SS/SCS/SB 74 - This act establishes the Prescription Drug Monitoring Act. The Department of Health and Senior Services is required to establish and maintain a program to monitor the prescribing and dispensing of all Schedule II through Schedule IV controlled substances by all licensed professionals who prescribe or dispense these substances in Missouri. The Department shall use an existing data aggregation platform through the State Data Center within the Office of Administration to establish the Prescription Drug Monitoring Program (PDMP). The provisions of this act shall be subject to appropriation and may also be funded by federal or private moneys. The Department is authorized to enter into a contract to establish and maintain the PDMP. No vendor may be awarded a contract if that vendor has had any data breach, compromise, hack, or any other data insecurity in any previous database. If a vendor is awarded the PDMP contract and the PDMP has a data breach, compromise, hack, or any other data insecurity, the vendor will be in breach of contract and the contract will be terminated.
The Department shall ensure the privacy and security of personal information while only aggregating necessary and appropriate information related to the prescribing or dispensing of Schedule II through Schedule IV controlled substances. The aggregated information from each prescriber and dispenser data source shall remain segregated from any other data source. All submitted prescription and dispensation information shall be kept confidential with specified exceptions. Beginning August 28, 2019, the Department shall maintain an individual's prescription and dispensation information for a maximum of 180 days, after which such information shall be deleted from the PDMP.
Most prescribers may, and all prescribers who hold themselves out to the public as pain management specialists and all dispensers shall, electronically submit to the Department information for each prescription or dispensation of a Schedule II through Schedule IV controlled substance. The Department may issue a waiver to a dispenser who is unable to submit the required information electronically. If a waiver is obtained, a dispenser can submit the required information in paper format or by other approved means. The Department shall reimburse each dispenser for the fees of transmitting the information required by this act.
This act delineates the duties of prescribers, dispensers, and the Department for communicating when there is a prescription for or dispensation of a Schedule II through Schedule IV controlled substance. In the case of a dispenser, if the Department responds with a message that there was a concern detected and describes the nature of that concern, the dispenser shall issue or not issue the prescription or the medication according to his or her professional judgment appropriate to the concern communicated. In the case of a prescriber, if the Department responds with a message that there was a concern detected and describes the nature of that concern, the Department shall provide the prescriber an option of entering certain identifying information in order to receive the PDMP's data for the specific patient to whom the prescriber intends to issue a prescription. The prescriber shall use his or her professional judgment, based on the nature of the concern identified and a review of the patient's PDMP data, to issue or not issue the prescription to the patient. If the Department's response is not timely for, a prescriber or dispenser shall issue or not issue the prescription or the medication according to his or her professional judgment.
The Department shall review the prescription and dispensation information and, if there is reasonable cause to believe a violation of law or breach of professional standards may have occurred, the Department shall notify the appropriate law enforcement or professional regulatory entity and provide the prescription or dispensation information required for an investigation. If, after staff review, it appears that there is reasonable cause to believe that a person has obtained a prescription fraudulently from more than one prescriber, the Department shall contact the prescribers, inform them of the potential problem, provide details, and request copies of medical records relating to the prescriptions of concern. The prescribers shall provide the records, if possible, by fax or electronically. If, after Department review of the provided records, it is clear that a person has obtained prescriptions under false pretenses, the entire matter shall be referred to the appropriate law enforcement agency or local prosecuting attorney for action. Nothing in the PDMP database shall be the sole basis for probable cause to obtain an arrest or search warrant as part of a criminal investigation.
Any person who unlawfully and knowingly accesses or discloses prescription and dispensation monitoring information or prescribers and dispensers who knowingly fail to submit the required information or who knowingly submit incorrect information shall be subject to penalties and shall be guilty of a Class A misdemeanor. Any persons authorized to have prescription or dispensation information who knowingly disclose such information or who use it in a manner and for a purpose in violation of the act shall be guilty of a Class E felony. Additionally, this act provides a private cause of action for persons whose data has been disclosed to an unauthorized person. Recovery under this cause of action for negligent disclosure shall include liquidated damages of $25,000 and compensatory economic and non-economic damages, attorney fees, and court costs. Punitive damages are available for intentional and malicious unauthorized disclosure. Neither the sovereign nor the official immunity doctrines shall apply to a person or department authorized to have private medical information who discloses such information to unauthorized parties.
The Department shall annually provide to the General Assembly a report as to the number of controlled substances dispensed, broken down by drug, the number of incidents of fraudulent prescriptions identified, and any other pertinent information requested by the General Assembly.
The Department shall create and implement educational courses regarding the provisions of this act and, when appropriate, shall work with associations for impaired professionals to ensure the intervention, treatment, and ongoing monitoring of individuals who have been identified as being addicted to substances monitored by this act.
The provisions of this act shall not apply to Schedules II, III, and IV controlled substances prescribed or dispensed where the ultimate user is an individual under 18.
The provisions of this act shall preempt all ordinances, rules, and regulations of political subdivisions relating to the prescription and dispensation of all Schedule II, III, and IV controlled substances.
The provisions of this act shall expire on August 28, 2023.
Provisions of this act are substantially similar to SB 768 (2016) and SS/SCS/SBs 63 & 111 (2015) and similar to HB 68 (2017), HB 90 (2017), SB 231 (2017), SB 314 (2017), and SB 340 (2017).
SARAH HASKINS