Consideration 1: What are the Federal reporting requirements?
The Drug Enforcement Administration (“DEA”) has federal jurisdiction over controlled substances. Once a provider discovers a “suspicious order,” which is defined as an unusually large controlled substance order, unusually frequent controlled substance orders, or controlled substance orders that deviate substantially from a normal pattern, the provider must notify the DEA Administrator and the Special Agent in Charge of the local DEA Division Office. If a provider has had their state license registration suspended, revoked, or denied, or the state licensing board has recommended suspension, revocation, or denial of the provider’s DEA registration, the DEA can suspend or revoke the provider’s DEA registration but will issue a show-cause order before the DEA takes any further action. 21 U.S.C. § 824.
Consideration 2: What are the State reporting requirements?
Many states require reports when disciplinary action has been taken, but providers may consider notifying their state medical boards if they are notifying the DEA to be transparent.
Each state is different, and you should consult the rules in all relevant states. Below are examples of how states may treat the situation where a physician inadvertently prescribes to a patient in a state where the physician is licensed:
Georgia
In Georgia, the Georgia Composite Medical Board can discipline a physician for engaging in unprofessional conduct. “Unprofessional conduct” includes any departure from, or failure to conform to, the minimum standards of acceptable and prevailing medical practice and includes the prescribing or use of drugs, treatment, or diagnostic procedures that are detrimental to the patient. “Unprofessional conduct” includes prescribing controlled substances or prescription drugs for a patient based solely on a telehealth consultation with the patient, except in cases where a physician prescribes a prescription drug to a patient under a valid physician-patient relationship or where a physician covering for another physician prescribes up to a 30-day supply of medications for a patient of that other physician.
If the Georgia Composite Medical Board disciplines a physician for inadvertently prescribing controlled substances where the physician is not licensed, physicians must disclose any final, public disciplinary action by the Georgia Composite Medical Board or any other state’s medical board within 10 days of the judgment or disciplinary action. A “final disciplinary action,” however, does not include an investigation but includes suspension, revocation, public/private reprimand, probation, etc.
Florida
In Florida, physicians are required to report to the Florida Medical Board in writing within 30 days of any revocation, suspension, or any adverse action taken against the physician, including denial of licensure, by the licensing authority of any jurisdiction. In Florida specifically, the Florida Medical Board could impose discipline for prescribing controlled substances other than during the physician’s professional practice, and Florida law gives a presumption that, regardless of intent, prescribing controlled substances inappropriately is not in the course of the physician’s professional practice.
These are just a few examples of how states may view inadvertently prescribing to a patient in a different state and the different timeframes to report disciplinary actions. If you need assistance determining whether to report an action to a state licensing board or would like to discuss this blog post, you may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.