The recently-passed Michigan opioid and controlled substance legislation includes a requirement that a prescriber have a “bona fide” patient relationship with an individual prior to prescribing a controlled substance (“CS”) for that person, and includes some follow-up care requirements. In response to prescribers’ concerns about how to satisfy this requirement when covering their colleagues’ patients during off hours, or writing orders for home care or hospice patients, the Michigan legislature passed HB 5678, delaying the effective date of the requirement one year to March 31, 2019, or the earlier date on which LARA publishes rules regarding the requirement. The original legislation contains a provision permitting LARA, in consultation with the Boards of Medicine, Osteopathic Medicine and Surgery, Dentistry, Nursing, Optometry and Podiatry, and the Physician’s Assistant Task Force, to promulgate rules describing when a bona fide patient relationship is not required, and possible alternative requirements. The governor is expected to sign the legislation.
HB 5678 underwent several modifications during its short journey through the Legislature. In its original version, HB 5678 would simply have exempted prescriptions for hospice patients from the requirement. Another version would have modified the “full assessment” requirement, and permitted prescribers to delegate certain parts of the requirement to other providers licensed under the Article 15 of the Public Health Code. In the end, the Legislature decided not to change the bona fide prescriber-patient relationship requirement described in the statute, but delay its effective date until LARA could address prescriber concerns through rule-making in cooperation with stakeholder boards.
Look here for a summary of all of the new Michigan opioid and controlled substance legislation.