Experts say our nation is entrenched in an opioid epidemic. Law enforcement agencies, the Texas legislature, and the Texas Medical Board (TMB) are heavily focused on addressing the epidemic.
Last year the TMB implemented new rules regarding pain management clinics and utilization of opioid antagonists. The TMB enforces its stringent regulations on medical professionals who prescribe opioids to their patients.
Clarifications Regarding Opioid Prescribing for Texas Doctors
Changing regulations, strict prescribing guidelines, and heightened scrutiny puts Texas physicians and other providers with prescribing authority at risk of licensing issues with TMB. In an effort to clear confusion, TMB President, Dr. Sherif Zaafran, M.C., FASA, published key clarifications regarding opioid prescribing in the TMB Bulletin December 2018.
2016 CDC Guidelines for Prescribing Opioids for Chronic Pain
In 2016, the Centers for Disease Control (CDC) issued guidelines for prescribing opioids for chronic pain. The medical community and patients voiced concerns that the CDC guidelines, if misapplied, could harm patient care and create unnecessary barriers for chronic pain patients.
Dr. Zaafran states that the CDC guidelines are "directed at primary care clinicians treating chronic pain patients in outpatient settings." The CDC guidelines are not intended for specialists who should already be appropriately managing their patients for pain, or for patients in hospice, palliative, or end-of life care, or cancer patients.
TMB Enforcement of Proper Prescribing Practices
"When it comes to the Medical Board’s enforcement of proper prescribing practices, the standard of care, along with applicable Board rules (Chapter 170 and 195) and laws are going to supersede suggested guidelines." TMB Bulletin December 2018. Dr. Zaafran emphasis the responsibility of physicians to closely monitor therapeutic opioid treatment and evaluate the patient on an ongoing basis. The federal guidelines do not require tapering of opioids; however, the CDC states that if the benefits of ongoing opioid therapy do not outweigh the potential harms of continued use, then other therapies should be utilized and clinicians should work with patients to lower dosages, taper, or discontinue opioid use over time.
TMB’s Use of Prescription Monitoring Program (PMP)
Under Texas law, the TMB and the Texas State Board of Pharmacy work together "to identify prescribing practices that may be potentially harmful and patient prescription patterns that may suggest drug diversion or drug abuse."
In furtherance of this mandate, the TMB compiles a list of the Top 50 hydrocodone prescribers in Texas every quarter. The Bulletin states that "no automatic enforcement action occurs simply from appearing on the list." There are numerous legitimate reasons why a provider would be a top prescriber, such as working in hospice care.
Heightened Scrutiny for Opioid Prescribers
The elevated focus on opioid prescribing by Texas doctors increases the likelihood that providers who have done nothing wrong, broken no rules will become targets of TMB investigations. Further, stringent regulations are imposed at the State and federal level, creating a greater risk that a provider may unwittingly run afoul on an obscure or misunderstood rule.
Targeted by the Texas Medical Board
If you are a physician or licensed health care provider being targeted by the Texas Medical Board for violations of Texas Medical Practices Act or other alleged malfeasance regarding your medical license, contact the medical license defense attorneys of BERTOLINO LLP.
Do not let the increased scrutiny of doctors treating patients in need of therapeutic opioid treatment jeopardize your Texas medical license.
The attorneys at BERTOLINO LLP know how to build a compelling case to protect your license. We know how to navigate the TMB enforcement process, gather evidence, question witnesses, show a proactive approach toward compliance, and prepare powerful defenses against allegations of misconduct.
BERTOLINO LLP represents licensed professionals across the entire State of Texas. If you are facing disciplinary action from a professional licensing board, contact us today or call (512) 717-5432 and schedule a case evaluation.
Follow BERTOLINO LLP on Facebook!
View free videos & subscribe to our YouTube channel!
Get a copy of Tony R. Bertolino's #1 Bestselling book When Your License is Under Attack: A Survival Guide for Texas Professionals in hardcover or for Kindle here.