Re: Controlled Substance Prescriptions

[Guest guest]

In maine the state has a program you register for as a provider then you log on and find out how many prescriptions for what narcotics smith has gotten recently And if you a re not the one providng them well there ya go

Medicaid in MAine coordinated it? call your state bureau of healht?? Our s is through DHSJean( Move to MAine .We need you!! Affordable housing!! Peace and Quiet! the way life should be !!)

Myria,

How can we get the DEA to give us that information? I understood there was no national clearinghouse because of HIPAA rules? Can you give me any suggestions?

Thanks!

From: Lynn Ho <lynnhrihotmail (DOT) com>Subject: RE: [Practiceimprovemen t1] Controlled Substance PrescriptionsTo: practiceimprovement 1yahoogroups (DOT) com

Date: Saturday, November 29, 2008, 8:01 AM

Hi Rian!I asked the head of the RI medical licensure board about this, because I had a patient on oxycontin for chronic pancreatitis and I was reading the DEA verbiage about what you could and couldn't do and it isn't clear. The patient lived about 45 minutes away and I didn't want to make him come down every month to get a new prescription - seemed like a waste of his and my time - chronic, stable no change in dose, no suspicion of abuse. He looked into it, with regard to DEA regulations etc., and what he said was, it was NOT illegal to mail him a presciption every month, without seeing him. The patient would call and leave me a message about a week before he was going to be out and I would mail him a rxn. He came down every 4-6 months for a visit.

But you are perfectly within your right to do it the way you please - the way I did it, I was working for free. I didn't mind with this patient and it

streamlined his care, BUT If you don't want to work for free, or you don't feel comfortable, have her come in. Depends on your comfort level. I got bored of having the patient come in so much, so I devolved to the method above which worked for us and apparently is not illegal (at least via RI law interpretation) .

Lynn Ho

To: Practiceimprovement 1yahoogroups (DOT) comFrom: mintekcharter (DOT) netDate: Sat, 29 Nov 2008 10:31:07 -0500Subject: [Practiceimprovemen t1] Controlled Substance Prescriptions

Here is a question: how to deal with a request for Methadone prescription. A new patient calls, and requests a call-back before scheduling appointment, so that she won't waste a trip. She explains

that she is suffering chronic pain, despite surgery (diskectomy and fusion procedure, for cervical disc disease), 6 years ago. She has been to the Chronic Pain Management consultants (45 minutes drive from our little town), and has tried numerous drugs, and is now relying on

Methadone. She is disabled by her pain, and driving to that chronic pain clinic is a hassle. A few months ago, she pushed the Chronic Pain Management specialist to agree that the patient would only need to drive that far once a year, and that the responsibility to write the

Methadone prescriptions could be carried by the patient's local family doctor (a member of a group practice, here in our small

town.)Actually, most of the time those prescriptions would be written-out by hand on paper prescription, by that family doctor, and just left for the patient at the reception desk; the patient would just stop

over to the F.P. clinic and pick-up her prescription right there at the desk, without needing to fork-out a co-pay, or waste time with scheduling appointment, waiting in the waiting room, bothering with the nuisance of vital signs, interval history, or exam ...

Now, she has learned that the family doctor in that scenario is leaving our town. So, the patient (who used to see me, like 11 years ago, when I used to work like a cog in that same machine), calls and says how much she always used to like me, and please wouldn't I help

her, the way Dr. X. was helping her ...My answer was that I would be happy to see her again in my little solo office, but I would need to review her records, and

repeat the history/physical about her pain, and I would generally require visits every time she needed a new prescription for Methadone. That hit a stalemate.So, to get back to the general question: if a Schedule II Controlled

Substance is regulated with rules that disallow telephone prescriptions, FAX'ed prescriptions, or refills, and instead requires that every single prescription must be hand-signed in ink by prescribing physician, doesn't that imply that the physician is

seeing that patient that often ? ...Rian Mintek, M.D. ... Allegan, Michigan ... re-connected to the list- serve with a new computer, and typing speed finally fast enough to pose a question; sorry if this issue has already been addressed by the

I.M.P.'s ...

Windows Live Hotmail now works up to 70% faster. Sign up today.

-- If you are a patient please allow up to 12 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD

ph fax

[Guest guest]

In maine the state has a program you register for as a provider then you log on and find out how many prescriptions for what narcotics smith has gotten recently And if you a re not the one providng them well there ya go

Medicaid in MAine coordinated it? call your state bureau of healht?? Our s is through DHSJean( Move to MAine .We need you!! Affordable housing!! Peace and Quiet! the way life should be !!)

Myria,

How can we get the DEA to give us that information? I understood there was no national clearinghouse because of HIPAA rules? Can you give me any suggestions?

Thanks!

From: Lynn Ho <lynnhrihotmail (DOT) com>Subject: RE: [Practiceimprovemen t1] Controlled Substance PrescriptionsTo: practiceimprovement 1yahoogroups (DOT) com

Date: Saturday, November 29, 2008, 8:01 AM

Hi Rian!I asked the head of the RI medical licensure board about this, because I had a patient on oxycontin for chronic pancreatitis and I was reading the DEA verbiage about what you could and couldn't do and it isn't clear. The patient lived about 45 minutes away and I didn't want to make him come down every month to get a new prescription - seemed like a waste of his and my time - chronic, stable no change in dose, no suspicion of abuse. He looked into it, with regard to DEA regulations etc., and what he said was, it was NOT illegal to mail him a presciption every month, without seeing him. The patient would call and leave me a message about a week before he was going to be out and I would mail him a rxn. He came down every 4-6 months for a visit.

But you are perfectly within your right to do it the way you please - the way I did it, I was working for free. I didn't mind with this patient and it

streamlined his care, BUT If you don't want to work for free, or you don't feel comfortable, have her come in. Depends on your comfort level. I got bored of having the patient come in so much, so I devolved to the method above which worked for us and apparently is not illegal (at least via RI law interpretation) .

Lynn Ho

To: Practiceimprovement 1yahoogroups (DOT) comFrom: mintekcharter (DOT) netDate: Sat, 29 Nov 2008 10:31:07 -0500Subject: [Practiceimprovemen t1] Controlled Substance Prescriptions

Here is a question: how to deal with a request for Methadone prescription. A new patient calls, and requests a call-back before scheduling appointment, so that she won't waste a trip. She explains

that she is suffering chronic pain, despite surgery (diskectomy and fusion procedure, for cervical disc disease), 6 years ago. She has been to the Chronic Pain Management consultants (45 minutes drive from our little town), and has tried numerous drugs, and is now relying on

Methadone. She is disabled by her pain, and driving to that chronic pain clinic is a hassle. A few months ago, she pushed the Chronic Pain Management specialist to agree that the patient would only need to drive that far once a year, and that the responsibility to write the

Methadone prescriptions could be carried by the patient's local family doctor (a member of a group practice, here in our small

town.)Actually, most of the time those prescriptions would be written-out by hand on paper prescription, by that family doctor, and just left for the patient at the reception desk; the patient would just stop

over to the F.P. clinic and pick-up her prescription right there at the desk, without needing to fork-out a co-pay, or waste time with scheduling appointment, waiting in the waiting room, bothering with the nuisance of vital signs, interval history, or exam ...

Now, she has learned that the family doctor in that scenario is leaving our town. So, the patient (who used to see me, like 11 years ago, when I used to work like a cog in that same machine), calls and says how much she always used to like me, and please wouldn't I help

her, the way Dr. X. was helping her ...My answer was that I would be happy to see her again in my little solo office, but I would need to review her records, and

repeat the history/physical about her pain, and I would generally require visits every time she needed a new prescription for Methadone. That hit a stalemate.So, to get back to the general question: if a Schedule II Controlled

Substance is regulated with rules that disallow telephone prescriptions, FAX'ed prescriptions, or refills, and instead requires that every single prescription must be hand-signed in ink by prescribing physician, doesn't that imply that the physician is

seeing that patient that often ? ...Rian Mintek, M.D. ... Allegan, Michigan ... re-connected to the list- serve with a new computer, and typing speed finally fast enough to pose a question; sorry if this issue has already been addressed by the

I.M.P.'s ...

Windows Live Hotmail now works up to 70% faster. Sign up today.

-- If you are a patient please allow up to 12 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD

ph fax

[Guest guest]

I agree with the scope of practice, does anybody know of a solo FP or IM that is prescribing methadone for narcotic addiction?-- Pedro Ballester, M.D.Warren, OH

[Guest guest]

I agree with the scope of practice, does anybody know of a solo FP or IM that is prescribing methadone for narcotic addiction?-- Pedro Ballester, M.D.Warren, OH