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.