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Important Information

from the State Medical Board of Ohio

Proposed Light-Based Medical Devices and Surgery Standards - Comment Period Open

You are invited to review proposed rule changes and submit comments. The proposed rules showing the amendments are located here on our website. Comments will be accepted until the close of business on February 2, 2018.

 

Memo concerning the proposed rules

4731-18-01  Definitions

4731-18-02 Use of light-based medical devices

4731-18-03 Delegation of the use of light-based medical devices for specified non-ablative procedures

4731-18-04 Delegation of phototherapy and photodynamic therapy

4731-25-08 Standards for surgery

 

Send your comments to: Nathan Smith, Senior Legal & Policy Counsel, State Medical Board of Ohio

Nathan.Smith@med.ohio.gov

 

Proposed Physician Assistant Rule Changes - Comment Period Open

You are invited to review proposed rule changes and submit comments. The proposed rules showing the amendments are located here on our website. Comments will be accepted until the close of business on January 18, 2018.

 

The following three rules have been reviewed by the Physician Assistant Policy Committee and the State Medical Board for consistency with current law. This memo sets out the proposed actions resulting from the review.

  • Rule 4730-1-05: Quality assurance system.

  • Rule 4730-2-04: Provisional period of physician-delegated prescriptive authority.

  • Rule 4730-2-05: Certificate to prescribe.

 

Send your comments to: Sallie Debolt, Senior Counsel, State Medical Board of Ohio

Sallie.Debolt@med.ohio.gov

 

Prescription Changes Beginning Tomorrow - 12/29/17

Beginning tomorrow, December 29, 2017, phase 2 of prescribing opioids for acute pain takes effect.

 

ICD-10 Required on Opioid Analgesic Prescriptions 

Prescribers are required to indicate the first four alphanumeric characters of the ICD-10-CM medical diagnosis code (ex. M16.5) on all opioid prescriptions. If your EHR system cannot generate the ICD-10 code automatically, you can simply add the ICD-10 numbers into the comment section on the prescription or write it in manually. 

 

Days’ Supply Required for Controlled Substance and Gabapentin Prescriptions

Changes in Pharmacy Board Rule 4729-5-30, OAC, require prescribers to include the days’ supply (i.e. minimum number of days) that the prescription for a controlled substance or gabapentin should last the patient. 

 

Written, Faxed and Electronic Prescriptions

The Pharmacy Board rule also makes changes to the requirements for written, faxed and electronic prescriptions. Except in limited circumstances, prescribers can no longer transmit prescriptions using a transmission system that converts the prescription into a computer-generated fax or scanned image.

For more information on the exceptions, visit: http://www.pharmacy.ohio.gov/approval

 

See our Prescriber Resources page for a complete reference guide, prescription requirements, video, FAQs and more.

 

Effective December 29 - Phase 2 of Prescribing Opioids for Acute Pain

Effective December 29 - Phase 2 of Prescribing Opioids for Acute Pain

Starting on December 29, 2017 prescribers are required to include the ICD-10 code on prescriptions for opioids to treat acute pain. Please confirm that your EMR and/or e-prescribing vendor(s) can support automated placement of the ICD-10 code on prescriptions. If your EMR system is not able to automate the code by December 29, 2017, you can simply add the ICD-10 numbers into the comment section on the prescription or write it in manually. 

See our Prescriber Resources page for a complete reference guide, prescription requirements, video, FAQs and more.

 

 

Prescribing Opioids for Acute Pain Rules - Phase 2 (Effective December 29, 2017)

Ohio’s rules for prescribing opioids to address acute pain took effect in August 2017. Starting December 29, 2017 prescribers are required to include the ICD-10 code on prescriptions for opioids to treat acute pain. If you have not yet confirmed that your EMR and/or e-prescribing vendor(s) can support automated placement of the ICD-10 code on prescriptions, is it strongly suggested that you contact them immediately. If your EMR system is not able to automate the code by December 29, 2017, you can simply add the ICD-10 numbers into the comment section on the prescription or write it in manually. The State Medical Board has provided information on the new acute prescribing rules over the past four months and will be releasing additional educational information next month about the new rule requirements.

 

Board Guidance on Filing Complaints for Sexual Misconduct

All license holders are held to the highest standards of legal and ethical behavior. The medical board has zero tolerance for sexual misconduct, and encourages the public to report all instances of inappropriate behavior immediately.

Recent media coverage of sexual assaults may encourage others in Ohio to come forward, and the medical board would like to ensure that victims are aware of not only the criminal charges but also the regulatory complaints that can be filed. If a complaint to the medical board is investigated and confirmed, professionals can face disciplinary action up to license revocation and a significant fine.

Steps to take if you feel you are the victim of – or have knowledge of – inappropriate touching or other assaults by a licensed provider in Ohio:

1. Contact law enforcement, and provide full details of the misconduct that occurred.

2. File a complaint with the State Medical Board of Ohio.

Please note that complaints and investigations are confidential per Ohio law; your name will never be made public to any outside party. Formal board action against licensees is available on the board’s website.

Those who hold a license from the State Medical Board of Ohio have a duty to report peers who have violated rules, laws and ethics standards. Failure to report can result in fines of up to $20,000 and disciplinary action.

Board Seeks Comments Regarding Proposed Physician CME Rules

Public comment is being sought on the following proposed Medical Board rules filed with the Common Sense Initiative Office. The Business Impact Analysis and the proposed rules can be found by clicking on the links below.

Comments on any of the rules should be submitted no later than October 16, 2017 to both the Medical Board (Sallie.Debolt@med.ohio.gov) And the Common Sense Initiative Office (csipubliccomments@governor.ohio.gov).

Physician CME Rules
Proposed amendments permit physicians to earn up to 33 hours of Category 2 CME credit per renewal cycle for providing volunteer health services to indigent or uninsured patients and the documentation requirements needed to claim this credit.

4731-10-02 Requisite hours of continuing medical education for license renewal or reinstatement
4731-10-08 Evidence of continuing medical education.
4731-10-09 Continuing medical education requirement for mid-term licensees.
4731-10-10 Continuing medical education requirements following licensure restoration.

 

Board Seeks Comments Regarding Proposed Limited Branch Rules

Public comment is being sought on the following proposed Medical Board rules filed with the Common Sense Initiative Office. The Business Impact Analysis and the proposed rules can be found by clicking on the links below.

Comments on any of the rules should be submitted no later than October 16, 2017 to both the Medical Board (Sallie.Debolt@med.ohio.gov) and the Common Sense Initiative Office (csipubliccomments@governor.ohio.gov).

Limited Branch Rules

4731-1-03 General prohibitions. No changes proposed.

4731-1-04 Scope of practice: mechanotherapy. Proposed to be amended.

4731-1-05 Scope of practice: massage therapy. Proposed to be amended to reflect that wallet cards are no longer issued.

4731-1-06 Scope of practice: naprapathy. No changes proposed.

4731-1-07 Eligibility of electrologists licensed by the Ohio state board of cosmetology to obtain licensure as cosmetic therapists pursuant to Chapter 4731 of the Revised Code and subsequent limitation. No changes proposed.

4731-1-09 Cosmetic therapy curriculum requirements. No changes proposed.

4731-1-10 Distance Education. Proposed to be amended.

4731-1-15 Determination of standing of school, college, or institution. Proposed to be amended.

4731-1-17 Instructional staff in Ohio cosmetic therapy and massage therapy programs. Proposed to be amended.

 

New Limits on Prescription Opioids for Acute Pain - Phase 1 (Effective August 31, 2017)

New Limits on Prescription Opioids for Acute Pain - Phase 1 (Effective August 31, 2017)

Effective August 31, 2017, the State of Ohio will have new rules for prescribing opioid analgesics for the treatment of acute pain.  Please be advised, these rules DO NOT apply to the use of opioids for the treatment of chronic pain. Click here to watch the educational video/overview.

In general, the rules limit the prescribing of opioid analgesics for acute pain, as follows:

  1. No more than seven days of opioids can be prescribed in the initial prescription for adults.

  2. No more than five days of opioids can be prescribed in the initial prescription for minors, and only after the written consent of the parent or guardian is obtained.

  3. Health care providers may prescribe opioids in excess of the day supply limits only if they provide a specific reason in the patient’s medical record.

  4. Except as provided for in the rules, the total morphine equivalent dose (MED) of a prescription for acute pain cannot exceed an average of 30 MED per day.

  5. The new limits do not apply to opioids prescribed for cancer, palliative care, end-of-life/hospice care or medication-assisted treatment for addiction.

NOTE: These rules do not apply to veterinarians.

 

Starting December 29, 2017, rule 4729-5-30 will require prescribers to include the first four characters (ex. M16.5) of the diagnosis code (ICD-10) or the full procedure code (Current Dental Terminology - CDT) on opioid prescriptions, which will be entered by the pharmacy into Ohio’s prescription monitoring program, OARRS.  This requirement will take effect for all other controlled substance prescriptions on June 1, 2018.  NOTE: This requirement does not apply to veterinarians.

Starting December 29, 2017, rule 4729-5-30 will also require prescribers to indicate the days’ supply on all controlled substance and gabapentin prescriptions. NOTE: This requirement does not apply to veterinarians.

 

To assist prescriber’s in calculating a patient’s morphine equivalent dose, the State of Ohio Board of Pharmacy has developed a conversion chart that can be accessed here: www.pharmacy.ohio.gov/MEDtable.

For additional information, please review your licensing board’s respective rules and the Board of Pharmacy’s manner of issuance rule:

 

Medical Board - Rules for Physicians and Physician Assistants

4731-11-01 - Definitions (related to controlled substances)
4731-11-02 - General provisions (related to controlled substances)
4731-11-13 - Prescribing of opioid analgesics for acute pain

Dental Board

4715-6-02 - Prescribing opioid analgesics for acute pain

Nursing Board

4723-9-10 - Formulary; standards of prescribing for advanced practice registered nurses designated as clinical nurse specialists, certified nurse-midwives, or certified nurse practitioners.

Pharmacy Board

4729-5-30 - Manner of issuance of a prescription.  (NOTE: This rule will not go into effect until December 29, 2017.  The Board has adopted a resolution regarding the diagnosis/procedure code provisions of this rule: www.pharmacy.ohio.gov/AcuteResolution)

 

Prescribing Opioids for the Treatment of Chronic Pain

As a reminder, Ohio developed guidelines for the treatment of chronic pain using opioids.  These guidelines can be accessed here.

 

For More Information

If you are a prescriber, please contact your respective regulatory board using the information below.

Newly Adopted and Amended Rules effective 8/31/17

Newly Adopted and Amended Rules

The Medical Board adopted the following new and amended rules that are effective on 8/31/17:

 

Medical or osteopathic licensure: 4731-6-01, 4731-6-05, 4731-6-10, 4731-6-21, 4731-6-22, 4731-6-30, 4731-6-32, 4731-6-33, 4731-6-34  

Drug treatment of chronic pain: 4731-21-01, 4731-21-02, 4731-21-03 , 4731-21-04, 4731-21-06

Emeritus registration: 4731-22-01, 4731-22-02, 4731-22-07

Mental or physical impairment: 4731-28-01