1. National Credentialing Forum 2019 San Diego, CA February 7 2019
OkAMSS Fall Conference
Oklahoma
Board of Medical Licensure & Supervision
Regulation of Opioid Drugs
&
Oklahoma Medical Marijuana Law
National Credentialing Forum 2019 San Diego, CA February
Ok Board of Medical Licensure & Supervision

2. OkAMSS Fall Conference
Agenda
Regulation of Opioid Drugs - SB 1446
We will review the ‘Opioid Best Practices’
Additional CME requirement for MDs
Ramification of SB1446 on Physicians and mid-levels
Oklahoma Medical Marijuana Law (SQ788)
Physician Registration
Board certification
What's around the corner?
February
Ok Board of Medical Licensure & Supervision

3. Regulation of Opioid Drugs - SB 1446 Effective November 1, 2018
OkAMSS Fall Conference
Regulation of Opioid Drugs - SB 1446 Effective November 1, 2018
CME: not less than one (1) hour of education in pain management or one (1) hour of education in opioid use or addiction each year preceding an application for renewal of a license, unless the licensee has demonstrated to the satisfaction of the Board that the licensee does not currently hold a valid federal Drug Enforcement Administration registration number.
OBNDD to make Board referrals: of physicians if a patient receives one (1) or more prescriptions in quantities or frequency inconsistent with accepted standards of safe practice.
PMP: Failure to check PMP is grounds for disciplinary action by licensing board. PMP must be checked at the initial prescription and then at least every 180 days.
February
Ok Board of Medical Licensure & Supervision

4. Acute Pain Effective November 1, 2018 -
OkAMSS Fall Conference
Acute Pain Effective November 1,
Initial Opioid Prescription w/new patient:
Lowest effective dose
No more than a 7 day supply
Thorough physical medical exam
Informed consent
Specific treatment plan
Check PMP
Special attention for under 18
Special attention for pregnant patients
Limit to lowest safe dose and 7 days
February
Ok Board of Medical Licensure & Supervision

5. Acute Pain Effective November 1, 2018
OkAMSS Fall Conference
Acute Pain Effective November 1, 2018
Exception
for major surgical procedure and/or “confined to home” status:
The practitioner provides the subsequent prescription on the same day as the initial prescription;
The practitioner provides written instruction on the subsequent prescription indicating the earliest date on which the prescription may be filled (i.e. “do not fill until” date); and
The subsequent prescription is dispensed no more than five (5) days after the “do not fill until” date indicated on the prescription.
February
Ok Board of Medical Licensure & Supervision

6. Acute Pain Effective November 1, 2018
OkAMSS Fall Conference
Acute Pain Effective November 1, 2018
IF the major surgical procedure and/or “confined to home” status conditions are NOT met:
a second 7-day prescription may be issued, after consultation* (in person or by telephone), if practitioner determines prescription is necessary and appropriate.
7-day consultation should be performed by the physician; however, it does not appear to be so required.
If a medication needs to be changed due to allergy, ineffective dose or other medical condition, document thoroughly in the record the need and rationale for change
February
Ok Board of Medical Licensure & Supervision

7. Chronic Pain Effective November 1, 2018
OkAMSS Fall Conference
Chronic Pain Effective November 1, 2018
If continuing treatment for 3 months or more, practitioner shall:
Review every 3 months - the course of treatment, any new information regarding etiology of pain and progress toward treatment objectives;
Assess patient prior to every renewal to determine if the patient is experiencing dependency and document assessment;
Periodically make reasonable efforts, unless clinically contraindicated to stop, decrease dosage or try other treatment modalities;
Review PMP;
Monitor compliance with pain management agreement.
According to the A.G.’s office, the assessment may be performed by a mid-level PA/APRN.
Face-to-face assessment is recommended, but not required
February
Ok Board of Medical Licensure & Supervision

8. OkAMSS Fall Conference
Exceptions
The pill limits do not apply to prescription for a patient who is currently in active treatment for cancer, receiving hospice care, palliative care or is a resident of a long-term care facility, or to any medications that are being prescribed for use in the treatment of substance abuse or opioid dependence
February
Ok Board of Medical Licensure & Supervision

9. OkAMSS Fall Conference
Make sure to Bookmark:
February
Ok Board of Medical Licensure & Supervision

10. OkAMSS Fall Conference
February
Ok Board of Medical Licensure & Supervision

11. OkAMSS Fall Conference
OK SQ 788 Medical Marijuana (MM) 1. There are no medical rules for marijuana! 2. There is no CME required by the law – CME programs are being developed 3. Physicians have to be *board certified in order to recommend MM. a. Board certification by ABMS, ABPS or approved by the OMB – list of approved Boards is on the website b. Health Department has a list of board certified physicians c. Recommend NOT prescribe – avoids federal law Schedule I 4. Physicians interested in this topic should visit the OMMA Website as an excellent resource: *fully expect this item to be discussed next legislative session
February
Ok Board of Medical Licensure & Supervision

12. OkAMSS Fall Conference
 IMPORTANT:  The Oklahoma Medical Marijuana Authority (OMMA) Food Safety Standards Board is the authority entrusted to carry out the requirements of this Law.
Please direct all calls and inquiries to OMMA at:
Oklahoma Medical Marijuana Authority  Phone: (405)   Website: omma.ok.gov
Guidance for Recommending Physicians
Physician Registration Form
February
Ok Board of Medical Licensure & Supervision

13. What's around the corner?
OkAMSS Fall Conference
What's around the corner?
Physical Therapy Licensure Compact - HB 3336 Effective:
MD Licensure Compact
Occupational Therapy Practice Act -Telemedicine/Telehealth/Tele-rehab
Medical Board Practice Act – Allied Licensure Application Electronic Circularization, Admin fine, other…
Supervision Form (form 5) – Online workflow process
Blockchain – e-Wallet Card
February
Ok Board of Medical Licensure & Supervision

14. OkAMSS Fall Conference
February
QUESTIONS?
Ext. 118
Reji T. Varghese
Deputy Executive Director
Ok Board of Medical Licensure & Supervision