MBML Updates Prescribing Rules

By Ryan Kelly –

You may have noticed previous posts from the MRHA regarding the Mississippi Board of Medical Licensure’s prescribing updates.  The Board met on Thursday, February 1st to finalize recommendation and provide extra clarity for comments made during the open comment period.

View Proposed Rules (updated 2.15.2018)

The overall goal of these rules is to curb the epidemic of opioid prescriptions in Mississippi.  It is estimated that more than 200,000 Mississippians are addicted to some form of opioid medication.  That is roughly 6.7% of our state’s population!

The regulations took meaningful but radical changes to prescribing regulations, primarily focused on opioid and benzodiazepine medications.  The number of changes are too numerous to include in this post, but you can find a white paper published by the MRHA on the rules by clicking here.

The board clarified many of the comments that we sent during the open comment period during their meeting on February 1st.  Those include the following:

• ADHD medication prescriptions do not require the use of the Mississippi Prescription Monitoring Program (MPMP)
• In Rule 1.7H, providers may issue a 10 day supply of opioid medication with an optional 10 day refill before a new script is made.  The new script may also include a 10 day supply with a 10 day refill, in perpetuity.  This does require strong documentation, however, and use of the MPMP.
• Point of Service drug testing for opioid and benzodiazepine prescription requirements are changed to CDC recommendations, which requires that they are performed no less than 3 times per calendar year.
• In Rule 1.11, telemedicine services and co-providers can both satisfy requirements for refilling and writing scripts for fellow providers.  Additional clarity on this is needed and may be reflected once the final text is posted.
• Addition of language from Rule 5.5 within Rule 1 to restate the availability of telehealth to satisfy the “physical exam” requirements set forth in Rule 1

Other Considerations

At this same meeting, the Mississippi Board of Medical Licensure addressed telehealth and scope of practice items, including:

• Mississippi officially being confirmed in the telehealth compact…we are now officially a state of primary licensure for telehealth
• Consideration of expanding tele-emergency offerings to both Level 1 and Level 2 trauma centers
• Refined definition of primary care to include family practice, general medicine, and pediatrics
• Expansion of physician / nurse practitioner collaboration to be with unlimited geographical distance within Mississippi for the definition of primary care collaboration mentioned above

Overall, the Board’s effort to refine the definition and intent of the rules and provide needed clarity is appreciated.  With this clarity, providers should have additional confidence in moving forward with prescribing medication to their patients in Mississippi.

Hopefully, our next step as a state will be to determine the best course of action for rehabilitation and detoxification of patients suffering from opioid addiction.