KRS 218A.205: Reports of improper, inappropriate, or illegal prescribing or dispensing

of controlled substances -- Administrative regulations for prescribing and

dispensing protocols and licensure actions and requirements -- Presumption of

medical necessity -- Complaint procedure -- Criminal record check.

(1) As used in this section:

(a) "Reporting agency" includes:

1. The Department of Kentucky State Police;

2. The Office of the Attorney General;

3. The Cabinet for Health and Family Services; and

4. The applicable state licensing board; and

(b) "State licensing board" means:

1. The Kentucky Board of Medical Licensure;

2. The Kentucky Board of Nursing;

3. The Kentucky Board of Dentistry;

4. The Kentucky Board of Optometric Examiners;

5. The State Board of Podiatry; and

6. Any other board that licenses or regulates a person who is entitled to

prescribe or dispense controlled substances to humans.

(2) (a) When a reporting agency or a law enforc ement agency receives a report of

improper, inappropriate, or illegal prescribing or dispensing of a controlled

substance it may, to the extent otherwise allowed by law, send a copy of the

report within three (3) business days to every other reporting agency.

(b) A county attorney or Commonwealth's attorney shall notify the Office of the

Attorney General and the appropriate state licensing board within three (3)

business days of an indictment or a waiver of indictment becoming public in

his or her jurisdict ion charging a licensed person with a felony offense

relating to the manufacture of, trafficking in, prescribing, dispensing, or

possession of a controlled substance.

(3) Each state licensing board shall, in consultation with the Kentucky Office of Drug

Control Policy, establish the following by administrative regulation for those

licensees authorized to prescribe or dispense controlled substances:

(a) Mandatory prescribing and dispensing standards related to controlled

substances, the requirements of which shall include the diagnostic, treatment,

review, and other protocols and standards established for Schedule II

controlled substances under KRS 218A.172 and which may include the

exemptions authorized by KRS 218A.172(4);

(b) In accord with the CDC Guidelin e for Prescribing Opioids for Chronic Pain

published in 2016, a prohibition on a practitioner issuing a prescription for a

Schedule II controlled substance for more than a three (3) day supply of a

Schedule II controlled substance if the prescription is in tended to treat pain as

an acute medical condition, with the following exceptions:

1. The practitioner, in his or her professional judgment, believes that more

than a three (3) day supply of a Schedule II controlled substance is

medically necessary to trea t the patient's pain as an acute medical

condition and the practitioner adequately documents the acute medical

condition and lack of alternative treatment options which justifies

deviation from the three (3) day supply limit established in this

subsection in the patient's medical records;

2. The prescription for a Schedule II controlled substance is prescribed to

treat chronic pain;

3. The prescription for a Schedule II controlled substance is prescribed to

treat pain associated with a valid cancer diagnosis;

4. The prescription for a Schedule II controlled substance is prescribed to

treat pain while the patient is receiving hospice or end -of-life treatment

or is receiving care from a certified community based palliative care

program;

5. The prescription for a Schedule II controlled substance is prescribed as

part of a narcotic treatment program licensed by the Cabinet for Health

and Family Services;

6. The prescription for a Schedule II controlled substance is prescribed to

treat pain following a major surge ry or the treatment of significant

trauma, as defined by the state licensing board in consultation with the

Kentucky Office of Drug Control Policy;

7. The Schedule II controlled substance is dispensed or administered

directly to an ultimate user in an inpatient setting; or

8. Any additional treatment scenario deemed medically necessary by the

state licensing board in consultation with the Kentucky Office of Drug

Control Policy.

Nothing in this paragraph shall authorize a state licensing board to promulgate

regulations which expand any practitioner's prescriptive authority beyond that

which existed prior to June 29, 2017;

(c) A prohibition on a practitioner dispensing greater than a forty -eight (48) hour

supply of any Schedule II controlled substance unless the dispensing is done

as part of a narcotic treatment program licensed by the Cabinet for Health and

Family Services;

(d) A procedure for temporarily suspending, limiting, or restricting a license held

by a named licensee where a substantial likelihood ex ists to believe that the

continued unrestricted practice by the named licensee would constitute a

danger to the health, welfare, or safety of the licensee's patients or of the

general public;

(e) A procedure for the expedited review of complaints filed aga inst their

licensees pertaining to the improper, inappropriate, or illegal prescribing or

dispensing of controlled substances that is designed to commence an

investigation within seven (7) days of a complaint being filed and produce a

charging decision by the board on the complaint within one hundred twenty

(120) days of the receipt of the complaint, unless an extension for a definite

period of time is requested by a law enforcement agency due to an ongoing

criminal investigation;

(f) The establishment and enforcement of licensure standards that conform to the

following:

1. A permanent ban on licensees and applicants convicted after July 20,

2012, in this state or any other state of any felony offense relating to

controlled substances from prescribing or dis pensing a controlled

substance;

2. Restrictions short of a permanent ban on licensees and applicants

convicted in this state or any other state of any misdemeanor offense

relating to prescribing or dispensing a controlled substance;

3. Restrictions mirroring in time and scope any disciplinary limitation

placed on a licensee or applicant by a licensing board of another state if

the disciplinary action results from improper, inappropriate, or illegal

prescribing or dispensing of controlled substances; and

4. A requirement that licensees and applicants report to the board any

conviction or disciplinary action covered by this subsection with

appropriate sanctions for any failure to make this required report;

(g) A procedure for the continuous submission of all disciplinary and other

reportable information to the National Practitioner Data Bank of the United

States Department of Health and Human Services;

(h) If not otherwise required by other law, a process for submitting a query on

each appli cant for licensure to the National Practitioner Data Bank of the

United States Department of Health and Human Services to retrieve any

relevant data on the applicant; and

(i) Continuing education requirements that specify that at least seven and one -

half p ercent (7.5%) of the continuing education required of the licensed

practitioner relate to the use of the electronic monitoring system established in

KRS 218A.202, pain management, addiction disorders, or pediatric ingestion

or inhalation of controlled subs tances, and include one (1) hour on the

recognition and prevention of pediatric ingestion or inhalation of controlled

substances.

(4) For the purposes of pharmacy dispensing, the medical necessity for a Schedule II

controlled substance as documented by the practitioner in the patient's medical

record and the prescription for more than a three (3) day supply of that controlled

substance are presumed to be valid.

(5) A state licensing board shall employ or obtain the services of a specialist in the

treatment of pain and a specialist in drug addiction to evaluate information received

regarding a licensee's prescribing or dispensing practices related to controlled

substances if the board or its staff does not possess such expertise, to ascertain if the

licensee under investigation is engaging in improper, inappropriate, or illegal

practices.

(6) Any statute to the contrary notwithstanding, no state licensing board shall require

that a grievance or complaint against a licensee relating to controlled substances be

sworn to or notarized, but the grievance or complaint shall identify the name and

address of the grievant or complainant, unless the board by administrative

regulation authorizes the filing of anonymous complaints. Any such authorizing

administrative regulation shall require that an anonymous complaint or grievance be

accompanied by sufficient corroborating evidence as would allow the board to

believe, based upon a totality of the circumstances, that a reasonable probability

exists that the complaint or grievance is meritorious.

(7) Every state licensing board shall cooperate to the maximum extent permitted by law

with all state, local, and federal law enforcement agencies, and all professional

licensing boards and agencies, state and federal, in the United States or its

territories in the coordination of actions to deter the improper, inappropriate, or

illegal prescribing or dispensing of a controlled substance.

(8) Each state licensing board shall require a fingerprint -supported criminal record

check by the Department of Kentucky State Police and the Federal Bureau of

Investigation of any applicant for initial licensure to practice any profession

authorized to prescribe or dispense controlled substances.