Government Relations Update April 2016
Opioid Bill - Chapter 52 Acts of 2016
Implications for Emergency Departments
- 7-day limit on opioid prescriptions. Effective immediately
- Please note that while the bill carries a 7 day limit on opioid prescriptions, MACEP as part of the MHA guidelines had previously supported a 5 day limit on opioids from the ED. MACEP continues to support this guideline and encourages each ED to educate their providers with respect to this distinction.
- The 7 day limit applies to the first time a provider gives a patient an opioid prescription (18 and over) and all opioid prescriptions for minors. Also must review with parent/guardian the inherent risks of an opioid and why it is necessary.
- Interestingly, there is currently an exception for an "acute medical condition," "chronic pain management," palliative care, and pain associated with cancer diagnoses.
- For all opioid prescriptions, before prescribing, providers need to notify patients of the option for a partial fill, and need to discuss the risks associated with the opioid. May need some sort of informational pamphlet.
- Partial fill: prescriptions must include a notation allowing for a partial fill.
- Use of the PMP (effective October 15, 2016)
- The law requires DPH to issue regulations by the October date to regulate all prescribers' use of the PMP.
- PMP will be used to evaluate benchmarking prescribing patterns by individual physician, to be shared annually.
- Substance abuse evaluation (effective July 1, 2016)
- Applies to any patient who arrives in an ED experiencing an opioid overdose or who was administered naloxone before arrival.
- Individuals must undergo a substance abuse evaluation by an ESP or licensed mental health professional (i.e. not emergency physician) within 24 hours. Patients may refuse this service and if they leave physicians are not held liable for any civil suit. The provider would need to document in the chart that the patient left prior to the evaluation being completed. For minors it would require providers to notify their parents.
- Upon discharge patient must receive information on local and statewide treatment programs, the overdose must be recorded in the EMR, and the facility must notify the PCP if known.
- There are still details about the this that have not been clarified by the state and will be updated later
House Bill - #1164 - To raise the minimum charge for assault on a healthcare worker to felony.
- The bill has been in judiciary committee and recently was moved to another committee for review
- Working with ACEP, AONE and EMS groups to draft a joint letter to encourage the house to bring the bill to a vote.
- There is another workplace bill (S. 1313 / H. 1687) that also addresss workplace violence and the steps that the hospitals should take about protecting workers.
Day on the Hill
- The annual day on the hill is coming up in May and Dan Nadworny and Maureen Curtis Cooper will be attending.
- Goals will be determined at the ENA meetings in April but the priorities from the national conference are the main focus areas including: Mental healthcare support and funding, opioid crisis, retention and workplace safety.
Massachusetts Government Affairs Chair