Chapter CSB 4

CSB 4.09(1)(c)1. 1. The patient is a direct patient of the healthcare professional.

CSB 4.09(1)(c)2. 2. The healthcare professional has obtained informed consent from the patient to access monitored prescription drug history reports for scientific research purposes.

CSB 4.09(1)(d) (d) Purposes of conducting an overdose fatality review.

CSB 4.09(2) (2) Pharmacist delegates and practitioner delegates may access monitored prescription drug history reports about a patient for any of the following reasons:

CSB 4.09(2)(a) (a) A pharmacist or practitioner who is directly treating or rendering assistance to the patient has delegated the task of obtaining monitored prescription drug history reports about the patient to the pharmacist delegate or practitioner delegate.

CSB 4.09(2)(b) (b) A pharmacist or practitioner who is being consulted regarding the health of the patient by an individual who is directly treating or rendering assistance to the patient has delegated the task of obtaining monitored prescription drug history reports about the patient to the pharmacist delegate or practitioner delegate.

CSB 4.09(3) (3) Healthcare professionals, pharmacist delegates, and practitioner delegates may only disclose a monitored prescription drug history report about a patient obtained pursuant to sub. (1) or (2) in the following situations:

CSB 4.09(3)(a) (a) To the patient as part of treating or rendering assistance to the patient.

CSB 4.09(3)(b) (b) To another healthcare professional or a medical coordinator for consultation about the health of the patient or as part of treating or rendering assistance to the patient.

CSB 4.09(3)(c) (c) To the pharmacist or practitioner who is directly treating or rendering assistance to the patient.

CSB 4.09(3)(d) (d) To a law enforcement agency as required by s. 146.82, Stats.

CSB 4.09(4) (4) To obtain access to monitored prescription drug history reports as authorized in subs. (1) and (2), healthcare professionals, pharmacist delegates, and practitioner delegates shall do one of the following:

CSB 4.09(4)(a) (a) Create an account with the PDMP system.

CSB 4.09(4)(b) (b) Create an account with a prescription monitoring program operated by a relevant agency in another jurisdiction with which the board exchanges monitored prescription drug history reports or PDMP data pursuant to s. CSB 4.14.

CSB 4.09(4)(c) (c) Create an account with a pharmacy or other entity at which pharmacists dispense or administer monitored prescription drugs in the course of professional practice with which the board has determined to have at least equivalent capability to maintain the confidentiality of monitored prescription drug history reports or that is connected to and lawfully obtains data from the state-designated entity under ch. 153, Stats.

CSB 4.09(4)(d) (d) Create an account with a hospital or other entity at which practitioners prescribe, dispense, or administer monitored prescription drugs in the course of professional practice with which the board has determined to have at least equivalent capability to maintain the confidentiality of monitored prescription drug history reports or that is connected to and lawfully obtains data from the state-designated entity under ch. 153, Stats.

CSB 4.09 History History: CR 12-009: cr. Register October 2012 No. 682, eff. 1-1-13; CR 14-003: am. (1), renum. (2) to (2) (intro.) and am., cr. (2) (a) to (d), am. (3) Register August 2014 No. 704, eff. 9-1-14; corrections in (1), (2) (b), (3) (a) Register September 2015 No. 717; EmR1706: emerg. r. and recr., eff. 4-1-17; CR 17-028: r. and recr. Register December 2017 No. 744, eff. 4-1-17; s. 35.17 corrections in (3) (intro.), (4) (intro.), Register December 2017 No. 744; CR 19-156: cr. (1) (c), (d) Register August 2020 No. 776, eff. 9-1-20.

CSB 4.093 CSB 4.093 Monitored prescription drug history reports and audit trails about healthcare professionals.

CSB 4.093(1) (1) Healthcare professionals may access audit trails about themselves and their practitioner delegates or pharmacist delegates.

CSB 4.093(2) (2) A practitioner may access the audit trails accessible to healthcare professionals and a prescribing metrics report about themself.

CSB 4.093(2m) (2m) Department staff who are charged with investigating dispensers, dispenser delegates, pharmacists, pharmacist delegates, practitioners, and practitioner delegates may access the audit trails related to s. CSB 4.12 (3) (f) and (g).

CSB 4.093(3) (3) Medical coordinators may access prescribing metrics reports and audit trails about a healthcare professional whom the medical coordinator coordinates, directs, or supervises or for whom the medical coordinator establishes standard operating procedures that contain no personally identifiable information about a patient if the medical coordinator is conducting any of the following activities:

CSB 4.093(3)(a) (a) Evaluating the job performance of the healthcare professional.

CSB 4.093(3)(b) (b) Performing quality assessment and improvement activities, including outcomes evaluation or development of clinical guidelines for the healthcare professional.

CSB 4.093(4) (4) To obtain access to prescribing metrics reports and audit trails as authorized in subs. (1) and (2), healthcare professionals, pharmacist delegates, and practitioner delegates shall create an account with the PDMP system.

CSB 4.093(5) (5) To obtain access to prescribing metrics reports, and audit trails about a healthcare professional, a medical coordinator shall create an account with the PDMP system.

CSB 4.093 History History: EmR1706: emerg. cr. eff. 4-1-17; CR 17-028: cr. Register December 2017 No. 744, eff. 4-1-17; s. 35.17 correction in (4), Register December 2017 No. 744; CR 19-156: cr. (2m) Register August 2020 No. 776, eff. 9-1-20.

CSB 4.097 CSB 4.097 Deny, suspend, revoke or otherwise restrict or limit access.

CSB 4.097(1) (1) The board may deny, suspend, revoke, or otherwise restrict or limit a healthcare professional’s, pharmacist delegate’s, practitioner delegate’s, or medical coordinator’s access to monitored prescription drug history reports, prescribing metrics reports, PDMP data, and audit tails for any of the following reasons:

CSB 4.097(1)(a) (a) The healthcare professional, pharmacist delegate, practitioner delegate, or medical coordinator is suspected of attempting to access, accessing, or disclosing a monitored prescription drug history report, prescribing metrics report, PDMP data, or audit trail in violation of s. 146.82 or 961.385, Stats., this chapter, or other state or federal laws or regulations relating to the privacy of patient health care records.

CSB 4.097(1)(b) (b) The healthcare professional is no longer licensed in this state or in another state and recognized by this state as a person to whom the board may grant access pursuant to s. CSB 4.09 or 4.093.

CSB 4.097(1)(c) (c) The board, or other licensing board, or regulatory agency takes adverse action against the healthcare professional, pharmacist delegate, practitioner delegate, or medical coordinator.

CSB 4.097(1)(d) (d) A licensing board or equivalent regulatory agency in another jurisdiction takes adverse action against the healthcare professional, pharmacist delegate, practitioner delegate, or medical coordinator.

CSB 4.097(1)(e) (e) The federal department of justice, drug enforcement administration takes adverse action against the healthcare professional, pharmacist delegate, practitioner delegate, or medical coordinator.

CSB 4.097(1)(f) (f) The healthcare professional, pharmacist delegate, practitioner delegate, or medical coordinator is convicted of a crime substantially related to the prescribing, administering, or dispensing of a monitored prescription drug.

CSB 4.097(1)(g) (g) The pharmacist delegate or practitioner delegate is no longer delegated the task of accessing monitored prescription drug history reports.

CSB 4.097(1)(h) (h) The medical coordinator no longer coordinates, directs, supervises, or establishes standard operating procedures for a healthcare professional.

CSB 4.097(2) (2) The board may temporarily suspend access to monitored prescription drug history reports, prescribing metrics reports, PDMP data, and audit trails upon discovering circumstances that indicate a healthcare professional, pharmacist delegate, practitioner delegate, or medical coordinator has performed any of the actions identified in sub. (1) (a).

CSB 4.097 History History: EmR1706: emerg. cr., eff. 4-1-17; CR 17-028: cr. Register December 2017 No. 744, eff. 1-1-18.

CSB 4.10 CSB 4.10 Requests for review.

CSB 4.10(1) (1) A dispenser, healthcare professional, pharmacist delegate, practitioner delegate, or medical coordinator may request that the board review any of the following:

CSB 4.10(1)(b) (b) The denial of an emergency waiver requested pursuant to s. CSB 4.06 (3).

CSB 4.10(1)(c) (c) The denial, suspension, revocation or other restriction or limitation imposed on the healthcare professional’s, pharmacist delegate’s, practitioner delegate’s, or medical coordinator’s account pursuant to s. CSB 4.097.

CSB 4.10(2) (2) To request a review, the dispenser, health care professional, pharmacist delegate, practitioner delegate, or medical coordinator shall file a written request with the board within 20 days after the mailing of the notice of the action in sub. (1). The request shall be in writing and include all of the following:

CSB 4.10(2)(a) (a) The dispenser’s, healthcare professional’s, pharmacist delegate’s, practitioner delegate’s, or medical coordinator’s name and address, including street address, city, state and ZIP code.

CSB 4.10(2)(b) (b) The citation to the specific statute or rule on which the request is based.

CSB 4.10(3) (3) The board shall conduct the review at its next regularly scheduled meeting and notify the dispenser, healthcare professional, pharmacist delegate, practitioner delegate, or medical coordinator of the time and place of the review.

CSB 4.10(4) (4) No discovery is permitted.

CSB 4.10(5) (5) The board shall preside over the review. The review shall be recorded by audio tape unless otherwise specified by the board.

CSB 4.10(6) (6) The board shall provide the dispenser, healthcare professional, pharmacist delegate, practitioner delegate, or medical coordinator with an opportunity to submit written documentation, make a personal appearance before the board and present a statement. The board may establish a time limit for making a presentation. Unless otherwise determined by the board, the time for making a personal appearance shall be 20 minutes.

CSB 4.10(7) (7) If the dispenser, healthcare professional, pharmacist delegate, practitioner delegate, or medical coordinator fails to appear for a review, or withdraws the request for a review, the board may note the failure to appear in the minutes and affirm its original decision without further action.

CSB 4.10 History History: CR 12-009: cr. Register October 2012 No. 682, eff. 1-1-13; correction in (1) (b) made under s. 13.92 (4) (b) 7., Stats., Register February 2014 No. 698; CR 14-003: am. (1) (intro.), (2) (intro.), (b), (3), (6), (7) Register August 2014 No. 704, eff. 9-1-14; correction in (1) (a) to (c) made under s. 13.92 (4) (b) 7., Stats., Register September 2015 No. 717; CR 15-101: am. (1) (c), (2) (a) Register June 2016 No. 726, eff. 7-1-16; s. 35.17 correction in (1) (c), Register June 2016 No. 726; EmR1706: emerg. am. (1) (intro.), r. (1) (a), am. (1) (c), (2) (intro.), (a), (3), (6), (7), eff. 4-1-17; CR 17-028: am. (1) (intro.), r. (1) (a), am. (1) (c), (2) (intro.), (a), (3), (6), (7) Register December 2017 No. 744, eff. 1-1-18; correction in (1) (c) made under s. 13.92 (4) (b) 7., Stats., December 2017 No. 744.

CSB 4.105 CSB 4.105 Practitioners’ requirement to review monitored prescription drug history reports.

CSB 4.105(1) (1) A practitioner, or a practitioner delegate assisting the practitioner in accordance with the standards of practice for the practitioner’s profession, shall review the monitored prescription drug history report about a patient before the practitioner issues a prescription order for the patient unless any of the following conditions are met:

CSB 4.105(1)(a) (a) The patient is receiving hospice care, as defined in s. 50.94 (1) (a).

CSB 4.105(1)(b) (b) The prescription order is for a number of doses that is intended to last the patient 3 days or less and is not subject to refill.

CSB 4.105(1)(c) (c) The monitored prescription drug is lawfully administered to the patient.

CSB 4.105(1)(d) (d) The practitioner is unable to review the patient’s monitored prescription drug history reports before issuing a prescription order for the patient due to an emergency.

CSB 4.105(1)(e) (e) The practitioner is unable to review the patient’s records under their program because the PDMP system is not operational or due to other technological failure that the practitioner reports to the board.

CSB 4.105(2) (2) Reviews of reports or other information not provided by the board as part of the program that summarize or analyze PDMP data do not satisfy the requirement to review a monitored prescription drug history report under sub. (1).

CSB 4.105(3) (3) The board may refer a practitioner that fails to review a monitored prescription drug history report about a patient prior to issuing a prescription order for that patient to the appropriate licensing or regulatory board for discipline.

CSB 4.105 History History: EmR1706: emerg. cr., eff. 4-1-17; CR 17-028: cr. Register December 2017 No. 744, eff. 1-1-18.

CSB 4.11 CSB 4.11 Methods of obtaining monitored prescription drug history reports.

CSB 4.11(1) (1) The board shall disclose the monitored prescription drug history report about a patient to the patient if he or she does all of the following:

CSB 4.11(1)(a) (a) Appears in person at the department with two forms of valid proof of identity, one of which is valid government-issued photographic identification or mails to the department copies of two forms of valid proof of identity, one of which is valid government-issued photographic identification.

CSB 4.11(1)(b) (b) Makes a request for the monitored prescription drug history reports about the patient on a form provided by the board. If the request is mailed, the form shall be notarized.

CSB 4.11(2) (2) The board shall disclose the monitored prescription drug history report about a patient to a person authorized by the patient if the person authorized by the patient does all of the following:

CSB 4.11(2)(a) (a) Appears in person at the department with two forms of valid proof of identity, one of which is valid government-issued photographic identification.

CSB 4.11(2)(b) (b) Provides proof sufficient to the board of the authorization or delegation from the patient.

CSB 4.11(2)(c) (c) Makes a request for the monitored prescription drug history report on a form provided by the board.

CSB 4.11(5) (5) The board shall disclose the minimum necessary amount of information in a monitored prescription drug history report about a patient, patient address, practitioner, or dispenser to designated staff of a federal or state governmental agency in the same or similar manner, and for the same or similar purposes, as those persons are authorized to access similar confidential patient health care records under ss. 146.82 and 961.385, Stats., this chapter, and other state or federal laws and regulations relating to the privacy of patient health care records if the designated staff does all of the following:

CSB 4.11(5)(a) (a) Creates an account with the PDMP system.

CSB 4.11(5)(b) (b) Provides proof sufficient to the board that the federal or state governmental agency is entitled to the information under s. 146.82 (2) (a) 5., Stats.

CSB 4.11(5)(c) (c) Makes a request for the monitored prescription drug history report through its PDMP system account.

CSB 4.11(5)(d) (d) If the PDMP system is unable to fulfill a request from designated staff through their account with the PDMP system, the board may disclose the minimum necessary amount of information necessary to designated staff of a federal or state governmental agency upon written request that cites the agency’s specific authorization to access similar confidential patient health care records under ss. 146.82 and 961.385, Stats., this chapter, and other state or federal laws and regulations relating to the privacy of patient health care records.

CSB 4.11(6) (6) The board shall disclose the minimum necessary amount of PDMP data or information in a monitored prescription drug history report about a patient, patient address, practitioner, or dispenser to designated staff of the department who is charged with investigating dispensers, dispenser delegates, pharmacists, pharmacist delegates, practitioners, and practitioner delegates in the same or similar manner, and for the same or similar purposes, as those persons are authorized to access similar confidential patient health care records under ss. 146.82 and 961.385, Stats., this chapter, and other state or federal laws and regulations relating to the privacy of patient health care records if the designated staff does all of the following:

CSB 4.11(6)(a) (a) Creates an account with the PDMP system.

CSB 4.11(6)(b) (b) Provides proof sufficient to the board that the department is entitled to the information under s. 146.82 (2) (a) 5., Stats.

CSB 4.11(6)(c) (c) Makes a request for the monitored prescription drug history report through its PDMP system account.

CSB 4.11(7) (7) The board shall disclose the minimum necessary amount of information in a monitored prescription drug history report about a patient or patient address to a prisoner’s health care provider, the medical staff of a prison or jail in which a prisoner is confined, the receiving institution intake staff at a prison or jail to which a prisoner is being transferred or a person designated by a jailer to maintain prisoner medical records or designated staff of the department of corrections in the same or similar manner, and for the same or similar purposes, as those persons are authorized to access similar confidential patient health care records under ss. 146.82 and 961.385, Stats., this chapter, and other state or federal laws and regulations relating to the privacy of patient health care records if the person does all of the following:

CSB 4.11(7)(a) (a) Creates an account with the PDMP system.

CSB 4.11(7)(b) (b) Provides proof sufficient to the board that the person is entitled to the information under s. 146.82 (2) (a) 21., Stats.

CSB 4.11(7)(c) (c) Makes a request for the monitored prescription drug history report through its PDMP system account.

CSB 4.11(8) (8) The board shall disclose the minimum necessary amount of information in a monitored prescription drug history report about a patient to a coroner, deputy coroner, medical examiner, or medical examiner’s assistant following the death of a patient in the same or similar manner, and for the same or similar purposes, as those persons are authorized to access similar confidential patient health care records under ss. 146.82 and 961.385, Stats., this chapter, and other state or federal laws and regulations relating to the privacy of patient health care records if the person does all of the following:

CSB 4.11(8)(a) (a) Creates an account with the PDMP system.

CSB 4.11(8)(b) (b) Provides proof sufficient to the board that the person is entitled to the information under s. 146.82 (2) (a) 18., Stats.

CSB 4.11(8)(c) (c) Makes a request for the monitored prescription drug history report through its PDMP system account with the board.

CSB 4.11(9) (9) The board may disclose PDMP data without personally identifiable information that could be reasonably used to identify any patient, healthcare professional, practitioner delegate, pharmacist delegate, or dispenser for public health and scientific research purposes. The board may require evidence of institutional review board approval.

CSB 4.11(10) (10) The board shall disclose the minimum necessary amount of information in a monitored prescription drug history report about a patient, patient address, practitioner, or dispenser to designated staff of a law enforcement agency or prosecutorial unit if the designated staff does all of the following: