New legislation affecting opioid prescriptions: What prescribers need to know

New legislation affecting opioid prescriptions is set to take effect.

Several pieces of legislation intended to reduce the improper prescription of opioids will go into effect over the next several months. These laws, the first of which goes into effect March 31, will impact the way Michigan Medicine providers prescribe opioids.

“The policy landscape around controlled substance prescribing is changing rapidly,” said Paul Hilliard, medical director for Michigan Medicine’s Institutional Opioid and Pain Management Strategy. “We are optimistic that these changes will help with the larger societal burden related to these medications, however, we will continue to deliver the highest standard of care for all of those who entrust us with their care. We will continue to update our providers as we learn more about how these laws will be interpreted.”

A summary of the new legislation appears below — however, many details are still under review, and the policy landscape continues to change rapidly. Visit the Pain Management website for updates as they become available. Click the “Summary of New Opioid Legislation” tab for more complete information on the legislation below.

The new legislation includes:

Public Act 247: Requires prescribers to have a bona fide relationship with the patient receiving a schedule II-V CS

Effective March 31

While no exceptions to a bona fide relationship were built into the act, the Michigan Department of Licensing and Regulatory Affairs (LARA) will accept proposed exceptions for one year in consultation with interested parties (State Boards). Michigan Medicine has several questions regarding how this act impacts refills and geographically-distant patients and is currently seeking further clarification from the state.

Public Act 248: Mandatory checking of the Michigan Automated Prescription System (MAPS) prior to writing more than three days of a DEA schedule II-V controlled substance

Effective June 1

Providers who prescribe opioids and are not registered on the MAPS system should register as soon as possible. Newly-registered users will receive an email from MLearning confirming registration status. Michigan Medicine is currently working to integrate MAPS into MiChart. More information and exemptions are available on the Pain Management website.

Public Act 246: Parental consent for opioid prescription

Effective June 1

Providers will be required to obtain parental consent with a signature before minors are prescribed controlled substances containing opioids. The prescriber is required to discuss addiction and overdose risks with both the minor and the parent/guardian. A mandatory “Start Talking Consent Form” (currently under development by the state) will be required, as well as a file in the medical record.

Public Act 251: Prescribing limits for opioids

Effective July 1

Patients under treatment for acute pain may not be prescribed more than a seven-day supply of an opioid within a seven-day period. Michigan Medicine recognizes the challenges this may provide regarding specific patients, such as those who undergo extensive surgery or those with high co-pays, and is seeking further clarification from the state.

Questions about how the new opioid legislation will affect Michigan Medicine? Contact Pain Management at  UMHS-Pain-Management@med.umich.edu. Recurring/frequently-asked questions will be posted to the Pain Management website.