The following is an update from the Pennsylvania Medical Society, originally released on October 23, 2017.
Senate Bill 472, sponsored by Sen. Gene Yaw, passed the Senate (Y: 49/N: 0) on Oct. 18, 2017, and has been referred to the House Health Committee. The bill has, among other requirements, a seven-day limit on prescribing opioids.
This legislation is an extension of a measure approved last session that limited opioid prescriptions for minors to a seven-day supply. Since that time, efforts have continued to further restrict the number of opioids a prescriber can provide to patients, not just minors. Recently, we have been informed that several pharmacy benefit managers (PBMs) have instituted policies that set limits on opioid prescriptions.
Several exemptions are in SB 472, including:
- If the treatment is associated with an emergency.
- If, in the prescriber’s professional judgement, complying with the restriction would not be in the best interest of the patient’s health and safety to treat the patient’s acute medical condition. Documentation in the patient’s chart must appropriately reflect the prescriber’s rationale for noncompliance and why a non-opioid alternative was not appropriate to treat the acute medical condition.
- If the patient is admitted to a health care facility or remains in observation status.
- The prescriber is continuing a treatment initiated by another member of the prescriber’s practice, the prescriber who initiated the treatment followed the appropriate procedures, and the prescriber who is continuing the treatment is not changing the therapy in any way other than dosage.
- Prescription is for management of pain related to cancer.
- Prescription is for a patient in palliative or hospice care.
- Prescriber is managing a patient’s chronic pain not associated with cancer.
- The prescriber is required to discuss with patients, for whom an opioid prescription is given, the risks associated with opioids.
The Pennsylvania Medical Society will continue to advocate for physicians and for the physician/patient relationship as this bill moves through the legislature.