Requirements for Florida's pain clinics seek to curb drug abuse.
Pain management clinics in Florida in recent years became a popular means of obtaining controlled substances such as oxycodone. The clinics, which issue prescription pain medications to patients in much the same way that pharmacies do, became a problem because of their growing popularity among drug-dependent abusers. To deal with various issues related to pain management clinics, Florida lawmakers passed new legislation in 2010 that places some requirements on pain clinics. Additionally, the state Department of Health used administrative code to set additional regulations.
Legislation Requirements
On June 4, 2010, Florida Gov. Charlie Crist signed into law legislation that prevents felons from owning pain management clinics. The new law also limits individuals who pay cash for their prescriptions to a 72-hour supply. The 72-hour limit does not apply to individuals who pay with credit cards. This is because the state legislature believes electronic payment can be monitored, if necessary, to determine whether pain management clinics are providing narcotics to drug abusers. Pain management clinics also are now required to stop advertising for the treatment of pain with oxycodone. The new regulations are set to take effect on October 1, 2010.
Registration Requirement
Florida Administrative Code, which is law set into place by state agencies, was proposed in 2009 to combat the problems associated with pain management clinics in the state. A hearing on the proposed rules was set for August 2010. If approved, all pain management clinics in Florida would be required to register with the Department of Health and to submit to inspections. The inspections are to be conducted annually at a cost of $1,500 per inspection. The pain clinics must pay the inspection costs. The inspection is necessary to obtain accreditation. Once a clinic has been accredited by state or national agencies, the frequency of inspections can decrease.
Facility Standards of Practice
The Florida Department of Health also sought to establish new administrative law that places special requirements on pain management clinics. The new regulations would require owners of these clinics to comply with facility and physical operations rules. The rules require drug testing of patients. The rules also set requirements for signage, telephones and emergency lighting. Pain management physicians are also required to obtain training.
Physician Requirements
Under the proposed administrative law rules, physicians would be required to complete a medical history and physical exam of all patients before beginning any treatment. The physical exam requirements are left to the judgment of the clinician, who must justify the need for treatment. At a minimum, the medical record must document the nature and intensity of the pain, current and past treatments for the pain, underlying or coexisting diseases and the effect of the pain on physical and psychological function. The medical record also must include a review of prior medical records and previous diagnostic studies and the patient's history of alcohol and substance abuse. The physician also must supply a written treatment plan stating the objectives used to determine successful treatment. Physicians are required to discuss with patients the risks and benefits of the use of controlled substances. The discussion must include the risks of abuse and addiction and the possible consequences of physical dependence. Clinics are also required to drug test patients twice per year for those who continue to use controlled substances to treat pain.
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