SB1665 EnrolledLRB101 05906 SLF 50927 b

1    AN ACT concerning criminal law.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Illinois Controlled Substances Act is
5amended by changing Sections 314.5, 316, and 320 as follows:
6    (720 ILCS 570/314.5)
7    Sec. 314.5. Medication shopping; pharmacy shopping.
8    (a) It shall be unlawful for any person knowingly or
9intentionally to fraudulently obtain or fraudulently seek to
10obtain any controlled substance or prescription for a
11controlled substance from a prescriber or dispenser while being
12supplied with any controlled substance or prescription for a
13controlled substance by another prescriber or dispenser,
14without disclosing the fact of the existing controlled
15substance or prescription for a controlled substance to the
16prescriber or dispenser from whom the subsequent controlled
17substance or prescription for a controlled substance is sought.
18    (b) It shall be unlawful for a person knowingly or
19intentionally to fraudulently obtain or fraudulently seek to
20obtain any controlled substance from a pharmacy while being
21supplied with any controlled substance by another pharmacy,
22without disclosing the fact of the existing controlled
23substance to the pharmacy from which the subsequent controlled



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1substance is sought.
2    (c) A person may be in violation of Section 3.23 of the
3Illinois Food, Drug and Cosmetic Act or Section 406 of this Act
4when medication shopping or pharmacy shopping, or both.
5    (c-5) Effective January 1, 2018, each prescriber
6possessing an Illinois controlled substances license shall
7register with the Prescription Monitoring Program.
8Notwithstanding any provision of this Act to the contrary,
9beginning on and after the effective date of this amendatory
10Act of the 101st General Assembly, a licensed veterinarian
11shall be exempt from registration and prohibited from accessing
12patient information in the Prescription Monitoring Program.
13Licensed veterinarians that are existing registrants shall be
14removed from the Prescription Monitoring Program. Each
15prescriber or his or her designee shall also document an
16attempt to access patient information in the Prescription
17Monitoring Program to assess patient access to controlled
18substances when providing an initial prescription for Schedule
19II narcotics such as opioids, except for prescriptions for
20oncology treatment or palliative care, or a 7-day or less
21supply provided by a hospital emergency department when
22treating an acute, traumatic medical condition. This attempt to
23access shall be documented in the patient's medical record. The
24hospital shall facilitate the designation of a prescriber's
25designee for the purpose of accessing the Prescription
26Monitoring Program for services provided at the hospital.



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1    (d) When a person has been identified as having 3 or more
2prescribers or 3 or more pharmacies, or both, that do not
3utilize a common electronic file as specified in Section 20 of
4the Pharmacy Practice Act for controlled substances within the
5course of a continuous 30-day period, the Prescription
6Monitoring Program may issue an unsolicited report to the
7prescribers, dispensers, and their designees informing them of
8the potential medication shopping. If an unsolicited report is
9issued to a prescriber or prescribers, then the report must
10also be sent to the applicable dispensing pharmacy.
11    (e) Nothing in this Section shall be construed to create a
12requirement that any prescriber, dispenser, or pharmacist
13request any patient medication disclosure, report any patient
14activity, or prescribe or refuse to prescribe or dispense any
16    (f) This Section shall not be construed to apply to
17inpatients or residents at hospitals or other institutions or
18to institutional pharmacies.
19    (g) Any patient feedback, including grades, ratings, or
20written or verbal statements, in opposition to a clinical
21decision that the prescription of a controlled substance is not
22medically necessary shall not be the basis of any adverse
23action, evaluation, or any other type of negative
24credentialing, contracting, licensure, or employment action
25taken against a prescriber or dispenser.
26(Source: P.A. 99-480, eff. 9-9-15; 100-564, eff. 1-1-18.)



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1    (720 ILCS 570/316)
2    Sec. 316. Prescription Monitoring Program.
3    (a) The Department must provide for a Prescription
4Monitoring Program for Schedule II, III, IV, and V controlled
5substances that includes the following components and
7        (1) The dispenser must transmit to the central
8    repository, in a form and manner specified by the
9    Department, the following information:
10            (A) The recipient's name and address.
11            (B) The recipient's date of birth and gender.
12            (C) The national drug code number of the controlled
13        substance dispensed.
14            (D) The date the controlled substance is
15        dispensed.
16            (E) The quantity of the controlled substance
17        dispensed and days supply.
18            (F) The dispenser's United States Drug Enforcement
19        Administration registration number.
20            (G) The prescriber's United States Drug
21        Enforcement Administration registration number.
22            (H) The dates the controlled substance
23        prescription is filled.
24            (I) The payment type used to purchase the
25        controlled substance (i.e. Medicaid, cash, third party



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1        insurance).
2            (J) The patient location code (i.e. home, nursing
3        home, outpatient, etc.) for the controlled substances
4        other than those filled at a retail pharmacy.
5            (K) Any additional information that may be
6        required by the department by administrative rule,
7        including but not limited to information required for
8        compliance with the criteria for electronic reporting
9        of the American Society for Automation and Pharmacy or
10        its successor.
11        (2) The information required to be transmitted under
12    this Section must be transmitted not later than the end of
13    the next business day after the date on which a controlled
14    substance is dispensed, or at such other time as may be
15    required by the Department by administrative rule.
16        (3) A dispenser must transmit the information required
17    under this Section by:
18            (A) an electronic device compatible with the
19        receiving device of the central repository;
20            (B) a computer diskette;
21            (C) a magnetic tape; or
22            (D) a pharmacy universal claim form or Pharmacy
23        Inventory Control form. ;
24        (4) The Department may impose a civil fine of up to
25    $100 per day for willful failure to report controlled
26    substance dispensing to the Prescription Monitoring



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1    Program. The fine shall be calculated on no more than the
2    number of days from the time the report was required to be
3    made until the time the problem was resolved, and shall be
4    payable to the Prescription Monitoring Program.
5    (a-5) Notwithstanding subsection (a), a licensed
6veterinarian is exempt from the reporting requirements of this
7Section. If a person who is presenting an animal for treatment
8is suspected of fraudulently obtaining any controlled
9substance or prescription for a controlled substance, the
10licensed veterinarian shall report that information to the
11local law enforcement agency.
12    (b) The Department, by rule, may include in the
13Prescription Monitoring Program certain other select drugs
14that are not included in Schedule II, III, IV, or V. The
15Prescription Monitoring Program does not apply to controlled
16substance prescriptions as exempted under Section 313.
17    (c) The collection of data on select drugs and scheduled
18substances by the Prescription Monitoring Program may be used
19as a tool for addressing oversight requirements of long-term
20care institutions as set forth by Public Act 96-1372. Long-term
21care pharmacies shall transmit patient medication profiles to
22the Prescription Monitoring Program monthly or more frequently
23as established by administrative rule.
24    (d) The Department of Human Services shall appoint a
25full-time Clinical Director of the Prescription Monitoring



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1    (e) (Blank).
2    (f) Within one year of January 1, 2018 (the effective date
3of Public Act 100-564) this amendatory Act of the 100th General
4Assembly, the Department shall adopt rules requiring all
5Electronic Health Records Systems to interface with the
6Prescription Monitoring Program application program on or
7before January 1, 2021 to ensure that all providers have access
8to specific patient records during the treatment of their
9patients. These rules shall also address the electronic
10integration of pharmacy records with the Prescription
11Monitoring Program to allow for faster transmission of the
12information required under this Section. The Department shall
13establish actions to be taken if a prescriber's Electronic
14Health Records System does not effectively interface with the
15Prescription Monitoring Program within the required timeline.
16    (g) The Department, in consultation with the Advisory
17Committee, shall adopt rules allowing licensed prescribers or
18pharmacists who have registered to access the Prescription
19Monitoring Program to authorize a licensed or non-licensed
20designee employed in that licensed prescriber's office or a
21licensed designee in a licensed pharmacist's pharmacy, and who
22has received training in the federal Health Insurance
23Portability and Accountability Act to consult the Prescription
24Monitoring Program on their behalf. The rules shall include
25reasonable parameters concerning a practitioner's authority to
26authorize a designee, and the eligibility of a person to be



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1selected as a designee. In this subsection (g), "pharmacist"
2shall include a clinical pharmacist employed by and designated
3by a Medicaid Managed Care Organization providing services
4under Article V of the Illinois Public Aid Code under a
5contract with the Department of Healthcare Health and Family
6Services for the sole purpose of clinical review of services
7provided to persons covered by the entity under the contract to
8determine compliance with subsections (a) and (b) of Section
9314.5 of this Act. A managed care entity pharmacist shall
10notify prescribers of review activities.
11(Source: P.A. 99-480, eff. 9-9-15; 100-564, eff. 1-1-18;
12100-861, eff. 8-14-18; 100-1005, eff. 8-21-18; 100-1093, eff.
138-26-18; revised 2-20-19.)
14    (720 ILCS 570/320)
15    Sec. 320. Advisory committee.
16    (a) There is created a Prescription Monitoring Program
17Advisory Committee to assist the Department of Human Services
18in implementing the Prescription Monitoring Program created by
19this Article and to advise the Department on the professional
20performance of prescribers and dispensers and other matters
21germane to the advisory committee's field of competence.
22    (b) The Prescription Monitoring Program Advisory Committee
23shall consist of 15 16 members appointed by the Clinical
24Director of the Prescription Monitoring Program composed of
25prescribers and dispensers licensed to practice medicine in his



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1or her respective profession as follows: one family or primary
2care physician; one pain specialist physician; 4 other
3physicians, one of whom may be an ophthalmologist; 2 advanced
4practice registered nurses; one physician assistant; one
5optometrist; one dentist; one veterinarian; one clinical
6representative from a statewide organization representing
7hospitals; and 3 pharmacists. The Advisory Committee members
8serving on August 26, 2018 (the effective date of Public Act
9100-1093) this amendatory Act of the 100th General Assembly
10shall continue to serve until January 1, 2019. Prescriber and
11dispenser nominations for membership on the Committee shall be
12submitted by their respective professional associations. If
13there are more nominees than membership positions for a
14prescriber or dispenser category, as provided in this
15subsection (b), the Clinical Director of the Prescription
16Monitoring Program shall appoint a member or members for each
17profession as provided in this subsection (b), from the
18nominations to serve on the advisory committee. At the first
19meeting of the Committee in 2019 members shall draw lots for
20initial terms and 6 members shall serve 3 years, 5 members
21shall serve 2 years, and 5 members shall serve one year.
22Thereafter, members shall serve 3-year 3 year terms. Members
23may serve more than one term but no more than 3 terms. The
24Clinical Director of the Prescription Monitoring Program may
25appoint a representative of an organization representing a
26profession required to be appointed. The Clinical Director of



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1the Prescription Monitoring Program shall serve as the
2Secretary of the committee.
3    (c) The advisory committee may appoint a chairperson and
4other officers as it deems appropriate.
5    (d) The members of the advisory committee shall receive no
6compensation for their services as members of the advisory
7committee, unless appropriated by the General Assembly, but may
8be reimbursed for their actual expenses incurred in serving on
9the advisory committee.
10    (e) The advisory committee shall:
11        (1) provide a uniform approach to reviewing this Act in
12    order to determine whether changes should be recommended to
13    the General Assembly;
14        (2) review current drug schedules in order to manage
15    changes to the administrative rules pertaining to the
16    utilization of this Act;
17        (3) review the following: current clinical guidelines
18    developed by health care professional organizations on the
19    prescribing of opioids or other controlled substances;
20    accredited continuing education programs related to
21    prescribing and dispensing; programs or information
22    developed by health care professional organizations that
23    may be used to assess patients or help ensure compliance
24    with prescriptions; updates from the Food and Drug
25    Administration, the Centers for Disease Control and
26    Prevention, and other public and private organizations



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1    which are relevant to prescribing and dispensing; relevant
2    medical studies; and other publications which involve the
3    prescription of controlled substances;
4        (4) make recommendations for inclusion of these
5    materials or other studies which may be effective resources
6    for prescribers and dispensers on the Internet website of
7    the inquiry system established under Section 318;
8        (5) semi-annually review the content of the Internet
9    website of the inquiry system established pursuant to
10    Section 318 to ensure this Internet website has the most
11    current available information;
12        (6) semi-annually review opportunities for federal
13    grants and other forms of funding to support projects which
14    will increase the number of pilot programs which integrate
15    the inquiry system with electronic health records; and
16        (7) semi-annually review communication to be sent to
17    all registered users of the inquiry system established
18    pursuant to Section 318, including recommendations for
19    relevant accredited continuing education and information
20    regarding prescribing and dispensing.
21    (f) The Advisory Committee shall select from its members 10
2211 members of the Peer Review Committee composed of: 6, and one
24        (1) 3 physicians;
25        (2) 3 pharmacists;
26        (3) one dentist;



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1        (4) one advanced practice registered nurse;
2        (4.5) (blank) one veterinarian;
3        (5) one physician assistant; and
4        (6) one optometrist.
5    The purpose of the Peer Review Committee is to establish a
6formal peer review of professional performance of prescribers
7and dispensers. The deliberations, information, and
8communications of the Peer Review Committee are privileged and
9confidential and shall not be disclosed in any manner except in
10accordance with current law.
11        (1) The Peer Review Committee shall periodically
12    review the data contained within the prescription
13    monitoring program to identify those prescribers or
14    dispensers who may be prescribing or dispensing outside the
15    currently accepted standard and practice of their
16    profession. The Peer Review Committee member, whose
17    profession is the same as the prescriber or dispenser being
18    reviewed, shall prepare a preliminary report and
19    recommendation for any non-action or action. The
20    Prescription Monitoring Program Clinical Director and
21    staff shall provide the necessary assistance and data as
22    required.
23        (2) The Peer Review Committee may identify prescribers
24    or dispensers who may be prescribing outside the currently
25    accepted medical standards in the course of their
26    professional practice and send the identified prescriber



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1    or dispenser a request for information regarding their
2    prescribing or dispensing practices. This request for
3    information shall be sent via certified mail, return
4    receipt requested. A prescriber or dispenser shall have 30
5    days to respond to the request for information.
6        (3) The Peer Review Committee shall refer a prescriber
7    or a dispenser to the Department of Financial and
8    Professional Regulation in the following situations:
9            (i) if a prescriber or dispenser does not respond
10        to three successive requests for information;
11            (ii) in the opinion of a majority of members of the
12        Peer Review Committee, the prescriber or dispenser
13        does not have a satisfactory explanation for the
14        practices identified by the Peer Review Committee in
15        its request for information; or
16            (iii) following communications with the Peer
17        Review Committee, the prescriber or dispenser does not
18        sufficiently rectify the practices identified in the
19        request for information in the opinion of a majority of
20        the members of the Peer Review Committee.
21        (4) The Department of Financial and Professional
22    Regulation may initiate an investigation and discipline in
23    accordance with current laws and rules for any prescriber
24    or dispenser referred by the Peer Review Committee peer
25    review subcommittee.
26        (5) The Peer Review Committee shall prepare an annual



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1    report starting on July 1, 2017. This report shall contain
2    the following information: the number of times the Peer
3    Review Committee was convened; the number of prescribers or
4    dispensers who were reviewed by the Peer Review Committee;
5    the number of requests for information sent out by the Peer
6    Review Committee; and the number of prescribers or
7    dispensers referred to the Department of Financial and
8    Professional Regulation. The annual report shall be
9    delivered electronically to the Department and to the
10    General Assembly. The report to the General Assembly shall
11    be filed with the Clerk of the House of Representatives and
12    the Secretary of the Senate in electronic form only, in the
13    manner that the Clerk and the Secretary shall direct. The
14    report prepared by the Peer Review Committee shall not
15    identify any prescriber, dispenser, or patient.
16(Source: P.A. 99-480, eff. 9-9-15; 100-513, eff. 1-1-18;
17100-861, eff. 8-14-18; 100-1093, eff. 8-26-18; revised
19    Section 99. Effective date. This Act takes effect upon
20becoming law.