S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4757
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             February 14, 2023
                                ___________
 
 Introduced  by  Sen.  LANZA  -- read twice and ordered printed, and when
   printed to be committed to the Committee on Alcoholism  and  Substance
   Abuse
 
 AN  ACT  to  amend  the  public health law, in relation to directing the
   commissioner of the department of health to promulgate rules and regu-
   lations promoting recovery from opioid misuse and  reducing  diversion
   of addiction medicines
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. The public health law is amended by adding  a  new  section
 3309-c to read as follows:
   § 3309-C. PROMOTING RECOVERY FROM OPIOID MISUSE AND REDUCING DIVERSION
 OF  ADDICTION MEDICINES. 1. THE COMMISSIONER SHALL, IN CONSULTATION WITH
 THE OFFICE OF ADDICTION SERVICES  AND  SUPPORTS,  PROMULGATE  RULES  AND
 REGULATIONS  PERTAINING  TO  INDIVIDUAL  PHYSICIANS  AND GROUP PRACTICES
 INCLUDING, BUT NOT LIMITED TO, PHYSICIAN'S  OFFICE-BASED  OPIOID  TREAT-
 MENT,  OPIOID TREATMENT PROGRAMS AND ANY OTHER TREATMENT PRACTICES SERV-
 ING MORE THAN FIFTY PATIENTS AT A TIME WHO HAVE A PRIMARY  OR  SECONDARY
 DIAGNOSIS  OF  OPIATE  MISUSE  OR  ADDICTION. SUCH RULES AND REGULATIONS
 SHALL AT A MINIMUM INCLUDE THE FOLLOWING PROVISIONS:
   (A) ALL PATIENTS SEEKING TREATMENT FOR OPIATE USE  DISORDER  SHALL  BE
 GIVEN  AN ORIENTATION INCLUDING FACTUAL INFORMATION AND AN EASILY UNDER-
 STOOD EXPLANATION OF EACH ADDICTION MEDICATION OPTION  APPROVED  BY  THE
 UNITED STATES FOOD AND DRUG ADMINISTRATION. SUCH EDUCATION MUST BE DOCU-
 MENTED  IN  THE  PATIENT  RECORD  ALONG WITH DOCUMENTATION REGARDING THE
 PATIENT'S CHOICE OF ONE OF THE MEDICATION OPTIONS OR NONE OF THEM.  SUCH
 DOCUMENTATION SHALL BE SIGNED BY THE PATIENT, OR  THE  COMMISSIONER  MAY
 SPECIFY  SOME  OTHER  FORM  OF  DOCUMENTATION  SHOWING  THAT THE MEDICAL
 PROVIDER MADE A GOOD FAITH EFFORT TO OBTAIN SUCH INFORMED  CONSENT  FROM
 THE PATIENT;
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD08760-01-3
 S. 4757                             2
              

 
   (B) IF A PATIENT CHOOSES AN ADDICTION MEDICATION NOT AVAILABLE THROUGH
 THE  MEDICAL  PRACTITIONER,  SUCH PRACTITIONER MUST MAKE A REFERRAL TO A
 TREATMENT SETTING WHERE THE PATIENT CAN  ACCESS  HIS  OR  HER  PREFERRED
 MEDICATION OPTION;
   (C)  THE  MEDICAL PROVIDER SHALL UTILIZE THE LEVEL OF CARE FOR ALCOHOL
 AND DRUG TREATMENT REFERRAL WEB APPLICATION PROVIDED BY  THE  OFFICE  OF
 ADDICTION SERVICES AND SUPPORTS OR ANOTHER PATIENT ASSESSMENT INSTRUMENT
 APPROVED BY THE OFFICE OF ADDICTION SERVICES AND SUPPORTS TO HELP DETER-
 MINE AN APPROPRIATE LEVEL OF PATIENT CARE;
   (D)  IN THE EVENT THAT THE PATIENT USING OPIATES DECLINES TO ENGAGE IN
 TREATMENT THE MEDICAL PROVIDER SHALL PROVIDE SUCH PATIENT WITH  INFORMA-
 TION ABOUT ACCESSIBLE HARM REDUCTION SERVICES;
   (E) TREATMENT COUNSELING SHALL BE PROVIDED TO ALL INDIVIDUALS FOR WHOM
 AN ADDICTION MEDICATION IS PRESCRIBED OR DISPENSED. SUCH TREATMENT COUN-
 SELING  MAY BE PROVIDED BY A QUALIFIED ADDICTION PROFESSIONAL, AS DETER-
 MINED BY THE OFFICE OF ADDICTION SERVICES AND SUPPORTS, EMPLOYED BY  THE
 MEDICAL  PRACTICE  OR  THROUGH  A  CONTRACT  WITH AN OFFICE OF ADDICTION
 SERVICES AND SUPPORTS CERTIFIED TREATMENT PROGRAM;
   (F) THE MEDICAL PROVIDER SHALL  DEVELOP  A  TREATMENT  PLAN  FOR  EACH
 PATIENT AND SUCH PLAN SHALL BE REVIEWED, AT A MINIMUM, EVERY SIX MONTHS.
 THE  STANDARDS FOR DEVELOPING INDIVIDUAL TREATMENT PLANS SHALL BE DETER-
 MINED BY THE OFFICE OF ADDICTION SERVICES  AND  SUPPORTS  AND  SHALL  BE
 CONSISTENT WITH THE STANDARDS USED IN OTHER OFFICE OF ADDICTION SERVICES
 AND SUPPORTS LICENSED OUTPATIENT TREATMENT PROGRAMS;
   (G)  THE  MEDICAL  PROVIDER SHALL INFORM PATIENTS ABOUT AVAILABLE PEER
 RECOVERY SUPPORT SERVICES; AND
   (H) WHEN AN ADDICTION MEDICATION IS NOT TAKEN  UNDER  DIRECT  CLINICAL
 SUPERVISION,  THE MEDICAL PROVIDER SHALL UTILIZE DIVERSION CONTROL PRAC-
 TICES TO ENSURE SUCH MEDICATION IS TAKEN AS PRESCRIBED AND NOT DIVERTED.
 SUCH PRACTICES  SHALL  BE  DETERMINED  BY  THE  COMMISSIONER  AND  SHALL
 INCLUDE:
   (I)  LIMITS  ON  THE AMOUNT OF MEDICATION PRESCRIBED AND THE NUMBER OF
 REFILLS GIVEN TO A PATIENT UNTIL SUCH PATIENT HAS ESTABLISHED A  PATTERN
 OF RELIABILITY; AND
   (II) MINIMUM TOXICOLOGY SCREENING STANDARDS.
   2.  FOR  ALL MEDICAL PROVIDERS SUBJECT TO THESE RULES AND REGULATIONS,
 THE COMMISSIONER SHALL ENSURE THAT PROVIDERS ARE MONITORED  FOR  COMPLI-
 ANCE.  SUCH MONITORING SHALL BE DONE DIRECTLY BY THE DEPARTMENT OR BY AN
 INDEPENDENT ORGANIZATION SPECIFIED BY THE COMMISSIONER.
   3. THE COMMISSIONER SHALL ESTABLISH APPROPRIATE PENALTIES FOR  MEDICAL
 PRACTITIONERS WHO FAIL TO COMPLY WITH SUCH RULES AND REGULATIONS PROMUL-
 GATED UNDER SUBDIVISION ONE OF THIS SECTION.
   §  2. This act shall take effect January 1, 2024. Effective immediate-
 ly, the addition, amendment and/or repeal  of  any  rule  or  regulation
 necessary  for  the implementation of this act on its effective date are
 authorized to be made and completed on or before such effective date.