; the advanced nurse practitioner shall document in the patient's medical 09 record the reason for the prescription of an opiate in a quantity that exceeds a seven- 10 day supply and indicate that a non-opiate alternative was not appropriate to address the 11 medical condition; in this paragraph, "practitioner" has the meaning given in 12 AS 11.71.900. 13 (d) In this section, 14 (1) "adult" means 15 (A) a person who has reached 18 years of age; or 16 (B) an emancipated minor; 17 (2) "emancipated minor" means a minor whose disabilities have been 18 removed for general purposes under AS 09.55.590; 19 (3) "minor" means a person under 18 years of age who is not an 20 emancipated minor. 21 * Sec. 9. AS 08.68.850 is amended by adding a new paragraph to read: 22 (11) "opiate" has the meaning given in AS 11.71.900. 23 * Sec. 10. AS 08.72.240 is amended to read: 24 Sec. 08.72.240. Grounds for imposition of disciplinary sanctions. The board 25 may impose disciplinary sanctions when the board finds after a hearing that a licensee 26 (1) secured a license through deceit, fraud, or intentional 27 misrepresentation; 28 (2) engaged in deceit, fraud, or intentional misrepresentation in the 29 course of providing professional services or engaging in professional activities; 30 (3) advertised professional services in a false or misleading manner; 31 (4) has been convicted of a felony or other crime which affects the 01 licensee's ability to continue to practice competently and safely; 02 (5) intentionally or negligently engaged in or permitted the 03 performance of patient care by persons under the licensee's supervision which does not 04 conform to minimum professional standards regardless of whether actual injury to the 05 patient occurred; 06 (6) failed to comply with this chapter, with a regulation adopted under 07 this chapter, or with an order of the board; 08 (7) continued to practice after becoming unfit due to 09 (A) professional incompetence; 10 (B) failure to keep informed of or use current professional 11 theories or practices; 12 (C) addiction or severe dependency on alcohol or other drugs 13 which impairs the licensee's ability to practice safely; 14 (D) physical or mental disability; 15 (8) engaged in lewd or immoral conduct in connection with the 16 delivery of professional service to patients; 17 (9) failed to refer a patient to a physician after ascertaining the 18 presence of ocular or systemic conditions requiring management by a physician; 19 (10) prescribed or dispensed an opiate in excess of the maximum 20 dosage authorized under AS 08.72.277; or 21 (11) procured, sold, prescribed, or dispensed drugs in violation of 22 a law, regardless of whether there has been a criminal action. 23 * Sec. 11. AS 08.72 is amended by adding a new section to read: 24 Sec. 08.72.277. Maximum dosage for opiate prescriptions. (a) A licensed 25 optometrist may not issue an initial prescription for an opiate that exceeds a seven-day 26 supply to an adult patient for outpatient use. 27 (b) A licensed optometrist may not issue a prescription for an opiate that 28 exceeds a seven-day supply to a minor. At the time a licensed optometrist writes a 29 prescription for an opiate for a minor, the licensed optometrist shall discuss with the 30 parent or guardian of the minor why the prescription is necessary and the risks 31 associated with opiate use. 01 (c) Notwithstanding (a) and (b) of this section, a licensed optometrist may 02 issue a prescription for an opiate that exceeds a seven-day supply to an adult or minor 03 patient if, in the professional judgment of the licensed optometrist, more than a seven- 04 day supply of an opiate is necessary for 05 (1) the patient's acute medical condition, chronic pain management, 06 pain associated with a cancer diagnosis, or pain experienced while the patient is in 07 palliative care; the licensed optometrist may write a prescription for an opiate for the 08 quantity needed to treat the patient's condition, chronic pain, pain associated with a 09 cancer diagnosis, or pain experienced while the patient is in palliative care; the 10 licensed optometrist shall document in the patient's medical record the condition 11 triggering the prescription of an opiate in a quantity that exceeds a seven-day supply 12 and indicate that a non-opiate alternative was not appropriate to address the medical 13 condition; or 14 (2) a patient who is unable to access a practitioner within the time 15 necessary for a refill of the seven-day supply because of a logistical or travel barrier; 16 the licensed optometrist may write a prescription for an opiate for the quantity needed 17 to treat the patient for the time that the patient is unable to access a practitioner; the 18 licensed optometrist shall document in the patient's medical record the reason for the 19 prescription of an opiate in a quantity that exceeds a seven-day supply and indicate 20 that a non-opiate alternative was not appropriate to address the medical condition; in 21 this paragraph, "practitioner" has the meaning given in AS 11.71.900. 22 (d) In this section, 23 (1) "adult" means 24 (A) a person who has reached 18 years of age; or 25 (B) an emancipated minor; 26 (2) "emancipated minor" means a minor whose disabilities have been 27 removed for general purposes under AS 09.55.590; 28 (3) "minor" means a person under 18 years of age who is not an 29 emancipated minor. 30 * Sec. 12. AS 08.72.300 is amended by adding a new paragraph to read: 31 (6) "opiate" has the meaning given in AS 11.71.900. 01 * Sec. 13. AS 08.98.235 is amended to read: 02 Sec. 08.98.235. Grounds for imposition of disciplinary sanctions. After a 03 hearing, the board may impose a disciplinary sanction on a person licensed under this 04 chapter when the board finds that the person 05 (1) secured a license through deceit, fraud, or intentional 06 misrepresentation; 07 (2) engaged in deceit, fraud, or intentional misrepresentation in the 08 course of providing professional services or engaging in professional activities; 09 (3) advertised professional services in a false or misleading manner; 10 (4) has been convicted of a felony or other crime which affects the 11 person's ability to continue to practice competently and safely; 12 (5) intentionally or negligently engaged in or permitted the 13 performance of animal care by the person's supervisees which does not conform to 14 minimum professional standards regardless of whether actual injury to the animal 15 occurred; 16 (6) failed to comply with this chapter, with a regulation adopted under 17 this chapter, or with an order of the board; 18 (7) continued to practice after becoming unfit due to 19 (A) professional incompetence; 20 (B) addiction or severe dependency on alcohol or other drugs 21 which impairs the person's ability to practice safely; 22 (C) physical or mental disability; 23 (8) engaged in lewd or immoral conduct in connection with the 24 delivery of professional service; 25 (9) procured, sold, prescribed, or dispensed drugs in violation of 26 law, regardless of whether there has been a criminal action. 27 * Sec. 14. AS 17.30.200(a) is amended to read: 28 (a) The controlled substance prescription database is established in the Board 29 of Pharmacy. The purpose of the database is to contain data as described in this 30 section regarding every prescription for a schedule [IA, IIA, IIIA, IVA, OR VA 31 CONTROLLED SUBSTANCE UNDER STATE LAW OR A SCHEDULE I,] II, III, 01 or IV [, OR V] controlled substance under federal law dispensed in the state to a 02 person other than those administered to a patient at a health care facility. [THE 03 DEPARTMENT OF COMMERCE, COMMUNITY, AND ECONOMIC 04 DEVELOPMENT SHALL ASSIST THE BOARD AND PROVIDE NECESSARY 05 STAFF AND EQUIPMENT TO IMPLEMENT THIS SECTION.] 06 * Sec. 15. AS 17.30.200(b) is amended to read: 07 (b) The pharmacist-in-charge of each licensed or registered pharmacy, or an 08 agent or employee of the pharmacist-in-charge whom the pharmacist-in-charge 09 has authorized to submit to the database on the pharmacist-in-charge's behalf, 10 regarding each schedule [IA, IIA, IIIA, IVA, OR VA CONTROLLED SUBSTANCE 11 UNDER STATE LAW OR A SCHEDULE I,] II, III, or IV [, OR V] controlled 12 substance under federal law dispensed by a pharmacist under the supervision of the 13 pharmacist-in-charge, and each practitioner who directly dispenses a schedule [IA, 14 IIA, IIIA, IVA, OR VA CONTROLLED SUBSTANCE UNDER STATE LAW OR A 15 SCHEDULE I,] II, III, or IV [, OR V] controlled substance under federal law or an 16 agent or employee of the practitioner whom the practitioner has authorized to 17 submit to the database on the practitioner's behalf, other than those administered 18 to a patient at a health care facility, shall submit to the board at least weekly, by a 19 procedure and in a format established by the board, the following information for 20 inclusion in the database: 21 (1) the name of the prescribing practitioner and the practitioner's 22 federal Drug Enforcement Administration registration number or other appropriate 23 identifier; 24 (2) the date of the prescription; 25 (3) the date the prescription was filled and the method of payment; this 26 paragraph does not authorize the board to include individual credit card or other 27 account numbers in the database; 28 (4) the name, address, and date of birth of the person for whom the 29 prescription was written; 30 (5) the name and national drug code of the controlled substance; 31 (6) the quantity and strength of the controlled substance dispensed; 01 (7) the name of the drug outlet dispensing the controlled substance; 02 and 03 (8) the name of the pharmacist or practitioner dispensing the controlled 04 substance and other appropriate identifying information. 05 * Sec. 16. AS 17.30.200(d) is amended to read: 06 (d) The database and the information contained within the database are 07 confidential, are not public records, and are not subject to public disclosure. The board 08 shall undertake to ensure the security and confidentiality of the database and the 09 information contained within the database. The board may allow access to the 10 database only to the following persons, and in accordance with the limitations 11 provided and regulations of the board: 12 (1) personnel of the board regarding inquiries concerning licensees or 13 registrants of the board or personnel of another board or agency concerning a 14 practitioner under a search warrant, subpoena, or order issued by an administrative law 15 judge or a court; 16 (2) authorized board personnel or contractors as required for 17 operational and review purposes; 18 (3) a licensed or registered practitioner having authority to prescribe 19 controlled substances or an agent or employee of the practitioner whom the 20 practitioner has authorized to access the database on the practitioner's behalf, to 21 the extent the information relates specifically to a current patient of the practitioner to 22 whom the practitioner is prescribing or considering prescribing a controlled substance; 23 (4) a licensed or registered pharmacist having authority to dispense 24 controlled substances or an agent or employee of the pharmacist whom the 25 pharmacist has authorized to access the database on the pharmacist's behalf, to 26 the extent the information relates specifically to a current patient to whom the 27 pharmacist is dispensing or considering dispensing a controlled substance; 28 (5) federal, state, and local law enforcement authorities may receive 29 printouts of information contained in the database under a search warrant, subpoena, 30 or order issued by a court establishing probable cause for the access and use of the 31 information; [AND] 01 (6) an individual who is the recipient of a controlled substance 02 prescription entered into the database may receive information contained in the 03 database concerning the individual on providing evidence satisfactory to the board that 04 the individual requesting the information is in fact the person about whom the data 05 entry was made and on payment of a fee set by the board under AS 37.10.050 that 06 does not exceed $10; 07 (7) a pharmacist who is responsible for administering prescription 08 drug coverage for the medical assistance program under AS 47.07, to the extent 09 that the information relates specifically to prescription drug coverage under the 10 program; 11 (8) a person responsible for utilization review of prescription 12 drugs for the medical assistance program under AS 47.07, to the extent that the 13 information relates specifically to utilization review of prescription drugs under 14 the program; 15 (9) the state medical examiner, to the extent that the information 16 relates specifically to investigating the cause and manner of a person's death; and 17 (10) an authorized employee of the Department of Health and 18 Social Services may receive information from the database that does not identify 19 patients, prescribers, dispensers, or dispenser locations, for the purpose of 20 identifying and monitoring public health issues in the state. 21 * Sec. 17. AS 17.30.200(e) is amended to read: 22 (e) The failure of a pharmacist-in-charge, pharmacist, or practitioner to 23 register with or submit information to the database as required under this section is 24 grounds for the board to take disciplinary action against the license or registration of 25 the pharmacy or pharmacist or for another licensing board to take disciplinary action 26 against a practitioner. 27 * Sec. 18. AS 17.30.200(h) is amended to read: 28 (h) An individual who has submitted information to the database in 29 accordance with this section may not be held civilly liable for having submitted the 30 information. [NOTHING IN THIS SECTION REQUIRES OR OBLIGATES A 31 DISPENSER OR PRACTITIONER TO ACCESS OR CHECK THE DATABASE 01 BEFORE DISPENSING, PRESCRIBING, OR ADMINISTERING A 02 MEDICATION, OR PROVIDING MEDICAL CARE TO A PERSON.] Dispensers or 03 practitioners may not be held civilly liable for damages for accessing or failing to 04 access the information in the database. 05 * Sec. 19. AS 17.30.200(k) is amended to read: 06 (k) In the regulations adopted under this section, the board shall provide 07 (1) that prescription information in the database shall be purged from 08 the database after two years have elapsed from the date the prescription was 09 dispensed; 10 (2) a method for an individual to challenge information in the database 11 about the individual that the person believes is incorrect or was incorrectly entered by 12 a dispenser; 13 (3) a procedure and time frame for registration with the database; 14 (4) that a pharmacist or practitioner shall review the information 15 in the database to check a patient's prescription records before prescribing, 16 dispensing, or administering to a patient more than a three-day supply of a 17 schedule II, III, or IV controlled substance under federal law; the regulations 18 must provide that a pharmacist or practitioner is not required to review the 19 information in the database before dispensing, prescribing, or administering a 20 controlled substance to a person who is receiving treatment 21 (A) in an inpatient setting; 22 (B) at the scene of an emergency or in an ambulance; in this 23 subparagraph, "ambulance" has the meaning given in AS 18.08.200; 24 (C) in an emergency room; or 25 (D) immediately before, during, or within the first 24 hours 26 after surgery or a medical procedure; 27 (5) an alternate procedure and format that complies with the 28 requirements of this section for a pharmacist or practitioner who is unable to 29 directly access the database by electronic means because of a technological or 30 infrastructure barrier; the board may authorize the use of the alternate 31 procedure and format for a pharmacist or practitioner who provides evidence to 01 the board sufficient to establish that the pharmacist or practitioner has a 02 technological or infrastructure barrier that prevents the pharmacist or 03 practitioner from directly accessing the database by electronic means. 04 * Sec. 20. AS 17.30.200 is amended by adding new subsections to read: 05 (o) The board shall develop in the database an alert system that automatically 06 sends an electronic notification to a pharmacist and practitioner at the time the 07 pharmacist or practitioner enters a prescription for a patient into the database if the 08 same patient has received one or more prescriptions for controlled substances in 09 quantities or with a frequency inconsistent with generally recognized standards of 10 dosage for that controlled substance. 11 (p) A pharmacist who dispenses or a practitioner who prescribes, administers, 12 or directly dispenses a schedule II, III, or IV controlled substance under federal law 13 shall register with the database by a procedure and in a format established by the 14 board. 15 (q) A pharmacist or practitioner may only delegate access to the database 16 under (b) or (d) of this section to an employee or agent who is licensed or registered in 17 the state for an occupation or activity listed under AS 08.01.010. 18 (r) The Department of Commerce, Community, and Economic Development 19 shall 20 (1) promptly notify the State Medical Board, the Board of Nursing, the 21 Board of Dental Examiners, the Board of Veterinary Examiners, and the Board of 22 Examiners in Optometry when a practitioner registers with the database under (p) of 23 this section; 24 (2) assist the board and provide necessary staff and equipment to 25 implement this section; and 26 (3) establish fees for registration with the database by a pharmacist or 27 practitioner required to register under (p) of this section so that the total amount of 28 fees collected by the department equals the total operational costs of the database 29 minus all federal funds acquired for the operational costs of the database; in setting the 30 fee levels, the department shall 31 (A) set the fees for registration with the database so that the 01 fees are the same for all practitioners and pharmacists required to register; and 02 (B) consult with the board to establish the fees under this 03 subsection. 04 (s) The board shall, on a weekly basis, update the database with the 05 information submitted to the board under (b) of this section. 06 * Sec. 21. The uncodified law of the State of Alaska is amended by adding a new section to 07 read: 08 TRANSITION: REGULATIONS. The Department of Commerce, Community, and 09 Economic Development, the Board of Pharmacy, the State Medical Board, the Board of 10 Nursing, the Board of Dental Examiners, the Board of Veterinary Examiners, and the Board 11 of Examiners in Optometry may adopt regulations necessary to implement the changes made 12 by secs. 14 - 20 of this Act. The regulations take effect under AS 44.62 (Administrative 13 Procedure Act), but not before the effective date of the relevant provision of secs. 14 - 20 of 14 this Act implemented by the regulation. 15 * Sec. 22. The uncodified law of the State of Alaska is amended by adding a new section to 16 read: 17 TRANSITION. (a) The Board of Pharmacy shall provide necessary information and 18 training to the State Medical Board, the Board of Nursing, the Board of Dental Examiners, the 19 Board of Veterinary Examiners, and the Board of Examiners in Optometry for implementing 20 the requirements of secs. 14 - 20 of this Act. 21 (b) On or before January 1, 2019, the Department of Commerce, Community, and 22 Economic Development shall solicit comments on the level of burden on providers created by 23 the review requirement in AS 17.30.200(k)(4), enacted by sec. 19 of this Act. The department 24 shall summarize, in a report to the legislature, the comments received by the department and 25 its findings based on the comments. The department shall deliver the report to the senate 26 secretary and the chief clerk of the house of representatives not later than January 1, 2019, 27 and notify the legislature that the report is available. The legislature may assess whether the 28 review requirement under AS 17.30.200(k)(4), enacted by sec. 19 of this Act, remains 29 necessary or if alternative language should be considered based on the report. 30 * Sec. 23. AS 17.30.200(r), enacted by sec. 20 of this Act, takes effect September 1, 2016. 31 * Sec. 24. Sections 21 and 22 of this Act take effect immediately under AS 01.10.070(c). 01 * Sec. 25. Except as provided in secs. 23 and 24 of this Act, this Act takes effect July 1, 02 2017.