Thank you for taking action and contacting the Michigan Licensing and Regulatory Affairs Agency (LARA) and your lawmakers to share concerns with the potential ramifications of the statutory definition of "bona fide prescriber-patient relationship" required when prescribing controlled substances, if it were to take effect as currently written. We've seen progress on this issue. On Wednesday, June 13, 2018, the Michigan Board of Pharmacy adopted Administrative Rule 338.6161a(3) with language reflecting the recommendations submitted by MSMS and other health care stakeholders. The language seeks to address concerns that have been raised, including the ability to provide quality care to patients during situations in which a prescriber is providing coverage for an unavailable colleague, another licensed member of the health care team has evaluated the patient, there is a transition of care from one setting to another, or a medical emergency. To ensure this issue is resolved without needlessly interrupting patient care or adversely impacting professional licensing, MSMS and other partners requested that LARA consider language recognizing that, in certain scenarios, an in-person/telehealth medical evaluation may be repetitive, impractical or an impediment to the timely delivery of care to a patient. The MSMS proposal would effectively deem that in the circumstances outlined above a bona fide relationship exists given the acting health care professional provides documentation in the patient's medical record in accordance with medically accepted standards of care.
The "bona fide prescriber-patient relationship" for prescribing controlled substances was originally defined in Public Act 247, part of a package of opioid bills signed into law in December 2017. Thankfully, earlier this year, the legislature took steps to delay the implementation of the law until March of 2019, instead requiring LARA to promulgate rules providing for exceptions when the relationship would not apply. With the Michigan Board of Pharmacy's approval of the new language, the next step in the rules process will be consideration by the Legislature's Joint Committee on Administrative Rules (JCAR). In light of the legislature's adjournment for the summer, no further action on the rule is anticipated prior to the fall.
MSMS will keep you apprised of future action on this important item.