ASMB Proposes New and Amended Rules

On Thursday, August 3, 2017, the Arkansas State Medical Board will hold public hearings on several proposed rule amendments and new rules. Comments can be submitted to the Board until the August 3rd public hearing. Among the proposals:

  1. Amendment to Regulation 2(4), listing the prescribing of excessive amounts of controlled substances as “malpractice.” The amendment defines “excessive” in two ways.
    1. “Any” amount prescribed without a detailed medical justification documented in the medical record.
    2. If there is medical justification, excessive would be an amount prescribed that exceeds the CDC guideline for prescribing opioids for chronic pain (greater than 90 MME per day) unless the prescriber documents that eight requirements have been met. These include documented alternative treatment plans; risk factor assessment/potential for abuse/diversion; checking the PDMP; in-person exam every 90 days, and consulting with a pain management specialist. There is an exemption for patients in hospice care.
  2. Amendment to Regulation 33 (Notification of Change of Practice) – This amendment incorporates the requirements of Act 754 of 2017, Patient Right to Know Act. Act 754 addresses continuity of care and patient abandonment issues that arise when a physician leaves a practice.
    1. Prohibits an entity (former employer or practice) from misleading patients about the new location of a physician’s practice or from failing to provide the new location or contact information (provided the physician has provided this information to the entity).
    2. Within two days of a request, the entity must provide the physician with a list and contact information for any patients with whom the physician has a scheduled appointment.
    3. Within 21 calendar days of a request the entity must do at least 1 of 3 things:
      1. Provide the physician with a listing of names and addresses of his/her existing patients. “Existing Patient” is defined as a patient actually seen by the physician within the previous 12 months. OR,
      2. Send a notice of the physician’s new location to “existing” patients. OR
      3. Post the new practice location on the entity’s website for at least 12 months.
  3. New Regulation 40 (Surgical Technologists) – This new regulation implements Act 390 of 2017 and provides for registration of surgical technologists. It does not include the practice of “surgical assisting” as performed by physician assistants, surgical assistants, or first assistants.
  4. New Regulation 41 (Prescription Drug Monitoring Program) – This new regulation implements the requirements of Act 820 of 2017. Act 820 is the controversial requirement that all prescribers must check the PDMP every time he/she prescribes a Schedule II or III opioid and the first time when prescribing a benzodiazepine medication for a patient.