By R Carter
Seems like I often talk to other patients who believe their prescribers are willfully complacent or in agreement with and therefore support, regulations adopted by state and federal agencies on controlled substance prescribing. The truth is, more physician disagree with some but not all regulations than those who support them.
The second misconception is that doctors could if they wanted to, disregard regulations without consequences. Or that prescribers are more or less wimps, unwilling to stand up to federal and state regulation for the sake of providing good care to patients.
Patients rarely know or understand what their prescribers face with regards to sanctions and fines should a physician be sighted for prescribing controlled substances inappropriately. Below are the fines which the SMBO (State Medical Board of Ohio) will fine physicians found in violation of prescribing guidelines for opiates.
The full list of fines can be downloaded here.
|Prescribing, dispensing, or administering
of any drug for excessive periods of time
and/or in excessive amounts.
|Failing to keep patient records of substances
prescribed, dispensed or administered; and/or
failing to perform appropriate prior
examination and/or failure to document in the
patient record performance of appropriate
|Failure to use acceptable methods in selection
of drugs or other modalities.
|Selling, prescribing, dispensing, giving away, or
administering any drug for other than a legal
and legitimate therapeutic purpose and/or
selling, prescribing, dispensing, giving away,
or administering any drug in exchange for
|Departure from or failure to conform to
minimal standards of care
|Code of ethics violation||$18,000||$3,000|
|Practice outside scope of license or registration||$20,000||$3,500|
If a physician is found guilty of one of these prescribing regulations, the trouble does not stop with the assignment of a fine. Depending on the infraction, the physician could face temporary license suspension. When such actions are taken the information eventually finds its way back to other agencies such as Medicare and Medicaid. These agencies review the finding and if they believe it is appropriate, can suspend participation privileges in Federal Medicare and State Medicaid programs. After that some private insurers, such as BCBS may also suspend participation privileges.
In short, an infraction can essentially stop a physician from any form of gainful employment. Fortunately the system works in such a way that it is nearly impossible to create trumped up charges, so when action is taken by the board, it is always for good reason.