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Part 1 Combatting the Opioid Epidemic: What You Need to Know as a Physician

The use of opioids has increased so dramatically it has reached epidemic proportions. Given the recent trends, LARA has been actively investigating physicians who are consistently prescribing opioids and other controlled substances. In response to the opioid epidemic, new legislation was enacted. This new legislation involves several bills which directly affect the prescription of and dispensing of opioids and other controlled substances.

Since there are several different bills, this article has been split into a two part series. The first part of the series will highlight the bills that take effect in March 2018. The second part of the series will highlight the bills that take effect in June 2018 and July 2018.

The following provisions take effect on March 27, 2018:

  • When treating a patient for an opioid-related overdose, the physician must provide the patient with information regarding available substance use disorder services. Senate Bill 273.

  • Physicians and are required to report relevant information to MAPS including patient identifiers, the name of the controlled substance being prescribed, the quantity of the controlled substance, and the prescribing physician’s name. The pharmacy is also responsible for reporting information relevant to the controlled substance including the quantity dispensed and the date it was dispensed. Senate Bill 47.

  • Physicians are also required to obtain and review MAPS for any patient being prescribed buprenorphine or a drug containing buprenorphine or methadone who is also involved in a substance use disorder program. Senate Bill 47.

Additionally, House Bill 4403 which takes effect on March 27, 2018, involves available options, such as inpatient care and clinical stabilization services, for treatment of Medicaid beneficiaries who require treatment for opioid addiction.

On March 31, 2018, Senate Bill 270 takes effect. Notable provisions are highlighted below.

  • In order to prescribe controlled substances listed in schedules 2 to 5, the prescriber must have a bona fine prescriber-patient relationship with the patient who is being prescribed the controlled substance.

  • The physician is also required to provide follow up care to the patient to monitor the efficacy of the controlled substance.

  • If follow up care cannot be provided, the physician is obligated to either refer the patient to their primary care physician or refer the patient to another licensed physician who is able to provide follow up care.

  • Prior to prescribing a controlled substance, a physician must discuss with the patient any other controlled substances the patient is currently using and record that information in the patient’s medical record.

  • In addition, a physician must make a separate record of all controlled substances he/she dispenses, other dispositions of controlled substances under the physician’s control, and invoices and other acquisition for records for each controlled substance prescribed.

LARA is actively and intensely investigating physicians who continuously prescribe controlled substances, especially opioids, and these investigations are likely to continue to increase with the passage of this new legislation. For example, Senate Bill 270 has provisions detailing when an investigation can occur as well as penalties that may be incurred should a physician be deemed to have violated the Bill. As such, there is a high probability that LARA will investigate any practices that do not comply with Senate Bill 270.

If you have been contacted by LARA for an interview, if you have been served with an Administrative Complaint, or if you have any questions or concerns regarding LARA or the information in this article, please contact the author, Megan R. Mulder of Cline, Cline & Griffin, P.C. at or by calling the office at 810-232-3141.

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