California
State Agencies Form Workgroup to Curb Prescription-Drug Deaths
Several California state agencies are combining resources to prevent deaths and injuries from opioid abuse and misuse by alerting health care providers, pharmacists and the public to the problem.
The recently formed Prescription Opioid Misuse and Overdose Prevention Workgroup includes representatives from the California Department of Public Health and the state's departments of Health Care Services, Justice, Education and Consumer Affairs; California State Board of Pharmacy; the Medical Board of California (MBC); the Dental Board of California; and the Emergency Medical Services Authority.
“Drug overdose brings to mind illegal street drugs, like heroin, but many deaths due to drug abuse are from misuse of the legal prescription drugs that many people find in their medicine cabinets,” said Ron Chapman, MD, state health officer and Director of the California Department of Public Health (CDPH), who leads the workgroup.
THE NUMBER OF PEOPLE BEING TREATED FOR PRESCRIPTION OPIOID ABUSE IN PUBLICLY FUNDED OR MONITORED PROGRAMS IN C ALIFORNIA HAS NEARLY DOUBLED SINCE 2007.
According to MBC, reported deaths involving opioid prescription medications in the state have increased 16.5% since 2006. In 2012, there were more than 1,800 deaths from all types of opioids, and 72% involved prescription opioids. The number of people being treated for prescription opioid abuse in publicly funded or monitored programs in California has nearly doubled since 2007.
One of the workgroup's goals is to provide information about MBC's recently revised guidelines for prescribing controlled substances for pain.
“We want to provide tools that will lead to better discussions between providers, pharmacists and their patients,” said MBC Executive Director Kimberly Kirchmeyer. “The Board's new guidelines will assist in this endeavor.”
Source: Medical Board of California News Release, December 30, 2014
Florida
New Executive Director Chosen for Florida Board of Medicine
André Ourso, JD, MPH, has been named the new Executive Director of the Florida Board of Medicine. He replaces former Executive Director Allison Dudley, JD, who was recently promoted to Bureau Chief of Florida's Department of Health Bureau of Health Care Practitioner Regulation.
Mr. Ourso earned a Master of Public Health degree from the College of Public Health at the University of South Florida, and a JD degree from the University of Florida's Levin College of Law. He was admitted to the Florida Bar in September 2011. Prior to becoming the Executive Director, Mr. Ourso served as a Senior Attorney and Team Leader in the Florida Department of Health's Office of the General Counsel, where he prosecuted administrative law cases against Florida Board of Medicine licensees and presented cases for final agency action before the Florida Board of Medicine.
Source: Florida Board of Medicine website announcement, February 17, 2015
Georgia
Georgia Board Reports on Pain Management Clinic Licensing Applications
After 17 months of licensing pain management clinics in Georgia, the Georgia Composite Medical Board reported recently that it has received 285 applications. Of that number, 263 were from clinics that were 100% physician owned, and 22 were from clinics that were grandfathered because they had some non-physician ownership. The Board has approved 217 applications.
Of the remaining applications, 41 were either denied or withdrawn by the applicants, and 27 are pending. Approximately 90% of the clinics with 100% physician ownership were approved; in the case of the clinics with some non-physician ownership, 50% were approved.
As of December 5, 2014, there were 196 pain management clinics with active licenses in the state.
Source: Georgia Composite Medical Board Newsletter, December 2014
Georgia Board Publishes Medical Malpractice Coverage Data Online
In keeping with Georgia's new medical malpractice insurance disclosure laws, the Georgia Medical Board has released a full list of medical malpractice insurance coverage for all physicians with active Georgia medical licenses. The data on the list — which is available at the Georgia Board's public website — is compiled from renewal-application responses and includes the most current response from the physician.
Georgia House Bill 147, which was passed and signed in 2011, required physicians to disclose on their state physician-profiles whether or not they carry medical malpractice insurance. Due to budgetary issues, the Georgia Board was not able to update all physician profiles, but in an effort to provide the information to the public it added a question about medical malpractice insurance to its physician license-renewal application and began collecting the data in late 2011.
Since physicians renew their licenses biennially in Georgia, the data set was not complete until 2014.
Board Executive Director LaSharn Hughes noted that the decision to publish the list as a separate file on the Board's public website rather than update physician profiles was the best choice available, in light of budgetary constraints.
“While the Board couldn't meet the letter of the law as it was written (including the information in the physician profile), we feel we have found a way to meet the spirit of the law,” she said. “We would rather incorporate the information into the physician profile, but until we can get the funding to accomplish that, the list we posted online provides Georgia citizens with more complete information to make decisions about health care choices.”
The file posted on the Georgia Board's website includes all active physicians who have submitted a renewal application. Physicians who have not submitted a renewal application since September 30, 2011, are not included on the list.
Since September 2011, the physician renewal form has included the following mandatory question: “Do you currently carry medical malpractice insurance, or are you covered under a medical malpractice insurance policy? (Yes or No)”
Of the 33,785 physicians with active licenses currently, the Georgia Board has collected malpractice coverage responses from 30,209 (89.4%).
Consumers can download the list and search for the physician by name or license number to see if the physician indicated he or she had coverage at the time the license was last renewed.
Source: Georgia Composite Medical Board Newsletter, December 2014
Iowa
New Brochure Helps Consumers in Iowa Better Understand Medical Board Investigations
The Iowa Board of Medicine has published a “consumer guide” to help Iowans understand how the Board receives, evaluates and investigates complaints against physicians and complaints that allege the unlicensed practice of medicine.
The new brochure, which can be downloaded at the Iowa Board's website, explains the complaint investigation process and how complaints are most often resolved.
The Iowa Board estimates that it receives about 750 complaints and reports annually, most of them from patients or their family members. Complaints and reports are also filed by other health care professionals, law enforcement agencies, pharmacies, hospitals and clinics, insurance companies and other regulatory agencies in Iowa and from throughout the nation, according to the Board.
To view the brochure, visit www.medicalboard.iowa.gov/images/pdf/Consumer's%20Guide1.pdf.
Source: Iowa Board of Medicine news release, February 20, 2015
Kentucky
Electronic Death Reporting Becoming Mandatory
Under new procedures in Kentucky, coroners, funeral home personnel, physicians and others responsible for the registration of death certificates will be required to electronically file information needed to complete death certificates, using the Kentucky Electronic Death Registration System (KY-EDRS).
The change took effect Jan. 1, 2015, phasing out the paper-based system formerly used by the Office of Vital Statistics in conjunction with electronic reporting. The transition to exclusive electronic filing, mandated by state law, is anticipated to speed the process, while maintaining the accuracy and security of the records.
‘DEATH DATA REGISTRATION IS GREATLY IMPROVED BECAUSE THE SYSTEM INCORPORATES EDITS, MINIMIZES ERRORS, AND ENABLES COMMUNIC ATION BETWEEN FUNERAL DIRECTORS AND MEDICAL CERTIFIERS.’
KY-EDRS was designed several years ago, giving users the option to file records electronically while others could continue to use the original, paper-based reporting system if they preferred. Electronic reporting is now mandatory.
KY-EDRS is a free and secure web-based application. With KY-EDRS, funeral directors, physicians, coroners and other medical certifiers are able to complete their portion of the death registration process faster, more efficiently and with fewer errors, according to state officials.
“KY-EDRS saves time and effort,” said Kentucky State Registrar Paul Royce. “Death data registration is greatly improved because the system incorporates edits, minimizes errors, and enables communication between funeral directors and medical certifiers. The efficiency of KY-EDRS far outweighs the previous paper-based system.”
Kentucky reported earlier this year that 404 funeral facilities, 81 coroners' offices and 40 medical facilities have signed on and are using KY-EDRS.
To be granted access to the electronic system, users must contact the state to create an account. For more information, visit http://chfs.ky.gov/dph/vital/KY-EDRS.htm.
Source: Kentucky Board of Medical Licensure Newsletter, Winter 2015
Nevada
Nevada Board Announces New Executive Director and Deputy Executive Director
Edward O. Cousineau, JD, has assumed the role of Executive Director of the Nevada State Board of Medical Examiners, replacing retiring Executive Director Douglas C. Cooper, CMBI.
Cousineau has worked for the Board for more than a decade in the roles of Deputy General Counsel, General Counsel, and for the last four years as Deputy Executive Director. Assuming Cousineau's role as Deputy Executive Director will be Todd C. Rich, who comes to the Board from the Nevada Division of Insurance, where he served as Chief Deputy Commissioner.
Source: Nevada State Board of Medical Examiners Newsletter, December 2014
New York
Some New York Nurse Practitioners No Longer Required to be Supervised by Physicians
Nurse practitioners in the state of New York who have accumulated more than 3,600 hours of clinical practice are no longer required to have a written collaborative agreement with a physician, under recently passed legislation.
The state's new Nurse Practitioners Modernization Act also lifts the requirement that nurse practitioners submit patient charts to physicians for review. Nurse practitioners with less than 3,600 hours of accumulated practice time will still be required to hold a written agreement with a supervising physician under the new law.
Roughly one third of states have now passed similar legislation in the United States, lifting restrictions on the scope of nurse practitioners' practice.
The Nurse Practitioner Association estimates that 3,600 hours of practice is the equivalent of roughly two years of full-time professional activity for a typical nurse practitioner.
Source: The Nurse Practitioner Association, Greater Rochester website announcement, accessed March 16, 2015
Oklahoma
Oklahoma Deploys NABP's Prescription Monitoring Program Data Exchange Tool
The Oklahoma Prescription Monitoring Program (PMP) recently deployed the National Association of Boards of Pharmacy (NABP) PMP InterConnect®tool, bringing the total number of state PMPs participating in the NABP program to 28.
Oklahoma joins PMPs in Arizona, Arkansas, Colorado, Connecticut, Delaware, Idaho, Illinois, Indiana, Kansas, Kentucky, Louisiana, Michigan, Minnesota, Mississippi, Nevada, New Jersey, New Mexico, North Dakota, Ohio, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Virginia, West Virginia, and Wisconsin which have implemented use of PMP InterConnect. The program gives authorized PMP users the ability to request and share program data across state lines. NABP is continuing to work with other states to facilitate their participation.
PMP InterConnect offers a highly secure communications exchange platform that facilitates the transmission of PMP data across state lines to authorized requestors, while ensuring that each state's data-access rules are enforced.
THE STATE'S NEW NURSE PRACTITIONERS MODERNIZATION ACT ALSO LIFTS THE REQUIREMENT THAT NURSE PRACTITIONERS SUBMIT PATIENT CHARTS TO PHYSICIANS FOR REVIEW.
Additional information about PMP InterConnect is available at www.nabp.net/programs/pmp-interconnect/nabp-pmp-interconnect.
Source: National Association of Boards of Pharmacy news release, January 28, 2015
Oregon
Joint statement from Oregon Medical Board and Oregon Board of Pharmacy Seeks to Clarify Electronic Prescribing Rules
In an effort to raise awareness and understanding of Oregon's electronic prescribing rules regarding controlled substances, the Oregon Medical Board and the Oregon Board of Pharmacy have issued a joint statement encouraging prescribers and pharmacists to become familiar with the state's electronic prescribing requirements and to “maintain open communication with one another and their patients to ensure the best care possible.”
...IN OREGON, ELECTRONIC PRESCRIPTIONS FOR CONTROLLED SUBSTANCES (INCLUDING SCHEDULE II) ARE PERMITTED ONLY IF THE PRESCRIBER'S AND PHARMACY'S SOFTWARE HAS BEEN AUTHENTICATED BY A DEA-APPROVED CERTIFYING ORGANIZATION.
The joint statement, which recognizes the complexity of U.S. Drug Enforcement Administration (DEA) requirements related to controlled substances, emphasizes that in Oregon, electronic prescriptions for controlled substances (including schedule II) are permitted only if the prescriber's and pharmacy's software has been authenticated by a DEA-approved certifying organization.
Oregon prescribers must:
Have a certification report for the Electronic Health Records (EHR) or electronic prescription application to verify compliance with the DEA rule.
Obtain credentials to electronically sign controlled substance prescriptions.
Restrict access so that only authorized individuals may sign controlled substance prescriptions.
Oregon pharmacies must:
Have a certification report for the electronic prescription application to verify compliance with the DEA rule.
Maintain original prescription records in the same physical manner as received. Therefore, prescriptions received electronically must be maintained electronically.
Source: Oregon Medical Board website announcement, accessed March 15, 2015
Oregon Medical Board Completes Major IT Systems Update
The Oregon Medical Board reported recently that it has completed a major update of its information technology (IT) systems, including a complete rebuilding of its website and modernization of its online services.
Various processes that have been improved, according to the Board, include log-in and information retrieval for licensees, online license application, license renewal, address change, and a variety of other functions.
The Board has also implemented new state-of-the art network security systems, including continual network testing and disaster recovery planning, and has begun regular staff training on best practices to ensure the security of sensitive data stored in its IT systems.
In addition to improvements to its systems, the Board reports that it has implemented an all-digital data process: All paper documents received with a license application are now scanned and uploaded into its new licensing management system.
Electronic review of license applications allows the Board to grant licenses daily rather than weekly. During license renewal, reminders to licensees are now sent via e-mail, and automated phone calls are made, in addition to the use of postcards. Laptops have also been distributed to members of the Board for more efficient and secure sharing of Board materials.
Source: Oregon Medical Board Report, Winter 2015.
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