Beginning April 1, 2015, new law will require Ohio prescribers to obtain an Ohio Automated Rx Reporting System (“OARRS”) report before prescribing or dispensing either an opioid analgesic or a benzodiazepine. For physicians, this new law is an additional requirement beyond those in the existing OARRS “red-flag” regulations established by State Medical Board of Ohio in November of 2011. 1
Ohio House Bill 341, one of a number of prescription drug related bills passed in 2014, comes into full effect on April 1, 2015. The requirements from this legislation expand Ohio law and will apply to all Ohio prescribers (physicians, podiatrists, dentists, advance practice nurses and physician assistants who hold certificates to prescribe, and optometrists holding therapeutic pharmaceutical agents certificates).
When are OARRS checks mandatory?
The mandatory OARRS checks under the new law are to be conducted: 1) before initial prescribing or dispensing the opioid analgesic or benzodiazepine; and 2) at least every 90 days after the initial report is requested if the patient’s therapy with an opioid analgesic or benzodiazepine continues for more than 90 days.
What must be documented?
The additional provisions of the new law require the OARRS report to cover at least the previous 12 months and that the patient’s medical record includes documentation that the OARRS report was received and assessed. Another new Ohio law, Senate Bill 276, effective March 19, 2015, clarifies existing law by permitting the OARRS report to be maintained in a patient’s medical records.
Border county prescribers must check neighboring state prescriptions through OARRS as well.
Under the new law, Ohio prescribers who practice primarily in an Ohio county that adjoins another state must also request the adjoining state’s prescription drug information through OARRS. Presently, this additional requirement only impacts those prescribers primarily practicing in Ohio counties that border Kentucky, West Virginia, Michigan, and Indiana, as Pennsylvania does not currently have a prescription monitoring program.
Exceptions to the new law.
- While the reach of the new law is broad, there are exceptions to the mandatory checks which apply:
- when treating hospice patients or the terminally ill;
- when treating acute pain resulting from a surgery or other invasive procedure or a delivery;
- when treating cancer or another condition associated with cancer;
- when treating patients in a hospital, nursing home, or residential care facility;
- when the amount of the drug furnished does not exceed a 7-day supply; and
- when OARRS is not available for use.
Failure to comply will be grounds for discipline.
The new law also makes the failure to obtain a mandatory OARRS report a ground for disciplinary action by each of the licensing boards which have oversight of Ohio prescribers - the Ohio State Dental Board, the Ohio Board of Nursing, the Ohio State Board of Optometry, and the State Medical Board of Ohio.
In light of Ohio’s current regulatory climate and the attention that is being given to prescription drug utilization, abuse and diversion, it is likely that compliance with these mandatory OARRS checks will be a priority. Ohio prescribers and their employers need to be prepared for these new requirements.