3 Easy Things You Can Do To Take Action

 

  • Write Letters to your legislators
  • Call your legislators
  • Spread the word through social media for others to do the same

HELP POWER OF PAIN FOUNDATION & YOUR PAIN COMMUNITY, GET MORE INVOLVED!

IF YOU DON’T KNOW WHERE YOU’RE GOING, YOU MAY MISS IT WHEN YOU GET THERE!

If you have efforts in your state related to pain care issues, please let us know so we can get it listed and get you more support! The Power of Pain Foundation is happy to support and sponsor pain care legislation. Please let us know if you need a support letter or sponsor for your bill.

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SPPAN is an association of leaders, representing a variety of health care and consumer organizations, and individuals, who work together in a cooperative and coordinated fashion to effect positive pain policy on the state level—policy that guarantees access to comprehensive and effective pain care for all people living with pain. http://sppan.aapainmanage.org/

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ARIZONA - Last Update: 5/15/2014

Arizona: AZ HB 2221. This bill would requires workers’ compensation providers to report results of PMP checks to insurance companies and would require prior authorization for greater than a 120 mg MED dose of opioids and subsequent escalations. This only applies if the treatment is off-label, which, in reality, probably doesn’t happen all that often, but passage of this bill could have a chilling effect that we find problematic. Status: Signed by Governor on 4/16/14; Chapter 52.

POPF AND SPPAN Position: Oppose.

Arizona: AZ SB 1124. The only important change in this bill is to allow a delegate who is authorized by the prescriber or dispenser to perform PMP checks. Status: Signed by Governor on 4/16/14; Chapter 106.

POPF AND SPPAN Position: Support.

Arizona: AZ HB 2221. This bill would requires workers’ compensation providers to report results of PMP checks to insurance companies and would require prior authorization for greater than a 120 mg MED dose of opioids and subsequent escalations. This only applies if the treatment is off-label, which, in reality, probably doesn’t happen all that often, but passage of this bill could have a chilling effect that we find problematic. Status: Signed by Governor on 4/16/14; Chapter 52.

POPF AND SPPAN Position: Oppose.

Arizona: AZ SB 1296. This bill has been amended, and now requires Medicaid contractors to intervene with the prescriber and with the patient when the patient receives ten or more prescriptions for a controlled substance in a 3-month period. It no longer has any provisions specific to the PMP. Status: Passed the Senate 27-2; read twice in the House; died when legislature adjourned on 4/24/14.

POPF AND SPPAN Position: Oppose.

Arizona: AZ SB 1297. This bill would require both the prescriber and the dispenser to check the PMP before issuing each prescription for a controlled substance. Prescribers who are board-eligible or board-certified hematologists or oncologists are not required to do so if they are treating pain associated with cancer or progressive sickle cell disease. We believe it is unnecessary to check the PMP for each prescription and worry that it would severely impede patient access. We also object to the exception on the grounds that, if this is intended to be a patient safety measure, then people with cancer and sickle cell disease are entitled to the same measure of protection. Status: Passed the Senate 22-7 and read twice in the House; died when legislature adjourned on 4/24/14.

POPF AND SPPAN Position: Oppose.

Arizona: AZ SB 1361. A study bill for an act requiring the development and use of a standard form for prior authorization of prescription drug benefits. Status: Died in the Senate Health and Human Services Committee when legislature adjourned on 4/24/14.

ARKANSAS

Bills Enacted Into Law

SB 862, sponsored by Sen. Irvin; passed both houses and signed by the governor. This bill would allow the Department of Human Services to access PMP data as part of a child maltreatment investigation. Specifically, the DHS would be allowed to petition a circuit court to allow investigator access, and that may be granted if there is probably cause that the mother has one or more prescription drugs, and the baby or the person tested positive for prescription drugs at the time of the birth of the baby. It also extends the confidentiality requirements inherent in using PMP data to cover this use.

ALASKA updated 5/15/2014

Alaska: AK HB 324. This bill provides for ongoing funding of the Alaska PMP through fees charged to prescribers and pharmacists. It also provides for naming of delegates to obtain PMP reports on behalf of prescribers and pharmacists. Status: Died in House Finance Committee when legislature adjourned on 4/25/14.

POPF AND SPPAN Position: Support.

ALABAMA

Bills Enacted Into Law

HB 150, sponsored by Rep. McClendon, and SB 115, sponsored by Sen. Ward and 9 others; HB 150 has passed both houses and has been signed by the governor. SB 115 passed out of the Senate Judiciary Committee on 3/7, and is indefinitely postponed, likely awaiting results of HB 150. This appears to be a broad effort to upgrade the PMP. The bills provide for the establishment of a trust fund to hold funds from a variety of sources to pay for the program; add representatives of the Department of Mental Health and AL Medicaid to the advisory committee, while deleting a representative of the AL Independent Drug Store Association; allow advisory committee to meet via teleconference; add method of payment and third-party payor to information reported to PMP; allow for designation of 2 delegates per physician; and remove a statement that practitioners have no requirement to access the PMP, without adding a specific requirement to do so.

Position: POPF and SPPAN supported these bills.

LEGISLATURES ADJOURNED – Bills DO NOT Carry Over to Next Year (bill died)

HB 110, sponsored by Rep. McClendon; bill has passed the full House and awaits action in the Senate Finance and Taxation General Fund Committee, where an amendment was proposed on 4/18. This bill would permit Medicaid authorities to access PMP data as part of an investigation of fraud, abuse, or misuse related to controlled substances by Medicaid recipients or providers.

Action: None requested at this time.

CALIFORNIA

CA AB 889, sponsored by Rep. Frazier; passed the Assembly; now awaiting action in the Senate.  If passed, this bill will amend the Health and Safety Code and the Insurance Code relating to health care coverage.  This bill would authorize health care service plans and health insurers to require step therapy when more than one drug is appropriate for the treatment of a medical condition.  The bill would further require a plan or insurer that requires step therapy to have an expeditious process in place to authorize exceptions to step therapy.  The duration of any step therapy or fail first protocol would have to be consistent with up-to-date, peer-reviewed, scientific, medical and pharmaceutical evidence, and would, except under certain conditions, prohibit a health care service plan from requiring that a patient try and fail on more than two (2) medications before allowing the patient access to other medications prescribed.  Further, if a patient switches plans or policies, the new plan or insurer may not require the patient to repeat step therapy when that person is already being treated by a prescription drug.

POPF Position: We strongly support this legislation and ask advocates to contact their legislators in support. Note that the primary thrust of this bill is step therapy, however, it does include provisions for an expeditious process for authorization of exceptions, making this a prior authorization issue as well.

SB 809, introduced by Sens. DeSaulnier and Steinberg, with 4 Senate and 1 House co-authors; passed the Senate and now awaits action in the Assembly. This bill would fund the California PMP (CURES) by establishing a separate CURES Fund within the state treasury, and would require the boards of medicine, dentistry, pharmacy, veterinary medicine, nursing, osteopathic medicine, optometry, podiatry, and the PA’s committee of the board of medicine, all to increase their licensure fees by up to 1.16%; would require the Board of Pharmacy to increase licensure fees for wholesalers, nonresident wholesalers, and veterinary food-animal drug retailers by up to 1.16%; and would tax controlled substances manufacturers and health insurers an unspecified amount to help fund the CURES program. The amount collected to fund the CURES program is not allowed to substantially exceed the cost of running the program, and thus will determine the amount of the fee increase and taxes levied.

Action: We support efforts to find sustainable funding for the CURES program, and do not oppose the very small increase in licensing fees; we are less convinced that it is fair to tax the drug manufacturers and insurance companies, and until the amount of that tax is known, we will take no position on that portion of the act. As in other cases, we oppose mandatory CURES checks with every prescription, and would ask that the legislature provide for the ability of prescribers and dispensers to name delegates to obtain CURES reports for them. We ask advocates to contact their legislators to ask for moderation of the frequency of required checks and the addition of delegate capability to this bill.

COLORADO - Last Update: 5/15/2014

Colorado: CO HB 1173. We support the portion of this bill that allows medical directors at substance abuse clinics to obtain permission from patients to access their PMP records.  We also support the amendment added which appropriates money for the PMP. We are taking no position on the rest of the bill. Status: Passed House with no amendments; Senate third reading passed with no amendments; last gubernatorial action must be taken by 6/6/14.

POPF AND SPPAN Position: Support (in part)

Colorado: CO HB 1283. Amends definitions; requires practitioners to register with PMP; allows delegates; allows access to Department of Public Health and Environment for analysis purposes, the Department of Health Care Policy and Financing for purposes of accessing data pertaining to recipients of benefits under the state program of medical assistance; allows unsolicited reports to prescribers and dispensers; sets up a task force to assist in maximizing the efficacy of the PMP; permits law enforcement to access data on pharmacies, subject to a subpoena; allows access to PMP data by out-of-state pharmacists. Status: Sent to the Governor on 5/12/14; last gubernatorial action must be taken by 6/6/14.

POPF AND SPPAN Position: Support

CONNECTICUT – last update 5/15/2014

Connecticut: CT HB 5474. A bill to exempt veterinarians from the Prescription Monitoring Program. Status: Received favorable report on 4/1/14; died when legislature adjourned on 5/7/14.

POPF AND SPPAN Position: Monitor

Connecticut: CT SB 7. This bill limits trials of any given medication to one; thus, if one medication fails to work, the insurer cannot mandate another trial on that drug. The bill also prohibits step therapy from including drugs for off-label use unless specifically prescribed. Status: Died when legislature adjourned on 5/7/14.

POPF AND SPPAN Position: Support.

Connecticut: CT SB 394.This bill limits the duration of step therapy to a 30-day period and requires insurance companies to provide an override mechanism for prescribers to use. Status: Passed both houses; in Concurrence on 5/7/14; last gubernatorial action must be taken by 5/22/14.

POPF AND SPPAN Position: Support.

DISTRICT OF COLUMBIA – last update 5/15/2014

District of Columbia: DC B20 127. Prescription Drug Monitoring Program Act of 2013. Status: Law Effective, L20-0066, on 2/22/14.

POPF AND SPPAN Position: Support

DELAWARE

SB 59, sponsored by Sen. Bushweller; passed out of the Senate Health & Social Services Committee, and now awaits action on the Senate floor.  This bill would appoint a Controlled Substance Advisory Committee to advise the Secretary of Health & Social Services; changes and clarifies requirements needed to have a controlled substance regulation; requires that dispensers check the PMP report for the past 12 months for any patient the dispenser believes may be seeking controlled substances for any non-medical reason; authorizes chemical dependency professionals and licensed professional counselors to access the PMP when a patient is enrolled in a substance abuse treatment program; authorizes the Chief Medical Examiner or a licensed physician designee to check the PMP as part of a death investigation; and authorizes interstate data sharing.

Action: We support this bill and ask that advocates contact their legislators in support.

FLORDIA - Last Update: 5/15/14

Florida: FL HB 1381. Requires prescriber to access and view certain patient information in database before initially prescribing controlled substance and provides additional grounds for discipline for failing to do so; revises provisions relating to database of controlled substance dispensing information; revises program funding requirements. Status: Died in Health Care Appropriations Subcommittee on 5/2/14.

POPF AND SPPAN Position: Support

Florida: FL HB 7177. This bill contains a number of provisions related to protecting PMP data from inappropriate disclosure. Status: Ordered engrossed, then enrolled on 5/2/14; effective on 10/1/14.

POPF AND SPPAN Position: Amend. This is a vast improvement over the current situation, but it still does not require law enforcement to demonstrate probable cause, which we believe should be necessary.

Florida: FL SB 862. This bill makes law enforcement access to PMP data subject to a demonstration of probable cause; permits unsolicited reporting; and, appropriates $500,000 to operate the program. Status: Died in Messages on 5/2/14.

POPF AND SPPAN Position: Support

Florida: FL HB 1001. Revises requirements for managed care programs, health insurers, and HMOs; mandates use of standardized prior authorization form; establishes process for providers to override certain treatment restrictions; provides requirements for approval of such overrides; prohibits retroactive denial of claims in certain circumstances; authorizes FSC to adopt form. Status: Died in Health Care Appropriations Subcommittee on 5/2/14.

Florida: FL SB 1352. Health Care Practitioners; Expanding who may prescribe brand drugs under the prescription drug program when medically necessary; excepting controlled substances prescribed by an advanced practice registered nurse from the disqualifications for continued certification or licensure as a deputy or state pilot; authorizing an advanced practice registered nurse to prescribe, Status: Died in Judiciary on 5/2/14.

POPF AND SPPAN position: Monitor

Florida: FL SB 866. This bill contains a number of provisions related to protecting PMP data from inappropriate disclosure. Status: Laid on Table on 4/24/14; substituted with FL HB 7177.

POPF AND SPPAN Position: Support

HAWAII – last update 5/15/2014

HB 1741 – SUPPORT Prior Authorization Legislation - Send your comments to http://www.capitol.hawaii.gov/emailtestimony   Thanks so much for your help with this critical patient access issue. 

Sample Letter:

Representative Robert Herkes

Hawaii State Capitol

Honolulu, HI 96813

RE: HB 1741 – SUPPORT

Dear Representative Herkes,

I support HB 1741, which streamlines and simplifies the Prior Authorization (PA) process for patients.  Under the guise of cost containment, Hawaii health insurers have implemented procedures and protocols such as prior authorization that threaten the doctor-patient relationship and interfere with effective patient care by denying or delaying access to treatment.

Prior- and pre-authorization policies – when an insurer requires a doctor to obtain authorization from the insurance carrier before the carrier will agree to cover the cost of medication or treatment – deliver costly bureaucratic hassles that take a physician’s time and attention from patient care.  The fact that each health plan has its own distinct prior authorization form only compounds the problem and adds to the time physicians must spend navigating the managed care maze in order to get patients access to the treatments they need.

The PA process is currently highly complex, lacks transparency, and the criteria and processes vary significantly among health plans.  Health plans in Hawaii have differing preauthorization, appeal, benefit advisory, and admission notification requirements; and these differing requirements create training and logistical complexity for providers, as their staff tries to keep track of the various requirements and the different methods of communicating the information.

HB 1741 institutes patient protections for PAs that will preserve the provider-patient relationship.

Should you have any questions please contact me at xxx-xxx-xxxx.

Sincerely,

xxxxxx

Hawaii: HI SB 2173. This bill limits patients’ coinsurance or copayment fees for specialty tier drugs to $150 per month for up to a thirty day period supply and allows patients to request an exception to obtain a specialty drug that would not otherwise be available on a health plan formulary. Status: Died when legislature adjourned on 5/1/14.

POPF AND SPPAN Position: Support.

HawaiiHI SCR 2014 64SR 2014 31. This resolution requests the auditor to conduct an impact assessment report on legislation mandating limits on specialty tier use by insurance companies. Status: Both bills died when legislature adjourned on 5/1/14.

POPF AND SPPAN Position: Support

INDIANA - Last Update: 5/15/14

Indiana: IN HB 1218. This bill establishes, among other things, standards and protocols for opioid treatment programs and requires that a practitioner check the PMP before initially prescribing a controlled substance and periodically during the course of the treatment with controlled substances. Status: Signed by the Governor on 3/25/14.

POPF AND SPPAN Position: Monitor.

Indiana: IN HB 1357. Requires the development a uniform prior authorization form for prescription coverage. Status: Awaiting action in the House Insurance Committee. Legislative session adjourned while bill was still in committee.

Indiana: IN SB 80. Interim study committee structure. Establishes 17 interim study committees with authority to study legislative topics. Permits the legislative council to establish additional interim study committees. Provides for the appointment of chairs, vice-chairs, legislative members, and lay members of interim study committees. Specifies uniform policies to govern interim study. Status: Signed by Governor on 3/24/14; Public Law 53.

IOWA - Last Update: 5/15/14

Iowa:IA HSB 186, SSB 1015. These companion bills would amend the PMP so that a pharmacist or prescribing practitioner must consult the PMP before prescribing or renewing a prescription for a controlled substance or filling a prescription for a controlled substance if the pharmacist or prescribing practitioner believes or has reason to believe that a patient is at risk of controlled substance diversion, misuse, or abuse. These bills have been carried over from 2013, in which they saw very little movement. Status: Both bills died when legislature adjourned on 5/1/14.

POPF AND SPPAN Position: Monitor.

Iowa: IA SF 2080. This bill would permit interstate data sharing by the PMP. Status: Signed by Governor on 4/3/14.

POPF AND SPPAN Position: Support.

Iowa:IA SSB 1017. This bill would permit interstate data sharing by the PMP. Status: Died when legislature adjourned on 5/1/14.

POPF AND SPPAN Position: Support.

Iowa:IA HSB 148 andSSB 1164. A study bill for an act requiring the development and use of a standard form for prior authorization of prescription drug benefits. Status: Both bills died when legislature adjourned on 5/1/14.

IowaIA HSB 653. The bill requires the development of a standard process and form for prior authorization by January 1, 2015. Before developing the process and form, the commissioner is required to hold at least one public hearing to obtain input from interested parties. The form must not exceed two pages in length and must be available and transmissible in an electronic
format. Status: Died when legislature adjourned on 5/1/14.

Iowa: IA HF 2376. This bill requires the development and use of a standard process and form to obtain prior authorization for prescription drug benefits under a health benefit plan. The bill requires the commissioner of insurance to develop, by rule, a standard process and form by January 1, 2015. Before developing the process and form, the commissioner is required to hold at least one public hearing to obtain input from interested parties. The form must not exceed two pages in length and must be available and transmissible. Status: Died when legislature adjourned on 5/1/14.

ILLINOIS - Last Update: 5/15/14

Illinois: IL HB 3638, SB 2585. Provides that on and after January 1, 2015, or 6 months after the form is developed, whichever is later, every prescribing provider may use that uniform prior authorization form to request prior authorization for coverage of prescription drug benefits and every health care service plan shall accept that form as sufficient to request prior authorization for prescription drug benefits. Status: HB 3638 scheduled for hearing in Senate Insurance Committee on 5/14/14; SB 2585 amended and re-referred to Assignments Committee on 4/11/14.

Illinois: IL SB 1807. Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that no later than November 1, 2013, the Department of Healthcare and Family Services shall promulgate and file a regulation defining criteria utilized for granting prior authorization for non-preferred medications; criteria utilized for denying a request for prior authorization; criteria utilized for approval or denial of a request for prior authorization made to any managed care entity under contract with the State to administer pharmaceutical drug benefits to any recipient of medical assistance benefits; and other matters. Provides that prior to promulgating this regulation, the Department shall consult with recipients of aid, health care advocates, including mental health care advocates, and providers. Status: Awaiting assignment by the Assignments Committee.

IDAHO - Last Update: 5/15/14

Idaho: ID H 348. This bill clarifies the specific criteria involved when a person who has received a controlled substance requests his or her own PMP information. Status: Signed by Governor on 3/6/14; effective 7/1/14.

POPF AND SPPAN Position: Support.

Idaho: ID H 396. This bill requires that prescribers other than veterinarians must annually register to access PMP data. This registration is to be done in conjunction with annual renewal of the prescriber’s state controlled substance registration. Status: Signed by Governor on 3/13/14; effective 7/1/14.

POPF AND SPPAN Position: Support.

KANSAS – updated 5/15/2014

Kansas: KS SB 251. Establishes that health plans that receive an electronic health predetermination request must provide information on the amounts of expected benefits coverage on the procedures specified in the request that is accurate at the time of the health plan’s response. The information provided in the real-time response is binding on the health plan in most circumstances. Status: Withdrawn from Committee on Ways and Means; re-referred to Committee on Financial Institutions and Insurance on 2/12/14.

KENTUCKY – updated 5/15/2014

Kentucky: KY HB 539. A bill to include interstate data sharing in the prescription monitoring program. Status: Died in the Judiciary Committee when legislature adjourned on 4/15/14.

POPF AND SPPAN Position: Support

Kentucky: KY SB 73. Amend KRS 304.17A-161 to define “preauthorization”; and establish requirements for pharmacy benefit managers to expedite the process of preauthorization of a non-formulary drug product. Status: Passed Senate 30-4 and passed House as amended 97-0; died when legislature adjourned on 4/15/14.

Kentucky: KY HB 578. This bill requires health benefit plans that provide coverage for prescription drugs subject to a tiered formulary to ensure that any copayment or coinsurance applicable to specialty drugs not exceed $100 per month for up to a 30-day supply and that the copayment or coinsurance for specialty tier drugs shall not exceed $200 per month in the aggregate. Status: Died in the House Banking and Insurance Committee when legislature adjourned on 4/15/14.

POPF AND SPPAN Position: Support.


Bills Enacted Into Law

HB 217, sponsored by Rep. Stumbo; passed both houses and signed by the governor. This is a clean-up bill from last year’s pain management clinic bill. Among other things, it allows hospitals and long-term care facilities to have their own PMP accounts.

LOUISIANA – updated

Louisiana: LA HB 275 Allows PMP data to be subpoenaed as part of a child custody case. Status: Heard by House Committee on Health and Welfare on 5/13/14.

POPF AND SPPAN Position: Oppose.  TAKE ACTION NOW.

Louisiana: LA HB 1180.  Provides for a feasibility study concerning a pharmaceutical and therapeutics committee for Medicaid managed care.  Specifies that the process for a prescriber to obtain prior authorization for a prescription drug from the prospective committee be conducted with an appropriate degree of administrative simplicity for the purpose of reducing unnecessary wait times and denials.  Status: Referred to the Committee on Health and Welfare on 4/2/14.

Louisiana: LA SB 165.  This bill limits patients’ coinsurance or copayment fees for specialty tier drugs to $150 per month for up to a thirty day period supply and allows patients to request an exception to obtain a specialty drug that would not otherwise be available on a health plan formulary.  Status: Passed Senate; passed to third reading in House on 5/8/14.

POPF AND SPPAN Position: Support

Louisiana: LA SB 410.  Requires pharmacy benefits managers to provide access to its Maximum Allowable Cost List and requires that the list be updated on a timely basis.  Requires a pharmacy benefits manager to provide a reasonable administrative appeal procedure and requires the manager to respond to an appeal challenge within seven business days.  Status: Passed Senate; scheduled for floor debate in House on 5/15/14.

POPF AND SPPAN Position: Support.

Bills Enacted Into Law

SB 187, sponsored by Sen. Thompson; passed both houses and signed by the governor. This bill would absolve veterinarians of the requirement to report to the PMP, would remove the veterinary representatives to the PMP Advisory Council, and would remove the ability of the state to charge a fee to veterinarians to support operation of the PMP.

POPF and SPPAN Position: We did not oppose this bill, but also did not ask advocates to take any action.

MARYLAND - Last Update: 5/15/2014

Maryland: MD HB 255 and SB 296. These bills would extend the sunset date for the PMP and require the Department of Legislative Services to conduct an outcome evaluation of the program. It also makes a few other changes to operational details of the program. Status: HB 255 approved by the Governor on 4/8/14; Chapter 92.

POPF AND SPPAN Position: Support.

Maryland: MD HB 1296. This bill provides for unsolicited reporting of information from the PMP. If a review of PMP data by the Technical Advisory Committee suggests that there is probably abuse or misuse, the program would be authorized to report that information to the prescribers and dispensers for the patient in question. Status: Passed House unanimously 3/15/14; passed Senate unanimously on 4/5/14; legislature adjourned on 4/7/14 and last gubernatorial action was due by 5/11/14. [NOTE: MD uses a “legislative date” rather than a “calendar date.”  The legislative date seems to currently be about one week behind the calendar date.  If that is so, the governor may actually have a few more days left to sign.]

POPF AND SPPAN Position: Support.

Maryland: MD HB 1233, SB 622. This bill generally relates to step therapy or fail-first protocols in health insurance policies and contracts. It requires that the Maryland Health Care Commission to work with payors and providers to attain benchmarks for overriding a payor’s step therapy or fail-first protocol. The bill requires the benchmarks to include, on or before January 1, 2015, establishment by a specified payor of a process for a provider to override the step therapy or fail-first protocol of the payor; limiting the duration of a step therapy or fail-first protocol, and more. Status: HB approved by Governor on 5/5/14, Chapter 317; SB approved by Governor on 5/5/14, Chapter 316.

POPF AND SPPAN Position: Support.

Maryland: MD SB 825. This bill generally relates to pharmacy benefit managers and specialty drugs. It requires, among other things, that a pharmacy benefits manager designates, on a specified formulary, the prescription drugs that are Tier I and Tier II specialty drugs, and the pharmacy benefits manager must submit a list of specified drugs to the Maryland Insurance Commissioner and update the list with a specified frequency. Status: Died when legislature adjourned on 4/7/14.

POPF AND SPPAN Position: Support.

MAINE

Bills Enacted Into Law

LD 388, sponsored by Rep. Dorney; passed both houses and became law without action by the governor. This bill allows the Maine PMP to establish automatic registration of prescribers as part of issuance or renewal of a license.

POPF and SPPAN Position: We supported this bill.

MONTANA

Bills Enacted Into Law

SB 323, sponsored by Sen. Thomas; passed both houses and has been signed by the governor. This amended bill permits prescribers to query the PMP before prescribing Schedule II or III medications to workers’ compensation patients. Note that they already have this capability.

POPF and SPPAN Position: POPF and SPPAN did not oppose this bill, but did not request any action by advocates.

MINNESOTA – update 5/15/2014

MinnesotaMN SF 2134HF 2527. This bill and its House twin contain a number of provisions updating and improving regulation of the PMP. Status: SF 2134 now refers to SF 1484, Article 2; re-referred to Finance. HF awaiting action in Civil Law Committee.

POPF AND SPPAN Position: Support

Minnesota: MN HF 2932. This bill makes multiple updates to the PMP.  It clarifies that, for purposes of the PMP, tramadol and butalbital are controlled substances.  It also exempts specific dispensers from reporting requirements, clarifies the length of time data will be maintained, and revises the management of the program.  Status: Committee on Government Operations reported “adopt as amended” and re-referred to Health and Human Services Policy on 3/26/14.

POPF AND SPPAN Position: Support

Minnesota: MN HF 1872. Specialty drugs and prescriptions designation requirements provided, mail-order prescriptions authorized, and cost pricing use limits imposed. Status: Commerce and Consumer Protection Finance and Policy Committee reported “adopt as amended” on 3/24/14.

POPF AND SPPAN Position: Support.

Bills Enacted Into Law

HF 1117, sponsored by Rep. Huntley, and SF 1077, sponsored by Sens. Rosen and Miller; both awaiting action in their respective committees; HF 1117 has passed both houses and was signed by the governor; SF 1077 has been replaced in the Senate by HF 1117. These twin bills would require the medical director of a methadone treatment program to check the PMP for program patients; document relevant findings in the patient’s file; seek the client’s consent to discuss the opioid treatment with prescribers of other contraindicated medications; and direct the commissioner overseeing these programs to seek a waiver from the federal government in order to allow methadone treatment programs to report their prescriptions to the PMP.

POPF and SPPAN Position: We opposed seeking a waiver to allow reporting to the PMP, and had no position on the rest of these bills’ provisions.

Bill Carried Over to Next Legislative Session (2013-2014): 

HF 1208, sponsored by Rep. Mullery, and SF 1081, sponsored by Sen. Rosen; HF 1208 is awaiting action in a House committee; SF 1081 has passed out of Senate committees and now awaits action on the Senate floor. These bills cover a number of topics. With respect to the PMP, they add tramadol and butalbital to the medications covered under the PMP; add a representative from the state association of medical examiners and coroners to the PMP Advisory Committee; allow access to PMP data by licensing boards when the disciplinary action does not relate to unusual or excessive prescribing; permit the PMP to archive data older than 12 months, with such an archive to be used only to administer, operate, or maintain the program or to conduct trend analyses and other effectiveness studies; allow access by licensing board personnel if investigating an allegation that a licensee is chemically dependent, has diverted controlled substances, or engaged in other inappropriate prescribing behavior; allow access by coroners and medical examiners; and allow access to personnel administering the impaired provider program; ensure that the log of people accessing the PMP is kept for at least 5 years; permit interstate data sharing; remove a provision that the board may release the name of a prescriber only with a written consent of the prescriber or valid search warrant or court order; and add the Board of Veterinary Medicine as one of the licensing boards responsible for contributing to funding of the program.

Action: We support these bills, and ask advocates to contact their legislators in support of them.

MISSOURI - Last Update: 5/15/14

Missouri: MO HB 1133.This is an act to establish a prescription monitoring program. POPF AND SPPAN has supported this bill and others like it in the past, and continues to do so. Status: Passed the House on a voice vote; awaiting action in Senate Governmental Accountability and Fiscal Oversight Committee.

POPF AND SPPAN Position: Support.

Missouri: MO HB 1799. Prohibits health carriers from requiring prior authorization for serious and urgent conditions and requires certain health benefit determinations to be made within four (4) hours rather than two (2) working days. This sounds like a good idea, but we are a little concerned that requiring such a rapid response to a PA request might lead to blanket rejections of requests. If assured that this is not the case, we would be supportive. Status: HCS voted ‘Do Pass’ on 4/10/14; referred to House Committee on Rules on 4/23/14.

Missouri: MO HB 2186. Establishes a single, standardized, one-page form for providers to submit written prior authorization requests. If an insurer or pharmacy benefit managers fails to use or accept a prior authorization form or fails to respond within 72 hours, the prior authorization shall be deemed granted.  Status: Public hearing completed on 5/1/14.

Missouri: MO SB 921. This bill is introduced by the state Senator who routinely filibusters and kills legitimate PMP legislation. It contains a number of very problematic provisions, and would create a PMP that is cumbersome and ineffective. Status: Awaiting action in Senate Governmental Accountability and Fiscal Oversight Committee.

POPF AND SPPAN Position: Strongly Oppose.

MISSISSIPPI - Last Update: 5/15/14

Mississippi: MS HB 414. This bill deletes the sunset date of the Mississippi PMP and specifies that veterinarians do not need to report their controlled substance prescriptions into the PMP. Status: Died in committee.

POPF AND SPPAN Position: Support.

Mississippi: MS HB 843. Specifies that PMP data may not be used in civil cases. Status: Died in committee.

POPF AND SPPAN Position: Support.

Mississippi: MS HB 844. Requires the Board of Veterinary Medicine to set up its own PMP to monitor medications dispensed by veterinarians. Status: Died in committee.

POPF AND SPPAN Position: Oppose; see HB 414 for related provisions.

Mississippi: MS HB 1178. Requires dispensers and prescribers to check the PMP before dispensing or prescribing controlled substances. Status: Died in committee.

POPF AND SPPAN Position: Oppose; request amendment.

Mississippi: MS HB 1272. Specifies that controlled substances dispensed by veterinarians be excluded from reporting requirements for the PMP. Status: Died in committee.

POPF AND SPPAN Position: Monitor; see HB 414 for similar provisions.

Mississippi: MS HB 1275. An act to extend the automatic repealer on the statute that provides health care services covered under Medicaid program; to delete limitation on ER visits covered under Medicaid; etc. Status: Approved by Governor on 4/15/14.

POPF AND SPPAN Position: Monitor

Mississippi: MS SB 2177. This bill extends the sunset date on the PMP to 2016. Read the Academy’s letter of support here. Status: Approved by Governor 3/13/14.

POPF AND SPPAN Position: Support.

NORTH CAROLINA - Last Update: 5/15/14

North Carolina: NC S 286. Would mandate use of PMP, stating that, prior to prescribing or dispensing a controlled substance, a prescriber or dispenser shall review all information pertaining to the patient in the controlled substances reporting system for the preceding 12-month period to determine if the prescription is medically necessary and appropriate. Status: Senate re-referred to Committee on Judiciary II on 4/10/14.

POPF AND SPPAN Position: Monitor.

NORTH DAKOTA

Bills Enacted Into Law

SB 2089, sponsored by the Human Services Committee on behalf of the Board of Pharmacy; signed by the governor on 4/1. Contains one clean-up provision regarding the format for reporting information into the PMP, and allows access to data by the state Department of Human Services for the additional purpose of “establishment and enforcement of child support and medical support.”

NEBRASKA - Last Update: 5/15/14

Nebraska: NE LB 535This bill would create a traditional PMP. Nebraska’s current PMP is atypical in that it revolves around participation in the Health Information Exchange. That approach has proven to be problematic. Status: Indefinitely postponed when legislature adjourned on 4/17/14.

POPF AND SPPAN Position: Support.

Nebraska: NE LB 1072. Changes some of the specifications of the current PMP model, but continues to implement and house it as part of the state health information exchange. Amendments also establish a separate fund to receive grants, gifts, and donations to support operation of the program, and establish a task force to study the status of the NE PMP in relation to other states’ PMPs, and to make recommendations on how best to proceed in NE. Status: Approved by Governor on 4/10/14

POPF AND SPPAN Position: We opposed the original bill, but we strongly support the amendments, so are changing our position to Support.

NEW HAMPSHIRE

SB 83, sponsored by Sen. Bradley and 14 other senators and 5 representatives; passed both houses and now awaits the governor’s action. This bill adds a representative of the NH Hospital Association to the advisory committee; changes the data of a required performance audit of the program from 12/31/14 to 12/31/17; and eliminates the sunset provision of the original bill.

Action: We support this bill, and ask advocates to contact the governor to express support.

WISCONSIN

Bills Enacted Into Law

AB 3, sponsored by Rep. Knudson and 48 other representatives and 15 Senators, and SB 7, sponsored by Sen. Moulton and 14 others, and by 49 representatives; AB 3 has passed both houses and has been signed by the governor. This bill would exempt veterinarians from reporting to the PMP.

NEW YORK – update 5/15/14

New York: NY AB 5214, SB 2711. This bill provides that when medications for the treatment of any medical condition are restricted by a step therapy or fail first protocol, a prescriber shall have access to a clear and convenient process, at no charge to the prescriber or patient, to expeditiously override such restriction under certain circumstances. Status: Assigned print numbers on 2/13/14 and 2/14/14, respectively; awaiting final committee action.

POPF AND SPPAN Position: Support.

New York: NY SB 6358. This bill contains provisions that the Commissioner of Health can mandate use of prior authorization if a refill is requested when more than a 6-day supply of the drug should remain, and when there are more than 4 prescriptions for an opioid analgesic in a 30-day period. These do not seem to us to be unreasonably onerous requirements. Status: Signed by Governor on 3/31/14; Chapter 58.

NEW MEXICO

LEGISLATURES ADJOURNED – Bills DO NOT Carry Over to Next Year (bill died)

HB 624, sponsored by Rep. McMillan and SB 641, sponsored by Sen. Ivey-Soto. As part of a larger set of policy changes, these bills would require licensing boards to set standards for how often providers need to query the PMP for their patients.

Action: We support these bills, although it should be noted that the licensing boards have already established these standards, as a result of legislation that passed last year. The legislature has adjourned for this year.

NEW JERSEY - Last Update: 5/15/14

New Jersey: NJ A 706. This bill does several things. 1) It permits unsolicited reporting of people seeing multiple prescribers in an attempt to obtain medications inappropriately; 2) It allows PMP administrators to screen for inappropriate/illegal behavior and make appropriate referrals to law enforcement and/or licensing boards; 3) It allows licensed healthcare workers to serve as delegates for prescribers; 4) It allows interstate data sharing; and 5) It requires a court order before PMP data can be released to law enforcement. It also provides access to data for a number of others, all of whom we believe to be appropriate. We support this bill, although we caution that the details about how administrators screen for inappropriate or illegal behavior could be problematic. Status: Awaiting action in Health and Senior Services Committee.

POPF AND SPPAN Position: Support

New Jersey: NJ A 1232. Requires prescribers and pharmacists to check prescription monitoring program prior to prescribing and dispensing Schedule II drugs. While we support universal use of the PMP, we are not yet ready to endorse mandated universal use. We can support such a mandate only when conditions are in place to streamline this process for healthcare providers; i.e., we need to see that PMP data are automatically integrated into EHRs or HIEs, that delegates are permitted to submit queries for providers, or other similar provisions are in place. Status: Awaiting action in the Health and Senior Services Committee.

POPF AND SPPAN Position: Neutral/Monitor

New Jersey: NJ A 3007. This bill would require practitioners to check the prescription monitoring program prior to issuing prescriptions for Schedule II controlled dangerous substances to certain patients and would require practitioners to submit to the prescription monitoring program certain information concerning all prescriptions issued for Schedule II controlled dangerous substances.  The bill would also expand access to PMP information by authorizing delegate authority.  Status: Awaiting action in the Health and Senior Services Committee.

POPF AND SPPAN Position: Amend. We support all of this bill except the requirement that the PMP be checked before every prescription; we believe that is too often.

New Jersey: NJ A 3008. This bill would require pharmacies to submit information on dispensed prescriptions at least once each business day (the current requirement is once each 15 days).  The bill also requires prescribers and dispensers of Schedule II drugs to check the information available through the PMP prior to doing so.  Further, the bill provides greater access to PMP information by law enforcement agencies, allowing an agency engaged in a bona fide specific investigation of a designated practitioner or patient to access PMP information without a court order or grand jury subpoena (required by current law).  Status: Awaiting action in the Health and Senior Services Committee.

POPF AND SPPAN Position: Oppose. We specifically oppose the requirement to check the PMP before every prescription, and we believe that law enforcement should be required to obtain a court order or subpoena before being allowed access to PMP information.

New Jersey: NJ A 3010. The bill would require pharmacy permit holders to submit information concerning prescriptions for Schedule II controlled dangerous substances at least once every five days, instead of once every 30 days as required under current law.  Status: Awaiting action in the Health and Senior Services Committee.

POPF AND SPPAN Position: Oppose. Although this would be a substantial improvement, it is not enough; we prefer submission every day.

New Jersey: NJ A 3062. This bill implements recommendations of the State Commission of Investigation’s July 2013 report entitled “Scenes from an Epidemic: A Report on the SCI’s Investigation of Prescription Pill and Heroin Abuse.”  In part, the bill requires pharmacies to submit information on dispensed prescriptions at least once each business day (current law is once each 15 days).  Further, a law enforcement agency who is engaged in a bona fide specific investigation of a designated practitioner or patient may access prescription monitoring information without a court order or grand jury subpoena.  The bill also requires prescribers and dispensers of Schedule II drugs to check the information available through the PMP prior to doing so. Status: Hearing scheduled in the Assembly Judiciary Committee on 5/15/14.

POPF AND SPPAN Position: Oppose. We support the change to daily reporting, but oppose the other two provisions.

New Jersey: NJ A 3075NJ S 1948.  This bill would require that pharmacies submit prescription monitoring information to the PMP on a real-time basis rather than every 14 days. Further, the bill would require that pharmacists and practitioners register to participate in the PMP, and that the division evaluate whether any person is obtaining a prescription in a manner indicative of misuse, abuse, or diversion of a controlled dangerous substance. Finally, the bill provides for interstate data sharing of PMP information. Status: A 3075 referred to Assembly Health and Senior Services Committee on 5/8/14; S 1948 referred to Senate Health, Human Services and Senior Citizens Committee on 4/28/14.

POPF AND SPPAN Position: Support, although we recognize that requiring real-time data submission may be pushing the envelope in terms of what is feasible at this time. We’d also accept a mandate for daily reporting.

New Jersey: NJ A 3129NJ S 1998.  This bill requires dispensers to submit identifying information for any individual other than the patient for whom the prescription was written who picks up a prescription.  Further, pharmacy permit holders must submit PMP information to the division every seven days, rather than every 30 days.  Further, the bill adds a provision requiring that the division evaluate whether any person is obtaining a prescription in a manner indicative of misuse, abuse, or diversion of a controlled dangerous substance.  The bill also increases access to PMP information, expanding the class of persons who may access a patient’s PMP history.  NJ A 3129 is a companion to NJ S 1998, but incorporates certain changes.  Status: A 3129 referred to Assembly Appropriations Committee on 5/8/14; S 1998 referred to Senate Health, Human Services and Senior Citizens Committee on 4/28/14.

POPF AND SPPAN Position: Support, although we believe that reporting data every seven days is not frequently enough. We would prefer to see daily reporting.

New Jersey: NJ S 101. This bill would require checking the PMP before prescribing and dispensing C-IIs. POPF AND SPPAN believes that if PMP checks are to be required, they should be required for all schedules. Status: Awaiting action in Senate Health, Human Services, and Senior Citizens Committee.

POPF AND SPPAN Position: Oppose in its current form.

New Jersey: NJ S 364. This bill would: provide for unsolicited reporting; allow delegate authority; allow interstate data sharing; require probable cause to disclose PMP info to law enforcement organizations. It also provides access for others, all of whom POPF AND SPPAN believes are appropriate. Status: Awaiting action in Senate Health, Human Services, and Senior Citizens Committee.

POPF AND SPPAN Position: Support.

New Jersey: NJ S 523. Under this bill, pharmacy benefits management companies must be certified by the Department of Banking and Insurance. Further, this bill requires a PBM to make certain disclosures to health care practitioners, covered persons, and purchasers if that PBM seeks authorization to substitute a drug prescribed by a healthcare practitioner to a covered person. It also defines the circumstances in which a prescribed drug may be substituted for another. Status: Introduced and referred to the Senate Commerce Committee on 1/14/14.

POPF AND SPPAN Position: Support.

New Jersey: NJ S 1231. This bill establishes rules for the use of step therapy or fail-first protocols for medications used for the treatment of pain. The duration of step therapy shall be determined by the prescriber; a patient shall not be required to try and fail on more than one pain medication before obtaining coverage for the pain medication which has been prescribed. Once a patient has tried and failed a step therapy medication, their prescribed medication shall no longer be subject to prior authorization. Status: Introduced and referred to the Senate Commerce Committee on 1/30/14.

POPF AND SPPAN Position: Support.

New Jersey: NJ A 2676. Concerning health benefits coverage for the treatment of pain and supplementing various parts of the statutory law. Restricts health insurers from limiting access to pain medication. Status: Introduced and referred to Assembly Health and Senior Services Committee on 2/20/14.

POPF AND SPPAN Position: Support.

New Jersey: NJ A 1713. Requires Commissioner of Banking and Insurance to develop standard prior authorization form for prescription drug benefits for use by network providers. Status: Awaiting action in the Assembly Financial Institutions and Insurance Committee.

New Jersey: NJ A 1942. Deletes prior authorization requirements by certain insurers for accessing certain health care services. Status: Awaiting action in the Assembly Financial Institutions and Insurance Committee.

OHIO - updated 5/15/2014

Ohio: OH HB 341. Requires dentists and optometrists to access the PMP before an initial prescription of an opioid or a benzodiazepine, and at least every 90 days thereafter if the patient continues to have those prescriptions; makes the same requirement for physicians, nurses and physician assistants, unless the supply in the prescription is for less than 7 days and/or prescribed for treatment of cancer-related pain or in hospice care; provides access to PMP data for the medical director of a worker’s compensation company. Status: Passed the House 96-0; heard by Senate Committee on Insurance and Financial Institutions on 5/13/14.

POPF AND SPPAN Position: Amend. We object to the exceptions related to cancer pain and hospice care. If this bill is legitimately designed to provide a measure of patient safety, then we do not think people with cancer or receiving hospice care should go unprotected.

Ohio:  OH HB 501.  To add the drug Zohydro to the list of Schedule I controlled substances.  See Academy’s statement and other relevant news on Zohydro here.  Status: Heard by the Opiate Addiction, Treatment, and Reform Subcommittee on 5/13/14.

POPF AND SPPAN Position:  Oppose.

OREGON – updated 5/15/14

Oregon: OR SB 1539. This bill establishes that health plans using step therapy shall provide a clear and convenient process for expeditiously obtaining an override in certain circumstances. Status: Died in committee upon adjournment.

POPF AND SPPAN Position: Support.

Oregon: OR HB 4013. Authorizes practitioners to electronically transmit prescriptions for Schedule II controlled substances in nonemergency situations. Requires specified entities that reimburse cost of prescription drugs to make easily accessible to prescribing practitioners information about step therapy protocols required by entities for prescription drug coverage. Declares emergency, effective on passage. Status: Signed by Governor 3/13/14; Chapter 55.

OKLAHOMA - Last Update: 5/15/14

Oklahoma: OK HB 2665. This bill provides for interstate data sharing by the Oklahoma PMP. Status: Approved by Governor on 4/25/14.

POPF AND SPPAN Position: Support.

Oklahoma: OK SB 1820. This bill permits access to PMP data for medical practitioners and their staffs employed by the federal government within Oklahoma. This is primarily designed to allow access by practitioners working at DOD, VA, and IHS facilities. Status: Passed both houses; House amendments rejected; Conference granted on 5/12/14.

POPF AND SPPAN Position: Support.

Oklahoma: OK SB 1821. This bill allows PMP access by medical practitioners and staff employed in Oklahoma by the federal government; expands access for law enforcement officers investigating civil or administrative cases; requires a PMP check prior to prescribing or authorizing a refill of any controlled substance, which must be documented in the patient’s file; exempts patients in hospice or end-of-life care from such a required PMP check. Status: Passed Senate; awaiting action in House Public Health Committee.

POPF AND SPPAN Position: Oppose

PENNSYLVANIA - Last Update: 5/15/14

PennsylvaniaPA SB 1180. An Act providing for prescription drug monitoring; creating the ABC-MAP Board; establishing the Achieving Better Care by Monitoring All Prescriptions Program; and providing for unlawful acts and penalties.  Status:  Passed Senate on 5/6/14.

POPF AND SPPAN Position: Support

Pennsylvania: PA HR 348. A Resolution directing the Legislative Budget and Finance Committee to study the issue of specialty tier prescription drug pricing in Pennsylvania. Status: Amended and adopted on 4/2/14.

POPF AND SPPAN Position: Support.

Pennsylvania: PA HB 2203.  An act to restrict access to the prescription painkiller Zohydro.  The bill outlines detailed instructions pertaining to steps a prescriber must take in order to prescribe Zohydro.  Status: Laid on the table on 5/6/14.

POPF AND SPPAN Position: Oppose. Many of the detailed instructions are parts of good medical practice, while others are unnecessary; however, there is no reason for these restrictions to be placed on Zohydro instead of the entire class of ER/LA opioids.

Pennsylvania: PA HB 1287. This bill provides for electronic prior approval for Medicaid. Status: Awaiting action in the House Public Health and Welfare Committee.

RHODE ISLAND - Last Update: 5/15/14

Rhode Island: RI H 7574. This bill adds delegate authority and mandates registration of providers to use the PMP. Status: Scheduled for hearing in Senate Health and Human Services Committee on 5/15/14.

POPF AND SPPAN Position: Support

Rhode Island: RI S 2501. This act would require all health insurance plans issued in this state that provide coverage for prescription drugs, to provide coverage for short term “step-therapy” prescription programs. The act would spell out the conditions under which a prescriber would be permitted to override certain drug restrictions. Status: Committee recommended measure be held for further study on 4/8/14.

POPF AND SPPAN Position: Support.

Rhode Island: RI H 6237. This act would give the prescribers of medication the discretion to request prior authorization for an abuse-deterrent medication for patients with a history of abuse or diversion or at risk of abusing drugs. Status: Awaiting action in the House Health, Education, and Welfare Committee.

POPF AND SPPAN position: Monitor

Rhode IslandRI S 2523. This bill permits delegates for prescribers and pharmacists to access PMP information, and requires that all prescribers and pharmacists register to use the PMP. Status: Scheduled for hearing in House H.E.W. on 5/14/14.

POPF AND SPPAN Position: Support

SOUTH CAROLINA - Last Update: 5/15/14

South Carolina: SC S 840. This bill would limit the disclosure of data from the PMP, limiting law enforcement organizations, workers’ compensation, Medicaid, and research users to 12 months of data unless they obtain a court order. Status: Passed the Senate unanimously; now awaiting action in the House Judiciary Committee.

POPF AND SPPAN Position: Monitor.

TENNESSEE - Last Update: 5/15/14

Tennessee: TN HB 1426, SB 1630. These twin bills would allow PMP reports to be placed into patients’ medical records. After inclusion in the medical record, they can be accessed the same as any other part of the medical record. This is an expansion of access to PMP reports, and further, those reports may no longer be timely and accurate by the time the report is reviewed within the medical record. POPF AND SPPAN does not see a need for this expansion and would oppose. Both bills have been amended to allow de-identified data to be provided for research. Status: SB 1630 was signed; became Pub. C. 622 on 4/14/14.

POPF AND SPPAN Position: Oppose.

Tennessee: TN HB 2400, SB 2547. These bills require the Board of Pharmacy, which operates the PMP, to consult with the state Health Commissioner before hiring staff to operate the program. This seems to be an unwarranted and unnecessary intrusion to us. Status: HB substituted for SB 2547; SB transmitted to Governor on 5/13/14.

POPF AND SPPAN Position: Oppose.

TEXAS

LEGISLATURES ADJOURNED – Bills DO NOT Carry Over to Next Year (bill died)

HB 3301, sponsored by Rep. McClendon; awaiting action in the House Public Health Committee. This bill permits the Texas State Board of Pharmacy to make a variety of rules to improve the efficiency of the PMP, including the addition or deletion of drugs to be monitored by the PMP; allows the state to contract with an outside vendor to run the PMP; allows the board to collect fees and accept gifts and grants to support operation of the PMP; and contains 42 more pages with various changes to pharmacy practice.

Action: We support the PMP provisions of this bill, and have no position on the remaining provisions.

UTAH - Last Update: 5/15/14

Utah: UT SB 29. Allows Medicaid managed care organizations to access PMP data if there is suspicion of a Medicaid recipient improperly obtaining controlled substances, subject to a written agreement with Departments of Health and of Commerce. Status: Signed by Governor on 3/27/14.

POPF AND SPPAN Position: Support.

Utah: UT SB 178. Allows pharmacists to designate pharmacy technicians as delegates to access PMP information. Status: Governor signed on 4/1/14.

POPF AND SPPAN Position: Support.

VIRGINIA - Last Update: 5/15/14

Virginia: VA HB 539. This bill allows delegate authority for PMP access. Status: Signed by the Governor on 3/3/14, Chapter 0072.

POPF AND SPPAN Position: Support.

Virginia: VA HB 874. This bill allows the promulgation of regulations designating specific drugs and substances, including any controlled substance or other drug or substance that is identified as having actual or relative potential for abuse, as drugs of concern. Drugs of concern shall be reported to the Department of Health Professions and shall be subject to reporting requirements for the PMP. Status: Signed by Governor on 4/6/14, Chapter 0664.

POPF AND SPPAN Position: Support.

Virginia: VA HB 923. Specifies that when the Director, in his discretion, discloses information that is in the possession of the program concerning a recipient who is over the age of 18 to that recipient, the information shall be mailed to the street or mailing address indicated on the recipient request form. Status: Passed both houses unanimously and signed by the Governor, Chapter 0012.

POPF AND SPPAN Position: Neutral.

Virginia: VA HB 998. Requires dispensers to comply with the reporting requirements of the Prescription Monitoring Program within three days of dispensing a covered substance. We strongly believe this should be amended to provide for daily reporting. Status: Bill is dead–stricken from docket by Health, Welfare, and Institutions by voice vote on 1/14/14.

POPF AND SPPAN Position: Neutral.

Virginia: VA HB 1249. This bill would require prescribers to request information from the PMP for the purpose of establishing treatment history prior to initiating treatment with buprenorphine and then 30 days after initiating such treatment and at least every 90 days thereafter for so long as the prescriber continues to prescribe buprenorphine for the patient. Status: Signed by the governor on 3/3/14, Chapter 0093.

POPF AND SPPAN Position: Support.

Virginia: VA SB 207. This bill would require licensed providers of treatment for persons with opiate addiction through the use of methadone or other opioid replacements to comply with the reporting requirements of the Prescription Monitoring Program. This would require a change to federal law, which currently prohibits disclosure of this information. Status: Stricken at the request of patron in Education and Health on 1/23/14.

POPF AND SPPAN Position: Oppose.

Virginia: VA SB 294. Requires prescribers licensed in the Commonwealth to register with the Prescription Monitoring Program. The bill also requires registered prescribers to request PMP information regarding a patient’s treatment history prior to issuing an initial prescription for benzodiazepine or an opiate. Status: Signed by Governor on 3/5/14; Chapter 0178; effective 7/1/15.

POPF AND SPPAN Position: Support

Virginia: VA HB 304. This bill establishes that enrollees’ coinsurance or copayment fees for specialty tier drugs will be limited to $150 per month for up to a 30-day supply of any single specialty tier drug. Patients will also be able to request an exception to obtain a specialty drug that would not otherwise be available on a health benefit plan formulary. Status: Died in House Committee on Commerce and Labor 2/12/14; legislative session adjourned on 3/8/14.

POPF AND SPPAN Position: Support.

VERMONT - Last Update: 5/15/14

Vermont: VT HB 77, SB 44. These twin bills propose to make publicly available the requirements for prior authorizations and to define and set standards for adverse determinations. Status: Both bills died when legislature adjourned on 5/10/14.

Vermont: VT HB 668. Eliminates the PA requirement for certain classes of medication and requires PA for medications for chronic conditions only once every three years. Status: Died when legislature adjourned on 5/10/14.

Vermont: VT SB 236. An act relating to prescription refill synchronization. Status: Died when legislature adjourned on 5/10/14.

WASHINGTON – updated 5/15/2014

Washington: WA HB 1593. This bill would allow PMP data to be shared with personnel of a clinical laboratory when such personnel is providing assistance in determining which medications are being used by a particular patient. Status: Passed the House unanimously and passed the Senate Committee on Health Care; needs to clear the Senate Rules Committee to reach the Senate floor; legislative session adjourned on 3/13/14.

POPF AND SPPAN Position: Oppose.

Washington: WA SB 6511. Provides that the insurance commissioner must reauthorize the efforts with the lead organization established in RCW 48.165.030, and must establish a new work group to develop recommendations for prior authorization requirements. The recommendations are to be submitted by October 31, 2014. Status: Signed by Governor on 3/28/14; Chapter 141, 2014 Laws; effective 6/12/14.


Bills Enacted Into Law

HB 1565 and SB 5493, sponsored by 6 representatives and 3 senators, respectively; HB 1565 passed both houses and was signed by the governor. These twin bills will provide for ongoing funding of the PMP with funds from the Medicaid fraud penalty account.

POPF and SPPAN Position:  We supported this bill.

WEST VIRGINIA – updated 5/15/2014

West Virginia:WV HB 2327. This bill adds the county sheriff, or his or her designee, to those law enforcement officials who are granted access to the PMP in order to identify unusual or abnormal drug practices. Status: Died in House Health and Human Resources Committee; legislative session adjourned on 3/8/14.

POPF AND SPPAN Position: Support.

West Virginia: WV HB 4059SB 108. This bill authorizes the Board of Dental Examiners to promulgate a legislative rule relating to practitioner requirements for accessing the West Virginia PMP; note that the rule has already been promulgated. Status: HB 4059 reported in Com. Sub. for HB 4039, passed on 3/8/14; SB 108 died awaiting action in the Senate Judiciary Committee; legislative session adjourned on 3/8/14.

POPF AND SPPAN Position: Support.

West Virginia: WV HB 4091SB 117. This bill authorizes the Board of Pharmacy to promulgate a legislative rule relating to requirements for accessing the West Virginia PMP; note that the rule has already been promulgated. Status: HB 4059 reported in Com. Sub. for HB 4039, passed on 3/8/14; SB 117 died awaiting action in the Senate Judiciary Committee; legislative session adjourned on 3/8/14.

POPF AND SPPAN Position: Support.

West Virginia: WV SB 492. This bill relates generally to specialty drugs. It requires, among other things, that: the Board of Pharmacy develop a list of specialty drugs after consulting with state pharmacy schools; establishment of criteria to select specialty drugs; and pharmacy benefit managers must follow the developed list. Status: Died in Senate Judiciary Committee; legislative session adjourned on 3/8/14.

POPF AND SPPAN Position: Support.

Bills Enacted Into Law

SB 236SB 277SB 295SB 297; and SB 305, all sponsored by Sen. Snyder, and all awaiting committee action; and HB 2689, sponsored by Rep. Poore. HB 2689 has passed both houses and was signed by the governor. These bills authorize the Boards of Dental Examiners, Medicine, Osteopathic Medicine, Pharmacy, and Registered Professional Nurses (respectively) all to make rules regarding requirements for their practitioners to access the PMP.

POPF and SPPAN Position:  We have no position on these bills and do not ask advocates to take action at this time. These bills appear to permit the boards to take actions they have already taken. The legislature has adjourned for this year.

SB 10, sponsored by Sens. Jenkins and Plymale; passed the Senate 34-0 on 3/27 and the House Government Organization Committee on 4/2; now goes to the House Judiciary Committee. This bill would allow the Boards of Medicine, Dental Examiners, and Osteopathy all to independently initiate disciplinary proceedings based on a report or information from an agent or investigator of the Board of Pharmacy related to data from the controlled substance monitoring program.

Action: This is a broad provision, and until we are able to determine the circumstances under which such information would be provided to the licensing boards, we do not support it. The legislature has adjourned for this year.

PUERTO RICO

C3281- November to be RSD awareness month

C3282- Oct. 17th to be International Pain Day

C3283- September to be Pain Awareness Month

Support for Puerto Rico Awareness Bills

Yazmine Michelle is asking for support for three projects under consideration of the Commission of Health of Puerto Rico:

C3281 month — November proclaimed as the awareness month for Complex Regional Pain Syndrome

C3282  International Pain Day– Oct. 17 as indicated by the World Health Organization

The C3283 Pain Awareness Month– September, as  proposed by the American Pain Foundation

Please offer your support by writing letters or e-mails indicating the condition that  affected you or your family or friend and include a brief story. Please remember to include the name of your town.

You can send them to gobierno.camara@gmail.com  with a copy to puertoricochallengersd@live.com  The title should indicate the project  number

Thank you for your collaboration and please share this information with others.

Apoyo A Proyectos De Sensibilización

De Puerto Rico

Yazmine Michelle está pidiendo apoyo a tres proyectos bajo consideración de la Comisión de salud de Puerto Rico:

C3281 Mes–noviembre proclamada como el mes de concienciación para el síndrome de dolor Regional complejo

C3282 internacional dolor día–17 de octubre como se indica por la Organización Mundial de la salud

El mes de concienciación de dolor de C3283–septiembre, propuesto por la Fundación Americana del dolor

Por favor, ofrecen su apoyo por escribir cartas o mensajes de correo electrónico que indica la condición que afectó a usted o a su familia o amigo e incluyen una breve historia. Recuerde que debe incluir el nombre de su ciudad.

Usted puede enviar a gobierno.camara@gmail.com  con copia a puertoricochallengersd@live.com  el título debe indicar el número de proyecto

Gracias por su colaboración y comparta esta información con otras personas.