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Chapter 70.225 RCW

PRESCRIPTION MONITORING PROGRAM

RCW Sections

70.225.010Definitions.
70.225.020Prescription monitoring program -- Subject to funding -- Duties of dispensers.
70.225.025Rules.
70.225.030Enhancement of program -- Feasibility study.
70.225.040Confidentiality of prescription information -- Procedures -- Immunity when acting in good faith.
70.225.050Department may contract for operation of program.
70.225.060Violations -- Penalties -- Disclosure exemption for health care providers.
70.225.900Severability -- Subheadings not law -- 2007 c 259.


70.225.010
Definitions.

The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.

     (1) "Controlled substance" has the meaning provided in RCW
69.50.101.

     (2) "Department" means the department of health.

     (3) "Patient" means the person or animal who is the ultimate user of a drug for whom a prescription is issued or for whom a drug is dispensed.

     (4) "Dispenser" means a practitioner or pharmacy that delivers a Schedule II, III, IV, or V controlled substance to the ultimate user, but does not include:

     (a) A practitioner or other authorized person who administers, as defined in RCW 69.41.010, a controlled substance; or

     (b) A licensed wholesale distributor or manufacturer, as defined in chapter 18.64 RCW, of a controlled substance.

[2007 c 259 § 42.]




70.225.020
Prescription monitoring program — Subject to funding — Duties of dispensers.

(1) The department shall establish and maintain a prescription monitoring program to monitor the prescribing and dispensing of all Schedules II, III, IV, and V controlled substances and any additional drugs identified by the pharmacy quality assurance commission as demonstrating a potential for abuse by all professionals licensed to prescribe or dispense such substances in this state. The program shall be designed to improve health care quality and effectiveness by reducing abuse of controlled substances, reducing duplicative prescribing and overprescribing of controlled substances, and improving controlled substance prescribing practices with the intent of eventually establishing an electronic database available in real time to dispensers and prescribers of controlled substances. As much as possible, the department should establish a common database with other states. This program's management and operations shall be funded entirely from the funds in the account established under RCW 74.09.215. Nothing in this chapter prohibits voluntary contributions from private individuals and business entities as defined under Title 23, 23B, 24, or 25 RCW to assist in funding the prescription monitoring program.

     (2) Except as provided in subsection (4) of this section, each dispenser shall submit to the department by electronic means information regarding each prescription dispensed for a drug included under subsection (1) of this section. Drug prescriptions for more than one day use should be reported. The information submitted for each prescription shall include, but not be limited to:

     (a) Patient identifier;

     (b) Drug dispensed;

     (c) Date of dispensing;

     (d) Quantity dispensed;

     (e) Prescriber; and

     (f) Dispenser.

     (3) Each dispenser shall submit the information in accordance with transmission methods established by the department.

     (4) The data submission requirements of subsections (1) through (3) of this section do not apply to:

     (a) Medications provided to patients receiving inpatient services provided at hospitals licensed under chapter 70.41 RCW; or patients of such hospitals receiving services at the clinics, day surgery areas, or other settings within the hospital's license where the medications are administered in single doses;

     (b) Pharmacies operated by the department of corrections for the purpose of providing medications to offenders in department of corrections institutions who are receiving pharmaceutical services from a department of corrections pharmacy, except that the department of corrections must submit data related to each offender's current prescriptions for controlled substances upon the offender's release from a department of corrections institution; or

     (c) Veterinarians licensed under chapter 18.92 RCW. The department, in collaboration with the veterinary board of governors, shall establish alternative data reporting requirements for veterinarians that allow veterinarians to report:

     (i) By either electronic or nonelectronic methods;

     (ii) Only those data elements that are relevant to veterinary practices and necessary to accomplish the public protection goals of this chapter; and

     (iii) No more frequently than once every three months and no less frequently than once every six months.

     (5) The department shall continue to seek federal grants to support the activities described in chapter 259, Laws of 2007. The department may not require a practitioner or a pharmacist to pay a fee or tax specifically dedicated to the operation and management of the system.

[2013 c 36 § 2; 2013 c 19 § 126; 2012 c 192 § 1; 2007 c 259 § 43.]

Notes:

     Reviser's note: This section was amended by 2013 c 19 § 126 and by 2013 c 36 § 2, each without reference to the other. Both amendments are incorporated in the publication of this section under RCW 1.12.025(2). For rule of construction, see RCW 1.12.025(1).

     Findings -- 2013 c 36: "The legislature finds that:

     (1) The prescription monitoring program contributes to patient safety and reduction in drug errors for all patients, including medicaid beneficiaries in Washington state. Further, the prescription monitoring program provides the critical function of reducing costs borne by medicaid and provides for the detection of fraud in the medicaid system.

     (2) Because of the nexus between medicaid, medicaid fraud, and cost reductions, the funding for the operations and management of the prescription monitoring program should be funded entirely from the medicaid fraud penalty account under RCW 74.09.215, with the option of funding the prescription monitoring program through voluntary contributions from private individuals and corporations as defined under Title 23, 23B, 24, or 25 RCW." [2013 c 36 § 1.]




70.225.025
Rules.

The department shall adopt rules to implement this chapter.

[2007 c 259 § 47.]




70.225.030
Enhancement of program — Feasibility study.

To the extent that funding is provided for such purpose through federal or private grants, or is appropriated by the legislature, the health care authority shall study the feasibility of enhancing the prescription monitoring program established in RCW 70.225.020 in order to improve the quality of state purchased health services by reducing legend drug abuse, reducing duplicative and overprescribing of legend drugs, and improving legend drug prescribing practices. The study shall address the steps necessary to expand the program to allow those who prescribe or dispense prescription drugs to perform a web-based inquiry and obtain real time information regarding the legend drug utilization history of persons for whom they are providing medical or pharmaceutical care when such persons are receiving health services through state purchased health care programs.

[2007 c 259 § 44.]




70.225.040
Confidentiality of prescription information — Procedures — Immunity when acting in good faith.

(1) Prescription information submitted to the department shall be confidential, in compliance with chapter 70.02 RCW and federal health care information privacy requirements and not subject to disclosure, except as provided in subsections (3) and (4) of this section.

     (2) The department shall maintain procedures to ensure that the privacy and confidentiality of patients and patient information collected, recorded, transmitted, and maintained is not disclosed to persons except as in subsections (3) and (4) of this section.

     (3) The department may provide data in the prescription monitoring program to the following persons:

     (a) Persons authorized to prescribe or dispense controlled substances, for the purpose of providing medical or pharmaceutical care for their patients;

     (b) An individual who requests the individual's own prescription monitoring information;

     (c) Health professional licensing, certification, or regulatory agency or entity;

     (d) Appropriate local, state, and federal law enforcement or prosecutorial officials who are engaged in a bona fide specific investigation involving a designated person;

     (e) Authorized practitioners of the department of social and health services and the health care authority regarding medicaid program recipients;

     (f) The director or director's designee within the department of labor and industries regarding workers' compensation claimants;

     (g) The director or the director's designee within the department of corrections regarding offenders committed to the department of corrections;

     (h) Other entities under grand jury subpoena or court order; and

     (i) Personnel of the department for purposes of administration and enforcement of this chapter or chapter 69.50 RCW.

     (4) The department may provide data to public or private entities for statistical, research, or educational purposes after removing information that could be used to identify individual patients, dispensers, prescribers, and persons who received prescriptions from dispensers.

     (5) A dispenser or practitioner acting in good faith is immune from any civil, criminal, or administrative liability that might otherwise be incurred or imposed for requesting, receiving, or using information from the program.

[2011 1st sp.s. c 15 § 87; 2007 c 259 § 45.]

Notes:

     Effective date -- Findings -- Intent -- Report -- Agency transfer -- References to head of health care authority -- Draft legislation -- 2011 1st sp.s. c 15: See notes following RCW 74.09.010.




70.225.050
Department may contract for operation of program.

The department may contract with another agency of this state or with a private vendor, as necessary, to ensure the effective operation of the prescription monitoring program. Any contractor is bound to comply with the provisions regarding confidentiality of prescription information in RCW 70.225.040 and is subject to the penalties specified in RCW 70.225.060 for unlawful acts.

[2007 c 259 § 46.]




70.225.060
Violations — Penalties — Disclosure exemption for health care providers.

(1) A dispenser who knowingly fails to submit prescription monitoring information to the department as required by this chapter or knowingly submits incorrect prescription information is subject to disciplinary action under chapter 18.130 RCW.

     (2) A person authorized to have prescription monitoring information under this chapter who knowingly discloses such information in violation of this chapter is subject to civil penalty.

     (3) A person authorized to have prescription monitoring information under this chapter who uses such information in a manner or for a purpose in violation of this chapter is subject to civil penalty.

     (4) In accordance with chapter 70.02 RCW and federal health care information privacy requirements, any physician or pharmacist authorized to access a patient's prescription monitoring may discuss or release that information to other health care providers involved with the patient in order to provide safe and appropriate care coordination.

[2007 c 259 § 48.]




70.225.900
Severability — Subheadings not law — 2007 c 259.

See notes following RCW 41.05.033.