H243 - Strengthen Opioid Misuse Prevention (STOP)Act. (SL 2017-74)

Overview: S.L. 2017-74 makes the following changes to the laws governing the prescribing of controlled substances:

• Extends the statewide standing order for opioid antagonists to allow practitioners to prescribe an opioid antagonist to any governmental or nongovernmental agency (effective July 1, 2017).
• Designates certain Schedule II and III drugs as "targeted controlled substances" and makes the following changes to the laws governing the prescribing of those substances:
• Requires physician assistants or nurse practitioners employed by pain clinics to personally consult with their supervising physician prior to prescribing the targeted controlled substance if the use of the targeted controlled substance will exceed 30 days (effective July 1, 2017).
• Requires electronic prescriptions for all targeted controlled substances not meeting certain exceptions (effective January 1, 2020).
• Limits prescriptions for targeted controlled substances upon initial consultations for acute pain to no more than a five-day supply, unless the prescription is for post-operative acute pain relief immediately following a surgical procedure, in which case the practitioner may not prescribe more than a 7-day supply (effective January 1, 2018).
• Requires hospice and palliative care providers who prescribe a targeted controlled substance to provide oral and written information to the patient and the patient's family regarding the proper disposal of the targeted controlled substance (effective January 1, 2017).
• Clarifies the allowable funds for syringe exchange programs.
• Makes changes to the statutes governing the Controlled Substance Reporting System (CSRS) database, including:
• Requiring dispensers to report information required by statute to the CSRS database no later than the close of the next business day after the prescription is delivered (effective September 1, 2017).
• Imposing a civil penalty upon dispensers for failing to report the information required within a reasonable time of being informed by DHHS that the required information is missing or incomplete (effective September 1, 2017).
• Allowing the Department to notify practitioners and their respective licensing boards of prescribing behavior that (i) increases the risk of diversion of controlled substances, (ii) increases the risk of harm to the patient, or (iii) is an outlier among other practitioner behavior (effective July 1, 2017).
• Requiring administrators of hospital emergency departments and acute care facilities to provide the Department with an annual list of delegates who are authorized to receive data on behalf of providers within the hospital (effective July 1, 2017).
• Requiring dispensers to demonstrate to the satisfaction of the NC Board of Pharmacy that they are registered for access to the CSRS database within 30 days of initial or renewal licensure (effective June 29, 2017, and applies to acts committed 30 days after State Chief Information Officer notifies the Revisor of Statutes that (i) upgrades to the CSRS database have been completed and (ii) the upgraded database is fully operational and connected to the statewide health information exchange).
• Requiring practitioners to review the patient's preceding 12-month history in the CSRS database prior to initially prescribing a targeted controlled substance to a patient and again every 3 months afterward that the targeted controlled substance remains a part of the patient's medical care (effective June 29, 2017, and applies to acts committed 30 days after State Chief Information Officer notifies the Revisor of Statutes that (i) upgrades to the CSRS database have been completed and (ii) the upgraded database is fully operational and connected to the statewide health information exchange).
• Requiring dispensers to review the patient's preceding 12-month history in the CSRS database prior to dispensing a targeted controlled substance and document the review under certain circumstances (effective June 29, 2017, and applies to acts committed 30 days after State Chief Information Officer notifies the Revisor of Statutes that (i) upgrades to the CSRS database have been completed and (ii) the upgraded database is fully operational and connected to the statewide health information exchange).
• Creating a CSRS Fund for the operation of the CSRS database (effective September 1, 2017).
• Requiring an annual report from the Department on data reported to the CSRS database (effective September 1, 2017).
• Amends language in the 2015 budget to facilitate the interstate connectivity of the CSRS database (effective July 1, 2017).