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HB2247
HB2247
HB2247
HB2247
HB2247
HB2247
HB2247
HB2247
HB2247
HB2247
HB2247
HB2247
HB2247
HB2247
HB2247
HB2247
HB2247
HB2247
HB2247
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HB2247

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  • 1. *LRB09607723ASK17824b* HB2247 96TH GENERAL ASSEMBLY State of Illinois 2009 and 2010 HB2247 Introduced 2/18/2009, by Rep. Angelo Saviano SYNOPSIS AS INTRODUCED: 225 ILCS 95/7.5 720 ILCS 570/102 from Ch. 56 1/2, par. 1102 720 ILCS 570/303.05 Amends the Physician Assistant Practice Act of 1987. Provides that a physician assistant may prescribe, dispense, and administer drugs and medical devices to the extent delegated by the supervising physician, including the prescribing and dispensing of Schedule II through V controlled substances as described in Article II of the Illinois Controlled Substances Act and all legend drugs (now, limited prescriptive authority may be delegated by a physician for Schedule III, IV, and V controlled substances in written guidelines to a physician assistant). Provides that dispensing activities of any physician assistant shall comply with appropriate federal and State regulations and occur when pharmacy services are not reasonably available, or when it is in the best interest of the patient, or when it is an emergency. Provides that physician assistants may request, receive, and sign for professional samples and may distribute professional samples to patients. Amends the Controlled Substances Act. Provides that the Department of Financial and Professional Regulation shall register licensed physician assistants and licensed advanced practice nurses to prescribe and dispense Schedule II, III, IV, or V controlled substances (now, III, IV or V controlled substances). Makes other changes. LRB096 07723 ASK 17824 b A BILL FOR
  • 2. HB2247 LRB096 07723 ASK 17824 b 1 AN ACT concerning professional regulation. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 5. The Physician Assistant Practice Act of 1987 is 5 amended by changing Section 7.5 as follows: 6 (225 ILCS 95/7.5) 7 (Section scheduled to be repealed on January 1, 2018) 8 Sec. 7.5. Prescriptions. A physician assistant may 9 prescribe, dispense, and administer drugs and medical devices 10 to the extent delegated by the supervising physician. 11 Prescribing and dispensing of drugs may include Schedule II 12 through V controlled substances as described in Article II of 13 the Illinois Controlled Substances Act and all legend drugs. 14 All dispensing activities of any physician assistant shall: 15 (1) comply with appropriate federal and State 16 regulations; and 17 (2) occur when pharmacy services are not reasonably 18 available, or when it is in the best interest of the 19 patient, or when it is an emergency. Physician assistants 20 may request, receive, and sign for professional samples and 21 may distribute professional samples to patients. A 22 supervising physician may delegate limited prescriptive 23 authority to a physician assistant. This authority may, but
  • 3. HB2247 - 2 - LRB096 07723 ASK 17824 b 1 is not required to, include prescription and dispensing of 2 legend drugs and legend controlled substances categorized 3 as Schedule III, IV, or V controlled substances, as defined 4 in Article II of the Illinois Controlled Substances Act, as 5 delegated in the written guidelines required by this Act. 6 To prescribe Schedule III, IV, or V controlled substances 7 under this Section, a physician assistant must obtain a 8 mid-level practitioner controlled substances license. 9 Medication orders issued by a physician assistant shall be 10 reviewed periodically by the supervising physician. The 11 supervising physician shall file with the Department notice of 12 delegation of prescriptive authority to a physician assistant 13 and termination of delegation, specifying the authority 14 delegated or terminated. Upon receipt of this notice delegating 15 authority to prescribe Schedule III, IV, or V controlled 16 substances, the physician assistant shall be eligible to 17 register for a mid-level practitioner controlled substances 18 license under Section 303.05 of the Illinois Controlled 19 Substances Act. Nothing in this Act shall be construed to limit 20 the delegation of tasks or duties by the supervising physician 21 to a nurse or other appropriately trained personnel. 22 The Department shall establish by rule the minimum 23 requirements for written guidelines to be followed under this 24 Section. 25 (Source: P.A. 90-116, eff. 7-14-97; 90-818, eff. 3-23-99.)
  • 4. HB2247 - 3 - LRB096 07723 ASK 17824 b 1 Section 10. The Illinois Controlled Substances Act is 2 amended by changing Sections 102 and 303.05 as follows: 3 (720 ILCS 570/102) (from Ch. 56 1/2, par. 1102) 4 Sec. 102. Definitions. As used in this Act, unless the 5 context otherwise requires: 6 (a) "Addict" means any person who habitually uses any drug, 7 chemical, substance or dangerous drug other than alcohol so as 8 to endanger the public morals, health, safety or welfare or who 9 is so far addicted to the use of a dangerous drug or controlled 10 substance other than alcohol as to have lost the power of self 11 control with reference to his addiction. 12 (b) "Administer" means the direct application of a 13 controlled substance, whether by injection, inhalation, 14 ingestion, or any other means, to the body of a patient, 15 research subject, or animal (as defined by the Humane 16 Euthanasia in Animal Shelters Act) by: 17 (1) a practitioner (or, in his presence, by his 18 authorized agent), 19 (2) the patient or research subject at the lawful 20 direction of the practitioner, or 21 (3) a euthanasia technician as defined by the Humane 22 Euthanasia in Animal Shelters Act. 23 (c) "Agent" means an authorized person who acts on behalf 24 of or at the direction of a manufacturer, distributor, or 25 dispenser. It does not include a common or contract carrier,
  • 5. HB2247 - 4 - LRB096 07723 ASK 17824 b 1 public warehouseman or employee of the carrier or warehouseman. 2 (c-1) "Anabolic Steroids" means any drug or hormonal 3 substance, chemically and pharmacologically related to 4 testosterone (other than estrogens, progestins, and 5 corticosteroids) that promotes muscle growth, and includes: 6 (i) boldenone, 7 (ii) chlorotestosterone, 8 (iii) chostebol, 9 (iv) dehydrochlormethyltestosterone, 10 (v) dihydrotestosterone, 11 (vi) drostanolone, 12 (vii) ethylestrenol, 13 (viii) fluoxymesterone, 14 (ix) formebulone, 15 (x) mesterolone, 16 (xi) methandienone, 17 (xii) methandranone, 18 (xiii) methandriol, 19 (xiv) methandrostenolone, 20 (xv) methenolone, 21 (xvi) methyltestosterone, 22 (xvii) mibolerone, 23 (xviii) nandrolone, 24 (xix) norethandrolone, 25 (xx) oxandrolone, 26 (xxi) oxymesterone,
  • 6. HB2247 - 5 - LRB096 07723 ASK 17824 b 1 (xxii) oxymetholone, 2 (xxiii) stanolone, 3 (xxiv) stanozolol, 4 (xxv) testolactone, 5 (xxvi) testosterone, 6 (xxvii) trenbolone, and 7 (xxviii) any salt, ester, or isomer of a drug or 8 substance described or listed in this paragraph, if 9 that salt, ester, or isomer promotes muscle growth. 10 Any person who is otherwise lawfully in possession of an 11 anabolic steroid, or who otherwise lawfully manufactures, 12 distributes, dispenses, delivers, or possesses with intent to 13 deliver an anabolic steroid, which anabolic steroid is 14 expressly intended for and lawfully allowed to be administered 15 through implants to livestock or other nonhuman species, and 16 which is approved by the Secretary of Health and Human Services 17 for such administration, and which the person intends to 18 administer or have administered through such implants, shall 19 not be considered to be in unauthorized possession or to 20 unlawfully manufacture, distribute, dispense, deliver, or 21 possess with intent to deliver such anabolic steroid for 22 purposes of this Act. 23 (d) "Administration" means the Drug Enforcement 24 Administration, United States Department of Justice, or its 25 successor agency. 26 (e) "Control" means to add a drug or other substance, or
  • 7. HB2247 - 6 - LRB096 07723 ASK 17824 b 1 immediate precursor, to a Schedule under Article II of this Act 2 whether by transfer from another Schedule or otherwise. 3 (f) "Controlled Substance" means a drug, substance, or 4 immediate precursor in the Schedules of Article II of this Act. 5 (g) "Counterfeit substance" means a controlled substance, 6 which, or the container or labeling of which, without 7 authorization bears the trademark, trade name, or other 8 identifying mark, imprint, number or device, or any likeness 9 thereof, of a manufacturer, distributor, or dispenser other 10 than the person who in fact manufactured, distributed, or 11 dispensed the substance. 12 (h) "Deliver" or "delivery" means the actual, constructive 13 or attempted transfer of possession of a controlled substance, 14 with or without consideration, whether or not there is an 15 agency relationship. 16 (i) "Department" means the Illinois Department of Human 17 Services (as successor to the Department of Alcoholism and 18 Substance Abuse) or its successor agency. 19 (j) "Department of State Police" means the Department of 20 State Police of the State of Illinois or its successor agency. 21 (k) "Department of Corrections" means the Department of 22 Corrections of the State of Illinois or its successor agency. 23 (l) "Department of Professional Regulation" means the 24 Department of Professional Regulation of the State of Illinois 25 or its successor agency. 26 (m) "Depressant" or "stimulant substance" means:
  • 8. HB2247 - 7 - LRB096 07723 ASK 17824 b 1 (1) a drug which contains any quantity of (i) 2 barbituric acid or any of the salts of barbituric acid 3 which has been designated as habit forming under section 4 502 (d) of the Federal Food, Drug, and Cosmetic Act (21 5 U.S.C. 352 (d)); or 6 (2) a drug which contains any quantity of (i) 7 amphetamine or methamphetamine and any of their optical 8 isomers; (ii) any salt of amphetamine or methamphetamine or 9 any salt of an optical isomer of amphetamine; or (iii) any 10 substance which the Department, after investigation, has 11 found to be, and by rule designated as, habit forming 12 because of its depressant or stimulant effect on the 13 central nervous system; or 14 (3) lysergic acid diethylamide; or 15 (4) any drug which contains any quantity of a substance 16 which the Department, after investigation, has found to 17 have, and by rule designated as having, a potential for 18 abuse because of its depressant or stimulant effect on the 19 central nervous system or its hallucinogenic effect. 20 (n) (Blank). 21 (o) "Director" means the Director of the Department of 22 State Police or the Department of Professional Regulation or 23 his designated agents. 24 (p) "Dispense" means to deliver a controlled substance to 25 an ultimate user or research subject by or pursuant to the 26 lawful order of a prescriber, including the prescribing,
  • 9. HB2247 - 8 - LRB096 07723 ASK 17824 b 1 administering, packaging, labeling, or compounding necessary 2 to prepare the substance for that delivery. 3 (q) "Dispenser" means a practitioner who dispenses. 4 (r) "Distribute" means to deliver, other than by 5 administering or dispensing, a controlled substance. 6 (s) "Distributor" means a person who distributes. 7 (t) "Drug" means (1) substances recognized as drugs in the 8 official United States Pharmacopoeia, Official Homeopathic 9 Pharmacopoeia of the United States, or official National 10 Formulary, or any supplement to any of them; (2) substances 11 intended for use in diagnosis, cure, mitigation, treatment, or 12 prevention of disease in man or animals; (3) substances (other 13 than food) intended to affect the structure of any function of 14 the body of man or animals and (4) substances intended for use 15 as a component of any article specified in clause (1), (2), or 16 (3) of this subsection. It does not include devices or their 17 components, parts, or accessories. 18 (t-5) "Euthanasia agency" means an entity certified by the 19 Department of Professional Regulation for the purpose of animal 20 euthanasia that holds an animal control facility license or 21 animal shelter license under the Animal Welfare Act. A 22 euthanasia agency is authorized to purchase, store, possess, 23 and utilize Schedule II nonnarcotic and Schedule III 24 nonnarcotic drugs for the sole purpose of animal euthanasia. 25 (t-10) "Euthanasia drugs" means Schedule II or Schedule III 26 substances (nonnarcotic controlled substances) that are used
  • 10. HB2247 - 9 - LRB096 07723 ASK 17824 b 1 by a euthanasia agency for the purpose of animal euthanasia. 2 (u) "Good faith" means the prescribing or dispensing of a 3 controlled substance by a practitioner in the regular course of 4 professional treatment to or for any person who is under his 5 treatment for a pathology or condition other than that 6 individual's physical or psychological dependence upon or 7 addiction to a controlled substance, except as provided herein: 8 and application of the term to a pharmacist shall mean the 9 dispensing of a controlled substance pursuant to the 10 prescriber's order which in the professional judgment of the 11 pharmacist is lawful. The pharmacist shall be guided by 12 accepted professional standards including, but not limited to 13 the following, in making the judgment: 14 (1) lack of consistency of doctor-patient 15 relationship, 16 (2) frequency of prescriptions for same drug by one 17 prescriber for large numbers of patients, 18 (3) quantities beyond those normally prescribed, 19 (4) unusual dosages, 20 (5) unusual geographic distances between patient, 21 pharmacist and prescriber, 22 (6) consistent prescribing of habit-forming drugs. 23 (u-1) "Home infusion services" means services provided by a 24 pharmacy in compounding solutions for direct administration to 25 a patient in a private residence, long-term care facility, or 26 hospice setting by means of parenteral, intravenous,
  • 11. HB2247 - 10 - LRB096 07723 ASK 17824 b 1 intramuscular, subcutaneous, or intraspinal infusion. 2 (v) "Immediate precursor" means a substance: 3 (1) which the Department has found to be and by rule 4 designated as being a principal compound used, or produced 5 primarily for use, in the manufacture of a controlled 6 substance; 7 (2) which is an immediate chemical intermediary used or 8 likely to be used in the manufacture of such controlled 9 substance; and 10 (3) the control of which is necessary to prevent, 11 curtail or limit the manufacture of such controlled 12 substance. 13 (w) "Instructional activities" means the acts of teaching, 14 educating or instructing by practitioners using controlled 15 substances within educational facilities approved by the State 16 Board of Education or its successor agency. 17 (x) "Local authorities" means a duly organized State, 18 County or Municipal peace unit or police force. 19 (y) "Look-alike substance" means a substance, other than a 20 controlled substance which (1) by overall dosage unit 21 appearance, including shape, color, size, markings or lack 22 thereof, taste, consistency, or any other identifying physical 23 characteristic of the substance, would lead a reasonable person 24 to believe that the substance is a controlled substance, or (2) 25 is expressly or impliedly represented to be a controlled 26 substance or is distributed under circumstances which would
  • 12. HB2247 - 11 - LRB096 07723 ASK 17824 b 1 lead a reasonable person to believe that the substance is a 2 controlled substance. For the purpose of determining whether 3 the representations made or the circumstances of the 4 distribution would lead a reasonable person to believe the 5 substance to be a controlled substance under this clause (2) of 6 subsection (y), the court or other authority may consider the 7 following factors in addition to any other factor that may be 8 relevant: 9 (a) statements made by the owner or person in control 10 of the substance concerning its nature, use or effect; 11 (b) statements made to the buyer or recipient that the 12 substance may be resold for profit; 13 (c) whether the substance is packaged in a manner 14 normally used for the illegal distribution of controlled 15 substances; 16 (d) whether the distribution or attempted distribution 17 included an exchange of or demand for money or other 18 property as consideration, and whether the amount of the 19 consideration was substantially greater than the 20 reasonable retail market value of the substance. 21 Clause (1) of this subsection (y) shall not apply to a 22 noncontrolled substance in its finished dosage form that was 23 initially introduced into commerce prior to the initial 24 introduction into commerce of a controlled substance in its 25 finished dosage form which it may substantially resemble. 26 Nothing in this subsection (y) prohibits the dispensing or
  • 13. HB2247 - 12 - LRB096 07723 ASK 17824 b 1 distributing of noncontrolled substances by persons authorized 2 to dispense and distribute controlled substances under this 3 Act, provided that such action would be deemed to be carried 4 out in good faith under subsection (u) if the substances 5 involved were controlled substances. 6 Nothing in this subsection (y) or in this Act prohibits the 7 manufacture, preparation, propagation, compounding, 8 processing, packaging, advertising or distribution of a drug or 9 drugs by any person registered pursuant to Section 510 of the 10 Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360). 11 (y-1) "Mail-order pharmacy" means a pharmacy that is 12 located in a state of the United States, other than Illinois, 13 that delivers, dispenses or distributes, through the United 14 States Postal Service or other common carrier, to Illinois 15 residents, any substance which requires a prescription. 16 (z) "Manufacture" means the production, preparation, 17 propagation, compounding, conversion or processing of a 18 controlled substance other than methamphetamine, either 19 directly or indirectly, by extraction from substances of 20 natural origin, or independently by means of chemical 21 synthesis, or by a combination of extraction and chemical 22 synthesis, and includes any packaging or repackaging of the 23 substance or labeling of its container, except that this term 24 does not include: 25 (1) by an ultimate user, the preparation or compounding 26 of a controlled substance for his own use; or
  • 14. HB2247 - 13 - LRB096 07723 ASK 17824 b 1 (2) by a practitioner, or his authorized agent under 2 his supervision, the preparation, compounding, packaging, 3 or labeling of a controlled substance: 4 (a) as an incident to his administering or 5 dispensing of a controlled substance in the course of 6 his professional practice; or 7 (b) as an incident to lawful research, teaching or 8 chemical analysis and not for sale. 9 (z-1) (Blank). 10 (aa) "Narcotic drug" means any of the following, whether 11 produced directly or indirectly by extraction from substances 12 of natural origin, or independently by means of chemical 13 synthesis, or by a combination of extraction and chemical 14 synthesis: 15 (1) opium and opiate, and any salt, compound, 16 derivative, or preparation of opium or opiate; 17 (2) any salt, compound, isomer, derivative, or 18 preparation thereof which is chemically equivalent or 19 identical with any of the substances referred to in clause 20 (1), but not including the isoquinoline alkaloids of opium; 21 (3) opium poppy and poppy straw; 22 (4) coca leaves and any salts, compound, isomer, salt 23 of an isomer, derivative, or preparation of coca leaves 24 including cocaine or ecgonine, and any salt, compound, 25 isomer, derivative, or preparation thereof which is 26 chemically equivalent or identical with any of these
  • 15. HB2247 - 14 - LRB096 07723 ASK 17824 b 1 substances, but not including decocainized coca leaves or 2 extractions of coca leaves which do not contain cocaine or 3 ecgonine (for the purpose of this paragraph, the term 4 "isomer" includes optical, positional and geometric 5 isomers). 6 (bb) "Nurse" means a registered nurse licensed under the 7 Nurse Practice Act. 8 (cc) (Blank). 9 (dd) "Opiate" means any substance having an addiction 10 forming or addiction sustaining liability similar to morphine 11 or being capable of conversion into a drug having addiction 12 forming or addiction sustaining liability. 13 (ee) "Opium poppy" means the plant of the species Papaver 14 somniferum L., except its seeds. 15 (ff) "Parole and Pardon Board" means the Parole and Pardon 16 Board of the State of Illinois or its successor agency. 17 (gg) "Person" means any individual, corporation, 18 mail-order pharmacy, government or governmental subdivision or 19 agency, business trust, estate, trust, partnership or 20 association, or any other entity. 21 (hh) "Pharmacist" means any person who holds a license or 22 certificate of registration as a registered pharmacist, a local 23 registered pharmacist or a registered assistant pharmacist 24 under the Pharmacy Practice Act. 25 (ii) "Pharmacy" means any store, ship or other place in 26 which pharmacy is authorized to be practiced under the Pharmacy
  • 16. HB2247 - 15 - LRB096 07723 ASK 17824 b 1 Practice Act. 2 (jj) "Poppy straw" means all parts, except the seeds, of 3 the opium poppy, after mowing. 4 (kk) "Practitioner" means a physician licensed to practice 5 medicine in all its branches, dentist, optometrist, 6 podiatrist, veterinarian, scientific investigator, pharmacist, 7 physician assistant, advanced practice nurse, licensed 8 practical nurse, registered nurse, hospital, laboratory, or 9 pharmacy, or other person licensed, registered, or otherwise 10 lawfully permitted by the United States or this State to 11 distribute, dispense, conduct research with respect to, 12 administer or use in teaching or chemical analysis, a 13 controlled substance in the course of professional practice or 14 research. 15 (ll) "Pre-printed prescription" means a written 16 prescription upon which the designated drug has been indicated 17 prior to the time of issuance. 18 (mm) "Prescriber" means a physician licensed to practice 19 medicine in all its branches, dentist, optometrist, podiatrist 20 or veterinarian who issues a prescription, a physician 21 assistant who issues a prescription for a Schedule III, IV, or 22 V controlled substance in accordance with Section 303.05 and 23 the written guidelines required under Section 7.5 of the 24 Physician Assistant Practice Act of 1987, or an advanced 25 practice nurse with prescriptive authority delegated under 26 Section 65-40 of the Nurse Practice Act and in accordance with
  • 17. HB2247 - 16 - LRB096 07723 ASK 17824 b 1 Section 303.05 and a written collaborative agreement under 2 Section 65-35 of the Nurse Practice Act. 3 (nn) "Prescription" means a lawful written, facsimile, or 4 verbal order of a physician licensed to practice medicine in 5 all its branches, dentist, podiatrist or veterinarian for any 6 controlled substance, of an optometrist for a Schedule III, IV, 7 or V controlled substance in accordance with Section 15.1 of 8 the Illinois Optometric Practice Act of 1987, of a physician 9 assistant for a Schedule III, IV, or V controlled substance in 10 accordance with Section 303.05 and the written guidelines 11 required under Section 7.5 of the Physician Assistant Practice 12 Act of 1987, or of an advanced practice nurse with prescriptive 13 authority delegated under Section 65-40 of the Nurse Practice 14 Act who issues a prescription for a Schedule III, IV, or V 15 controlled substance in accordance with Section 303.05 and a 16 written collaborative agreement under Section 65-35 of the 17 Nurse Practice Act. 18 (oo) "Production" or "produce" means manufacture, 19 planting, cultivating, growing, or harvesting of a controlled 20 substance other than methamphetamine. 21 (pp) "Registrant" means every person who is required to 22 register under Section 302 of this Act. 23 (qq) "Registry number" means the number assigned to each 24 person authorized to handle controlled substances under the 25 laws of the United States and of this State. 26 (rr) "State" includes the State of Illinois and any state,
  • 18. HB2247 - 17 - LRB096 07723 ASK 17824 b 1 district, commonwealth, territory, insular possession thereof, 2 and any area subject to the legal authority of the United 3 States of America. 4 (ss) "Ultimate user" means a person who lawfully possesses 5 a controlled substance for his own use or for the use of a 6 member of his household or for administering to an animal owned 7 by him or by a member of his household. 8 (Source: P.A. 94-556, eff. 9-11-05; 95-242, eff. 1-1-08; 9 95-639, eff. 10-5-07; 95-689, eff. 10-29-07; 95-876, eff. 10 8-21-08.) 11 (720 ILCS 570/303.05) 12 Sec. 303.05. Mid-level practitioner registration. 13 (a) The Department of Financial and Professional 14 Regulation shall register licensed physician assistants and 15 licensed advanced practice nurses to prescribe and dispense 16 Schedule II, III, IV, or V controlled substances under Section 17 303 and euthanasia agencies to purchase, store, or administer 18 euthanasia drugs under the following circumstances: 19 (1) with respect to physician assistants or advanced 20 practice nurses, 21 (A) the physician assistant or advanced practice 22 nurse has been delegated prescriptive authority by a 23 physician licensed to practice medicine in all its 24 branches in accordance with Section 7.5 of the 25 Physician Assistant Practice Act of 1987 or Section
  • 19. HB2247 - 18 - LRB096 07723 ASK 17824 b 1 65-40 of the Nurse Practice Act; and 2 (B) the physician assistant or advanced practice 3 nurse has completed the appropriate application forms 4 and has paid the required fees as set by rule; or 5 (2) with respect to euthanasia agencies, the 6 euthanasia agency has obtained a license from the 7 Department of Professional Regulation and obtained a 8 registration number from the Department. 9 (b) The mid-level practitioner shall only be licensed to 10 prescribe those schedules of controlled substances for which a 11 licensed physician has delegated prescriptive authority, 12 except that a euthanasia agency does not have any prescriptive 13 authority. 14 (c) Upon completion of all registration requirements, 15 physician assistants, advanced practice nurses, and euthanasia 16 agencies shall be issued a mid-level practitioner controlled 17 substances license for Illinois. 18 (Source: P.A. 95-639, eff. 10-5-07.)

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