S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  9098

                          I N  A S S E M B L Y

                             March 17, 2014
                               ___________

Introduced by M. of A. CUSICK -- read once and referred to the Committee
  on Higher Education

AN  ACT to amend the education law, in relation to maintenance of licen-
  sure for prescribers of controlled substances

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. The education law is amended by adding a new section 6505-d
to read as follows:
  S  6505-D.  COURSEWORK  OR  TRAINING  FOR  MAINTENANCE OF PROFESSIONAL
LICENSURE. 1. IN ORDER TO MAINTAIN  HIS  OR  HER  PROFESSIONAL  LICENSE,
EVERY  PRESCRIBER SHALL COMPLETE THE COURSEWORK OR TRAINING DESCRIBED IN
THIS SECTION RELATING TO THE TREATMENT AND  MANAGEMENT  OF  PATIENTS  TO
WHOM  CONTROLLED  SUBSTANCES  ARE  PRESCRIBED.  FOR THE PURPOSES OF THIS
SECTION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEANINGS:
  (A) "PRESCRIBER" SHALL MEAN ANY PRACTITIONER THAT IS (I) AUTHORIZED TO
PRESCRIBE CONTROLLED SUBSTANCES TO A HUMAN PATIENT PURSUANT  TO  HIS  OR
HER LICENSED PROFESSIONAL PRACTICE, AND (II) REGISTERED UNDER THE FEDER-
AL  CONTROLLED SUBSTANCES ACT AND IN POSSESSION OF A REGISTRATION NUMBER
FROM THE DRUG ENFORCEMENT ADMINISTRATION, UNITED  STATES  DEPARTMENT  OF
JUSTICE, OR ITS SUCCESSOR AGENCY.
  (B)  "HIGH  VOLUME  PRESCRIBER"  SHALL  MEAN A PRESCRIBER THAT (I) HAS
THIRTY OR MORE PATIENTS BEING TREATED FOR CHRONIC PAIN FOR WHOM ANY DOSE
OF AN OPIOID HAS BEEN PRESCRIBED FOR NINETY  OR  MORE  CONTINUOUS  DAYS,
AND/OR  (II)  HAS AT LEAST ONE PATIENT FOR WHOM A DAILY DOSE OF AT LEAST
ONE HUNDRED MILLIGRAMS OF MORPHINE  OR  ITS  EQUIVALENT  WAS  PRESCRIBED
WITHIN THE PAST TWELVE MONTHS.
  2.  (A)  WITHIN AVAILABLE APPROPRIATIONS OR FROM OTHER FUNDS APPROPRI-
ATED FOR THE PURPOSES OF THIS SECTION, THE OFFICE OF THE PROFESSIONS, IN
CONSULTATION WITH THE DEPARTMENT OF HEALTH AND THE OFFICE OF  ALCOHOLISM
AND SUBSTANCE ABUSE SERVICES, SHALL ESTABLISH AN EXPERT-LEVEL WORK GROUP
TO  DEVELOP  CONTENT AREAS, EVIDENCE-BASED CURRICULA, AND OUTCOMES MEAS-
UREMENT METHODS FOR COURSEWORK OR TRAINING RELATING TO THE TREATMENT AND
MANAGEMENT OF PATIENTS TO WHOM  CONTROLLED  SUBSTANCES  ARE  PRESCRIBED.
SUCH  WORK GROUP SHALL BE COMPOSED OF NO LESS THAN SEVEN INDIVIDUALS AND

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
              

                                                           LBD14237-02-4

A. 9098                             2

SHALL CONSIST OF PRACTICING PHYSICIANS  OR  OTHER  PRESCRIBERS,  PHARMA-
CISTS,  ADDICTION  MEDICINE  EXPERTS,  EXPERTS  IN MEDICAL EDUCATION AND
DELIVERY OF EDUCATIONAL PROGRAMS, AND AT LEAST ONE PARENT OR OTHER ADVO-
CATE  FOR  CHILDREN  WITH ADDICTION. THE MEMBERS OF THE WORK GROUP SHALL
NOT HAVE ANY DIRECT RELATIONSHIP TO ANY PHARMACEUTICAL  COMPANY  OR  ANY
ORGANIZATION REPRESENTING THE INTERESTS OF PHARMACEUTICAL COMPANIES. THE
MEMBERS  OF  THE  WORK GROUP SHALL BE SELECTED WITHIN ONE HUNDRED EIGHTY
DAYS OF THE EFFECTIVE DATE OF THIS SECTION. MEMBERS OF  THE  WORK  GROUP
SHALL  RECEIVE  NO COMPENSATION FOR THEIR SERVICES, BUT SHALL BE ALLOWED
ACTUAL AND NECESSARY EXPENSES IN THE PERFORMANCE OF THEIR DUTIES  PURSU-
ANT TO THIS SECTION.
  (B)  THE  COURSEWORK  OR  TRAINING  DEVELOPED  BY  THE  WORK GROUP MAY
INCLUDE, BUT NOT BE LIMITED TO, INSTRUCTION  IN  THE  FOLLOWING  SUBJECT
AREAS:  (I)  REQUIREMENTS  OF  THE  INTERNET  SYSTEM  FOR  TRACKING OVER
PRESCRIBING (I-STOP) ACT; (II) FEDERAL DRUG ENFORCEMENT AGENCY  REQUIRE-
MENTS  RELATING  TO  PRESCRIBING  CONTROLLED  SUBSTANCES; (III) MANAGING
ACUTE PAIN;  (IV)  MANAGING  ADDICTION  INCLUDING  BUT  NOT  LIMITED  TO
PREVENTION, SCREENING AND INTERVENTION FOR AT-RISK BEHAVIOR, IDENTIFICA-
TION  OF  ADDICTION,  AND TREATMENT REFERRALS; (V) OPIOID AND NON-OPIOID
PAIN MANAGEMENT; (VI) DOSING AND MONITORING FOR ALL PRESCRIPTION  DRUGS;
(VII)  PRESCRIBING  GUIDELINES  FOR  ALL  PRESCRIPTION DRUGS; AND (VIII)
SPECIALTY CARE REFERRALS FOR PAIN, MENTAL  HEALTH  AND  SUBSTANCE  ABUSE
DISORDERS.  IN  DEVELOPING  THE  CONTENT  AREAS, CURRICULA, AND OUTCOMES
MEASUREMENT METHODS FOR SUCH COURSEWORK OR TRAINING, THE WORK GROUP  MAY
ALSO  INCLUDE INSTRUCTION SUBSTANTIALLY SIMILAR TO THE COURSES DESCRIBED
IN THE FEDERAL DRUG ADDICTION TREATMENT ACT  OF  2000  RELATING  TO  THE
TREATMENT  AND  MANAGEMENT  OF  OPIOID-ADDICTED PATIENTS. THE WORK GROUP
SHALL, TO THE MAXIMUM EXTENT  PRACTICABLE,  DEVELOP  THE  COURSEWORK  OR
TRAINING IN SUCH A MANNER THAT IT SHALL QUALIFY FOR CREDIT IN CONNECTION
WITH EXISTING CONTINUING MEDICAL EDUCATION REQUIREMENTS FOR PRESCRIBERS.
THE COURSEWORK OR TRAINING DEVELOPED BY THE WORK GROUP MAY BE STRUCTURED
AS  ONE COURSE OR AS MULTIPLE COURSES. THE WORK GROUP SHALL COMPLETE THE
DEVELOPMENT OF THE CONTENT AREAS, CURRICULA, AND  OUTCOMES  MEASUREMENTS
METHODS WITHIN TWELVE MONTHS OF THE EFFECTIVE DATE OF THIS SECTION.
  (C)  UPON COMPLETION OF THE DEVELOPMENT OF THE COURSEWORK OR TRAINING,
THE OFFICE OF THE PROFESSIONS SHALL TAKE  ACTIONS  NECESSARY  TO  OBTAIN
ACCREDITATION  OF SUCH COURSEWORK OR TRAINING BY THE ACCREDITATION COUN-
CIL FOR CONTINUING MEDICAL EDUCATION OR ITS DESIGNEES. THE OFFICE OF THE
PROFESSIONS MAY TAKE SUCH ACTIONS FOR ACCREDITATION ON  ITS  OWN  OR  IN
COLLABORATION WITH ONE OR MORE STATEWIDE MEDICAL ASSOCIATIONS, SPECIALTY
MEDICAL BOARDS, AND/OR STATE UNIVERSITY MEDICAL SCHOOLS.
  3.  THE  COURSEWORK  OR  TRAINING  DEVELOPED  BY THE WORK GROUP MAY BE
PROVIDED BY: (A) THE DEPARTMENT; (B)  THE  DEPARTMENT  IN  COLLABORATION
WITH  ONE  OR  MORE  STATEWIDE  MEDICAL  ASSOCIATIONS, SPECIALTY MEDICAL
BOARDS, AND/OR STATE UNIVERSITY MEDICAL SCHOOLS; AND/OR (C)  ANY  ORGAN-
IZATION  THAT  THE  COMMISSIONER  DETERMINES  TO  BE APPROPRIATE FOR THE
PURPOSES OF THIS SECTION.  SUCH COURSEWORK OR TRAINING MAY BE OFFERED IN
A CLASSROOM SETTING, THROUGH INTERNET-BASED INSTRUCTION,  OR  OTHERWISE,
AS APPROVED BY THE COMMISSIONER.
  4.  (A)  IN ORDER TO SATISFY THE MAINTENANCE OF LICENSURE REQUIREMENTS
SET FORTH IN THIS SECTION, A PRESCRIBER SHALL COMPLETE  AT  LEAST  THREE
HOURS  OF  COURSEWORK OR TRAINING DEVELOPED BY THE WORK GROUP WHICH MUST
INCLUDE, AMONG OTHER THINGS, INSTRUCTION ON PRESCRIPTION DRUG ADDICTION;
PROVIDED HOWEVER, THAT A HIGH VOLUME PRESCRIBER SHALL COMPLETE AT  LEAST
EIGHT  HOURS OF COURSEWORK OR TRAINING DEVELOPED BY THE WORK GROUP WHICH
MUST INCLUDE, AMONG OTHER THINGS, INSTRUCTION ON THE USE OF OPIOIDS  FOR

A. 9098                             3

THE MANAGEMENT OF CHRONIC PAIN. EACH PRESCRIBER AND HIGH VOLUME PRESCRI-
BER SHALL COMPLETE SUCH COURSEWORK PRIOR TO HIS OR HER NEXT REGISTRATION
OR RE-REGISTRATION, BUT IN NO EVENT SHALL SUCH COURSEWORK OR TRAINING BE
TAKEN  LESS  THAN  ONCE  EVERY  FIVE  YEARS.    DOCUMENTATION  OF COURSE
COMPLETION SHALL BE PROVIDED TO THE DEPARTMENT BY A PRESCRIBER  OR  HIGH
VOLUME PRESCRIBER IN ORDER TO MAINTAIN HIS OR HER PROFESSIONAL LICENSE.
  (B)  THE  DEPARTMENT,  IN  CONSULTATION WITH THE DEPARTMENT OF HEALTH,
SHALL PROVIDE AN EXEMPTION FROM THE REQUIREMENTS OF THIS SECTION TO  ANY
PRESCRIBER  WHO REQUESTS SUCH AN EXEMPTION AND WHO SHOWS, TO THE DEPART-
MENT'S SATISFACTION, THAT SUCH PRESCRIBER IS NOT SUBJECT TO THE REQUIRE-
MENTS OF THIS SECTION. THE DEPARTMENT  MAY,  IN  CONSULTATION  WITH  THE
DEPARTMENT  OF  HEALTH,  PROVIDE  AN EXEMPTION TO OTHER PRESCRIBERS THAT
DEMONSTRATE TO THE DEPARTMENT'S SATISFACTION THAT SUCH PRESCRIBER'S  USE
OF  CONTROLLED  SUBSTANCES IS LIMITED EXCLUSIVELY TO USE IN AN OPERATING
ROOM OR TO USE IN OTHER SUBSTANTIALLY SIMILAR CIRCUMSTANCES.
  5. THE MAINTENANCE OF LICENSURE REQUIREMENTS SET FORTH IN THIS SECTION
MAY ALSO BE SATISFIED BY COMPLETION OF A COURSE OR  COURSES  SIMILAR  TO
THE  COURSEWORK  OR  TRAINING  DEVELOPED BY THE WORK GROUP PROVIDED THAT
SUCH COURSE OR COURSES: (A) ARE PROVIDED BY A MEMBER BOARD OF THE AMERI-
CAN BOARD OF MEDICAL SPECIALTIES AS PART OF ITS MAINTENANCE  OF  CERTIF-
ICATION  PROCESS OR ARE PROVIDED BY ANY OTHER ORGANIZATION DETERMINED BY
THE COMMISSIONER TO BE APPROPRIATE FOR THE PURPOSES OF THIS SECTION; (B)
SATISFY THE APPLICABLE HOUR REQUIREMENTS SET FORTH IN PARAGRAPH  (A)  OF
SUBDIVISION  FOUR  OF THIS SECTION; (C) ARE SUBSTANTIALLY SIMILAR TO THE
COURSEWORK OR TRAINING DEVELOPED BY THE WORK GROUP AS DETERMINED BY  THE
OFFICE  OF  THE  PROFESSIONS;  AND (D) ARE APPROVED BY THE OFFICE OF THE
PROFESSIONS.
  6.  THE PROVISIONS OF THIS SECTION SHALL NOT APPLY TO  ANY  PRESCRIBER
THAT  IS  CERTIFIED  BY  A MEMBER BOARD OF THE AMERICAN BOARD OF MEDICAL
SPECIALTIES UNTIL SUCH TIME AS SUCH  MEMBER  BOARD  HAS  INTEGRATED  THE
COURSEWORK OR TRAINING REQUIRED BY THIS SECTION INTO SUCH MEMBER BOARD'S
EXISTING  MAINTENANCE  OF CERTIFICATION PROCESS; PROVIDED, HOWEVER, THAT
THE PROVISIONS OF THIS SECTION SHALL APPLY TO SUCH PRESCRIBERS NO  LATER
THAN TWENTY-FOUR MONTHS AFTER THIS SECTION SHALL TAKE EFFECT.
  S 2. This act shall take effect immediately.