HOUSE BILL No. 6329
September 6, 2018, Introduced by Rep. Kahle and referred to the Committee on Health Policy.
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending section 7303a (MCL 333.7303a), as amended by 2018 PA
101.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 7303a. (1) A prescriber who holds a controlled substances
license may administer or dispense a controlled substance listed in
schedules 2 to 5 without a separate controlled substances license
for those activities.
(2) Except as otherwise provided in rules promulgated under
section 16204e, beginning March 31, 2019 or, if rules are
promulgated under section 16204e before March 31, 2019, on the date
on which rules are promulgated under section 16204e, a licensed
prescriber shall not prescribe a controlled substance listed in
schedules 2 to 5 unless the prescriber is in a bona fide
prescriber-patient relationship with the patient for whom the
controlled substance is being prescribed. Except as otherwise
provided in this subsection, if a licensed prescriber prescribes a
controlled substance under this subsection, the prescriber shall
provide follow-up care to the patient to monitor the efficacy of
the use of the controlled substance as a treatment of the patient's
medical condition. If the licensed prescriber is unable to provide
follow-up care, he or she shall refer the patient to the patient's
primary care provider for follow-up care or, if the patient does
not have a primary care provider, he or she shall refer the patient
to another licensed prescriber who is geographically accessible to
the patient for follow-up care.
(3) Before prescribing or dispensing a controlled substance to
a patient, a licensed prescriber shall ask the patient about other
controlled substances the patient may be using. The prescriber
shall record the patient's response in the patient's medical or
clinical record.
(4) Beginning June 1, 2018, before prescribing or dispensing
to a patient a controlled substance in a quantity that exceeds a 3-
day supply, a licensed prescriber shall obtain and review a report
concerning that patient from the electronic system for monitoring
schedule 2, 3, 4, and 5 controlled substances established under
section 7333a. This subsection does not apply under any of the
following circumstances:
(a) If the dispensing occurs in a hospital or freestanding
surgical outpatient facility licensed under article 17 and the
controlled substance is administered to the patient in that
hospital or facility.
(a) (b) If the patient is an animal as that term is defined in
section 18802, the dispensing occurs in a veterinary hospital or
clinic and the controlled substance is administered to the patient
in that hospital or clinic.
(b) (c) If the controlled substance is prescribed by a
licensed prescriber who is a veterinarian and the controlled
substance will be dispensed by a pharmacist.
(c) Except as otherwise provided in section 7333a(11), if the
patient is a patient of a health facility or agency licensed under
article 17 that is rendering services to the patient at that health
facility or agency and the licensed prescriber has obtained and
reviewed a report concerning the patient from the electronic system
described in this subsection at the time the patient was admitted
to the health facility or agency.
(5) Beginning June 1, 2018, before prescribing or dispensing a
controlled substance to a patient, a licensed prescriber shall
register with the electronic system for monitoring schedule 2, 3,
4, and 5 controlled substances established under section 7333a.
(6) A licensed prescriber who dispenses controlled substances
shall maintain all of the following records separately from other
prescription records:
(a) All invoices and other acquisition records for each
controlled substance acquired by the prescriber for not less than 5
years after the date the prescriber acquires the controlled
substance.
(b) A log of all controlled substances dispensed by the
prescriber for not less than 5 years after the date the controlled
substance is dispensed.
(c) Records of all other dispositions of controlled substances
under the licensee's control for not less than 5 years after the
date of the disposition.
(7) The requirement under section 7303 for a license is waived
in the following circumstances:
(a) When a controlled substance listed in schedules 2 to 5 is
administered on the order of a licensed prescriber by an individual
who is licensed under article 15 as a practical nurse or a
registered professional nurse.
(b) When methadone or a methadone congener is dispensed on the
order of a licensed prescriber in a methadone treatment program
licensed under article 6 or when a controlled substance listed in
schedules 2 to 5 is dispensed on the order of a licensed prescriber
in a hospice rendering emergency care services in a patient's home
as described in section 17746 by a registered professional nurse
licensed under article 15.
(8) As used in this section:
(a) "Bona fide prescriber-patient relationship" means a
treatment or counseling relationship between a prescriber and a
patient in which both of the following are present:
(i) The prescriber has reviewed the patient's relevant medical
or clinical records and completed a full assessment of the
patient's medical history and current medical condition, including
a relevant medical evaluation of the patient conducted in person or
through telehealth.
(ii) The prescriber has created and maintained records of the
patient's condition in accordance with medically accepted
standards.
(b) "Telehealth" means that term as defined in section 16283.