Medical Board October 2018 eNews

October 2018 Newsletter from the State Medical Board of Ohio

med.ohio.gov
eLicense.ohio.gov

October 2018 Newsletter

Communications to Prescribers Regarding OARRS and ICD-10 Code Compliance

On October 15, the State Medical Board of Ohio sent communication to prescribers on mandatory use of OARRS and inclusion of ICD-10 codes on controlled substance prescriptions. This is the first time that the medical board has looked at ICD-10 code information and contacted providers who appear to be out of compliance. State of Ohio Board of Pharmacy identified and provided the records that indicated missing checks or ICD-10 codes.

Through correspondence with prescribers, the medical board and pharmacy board have learned of several ways future data from the Board of Pharmacy can be improved:

Although entered by the EHR, physician or the physician’s delegate, the ICD-10 code was not being transmitted to the pharmacy in many instances.
Gabapentin does not require an ICD-10 code and should not be counted in the prescriptions missing the code.
OARRS data reports need to include an automatic integration of prescribers’ license number and email as merging the reports can produce erroneous pairing.
Prescribers need additional information on who is exempt from requirements as ICD-10 exemptions differ from OARRS usage exemptions.

We thank you for your patience and cooperation during this process.

Chronic and Sub-Acute Pain Prescribing Rules Update

The Joint Committee on Agency Rule Review (JCARR) will meet on November 15 to review the Chronic and Sub-Acute Pain Prescribing Rules proposed by the Medical Board.

The amendments to rules 4731-11-01 and 4731-11-02 and new rule 4731-11-14 establish the requirements and procedures for prescribing for subacute and chronic pain. The rules will apply to physicians and physician assistants. A public hearing on the proposed rules, and the proposed rescission of the current intractable pain rules found in Chapter 4731-21 of the Administrative Code, was held on September 26, 2018.

As a result of comments, several proposed changes to the rules were taken into consideration.

(1) The definition of chronic pain was amended to state: "Chronic pain" does not include pain associated with a terminal condition or with a progressive disease that, in the normal course of progression, may reasonably be expected to result in a terminal condition.

(2) The type of providers who may write prescriptions for >120 MED were expanded from pain management specialists to include board-certified hospice and palliative care providers.

(3) Requests to substantially increase the frequency of required drug screens were rejected as it would have created hardship for patients (cost, travel, delay of receiving prescriptions).

(4) Comments were provided urging the medical board to mandate co-prescribing of Naloxone starting at 50 MEDs as recommended by CDC. This amendment was not made, as CDC does NOT call for mandatory co-prescribing, rather an offer from the prescriber to also provide Naloxone.

If approved by JCARR, the medical board will vote to adopt the rules with an effective date in late December.

One-Bite:
Confidential Monitoring Program

Proposed rules 4731-16-17 through 4731-16-21 establish the One-Bite Program for Impaired Practitioners. The One-Bite Program will be a confidential monitoring program for treatment of impairment by alcohol and/or drugs. It will be available to any licensee who meets the eligibility criteria.

A public hearing on the proposed rules will occur on November 28, 2018, at 1:30 p.m. in the Lobby Hearing Room of the Rhodes State Office Tower.

Other rules to be addressed at the public hearing:

Physician Assistants: Rules 4730-4-01 through 4730-4-04: Medication-assisted treatment
Massage Therapists: Rule 4731-1-16: Massage therapy curriculum requirements
Physicians: Rules 4731-33-01 through 4731-33-04: Medication-assisted treatment

Did You Know?

Ohio Physician Loan Repayment Program (OPLRP)

Many physicians ask about the OPLRP after seeing the fee upon renewal. The program provides loan repayment assistance to eligible physicians who commit to practice in underserved areas. It is administered by the Ohio Department of Health Primary Care Office and the program placed its first participants in 1994. Section 4731.281 of the Revised Code (ORC 4731.281) mandates that $20 of each physician’s license renewal fee is deposited to this program. This fee is not new, but now shows as a line item on the eLicense renewal payment page. For more information or to apply for this program, please visit ODH Ohio Physician Loan Repayment Program.

Please Update Your Public Address

Ohio law mandates the State Medical Board of Ohio publish rosters listings licensees’ contact information. The “public address” information provided by each licensee is the address included in the roster listing. The public address can be different than the mailing address at which you wish to receive official Medical Board correspondence. Be sure to keep this information up-to-date by accessing your eLicense account and updating your addresses.

https://elicense.ohio.gov/OH_CommunitiesLogin

Certified nurse-midwife (APRN-CNM), Clinical Nurse Specialist (APRN-CNS), or Certified Nurse Practitioner (APRN-CNP) are required to enter into a Standard Care Arrangement (SCA) with one or more collaborating physicians or podiatrists and practice in accordance with the SCA.

The nurse’s employer is required to retain a copy of the SCA on file. The SCA does not need to be filed with the Medical Board. The APRN is responsible for providing information regarding the collaborating physician/podiatrist to the Ohio Board of Nursing through the APRN’s eLicense account.

Standard Care
Arrangements with
Advanced Practice Nurses

Data 2000 Prescriber Training for Medication-Assisted-Treatment

The Drug Abuse Treatment Act of 2000 (DATA 2000) specifies training is necessary for prescribers to obtain a waiver to engage in office‐based treatment of opioid use disorders using Schedule III drugs approved by the FDA. The American Society of Addiction Medicine will host the eight-hour day of training to meet federal requirements for the DATA 2000 Waiver. This will be followed by a half-day of training from Ohio experts who will discuss topics including low-dose prescribing according to federal and state guidelines, and referral to behavioral health treatment.

Training events are available several times each month across the state. Click here for more information.

Now Open – Ohio Department of Health 2019 State J-1 Visa Waiver Program Application Cycle

Potential sponsors for the 2019 application cycle should complete and submit the Notice of Intent to Apply form as soon as possible. All applications must be postmarked by November 9, 2018. A second application cycle may be added if less than 30 applications are received by this deadline.

Please thoroughly read application instructions and forms and be sure to use only the 2019 application forms. Check all documents for completeness, accuracy and consistency before submission. Do not submit additional materials unless requested.
Applications from sponsors who submit more than one application will not be reviewed unless the same sponsor-identified representative is named on each application.
Application reviews will include evaluation of the sponsor’s adherence to program requirements for current and past participants.
Please note new application formatting requirements as described on the first page of the application packet.

More information about the J-1 Visa Waiver Program is available here.

Medical Marijuana

View a brief video highlighting the process that physicians should follow when recommending medical marijuana in Ohio. For more info visit: medicalmarijuana.ohio.gov

CTR Applications

The State Medical Board of Ohio is now accepting applications for a certificate to recommend (CTR) under the Ohio Medical Marijuana Control Program. Ohio MDs and DOs with a full, unrestricted license are eligible to apply for a certificate to recommend medical marijuana. Click here to read full details. Once a physician's CTR application is approved by the board, the physician should review the standards of care outlined in Ohio Administrative Code 4731-32-03.

Once the patient registry is established by the State of Ohio Board of Pharmacy (coinciding with the availability of product in dispensaries), the physician will create a patient record in this portal and certify the patient's qualifying condition.

Office Closure

The Medical Board’s office will be closed on Monday, November 12 for the Veterans Day holiday. The office will reopen at 8 a.m. on Tuesday, November 13.

Manage Pain, Prevent Addiction

Take Charge Ohio features resources for providers and patients to help educate about opioid addiction, its impact in Ohio, and how to take action using these free, ready-to-use resources.

TakeChargeOhio.org >

No More Paper
Applications

The medical board is no longer accepting paper applications, renewal applications or license verification requests.
All of these items need to be completed electronically through eLicense.ohio.gov.

eLicense.ohio.gov >

Monthly Formal Action Report

Review summary descriptions of the disciplinary actions initiated and the disciplinary sanctions imposed by the medical board at its monthly meeting. Individual's license information can be found on eLicense.

Monthly Formal Actions >

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