Updates to the Controlled Substances Act
(Effective January 1, 2012)
Added Drugs to Controlled Substance List
II. Tapentadol, Lisdexamfetamine (720 ILCS 570/206)
III. Aprobarbital, Butabarbital, Butalbital, Butobarbital, Thiopental, Buprenorphine (720 ILCS 570/207)
IV. Carisoprodol, Dichloralphenazone, Fospropofol, Tramadol, Zopiclone (720 1LCS 570/209)
V. Lacosamide, Pregabalin (720 ILCS 570/211)
Electronic Prescriptions
(720 ILCS 570/311.5) Click on Link for more information.
Electronic prescriptions for controlled substances. Notwithstanding any other Section in this Act, a prescriber who is otherwise authorized to prescribe controlled substances in Illinois may issue an electronic prescription for Schedule II, III, IV, and V controlled substances if done in accordance with the federal rules for electronic prescriptions for controlled substances, as set forth in 21 C.F.R. Parts 1300, 1304, 1306, and 1311.
3 Sequential 30-day Prescriptions for Schedule II
(720 ILCS 570/312) Click on Link for more information.
(a-5) Physicians may issue multiple prescriptions (3 sequential 30-day supplies) for the same Schedule II controlled substance, authorizing up to a 90-day supply. Before authorizing a 90-day supply of a Schedule II controlled substance, the physician must meet both of the following conditions:
1. Each separate prescription must be issued for a legitimate medical purpose by an individual physician acting in the usual course of professional practice.
2. The individual physician must provide written instructions on each prescription (other than the first prescription, if the prescribing physician intends for the prescription to be filled immediately) indicating the earliest date on which a pharmacy may fill that prescription.
Mailing of Controlled Substances
(k) Controlled substances may be mailed if all of the following conditions are met:
1. The controlled substances are not outwardly dangerous and are not likely, of their own force, to cause injury to a person's life or health.
2. The inner container of a parcel containing controlled substances must be marked and sealed as required under this Act its rules, and be placed in a plain outer container or securely wrapped in plain paper.
3. If the controlled substances consist of prescription medicines, the inner container must be labeled to show the name and address of the pharmacy or practitioner dispensing the prescription.
4. The outside wrapper or container must be free of markings that would indicate the nature of the contents.
Medication Shopping, Pharmacy Shopping, and Unsolicited Reporting
(720 ILCS 570/314.5) Click on Link for more information.
It shall be unlawful for any person knowingly or intentionally to fraudulently obtain or fraudulently seek to obtain any controlled substance or prescription for a controlled substance from a prescriber or dispenser while being supplied with any controlled substance or prescription for a controlled substance by another prescriber or dispenser, without disclosing the fact of the existing controlled substance or prescription for a controlled substance to the prescriber or dispenser from whom the subsequent controlled substance or prescription for a controlled substance is sought.
When a patient is identified as hitting a predefined threshold of multiple prescription and multiple prescribers, the PMP may issue an unsolicited report to the prescribers informing them to the potential medication shopping.
Additional Reporting Fields for the Prescription Monitoring Program
(720 ILCS 570/316) Click on Link for more information.
Date Filled, Payment Type (Medicaid, Cash, Insurance, etc...), Patient Location Code, etc...
Long-Term Care Medication Management
(c) The collection of data on select drugs and scheduled substances by the Prescription Monitoring Program may be used as a tool for addressing oversight requirements of long-term care institutions as set forth by Public Act 96-1372. Long-term care pharmacies shall transmit patient medication profiles to the Prescription Monitoring Program monthly or more frequently as e stablished by administrative rule.
To Review the entire revision of the IL Controlled Substances Act (Public Act 097-0334)
please follow this link:
http://www.ilga.gov/legislation/publicacts/fulltext.asp?Name=097-0334&GA=97
Ready to Register for the event?
The new Patient Protection and Affordable Care Act has extended the time limit for pharmacy submission to CMS of providing proof that the pharmacy has obtained DMEPOS accreditation to deadline date of January 1, 2011. The Act has provided certain exemptions from CMS mandated accreditation provided that a pharmacy satisfies all of the below exemptions.
Pharmacies which meet all of the following criteria by January 1, 2011 will be exempt from the need to acquire accreditation:
• The pharmacy's total billing for DMEPOS products is less than 5% of the pharmacy's total sales for the previous 3 calendar years. (Note: This only applies to the pharmacy revenue not the total store revenue).
• The pharmacy has been enrolled as a supplier of durable medical equipment, prosthetics, orthotics and supplies and has been issued a provider number for at least 5 years.
• No final adverse action, either a Board of Pharmacy or other regulatory agency, has been imposed upon the pharmacy for the past 5 years.
• The pharmacy must submit proof of attestation to CMS that the pharmacy meets the above 3 criteria. ( I can help pharmacy owners draft and submit an attestation to CMS)
• The pharmacy agrees to submit materials as requested during the course of an audit conducted on a random sample of pharmacies selected annually.
Pharmacies that do not meet all of the above exemptions by January 1, 2011, should obtain DMEPOS accreditation by the earliest date possible.
Newly opened pharmacies must be accredited because they do not meet the exemption requirement of having been enrolled in the Medicare program as a DMEPOS supplier for at least 5 years. Therefore newly opened pharmacies within the past 5 years, including both chain and single store must become accredited. The obtaining of accreditation need not be prior to the January 1, 2011 deadline.
IL DHFS Requirements on NPI Numbers
Effective September 1, we will no longer accept the DEA or legend provider ID as the prescriber ID on drug claims. We will require the NPI in the prescriber ID field, as well as the primary care provider ID field if that field is populated. Over 90% of our claims are coming in with the NPI as the prescriber ID, so I don’t anticipate a significant problem for pharmacies.
In response to our questions as it relates to some hospital prescriptions being written by residents etc the Dept. has responded with the following:
“In addition, if a prescriber who practices at a hospital writes a prescription on a prescription pad that contains only the hospital’s name and address, the prescribing practitioner must print their name legibly on the prescription pad, and include their NPI. Residents must also record their NPI on their prescriptions. Residents can obtain their own NPI. See Centers for Medicare and Medicaid Services (CMS) guidance related to this topic at https://questions.cms.hhs.gov/ Search for question number 8479.”
I can ask our staff that work closely with hospitals to also reach out to them and make sure they are aware of this requirement.
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