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New laws will benefit patients, help you practice
e-Reports, June 24, 2013
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New laws will go into effect July 1; many concern your patients and the practice of medicine.

Here is a brief review of some of the most significant bills addressed by the ISMA this year.

HB 1182 – Physician Orders for Scope of Treatment
This new law presents one of the best examples of how resolutions form ISMA policy and direct ISMA legislative efforts.

The ISMA worked to put into legislation the concept of a physician’s order for scope of treatment (POST) form. The document will be a state-recognized form in full force and effect in any health care facility. Made in consultation with the physician, the form will carry the wishes of the qualified patient diagnosed with a terminal illness. It is a direct physician order that represents the patient’s wishes concerning hydration, nutrition, resuscitation and medical intervention.

Under the law, the Indiana State Department of Health (ISDH) will be required to develop the form and make it available on the ISDH website.

Pence signs POST
Gov. Mike Pence signs HB 1465 INSPECT Funding into law. Sitting left to right - Sen. Patricia Miller and Gov. Pence. Standing left to right - ISMA Director of Government Relations Mike Rinebold, Deputy Attorney General David Miller, Attorney General Chief of Staff Staci Schneider and Attorney General Greg Zoeller.

HB 1465 – INSPECT Funding
The idea for INSPECT, the Indiana Scheduled Prescription Electronic Collection and Tracking program, also began as a resolution. The program is a helpful tool in reviewing controlled substance prescription history on patients. However, budget issues threatened the continued funding of INSPECT, which recently received the national Administrators in Medicine Best of Boards award.

“Our foremost priority with this bill was to maintain current funding for INSPECT, but we also asked for increased funding to improve program infrastructure, so that INSPECT can be of even more value to more prescribers and pharmacists in our state,” explained Jerome Adams, M.D., an Indianapolis physician who testified in support of the bill. “I told our legislators that if we were serious about stopping opioid abuse, then we absolutely needed not just to continue but to increase funding for the INSPECT program.”

Now, the program will be funded by controlled substances registration fees, but the law also creates a summer study committee to consider enhancements and requirements.

Read more about INSPECT at in.gov.

Prepare now for CHIRP data requirement
If you administer immunizations to children, you will be required  by July 1, 2015, to enter that data in the web-based Children and Hoosiers Immunization Registry Program (CHIRP). The requirement was signed into law last month.

To help you comply, the Indiana State Department of Health is hosting monthly webcasts every third Tuesday of the month at 11 a.m. EDT. The forums allow you to ask questions, seek assistance and make suggestions for enhancements to CHIRP.

Join the live webcast by clicking on the Live Videos button.The webcasts also are archived at the CHIRP website. Select Most Recent Webcast.

For additional information, call (317) 233-8828 or (800) 701-0704.

SB 246 – Controlled Substances
As a result of this new law, the ISMA will begin working with the Medical Licensing Board (MLB) of Indiana to help draft the state’s first comprehensive pain management rules.

“Movement of the bill to the medical licensing board permits us to create a standard template applicable for all physicians for appropriate patient selections, prescribing and patient monitoring rules, including use of INSPECT,” noted Michael Whitworth, M.D., chairman of the Indiana Pain Society.

The rules will address MLB procedures and protections for physicians.

“All Indiana physicians who prescribe opioids will have parameters and guidelines under which to operate,” said Dr. Whitworth, an ISMA member. “This will permit us to tailor our practices to appropriate prescribing, as laid out in advance by the medical licensing board.”

In July, the MLB will hold hearings on the emergency proposed rules for prescribing controlled substances. The MLB will vote by its October meeting to adopt the rules that will become effective Nov. 1, 2013. Final rules must be adopted and signed by the governor by Nov. 1, 2014.

HB 1099 – Physician Assistants (PAs)
If you practice in an underserved area, this law may help you deliver care. It provides new supervisory definitions as follows:

  • PAs who meet certain practice requirements may prescribe scheduled II controlled substances; PAs, under their supervisor’s authority, already may prescribe controlled substances.
  • The bill clarifies existing law regarding the supervising physician’s delegation to a PA to prescribe a controlled substance for an aggregate 30-day supply.
  • A physician may supervise no more than two PAs on active duty at the same time, but the physician may employ more than two, allowing for more options when hiring PAs.

HB 1135 – Midwives
Opposed by the ISMA, this law requires midwives to obtain a certified direct entry midwife (CDEM) accreditation, regulated by the MLB.

Among other requirements, midwives must have additional education, such as an associate’s degree in nursing or other science-related associate’s or bachelor’s degree from a postsecondary educational institution. A CDEM must agree to be supervised by a physician, with their agreement updated annually and made available to the MLB upon request.

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