HB 93 Introduced to Address Prescription Drug Issues in Ohio – AMCNO to Send Comments
Legislators are reviewing legislation that would penalize "rogue prescribers" that contribute to the rising addiction of prescription medications in Ohio. Rep. David Burke, a pharmacist from Marysville, and Rep. Terry Johnson, a former Scioto County Coroner, introduced HB 93 to expand prescription drug regulations and address prescription drug abuse that has risen to epidemic proportions in rural southern Ohio and Ohio’s inner city neighborhoods. In various parts of the state prescription drug abuse has become a major source of criminal activity and adds the burden of additional cost to state and local governments. According to the Ohio Department of Alcohol and Drug Addiction Services, a strong example of this abuse is in Scioto County, where providers prescribed 9.8 million doses of prescription opiates in 2010, enough for 123 doses for every county resident.

These providers operate what are referred to as “pill mills” where it is very easy to obtain an illegal drug prescription. The legislation contains a number of provisions aimed at improving enforcement of prescription drug regulations, such as requiring that prescribers report dispensing to Ohio Automated Rx Review System (OARRS). Currently OARRS can't tell pharmacists if an individual had just filled the same prescription 20 minutes earlier. Speaker of the Ohio House of Representatives Bill Batchelder has signed on as a co-sponsor, which indicates the legislation will probably pass out of the chamber. Other provisions will:

  • Create a $150 Terminal Distributor License with a Pain Management Clinic classification.
  • Establish a penalty of up to $20,000 for physicians who fail to obtain a license.
  • Define "pain management clinics" with an exemption for hospitals, medical and dental schools, and hospice.
  • Authorize the State Board of Pharmacy to suspend a terminal distributor license if there is clear and convincing evidence that the provider presents a danger of immediate and serious harm to others.
  • Prohibit providers from dispensing controlled substances that exceed a 24-hour dosage.
  • Restrict prescribers' ability to dispense controlled substances that exceed 2,500 dosage units in any 30-day period.
  • Require Medicaid recipients who are found to have obtained drugs that are not medically necessary to fill prescriptions at a single pharmacy.
  • Authorize the Board of Pharmacy, ODADAS, and the Attorney General's Office to create a statewide Drug Take Back Program.
  • Require the Board of Pharmacy to recommend improvements to General Assembly within six months of passage.

A substitute bill was agreed to that expands the definition of a pain management clinic and provides that the State Medical Board may establish other criteria to define such a clinic in the future. A new provision requires owners of pain management clinics to supervise, control and direct the activities of employees, volunteers or persons under contract providing services to the clinic. The substitute also includes ambulatory surgical facilities, along with hospitals, medical or dental schools and hospice programs, within pain management clinic licensure.

Under the substitute, the office of the Attorney General would be solely responsible for the costs incurred in the establishment and administration of the drug take-back program and changes the date of the first collection to not later than one year after the bill's effective date. The original bill divided the cost of the administering the program among the attorney general, Department of Alcohol and Drug Addiction Services and the State Board of Pharmacy and established the first take-back collection date of Dec. 31, 2011.

The physician reporting requirement of drugs that are controlled substances and other drugs included in the Ohio Automated Rx Reporting System (OARRS) was expanded to all prescribers who personally furnish the drugs and includes dentists and podiatrists within the groups subject to disciplinary action for failing to report the information. The substitute also permits a coroner to notify and provide information to the Medical Board when the coroner determines that a drug overdose caused a death.
Attorney General Mike DeWine has also announced that he plans to devote more funding and staff to combat prescription drug abuse in the state. Mr. DeWine appointed Adams County Prosecutor Aaron Haslam to serve as his "point man" on prescription drug abuse to coordinate efforts with local law enforcement officials.
He also hired two additional attorneys to help prepare cases and assist local prosecutors. The attorney general also said he would dedicate funds for the Ohio Peace Officer Training Academy to train law enforcement agents and for the Bureau of Criminal Investigation to assist local authorities fight prescription drug abuse. The focus of the office will be to focus on “pill mills” and not doctors who legitimately treat patients for chronic pain.

The AMCNO was involved in the prescription drug task force last year which evaluated many of the issues contained in this legislation. The AMCNO has sent a letter of support to the legislature with regard to the many of the provisions contained in HB 93. Body