Pain Management Regulations Affect More Than Pain Management Specialists

The recently passed House Bill 7095 affects more than just pain management specialists.  Practitioners who prescribe controlled substances for individuals with “chronic nonmalignant pain” also are required to comply with new state regulations, including designation “as a controlled substance prescribing practitioner on the physician’s practitioner profile”“with the state Board of Medicine by January 1, 2012. What follows is a bulleted summary of the new regulations.

Prescription s for controlled substances must be either written or electronic.  Telephone prescriptions no longer are allowed.

Written Prescriptions for Controlled Substances

  • Must have quantity in textual and numerical format
  • Must be dated with the abbreviated month written out
  • Must be written on a standardized counterfeit-proof prescription pad produced by a DOH approved vendor

Physicians who prescribe any controlled substance for the treatment of “chronic nonmalignant pain” must designate him or herself as a controlled substance prescribing physician on the physician’s practitioner profile and must comply with statutory requirements and applicable board rules

  • “Chronic  nonmalignant pain “ is defined as pain unrelated to cancer or rheumatoid arthritis which persists beyond the usual course of disease or the injury that is the cause of the pain or more than 90 days after surgery .

A complete medical history and physical exam must be documented in the medical record

The exact nature of the examination is not dictated, but it must be proportionate to the diagnosis that justifies treatment and must minimally document:

  • The pain’s nature and intensity
  • Current and past treatment for pain
  • Underlying or coexisting diseases or conditions
  • The effect of the pain on physical and psychological functions
  • A review of previous medical records and previous diagnostic studies
  • History of alcohol and substance abuse
    • Notably, patients with such a history require referral to, or consultation with, a phsyiatrist or addictionologist
  • The presence of one or more recognized indications for the use of a controlled substance

New Prescription Pad Laws Effective July 1, 2011

Effective July 1, 2011, physicians and pharmacies (should) have been notified by the State of Florida of a new law requiring the use of counterfeit-proof script pads for controlled substances. Orders on a generic prescription pad will not be honored by the retail pharmacies. For additional information about counterfeit-proof pads and vendors follow the links below: http://www.doh.state.fl.us/mqa/counterfeit-proof.html