Revision: Dec. 10, 2009, midnight
HB 1435-FN – AS INTRODUCED
2010 SESSION
10/01
HOUSE BILL 1435-FN
AN ACT relative to the practitioner-patient relationship in the dispensing of prescriptions.
SPONSORS: Rep. Case, Rock 1; Rep. Wendelboe, Belk 1; Rep. Bulis, Graf 1; Rep. Donovan, Sull 4; Rep. Mann, Rock 1; Sen. Carson, Dist 14
COMMITTEE: Health, Human Services and Elderly Affairs
This bill requires that prescriptions submitted using an electronic or on-line medical history form establish a valid practitioner-patient relationship. A violation is a misdemeanor.
This bill was requested by the pharmacy board.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
10-2455
10/01
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Ten
AN ACT relative to the practitioner-patient relationship in the dispensing of prescriptions.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Paragraph; Pharmacists. Amend RSA 318:1 by inserting after paragraph XV the following new paragraph:
XV-a. “Practitioner-patient relationship” means a medical connection between a licensed practitioner and a patient that includes an in-person exam, a history, a diagnosis, a treatment plan appropriate for the licensee’s scope of practice, and documentation of all prescription drugs including name and dosage. A licensee may prescribe for a patient whom the licensee does not have a practitioner-patient relationship under the following circumstances: for a patient of another licensee for whom the prescriber is taking call; for a patient examined by another New Hampshire licensed practitioner; or for medication on a short-term basis for a new patient prior to the patient’s first appointment. The definition of a practitioner-patient relationship shall not apply to a practitioner licensed in another state who is consulting to a New Hampshire licensed practitioner with whom the patient has a relationship.
2 Prescriptions; Fraud or Deceit. Amend RSA 318:52-a to read as follows:
318:52-a Fraud or Deceit. It is unlawful to obtain or attempt to obtain a drug or device sold by prescription of a physician, dentist, veterinarian, or advanced practice registered nurse that bears a statement that it is to be dispensed or sold only by or on the prescription of a physician, dentist, veterinarian, or advanced practice registered nurse by:
[(a)] I. Fraud, deceit, misrepresentation or subterfuge;
[(b) by] II. The forgery or alteration of a prescription or of any written order;
[or (c) by] III. The concealment of a material fact;
[or (d)] IV. The use of a false name or the giving of a false address[.]; or
V. Submission of an electronic or on-line medical history form that fails to establish a valid practitioner-patient relationship.
3 Effective Date. This act shall take effect January 1, 2011.
LBAO
10-2455
11/19/09
HB 1435-FN - FISCAL NOTE
AN ACT relative to the practitioner-patient relationship in the dispensing of prescriptions.
FISCAL IMPACT:
The Judicial Branch, Judicial Council, Department of Justice, and the New Hampshire Association of Counties state this bill may increase state and county expenditures by an indeterminable amount in FY 2011 and each year thereafter. This bill will have no fiscal impact on local expenditures or state, county, and local revenue.
METHODOLOGY:
The Judicial Branch states this bill would make unlawful the submission of an electronic or on-line medical history form that fails to establish a valid practitioner-patient relationship in obtaining a drug or device by prescription. The offense would be an unspecified misdemeanor if committed by a natural person and a felony if committed by any other person. The Branch is unable to estimate how many charges will be brought, but does, however, have information on the average cost of processing a misdemeanor charge in the trial courts. Misdemeanor charges can be either class A or class B, and the Branch assumes that charges brought pursuant to this bill will be class B misdemeanors. The cost to the Branch to process an average class B misdemeanor charges is $36.89 in FY 2010 and beyond, without consideration of any salary increases or decreases that may occur. These numbers also do not consider the cost of any appeals that may be taken following trial in any such case. With respect to felony charges the Branch has no information on which to estimate how many new felonies will be brought as a result of this bill, but the cost of an average routine felony case is $335.98 in FY 2010 and beyond, without consideration of any salary increases or decreases that may occur. These numbers also do not consider the cost of any appeals that may be taken following trial. The exact fiscal impact cannot be determined at this time.
The Judicial Council states this bill may result in an indeterminable increase in general fund expenditures. The Council states if an individual is found to be indigent, the flat fee of $275 per misdemeanor is charged by a public defender or contract attorney. If an assigned counsel attorney is used the fee is $60 per hour with a cap of $1,400 for a misdemeanor charge. The Council also states additional costs could be incurred if an appeal is filed. The public defender, contract attorney and assigned counsel rates for Supreme Court appeals is $2,000 per case,
LBAO
10-2455
11/19/09
with many assigned counsel attorneys seeking permission to exceed the fee cap. Requests to exceed the fee cap are seldom granted. Finally, expenditures would increase if services other than counsel are requested and approved by the court during the defense of a case or during an appeal. The exact fiscal impact cannot be determined at this time.
The Department of Justice states criminal violations under this bill would be prosecuted by the county or local prosecutor. There would be some fiscal impact to the Department in instances when an appeal would be taken to the Supreme Court from a prosecution. Because it is difficult to estimate how many cases would be generated, or if any of these cased would be appealed to the Supreme Court, the Department is unable to determine a fiscal impact at this time.
The New Hampshire Association of Counties states to the extent an individual is convicted, and sentenced to incarceration, the counties may have increased expenditures. The Association is unable to determine the number of individuals who might be detained or incarcerated as a result of this bill. The average cost to incarcerate an individual in a county facility is $35,342 a year.
The New Hampshire Board of Medicine states this bill would have no fiscal impact on the Board.