HB 53: "An Act establishing a consultation requirement with respect to the prescription of opiates under certain circumstances."
00 HOUSE BILL NO. 53 01 "An Act establishing a consultation requirement with respect to the prescription of 02 opiates under certain circumstances." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04 * Section 1. AS 08.64 is amended by adding a new section to article 3 to read: 05 Sec. 08.64.364. Prescription of opiates; consultation requirement. (a) 06 Except as provided in (c) of this section, a physician, osteopath, or podiatrist who 07 prescribes 120 milligrams or more a day of an opiate to a patient shall consult with a 08 pain management specialist. 09 (b) The consultation required under (a) of this section must consist of at least 10 one of the following: 11 (1) an office visit with the patient and the pain management specialist; 12 (2) a telephone or electronic consultation between the pain 13 management specialist and the physician, osteopath, or podiatrist; or 14 (3) an audio-visual evaluation conducted remotely by the pain
01 management specialist, at which the patient is present with either 02 (A) the physician, osteopath, or podiatrist; or 03 (B) a licensed health care practitioner designated by the 04 physician, osteopath, podiatrist, or pain management specialist. 05 (c) The consultation requirement under (a) of this section does not apply to 06 (1) the provision of palliative, hospice, or other end-of-life care; 07 (2) the management of acute pain caused by an injury or a surgical 08 procedure; 09 (3) a patient who is following a tapering schedule; 10 (4) a patient who requires treatment for acute pain that necessitates a 11 temporary escalation in opiate dosage before an expected return to or below the 12 patient's baseline dosage; 13 (5) a situation in which the physician, osteopath, or podiatrist 14 documents reasonable attempts to obtain a consultation with a pain management 15 specialist, and the circumstances justify prescribing 120 milligrams or more a day of 16 an opiate without obtaining a consultation; 17 (6) a patient whose pain and function are stable and who is on a 18 nonescalating dose of an opiate; or 19 (7) the practice of a physician, osteopath, or podiatrist who is a pain 20 management specialist. 21 (d) The board shall adopt regulations that define the procedure for the board to 22 approve a physician, osteopath, or podiatrist as a pain management specialist. The 23 regulations must require the physician, osteopath, or podiatrist to have a 24 (1) certification in pain management care by a credentialing agency or 25 organization acceptable to the board; 26 (2) minimum of three years of clinical experience acceptable to the 27 board in a pain management care setting; or 28 (3) current practice at least 30 percent of which consists of the direct 29 provision of pain management care. 30 (e) In this section, 31 (1) "advanced nurse practitioner" has the meaning given in
01 AS 08.68.850; 02 (2) "opiate" has the meaning given in AS 11.71.900; 03 (3) "pain management specialist" means 04 (A) a physician, osteopath, or podiatrist approved by the board 05 as a pain management specialist; or 06 (B) an advanced nurse practitioner approved as a pain 07 management specialist by the Board of Nursing under AS 08.68.701. 08 * Sec. 2. AS 08.68 is amended by adding a new section to article 6 to read: 09 Sec. 08.68.701. Prescription of opiates; consultation requirement. (a) 10 Except as provided in (c) of this section, an advanced nurse practitioner who 11 prescribes 120 milligrams or more a day of an opiate to a patient shall consult with a 12 pain management specialist. 13 (b) The consultation required under (a) of this section must consist of at least 14 one of the following: 15 (1) an office visit with the patient and the pain management specialist; 16 (2) a telephone or electronic consultation between the pain 17 management specialist and the advanced nurse practitioner; or 18 (3) an audio-visual evaluation conducted remotely by the pain 19 management specialist, at which the patient is present with either 20 (A) the advanced nurse practitioner; or 21 (B) a licensed health care practitioner designated by the 22 advanced nurse practitioner or pain management specialist. 23 (c) The consultation requirement under (a) of this section does not apply to 24 (1) the provision of palliative, hospice, or other end-of-life care; 25 (2) the management of acute pain caused by an injury or surgical 26 procedure; 27 (3) a patient who is following a tapering schedule; 28 (4) a patient who requires treatment for acute pain that necessitates a 29 temporary escalation in opiate dosage before an expected return to or below the 30 patient's baseline dosage; 31 (5) a situation in which the advanced nurse practitioner documents
01 reasonable attempts to obtain a consultation with a pain management specialist, and 02 the circumstances justify prescribing 120 milligrams or more a day of an opiate 03 without obtaining a consultation; 04 (6) a patient whose pain and function are stable and who is on a 05 nonescalating dose of an opiate; or 06 (7) the practice of an advanced nurse practitioner who is a pain 07 management specialist. 08 (d) The board shall adopt regulations that define the procedure for the board to 09 approve an advanced nurse practitioner as a pain management specialist. The 10 regulations must require the advanced nurse practitioner to have a 11 (1) certification in pain management care by a credentialing agency or 12 organization acceptable to the board; 13 (2) minimum of three years of clinical experience acceptable to the 14 board in a pain management care setting; or 15 (3) current practice at least 30 percent of which consists of the direct 16 provision of pain management care. 17 (e) In this section, 18 (1) "opiate" has the meaning given in AS 11.71.900; 19 (2) "osteopath" means a person licensed to practice osteopathy under 20 AS 08.64; 21 (3) "pain management specialist" means 22 (A) a physician, osteopath, or podiatrist approved as a pain 23 management specialist by the State Medical Board under AS 08.64.364; or 24 (B) an advanced nurse practitioner approved by the board as a 25 pain management specialist; 26 (4) "physician" means a person licensed to practice medicine under 27 AS 08.64; 28 (5) "podiatrist" means a person licensed to practice podiatry under 29 AS 08.64.