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November 28, 2018

New opioid prescribing rules: Start preparing today

New opioid prescribing rules for Washington state prescribing professions, prompted by House Bill 1427 and shaped by more than a year of stakeholder input, have been adopted. The following guidance from the WSMA can assist members, both physicians and physician assistants (allopathic and osteopathic), in understanding, preparing for, and succeeding under these new requirements.

The comprehensive rules represent a significant change in how opioids are prescribed. Key provisions applicable to all prescribing physicians and PAs include:

  • A seven-day pill limit for acute prescriptions and 14 days for acute operative pain, with an exemption to these limits when clinical judgment is documented in the medical record.
  • A specific care plan and documentation requirements for each phase of pain.
  • Mandated registration and targeted checks of the prescription drug monitoring program.
  • Required continuing medical education on opioid prescribing.

As the state's regulatory bodies adopted under their own authority, there are several differences between the rules for each profession. For allopathic physicians and physician assistants, the new prescribing rules go into effect Jan. 1; new rules for osteopathic physicians and PAs went into effect on Nov. 1. For more on the differing requirements between Washington Medical Commission and the Board of Osteopathic Medicine and Surgery rulemaking, see this Table of Differences from the Department of Health.

How to prepare:

  • Register to attend WSMA's free one-hour webinar, Understanding New State Opioid Prescribing Rules, on Wednesday, Dec. 19, noon–1 p.m., designed to help you understand how to comply with the new requirements. Register for the webinar online. This activity has been approved for AMA PRA Category 1 Credit™. Attendance will fulfill the new state requirement for continuing medical education on opioid prescribing.
  • Set up your account with Washington state's prescription monitoring program, Prescription Review. Prescription Review uses a secure platform to allow a prescribing physician to access crucial patient information before prescribing, such as duplicate prescribing, misuse, drug interactions, and other potential concerns. Don't wait until the last minute—get started today setting up your account. The DOH website has a section with instructions for physicians, including video tutorials.

Also: The WSMA has joined the Washington State Hospital Association to reach out to hospital and health system leaders, encouraging them to work with their IT departments to build edits and prompts into electronic health records that assist clinicians with compliance under the rules.

For more information on the new rules and other WSMA efforts to assist physicians and other clinicians with safe opioid prescribing, visit the WSMA's Opioid Clinical Guidance webpage.

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