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§ 872.9. Access to prescription information

Purdon's Pennsylvania Statutes and Consolidated StatutesTitle 35 P.S. Health and SafetyEffective: September 30, 2021

Purdon's Pennsylvania Statutes and Consolidated Statutes
Title 35 P.S. Health and Safety (Refs & Annos)
Chapter 6B. Drugs, Poisons and Dangerous Substances
Achieving Better Care by Monitoring All Prescriptions Program (Abc-Map) Act (Refs & Annos)
Effective: September 30, 2021
35 P.S. § 872.9
§ 872.9. Access to prescription information
Currentness
(a) Confidentiality.--Except as set forth in subsection (b), prescription information submitted to the system and records of requests to query the system shall be confidential and not subject to disclosure under the act of February 14, 2008 (P.L. 6, No. 3),1 known as the Right-to-Know Law.
(b) Authorized users.--The following individuals may query the system according to procedures determined by the board and with the following limitations:
(1) Prescribers may query the system for:
(i) an existing patient; and
(ii) prescriptions written using the prescriber's own Drug Enforcement Agency number.
(2) Dispensers may query the system for a current patient to whom the dispenser is dispensing or considering dispensing any controlled substance.
(3)(i) The Office of Attorney General shall query the system on behalf of all law enforcement agencies, including, but not limited to, the Office of the Attorney General and Federal, State and local law enforcement agencies for:
(A) Schedule II controlled substances as indicated in the act of April 14, 1972 (P.L. 233, No. 64),2 known as The Controlled Substance, Drug, Device and Cosmetic Act, and in the manner determined by the Pennsylvania Attorney General pursuant to 28 Pa. Code § 25.131 (relating to every dispensing practitioner); and
(B) all other schedules upon receipt of a court order obtained by the requesting law enforcement agency. Upon receipt of a motion under this clause, the court may enter an ex parte order granting the motion if the law enforcement agency has demonstrated by a preponderance of the evidence that:
(I) the motion pertains to a person who is the subject of an active criminal investigation with a reasonable likelihood of securing an arrest or prosecution in the foreseeable future; and
(II) there is reasonable suspicion that a criminal act has occurred.
(ii) Data obtained by a law enforcement agency under this paragraph shall only be used to establish probable cause to obtain a search warrant or arrest warrant.
(iii) Requests made to the Office of Attorney General to query the system under this paragraph shall be made in a form or manner prescribed by the Office of Attorney General and shall include the court order, when applicable. Each individual designee of the Office of Attorney General shall have a unique identifier when accessing the system.
(4) The Office of Attorney General shall query the system on behalf of a grand jury investigating a criminal violation of a law governing controlled substances.
(5) Approved department personnel may query the system for the purpose of:
(i) conducting internal reviews related to controlled substance laws; or
(ii) engaging in the analysis of controlled substance prescription information as part of the assigned duties and responsibilities of employment.
(6) Designated representatives from the Commonwealth or out-of-State agency or board responsible for licensing or certifying prescribers or dispensers whose professional practice was or is regulated by that agency or board for the purpose of conducting administrative investigations or proceedings.
(7) Designated Commonwealth personnel and contracted staff who are responsible for the development and evaluation of quality improvement strategies, program integrity initiatives or conducting internal compliance reviews and data reporting for the following:
(i) The medical assistance program.
(ii) The Children's Health Insurance Program (CHIP).
(iii) The Pharmaceutical Assistance Contract for the Elderly (PACE) or Pharmaceutical Assistance Contract for the Elderly Needs Enhancement Tier (PACENET).
(iv) The Catastrophic Loss Benefits Continuation Fund.
(v) The Workers’ Compensation Security Fund.
(8) Personnel from the Department of Drug and Alcohol Programs engaged in the administration of the Methadone Death and Incident Review Team.
(9) A medical examiner or county coroner for the purpose of investigating the death of the individual whose record is being queried.
(10) A prescription drug monitoring official, dispenser or prescriber of a state with which this Commonwealth has an interoperability agreement.
(11) Upon providing evidence of identity and within 30 days from the date of the request, an individual who is the recipient of a controlled substance prescription entered into the system, the individual's parent or guardian if the individual is under 18 years of age or the individual's health care power of attorney.
(12) Medical directors and pharmacy directors, or their designees, of an organization that has an agreement to be paid on a capitated basis to provide services to medical assistance beneficiaries, who are engaged in care management, the development and evaluation of quality improvement strategies, program integrity initiatives or conducting internal compliance reviews and data reporting for the medical assistance program. Personnel engaged in these activities:
(i) May query the system to review the requested dispensing or prescribing of a controlled substance under this act to an individual to whom the organization provides services under Title XIX of the Social Security Act (Public Law 74-271, 42 U.S.C. § 1396 et seq.).
(ii) Shall notify the Department of Human Services and the Office of Attorney General if Medicaid fraud is suspected based on the results of the query and review of the database.
(13)(i) An authorized employee of a county or municipal health department or the Department of Health of the Commonwealth may have access to data from the system for any of the following purposes:
(A) Developing education programs or public health interventions relating to specific prescribing practices, controlled substances and the prevention of fraud and abuse.
(B) Conducting analyses on prescribing trends in their respective jurisdictions.
(ii) For purposes of subparagraph (i)(A), a county or municipal health department shall implement appropriate technical and physical safeguards to ensure the privacy and security of data obtained from the system.
(14) Personnel from the Department of Labor and Industry engaged in the administration and regulation of medical fee review disputes and utilization review of medical treatment under the act of June 2, 1915 (P.L. 736, No. 338),3 known as the Workers' Compensation Act.
(c) Access for active investigation.--In the case where a law enforcement agency has accessed the system for an active investigation, the information about that query shall be withheld from the individual subject to the query for a period of six months after the conclusion of the investigation.
(d) Preemption.--Political subdivisions of the Commonwealth may not establish a database requiring the submission and query of prescription data by prescribers and dispensers in addition to the database established under section 6.4

Credits

2014, Oct. 27, P.L. 2911, No. 191, § 9, effective June 30, 2015. Amended 2020, Feb. 12, P.L. 23, No. 8, § 1; 2021, Sept. 30, P.L. 402, No. 72, § 2, imd. effective.

Footnotes

1
65 P.S. § 67.101 et seq.
2
35 P.S. § 780-101 et seq.
3
77 P.S. § 1 et seq.
4
35 P.S. § 872.6.
35 P.S. § 872.9, PA ST 35 P.S. § 872.9
Current through Act 13 of the 2024 Regular Session. Some statute sections may be more current, see credits for details.
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