Arizona
Medical Marijuana Guidelines Moving Forward in Arizona
Arizona's state health department has released a final version of its new medical-marijuana rules, which provide guidelines for how dispensaries will be chosen and distributed in the state.
The new guidelines are the end result of a proposition Arizona voters passed in November 2010, allowing some patients with debilitating medical conditions to receive up to 2½ ounces of marijuana every two weeks from dispensaries or cultivate up to 12 marijuana plants if they live 25 miles or farther from a marijuana dispensary. There will be between 120 and 126 dispensaries throughout the state.
After Proposition 203 was passed a four-month rule-making process began. With the guidelines now in place, the Arizona Department of Health Services will begin accepting applications from patients to participate in the state's medical marijuana program. Arizona physicians will be allowed to write medical marijuana prescriptions if warranted under the parameters of the new law.
State officials expect that the program will be fully operational by the end of 2011.
The state's health department received more than 1,000 electronic comments on the second draft of its rules, and it held several public forums to allow additional public input.
Arizona's law regulates the activities of medical marijuana dispensers, requiring them to apply for a registration certificate, undergo a background check, and then apply for an operating license. Issuance of an operating license will be contingent on other factors, including a site plan for dispensaries, a certificate of occupancy and a business plan that shows projected expenditures before and after the dispensary begins doing business.
The new guidelines call for one dispensary to be available in each of 126 Community Health Analysis Areas throughout the state that it has used in the past to analyze public health issues and trends.
One of the reasons this provision was included in the final rules was to encourage applicants to set up shop in rural areas of the state. If applicants do not meet the standards, they will have a better chance applying for a less competitive health area. After three years, dispensary owners can apply to move to a different health area.
Source: AZCentral.com, March 2011
Florida
Florida Begins Large Scale Effort to Crack Down on Pill Mills
Florida Governor Rick Scott and Attorney General Pam Bondi announced recently the creation of a strike force in that state that will focus on illegal “pill mill” operations.
The action comes as a number of Southwest Florida communities continue efforts to enact moratoriums on new pain clinics.
Scott claimed that strong action is needed because Florida has become the nation's main source of improper oxycontin sales, as well as trafficking in similar pain killers.
Investigations into pill mill activity have been under way, but the illicit activity continues to be a major problem in the state. As a part of the new law enforcement strategies, state financial officials will contribute investigation resources aimed at insurance fraud related to pill mills.
As many as 30 Florida communities have already passed one-year bans on new pain clinics.
Source: News-Press.com (Fort Myers, Florida), April 2011
Georgia
Medical Complaints Up in Georgia, According to State Board Annual Report
Complaints against medical licensees in Georgia rose by 11.5 percent in 2010 over 2009, according to statistics recently released in the Georgia Composite Medical Board's (GCMB) Annual Report for 2010. The board received 2,145 complaints in 2010, which represented an increase of 39.4 percent over 2008.
Of complaints received, 1,136 were assigned to agents of the board for more extensive investigation. Malpractice and quality-of-care cases accounted for 59 percent of the total cases referred for further investigation, which the board reported was in keeping with recent trends. The report showed a significant spike upward, however, in prescribing-related cases. In 2004, the board investigated 76 cases involving inappropriate prescribing. In 2010, that number was 116, a nearly 53 percent increase.
The report also noted the increase in activity related to so-called “pill mills” in Georgia, which inappropriately dispense prescription drugs. Autopsy data from the Georgia Bureau of Investigation indicate that 80 percent or more of all deaths due to drug overdose were related to prescription drugs.
“GCMB agents have also noted increasing activity among pill mills, with ‘patients’ driving into Georgia, often in carpools, to obtain prescriptions for controlled substances,” the report said. “The Board believes that the rise of pill mills in Georgia is directly attributable to the fact that all contiguous states — and, in fact, most other southern states — have passed bills implementing prescription monitoring programs, driving many pill mills from those states into ours.”
Source: Georgia Composite Medical Board 2010 Annual Report
Iowa
Board Seeks New Rules to Address Pain Medication Prescribing Issues
The Iowa Board of Medicine has taken a number of steps to help physicians improve patient care by reducing their patients' risk of addiction, abuse and diversion of controlled substances prescribed for chronic pain.
The board announced recently that it is seeking administrative rules to emphasize screening tools that physicians can use when prescribing pain medications, and to heighten physicians' awareness of appropriate diagnosis and treatment of chronic pain.
The new rules include several proposed changes, including:
Requiring the use of a physician-patient agreement for patients treated with controlled substances.
Encouraging physicians to use drug testing on chronic pain patients to ensure they are receiving appropriate levels of prescribed medications and are not abusing other drugs.
Encouraging physicians to use the Iowa Prescription Monitoring Program, established by the Iowa Board of Pharmacy. The confidential online database tracks a patient's prescriptions for controlled substances, allowing physicians to know, before they prescribe, whether the patient has had a recent similar prescription from another physician.
Requiring physicians to complete a two-hour class on chronic-pain management. The mandatory education would be every five years for physicians who regularly provide primary health care to patients.
In addition, the board is making available to physicians a copy of “Responsible Opioid Prescribing: A Physician's Guide,” a handbook on pain-medication prescribing written by Scott Fishman, M.D., and published by the Federation of State Medical Boards.
In the past two years, the Iowa board has charged five physicians and issued confidential reprimands to another six for inappropriate pain medication practices, such as prescribing controlled substances to drug-seeking patients.
Source: Iowa Board of Medicine website, April 2011
Michigan
New Online Module Teaches Michigan Health Care Professionals About Medical Regulation
The Michigan Bureau of Health Professions (MBHP) is reaching out to health care professionals in the state with a new training module intended to help them better understand medical regulation.
The new web-based module, titled “Licensing, Professionalism and the Regulatory Process,” is made up of a three-part slide presentation narrated by four bureau staff members. The slide presentation details how the bureau and other state boards operate, explains how to get through the licensing process as smoothly as possible and describes the importance of professionalism and ways to prevent disciplinary action.
The MBHP developed the presentation from resources made available to state boards as a part of the FSMB Foundation's Professionalism Project, launched in 2009. The objective of the ongoing project is to provide essential information to help raise awareness of the work medical boards do in the areas of licensing, discipline and the promotion of professionalism.
The MBHP customized Foundation materials to explain state-specific programs and is now in the process of promoting its training-module to a variety of health care stakeholders. The bureau is including outreach to residency directors and the deans of the four medical schools in Michigan, and is including inserts in mailings related to license renewals.
More information about the FSMB Foundation's Professionalism Project is available at www.fsmbfoundation.org.
Source: FSMB Newsline, December 2010/January 2011
Minnesota
Minnesota Board of Medical Practice Announces MOC/CME Policy
The Minnesota Board of Medical Practice (MBMP) recently announced its acceptance of Maintenance of Certification (MOC) in lieu of compliance with the Continuing Medical Education (CME) requirements during the cycle in which certification or recertification is granted.
In a statement, MBMP said it “recognizes that lifelong learning is important to keep up to date medical knowledge and skills…Government payers, private insurers, and the public want assurance that physicians have current knowledge and skills. In light of Maintenance of Certification (MOC), the Board has revisited the issue to determine whether MOC would be acceptable as meeting the rule requirements and has determined that it does.”
Maintenance of Certification is a lifelong learning program of the American Board of Medical Specialties (ABMS) that requires physicians to self-assess their competency periodically. Twenty four ABMS medical specialties representing 145 specialties build their competency requirements on six core competencies, including patient care, medical knowledge, practice-based learning, systems-based practice, professionalism and interpersonal and communication skills.
Source: Minnesota Board of Medical Practice website, April 2011
Nevada
Nevada State Board of Medical Examiners Adopts FSMB Uniform Application
The Nevada State Board of Medical Examiners became the most recent adopter of FSMB's Uniform Application for Physician Licensure (UA) on March 9, 2011. Nevada is the 12th member board to begin using this tool, which was designed to enhance license portability. Through the UA, state boards utilize common application elements while capturing the unique state requirements in an addendum that is customized to meet the state-specific needs.
Users of the UA include Idaho State Board of Medicine, Medical Licensing Board of Indiana, Kansas State Board of Healing Arts, Minnesota Board of Medical Practice, Montana Board of Medical Examiners, New Hampshire Board of Medicine, State Medical Board of Ohio, Rhode Island Board of Medical Licensure & Discipline, South Dakota Board of Medical & Osteopathic Examiners, Vermont Board of Medical Practice and the Oklahoma State Board of Osteopathic Examiners.
To date, more than 38 boards are engaged in some manner with the FSMB on the UA program. Nearly 17,000 physicians have successfully submitted their application for licensure utilizing the Uniform Application.
Source: FSMB eNews, March 2011
North Carolina
Rule Change Makes FCVS Mandatory for IMGs in North Carolina
The North Carolina Medical Board has approved an administrative rule change that would require all international medical graduates (IMGs) to use FSMB's Federation Credentials Verification Service (FCVS) when applying for an initial, full North Carolina medical license. The board expects the change to be in effect October 1, pending final approval by the North Carolina Rules Review Commission.
FCVS establishes a permanent repository of primary-source verified credentials for physicians and physician assistants. Core credentials collected and stored by FCVS include physician identity, medical education, graduate medical education, examination history and a variety of other records. The service was launched in 1996 and recently underwent a major technology upgrade.
Source: North Carolina Medical Board website, February 2011
Quicker Path to a North Carolina Medical License Created
The North Carolina Medical Board has developed an expedited path to licensure for experienced physicians, in response to suggestions raised by North Carolina hospitals and others that the board's licensing process be made faster.
The North Carolina Rules Review Commission approved rules establishing the expedited physician license late last year. The state is hoping the new procedure will make it faster and easier for out-of-state physicians to obtain a North Carolina license. The typical processing time before implementation of the new path was estimated at anywhere from four to six months.
Applicants who qualify for the expedited license application will not have to document their medical or osteopathic education, their postgraduate medical training, or USMLE or other examination scores. In addition, qualified applicants will not have to submit letters of recommendation.
The board estimates that 20 percent of the approximately 2,000 physicians who seek licensure in North Carolina each year will qualify to use the new process. It is expected that diverting qualified applicants to the streamlined application also should expedite the licensing process for other applicants, by reducing the workload of the board's licensing staff.
Source: North Carolina Medical Board website, February 2011
Ohio
Medical Board of Ohio Adopts Resolution Regarding Prescription Drug Abuse
The Medical Board of Ohio recently adopted a resolution signaling its intent to more aggressively address inappropriate prescribing in the state.
The resolution, adopted March 9, 2011, identifies cases involving inappropriate prescribing practices as a high priority for the board and lists a number of tactics it will aim at the problem. Steps the board plans to take include:
Development of enhanced rules regarding prescribing practices.
Development of voluntary continuing education regarding controlled substances prescribing.
Improvement of coordination with state and local law enforcement and drug task forces.
Coordination of investigative efforts of cases involving overprescribing or pill mills with the state attorney general's organized crime section.
Holding expedited hearings for overprescribing and pill mill cases.
The board's actions were taken partly in response to a recent report by the Ohio Prescription Drug Abuse Task Force, which identified a prescription drug abuse epidemic in the state.
Source: State Medical Board of Ohio website, April 2011
Pennsylvania
New Legislation Will Impact Physicians and Health Care Employees
Two bills were recently signed into law in Pennsylvania that are expected to impact health care professionals in a variety of settings.
House Bill 1482, signed into law as Act 110 of 2010, amends the Health Care Facilities Act to require Pennsylvania's Department of Health to promulgate regulations requiring employees of health care facilities, health care providers and physicians' private practices who deliver direct care to consumers to wear photo identification tags when working.
House Bill 2521, signed into law as Act 121 of 2010, establishes the Anatomic Pathology Service Disclosure Act, which requires physicians or physician group practices that order, but do not supervise or perform, a component of an anatomic pathology service to disclose certain information on the bill for the service which is presented to a patient, insurer or other third-party payor.
Source: Pennsylvania State Board of Osteopathic Medicine website, March 2011
