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AB-1048 Health care: pain management and Schedule II drug prescriptions.(2017-2018)

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Date Published: 07/04/2017 04:00 AM
AB1048:v93#DOCUMENT

Amended  IN  Senate  July 03, 2017
Amended  IN  Senate  June 21, 2017
Amended  IN  Senate  June 15, 2017
Amended  IN  Assembly  April 27, 2017
Amended  IN  Assembly  April 19, 2017
Amended  IN  Assembly  March 21, 2017

CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Assembly Bill No. 1048


Introduced by Assembly Member Arambula

February 16, 2017


An act to add Section 4052.10 to the Business and Professions Code, to amend Section 1254.7 of, and to add Section 1367.43 to, the Health and Safety Code, and to add Section 10123.203 to the Insurance Code, relating to health care.


LEGISLATIVE COUNSEL'S DIGEST


AB 1048, as amended, Arambula. Health care: pain management and Schedule II drug prescriptions.
(1) The Pharmacy Law provides for the licensing and regulation of pharmacists by the California State Board of Pharmacy in the Department of Consumer Affairs. The law specifies the functions pharmacists are authorized to perform, including to administer, orally or topically, drugs and biologicals pursuant to a prescriber’s order, and to administer immunizations pursuant to a protocol with a prescriber. A violation of the Pharmacy Law is a crime.
This bill would would, beginning July 1, 2018, authorize a pharmacist to dispense a Schedule II controlled substance as a partial fill if requested by the patient or the prescriber. The bill would require the pharmacy to retain the original prescription, with a notation of how much of the prescription has been filled, the date and amount of each partial fill, and the initials of the pharmacist dispensing each partial fill, until the prescription has been fully dispensed. The bill would authorize a pharmacist to charge a professional dispensing fee to cover the actual supply and labor costs associated with dispensing each partial fill associated with the original prescription. By creating a new crime, this bill would impose a state-mandated local program.
(2) Existing law provides for the licensure and regulation of health facilities by the State Department of Public Health. Existing law requires a health facility, as a condition of licensure, to include pain as an item to be assessed at the same time vital signs are taken and to ensure that pain assessment is performed in a consistent manner that is appropriate to the patient.
This bill would remove the requirement that pain be assessed at the same time as vital signs.
(3) Existing law, the Knox-Keene Health Care Service Plan Act of 1975 (Knox-Keene Act), provides for the licensure and regulation of health care service plans by the Department of Managed Health Care, and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law imposes various requirements and restrictions on health care service plan contracts issued by health care service plans and health insurance policies issued by health insurers, including those that cover prescription drug benefits, as specified.
This bill would prohibit a health care service plan contract or a health insurance policy that is issued, amended, or renewed on or after January July 1, 2018, from allowing the health care service plan, the insurer, or the entity with which either contracts to administer prescription drug benefits from considering a copayment or any portion thereof, or the payment for the ingredient costs of the drug, paid to a pharmacy for a partial fill of a prescription, to be an excess payment recoverable by the plan, the insurer, or the contracting entity or a basis for denial of the pharmacy’s claim for reimbursement for the medication. The bill would also require a health care service plan and an insurer to prorate a copayment for a partial fill of a prescription. By creating a new crime under the Knox-Keene Act, this bill would impose a state-mandated local program.
(4) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: YES  

The people of the State of California do enact as follows:


SECTION 1.

 Section 4052.10 is added to the Business and Professions Code, to read:

4052.10.
 (a) A pharmacist may dispense a Schedule II controlled substance, as listed in Section 11055 of the Health and Safety Code, as a partial fill if requested by the patient or the prescriber.
(b) If a pharmacist dispenses a partial fill on a prescription pursuant to this section, the pharmacy shall retain the original prescription, with a notation of how much of the prescription has been filled, until the prescription has been fully dispensed. The total quantity dispensed shall not exceed the total quantity prescribed.
(c) Subsequent fills, until the original prescription is completely dispensed, shall occur at the pharmacy where the original prescription was partially filled. The full prescription shall be dispensed not more than 30 days after the date on which the prescription was written. Thirty-one days after the date on which the prescription was written, the prescription shall expire and no more of the drug shall be dispensed without a subsequent prescription.
(d) The pharmacist shall record in the state prescription drug monitoring program only the actual amounts of the drug dispensed.
(e) The pharmacist shall record the date and amount of each partial fill in a readily retrievable form and on the original prescription, and shall include the initials of the pharmacist who dispensed each partial fill.
(f) A pharmacist may charge a dispensing fee professional dispensing fee, as defined in Section 14105.45 of the Welfare and Institutions Code, to cover the actual supply and labor costs associated with dispensing each partial fill associated with the original prescription.
(g) This section is not intended to conflict with or supersede any other requirement established for the prescription of a Schedule II controlled substance.
(h) For purposes of this section, the following definitions apply:
(1) “Original prescription” means the prescription presented by the patient to the pharmacy or submitted electronically to the pharmacy.
(2) “Partial fill” means a part of a prescription filled that is of a quantity less than the entire prescription.
(i) This section shall become operative on July 1, 2018.

SEC. 2.

 Section 1254.7 of the Health and Safety Code is amended to read:

1254.7.
 (a) It is the intent of the Legislature that pain be assessed and treated promptly, effectively, and for as long as pain persists.
(b) A health facility licensed pursuant to this chapter shall, as a condition of licensure, include pain as an item to be assessed. The health facility shall ensure that pain assessment is performed in a consistent manner that is appropriate to the patient. The pain assessment shall be noted in the patient’s chart.

SEC. 3.

 Section 1367.43 is added to the Health and Safety Code, to read:

1367.43.
 (a) A health care service plan contract that is issued, amended, or renewed on or after January July 1, 2018, shall not allow the health care service plan or the entity with which it contracts to administer prescription drug benefits for enrollees, enrollees to consider a copayment or any portion thereof, or the payment for the ingredient costs of the drug, paid to a pharmacy for a partial fill of a prescription pursuant to Section 4052.10 of the Business and Professions Code, Code to be an excess payment recoverable by the plan or its contracting entity or a basis for denial of the pharmacy’s claim for reimbursement for the medication.
(b) A health care service plan shall prorate a copayment for a partial fill of a prescription dispensed pursuant to Section 4052.10 of the Business and Professions Code.

SEC. 4.

 Section 10123.203 is added to the Insurance Code, to read:

10123.203.
 (a) A health insurance policy that is issued, amended, or renewed on or after January July 1, 2018, shall not allow the insurer or the entity with which it contracts to administer prescription drug benefits for the insured, insured to consider a copayment or any portion thereof, or the payment for the ingredient costs of the drug, paid to a pharmacy for a partial fill of a prescription pursuant to Section 4052.10 of the Business and Professions Code, Code to be an excess payment recoverable by the insurer or its contracting entity or a basis for denial of the pharmacy’s claim for reimbursement for the medication.
(b) An insurer shall prorate a copayment for a partial fill of a prescription dispensed pursuant to Section 4052.10 of the Business and Professions Code.

SEC. 5.

 No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.