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Prescribing Rules and Guidelines

New rules governing opioid prescribing are now in effect for most prescribing professions in Washington state, including physicians and physician assistants, prompted by House Bill 1427 from 2017. Information on these state requirements, plus links to state and federal opioid prescribing guidelines, below.

Washington’s new opioid prescribing rules

New rules governing opioid prescribing, prompted by House Bill 1427 from 2017, are now in effect in Washington state. 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.

There are some differing requirements between Washington Medical Commission and the Board of Osteopathic Medicine and Surgery rulemaking. Prescribing clinicians are advised to review this Table of Differences from the Department of Health to understand the difference between professions.

WSMA resources

Preparing for New Opioid Prescribing Rules
Completion of WSMA’s one-hour webinar will fulfill the new state requirement for continuing medical education on opioid prescribing. This activity has been approved for AMA PRA Category 1 Credit™.

Preparing Care Teams for New Opioid Rx Rule
The WSMA has put together this customizable PowerPoint template to help practice leaders educate their practice care teams, regardless of size, on the new rules.

WSMA Pain Management Rule Requirements Checklist (Epic compatible)
This checklist can be used to build prompts into your electronic health record (e.g. Epic dot phrase) in order to adjust practice workflow. Or use this PDF checklist for manual use.

Other resources

Patient handouts (look under Public/Patient)

The Department of Health offers patient handouts for all categories of pain patients (chronic, surgical, acute, and subacute) to satisfy a new state requirement for prescribers to inform patients of the risks, safe storage, and safe disposal of prescription opioids.

More information on the new rules

The Washington State Department of Health opioid prescribing webpage.

The Washington Medical Commission rules overview and resources and rule text.

Board of Osteopathic Medicine and Surgery rules overview and resources and rule text.

State and federal prescribing guidelines

Washington Agency Medical Directors' Group prescribing guidelines and resources

CDC Guideline for Prescribing Opioids for Chronic Pain

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