/>iThe Kentucky General Assembly passed House Bill 1, also known as the “pill mill bill” in 2012. Following its enactment, the Cabinet for Health and Family Services and various licensure boards issued regulations implementing its requirements. It was soon realized that the law would need some refinement to address concerns raised by the provider community and stakeholders. In 2013, House Bill 217 amended portions of House Bill 1 to address some unintended consequences of the original legislation. One of those amendments was giving an exemption to hospitals, long-term care facilities and approved researchers from the law’s requirement to report controlled substances administered directly to patients through the state’s description drug monitoring system, KASPER. However, for those licensees not exempt from the reporting, it remains a stringent requirement that a KASPER report is filed within one day of dispensing a controlled substance. (See more on HB 217 here.)
Complying with KASPER can be tedious, to say the least. But, there are some common sense tips that, when utilized, can make the system run more smoothly. Here are some pointers for prescribers:[1]
1. Distinguish yourself.
If you work alongside multiple prescribers and the prescription pad is pre-printed with the names and DEA numbers of everyone in the practice, you will need to specify who is actually prescribing. You can do this by circling your name and DEA number in the pre-printed area or by clearly printing your name, DEA number and/or state license number alongside your signature.
2. Identify the patient.
It goes without saying that the patient’s name should be on the prescription, but double-check to make sure you are including their full name and any suffixes (Sr., Jr., III, etc.). Any incident of fraud can be further reduced by including the patients’ date of birth, address and Social Security Number. The more information, the better.
3. Do not pre-sign or post-date.
Title 21 in the Code of Federal Regulations §1306.05(a) clearly directs that “all prescriptions for controlled substances shall be dated as of, and signed on, the day when issued…”. An office staff member cannot complete a pre-signed or post-dated prescription at a later time.
4. Clarify acetaminophen strength.
Manufacturers have until January 14, 2014 to remove prescription medications containing more than 325mg of acetaminophen per tablet/capsule from the market, in line with the Food and Drug Administration’s directive. Combination products are now hitting the market, with various strengths of acetaminophen under the 325mg limit. If you prescribe one of these combination products, include the strength of the acetaminophen. Failure to do so will lead to a phone call requesting the correct mg.
There are many state and federal statutes and regulations that govern controlled substances. If you have a question about any of these, you can always call your licensing board, DEPPB, or the DEA. You can also contact one of the health care attorneys at McBrayer. If you have ever received a KASPER report and been perplexed about some of the information included therein, check back on Thursday and I’ll offer some tips for decoding it.
[1] This guidance was originally provided in the Fall 2013 Kentucky Board of Medical Licensure Newsletter by Amanda J. Ward of the Drug Enforcement and Professional Practices Branch.
