Everybody Hurts: Prescription drug tracking advances in California Senate
California is taking another run at requiring doctors to check a patient’s prescription history before prescribing potentially addictive drugs.
The bill – Senate Bill 482 – passed the California Senate on Thursday on a 28-11 vote and now heads to the Assembly. I was curious about how the California law would stack up against Oklahoma’s new law, passed and signed by the governor this year. So far, California has not had to make the kind of compromises seen in the Oklahoma law. It remains to be seen whether the California Medical Association, the chief lobbying group for doctors in the state, demands any changes at this point.
Here’s a comparison.
1. No time limit on checks. California’s bill does not put a limit on when physicians have to check the prescription drug database. Instead it says, “A prescriber shall access and consult the CURES database for the electronic history of controlled substances dispensed to a patient under his or her care before prescribing a Schedule II or Schedule III controlled substance for the first time to that patient and at least annually when that prescribed controlled substance remains part of his or her treatment.” In Oklahoma, the law only requires physicians to check the database if 180 days have passed since the last check.
2. Broader inclusion of drugs. In California, a broader group of drugs is included in the law, including any drug that is Schedule II or Schedule III. This would include stimulants, such as amphetamine and depressants such as pentobarbital. The legislation, if strictly interpreted, would mean that any drug added to the U.S. Drug Enforcement Administration’s list would prompt a check. The Oklahoma law focuses on painkillers and excludes many other drugs.
3. Inclusion of nursing homes and hospice care. The law does not make any distinctions based on the clinical setting. It says that prescribers have to make these checks. Period. In Oklahoma, the law specifically says that the rules do not apply to “practitioners who prescribe the controlled substances … for hospice or end-of-life care, or … for a patient residing in a nursing facility.”
4. No protection from lawsuits. The law makes no mention of legal protection for physicians. The Oklahoma law says that physicians and their staff “shall not be liable to any person for any claim of damages as a result of accessing or failing to access the information in the central repository and no lawsuit may be predicated thereon.”
5. Protection from severe regulatory action. This is where both the Oklahoma law and the California law line up. Both put any infractions of the law in the court of the health practitioner board in charge of the prescriber. In California, most of the action would probably take place in the Medical Board of California, an agency that is still predominately made up of physicians. The California law says, “The bill would make the failure to consult a patient’s electronic history in the CURES database a cause for disciplinary action by the prescriber’s licensing board and would require the licensing boards to notify all prescribers authorized to prescribe controlled substances of these requirements.”
I asked the California Medical Association for a comment on the Oklahoma law and on prospects for a similar law in California. I will let you know if I receive a response.
[Photo via Pixabay.]