Regulation of Medicine
Georgia H.B. 249/PDMP Provisions Overview
MagMutual and the Medical Association of Georgia (MAG) are encouraging every physician in the state to review the following summary of H.B. 249, an omnibus bill by Rep. Kevin Tanner (R-Dawsonville) that Gov. Nathan Deal signed into law on May 4. The bill is designed to address opioid abuse in the state. Note that the bill’s provisions will go into effect at different times.
H.B. 249 moves the Prescription Drug Monitoring Program (PDMP) from the Georgia Drugs and Narcotics Agency to the Department of Public Health (DPH).
PDMP Review Delegation
Under H.B. 249, a prescriber may delegate their authority to check the PDMP to two members of their medical staff. For a prescriber to delegate this authority to unlicensed or unregistered staff (i.e., an office manager or medical assistant), the staff member must submit to an annual registration process that will be administered by the Georgia Board of Pharmacy. A health care facility (e.g., hospital or ambulatory surgery center) may select two employees to serve as delegates per shift or rotation. And at hospitals that provide emergency services, each prescriber may designate two individuals who are employed by that hospital per shift or rotation.
Any unauthorized use of PDMP data by a delegate can result in civil or criminal liability for the prescriber. Delegates may only use PDMP data for the purpose of providing medical care or to inform the prescriber of a patient’s potential use, misuse, abuse or underutilization of a prescribed medication.
Mandatory PDMP Enrollment
By January 1, 2018, every prescriber who has a DEA registration number must enroll as a PDMP user. If a prescriber obtains a DEA license after January 1, 2018, they must enroll with the PDMP within 30 days.
Mandatory PDMP Review
Between January 1, 2018 and May 31, 2018, the DPH must randomly test the PDMP to confirm it is accessible and operational 99.5 percent of the time.
Assuming DPH has certified that the PDMP’s accessibility and operational standards have been met, the prescriber or their delegate must review the information from the PDMP when prescribing a controlled substance that is listed in paragraph (1) or (2) of Code Section 16-13-26 (click the link that is at the bottom of this alert for the code sections) or a benzodiazepine beginning July 1, 2018. This review is limited to the first time the prescriber issues a prescription for the given patient and at least every 90 days thereafter.
Exemptions from the requirement to check the database are as follows…
- Prescriptions for no more than a three-day supply of a covered substance and no more than 26 pills
- The patient is in a hospital or health care facility, including – but not limited to – a nursing home, an intermediate care home, a personal care home, or a hospice program that provides patient care and whereby the prescriptions are to be administered and used by a patient on the premises of the facility
- The patient has had outpatient surgery at a hospital or ambulatory surgical center and the prescription is for no more than a 10-day supply of a covered substance and no more than 40 pills
- The patient is terminally ill or under the supervised care of an outpatient hospice program
- The patient is receiving treatment for cancer
Medical Record Notations
Prescribers or their delegate must make a notation in the patient’s medical record that the PDMP was consulted and identify the individual who conducted the PDMP patient search. If the PDMP does not allow the prescriber/delegate to gain access to the patient’s information for any reason, the prescriber/delegate should note the time and date and the prescriber/delegate’s name in the patient’s medical record.
Prescribers may now include PDMP prescription information in a patient’s electronic health or medical record.
If a prescriber fails to check the PDMP as outlined above, he or she will be held administratively accountable to the Georgia Medical Composite Board; however, the prescriber may not be held civilly liable or criminally responsible.
Required Prescribing Information
When prescribing an opiate, opioid, opioid analgesic, or opioid derivative, the prescriber must provide the patient with information on the drug’s addictive risks and the options that are available for safely disposing of any unused medications. This information may be provided in either verbal or written form.
Neonatal Abstinence Syndrome Reporting
A health care provider, coroner, or medical examiner must report all incidents of neonatal abstinence syndrome to DPH, which will submit an annual report – including findings and recommendations on how to reduce the number of infants born with neonatal abstinence syndrome – to the president of the Georgia Senate, the speaker of the Georgia House of Representatives, and the chairs of both the Georgia House and Senate Health and Human Services committees.
Other H.B. 249 provisions include codifying Gov. Deal’s executive order to make naloxone available on an over-the-counter basis, annual inspections of narcotic treatment programs, and a requirement that calls for the Department of Community Health and the Department of Behavioral Health and Developmental Disabilities to report the number of patients who are enrolled in or have been discharged from a treatment program.
If you have any further questions please contact your patient safety consultant at 1-800-282-4882 or MagMutual’s Government and Legislative Affairs contact Nichole Lydon at 404-842-5574.
This alert was originally posted by The Medical Association of Georgia and is republished here with permissions.
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The information provided in this resource does not constitute legal, medical or any other professional advice, nor does it establish a standard of care. This resource has been created as an aid to you in your practice. The ultimate decision on how to use the information provided rests solely with you, the PolicyOwner.