ALERT: Opioid Emergency Regulations Adopted

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Good afternoon:

The State Board of Medical Examiners yesterday, March 2nd, adopted emergency regulations to implement the new opioid prescribing limitations law recently signed into law by Governor Christie immediately. Please note that you and your physician colleagues should immediately comply with these regulations. Please find the emergency regulations here: http://www.njconsumeraffairs.gov/bme/Documents/BME-Emergency-Adoption-and-Concurrent-Proposal.pdf. In addition, please find an update to the bulletin we recently provided below. Again, the law’s prescribing requirements are now in effect. These emergency rules are effective immediately and will remain in effect for 60 days, and are being concurrently proposed for re-adoption to permit the submission of comments concerning the rules and the intention of the Attorney General and Board to make these rules permanent. Comments may be submitted after March 20th when this rule is officially published. We will remind you when that date approaches. contact us with any questions.

BULLETIN

NEW STATE OPIOID PRESCRIBING INFORMATION

Please review this entire bulletin and share it with your physician colleagues so they can comply with this new state law as soon as possible. Last month, Governor Chris Christie signed sweeping new legislation changing state law as to how and when opioid drugs may be prescribed. The law has now taken effect via emergency regulations. The bill was scheduled to take effect on May 16, 2017 but as we suspected the prescribing provisions are now in effect. Under the new law and according to the emergency regulations, a practitioner is not permitted to issue an initial prescription for an opioid drug in a quantity exceeding a five-day supply for treatment of acute pain. We advise members to amend their opioid prescribing practices to comply with the law as soon as possible.

Prior to issuing such an initial prescription, a practitioner shall:

Discuss with the patient the risks associated with the drug, including risks of addiction and overdose;
Explain the reasons why the prescription is necessary;
Set forth available alternative treatments;
Take and document the results of a thorough medical history;
Conduct, as appropriate, a physical examination;
Develop a treatment plan focused on the patient’s pain;
Access relevant information from the Prescription Monitoring Program.
On the fourth day of an initial prescription a practitioner may, after consultation with the patient, issue a subsequent prescription for the opioid drug. In order to do so, the practitioner must determine that the subsequent prescription is: (i) necessary and appropriate; and (ii) will not present an undue risk of abuse, addiction or diversion.

If a third prescription is issued to a patient for an opioid, the practitioner is required to enter into a pain management agreement with the patient. Finally, any health care professional authorized to prescribe an opioid shall take part in at least one educational credit (in each reporting period) related to prescribing opioid drugs.

Out-of-Network Update

On Monday, December 5th the Senate version of the Out-of-Network (OON) legislation, S-1285, was scheduled for a vote by the Senate Budget and Appropriations Committee. Over the course of the past weekend the New Jersey Hospital Association (NJHA) cut a last-minute deal with the OON bill sponsors. That deal would have called for amendments to the bill which would have proposed a cap on OON charges instead requiring an interim payment for OON services creating an option for binding arbitration only if the two parties could not come to an agreement. As soon as that deal was cut between the sponsors and NJHA other proponents of the bill including Horizon Blue Cross Blue Shield and major public employee unions expressed their opposition to this new proposal. As a result of those sudden changes and our continued opposition, Senator Vitale asked that the bill be removed from Monday’s Senate Committee agenda until a later date. A press conference announcing the NJHA deal was postponed. However, our Access to Care Coalition went forward with our press conference featuring bi-partisan legislators, physicians, and a patient to oppose this bill. Thank you to Dr. Monaghan for representing the Society at the press conference.

While we have slowed the advancement of OON we have not stopped it. We know that the sponsors will continue working on helping their supporters understand these changes so that the bill may move forward. This could happen as soon as December 15, 2016 or early next year. Your continued advocacy as a member of our society, in your practice, and in your hospital with your colleagues is very important. We continue to work within our Access to Care Coalition to strategize about next steps and raise questions and opposition to the bill. We will be in touch with new developments.

Regards,

AJ Sabath
NJOS Lobbyist