The Indiana Medical Directors Association (INMDA) is a professional association of medical directors and physicians practicing in the long term care continuum dedicated to excellence in patient care.
On this site, INMDA will post original materials along with links to existing resources, tools, articles and legislative information designed to advance our mission to improve patient care and promote the professional development of long term care practitioners. INMDA members are encouraged to submit non-commercial, long term care related items which they feel should be shared with our members.
Indiana University's "Sound Medicine" Interviews INMDA's Arif Nazir, MD, CMD
To access the Indiana University audio digest recording, on "Misleading Nursing Home Report Cards" click the following link:
DEA Issues Statement on Authorized Agents for Schedule III-V Controlled Substances
The Drug Enforcement Administration (DEA) issued a 5-page Statement of Policy on the Role of Authorized Agents in Communicating Controlled Substance Prescriptions to Pharmacies at http://edocket.access.gpo.gov/2010/pdf/2010-25136.pdf. The DEA Statement provides an example of a written agreement that would confer authority to an agent to act on behalf of an individual practitioner with regard to controlled substance prescriptions. In the Statement, the DEA states "where a DEA-registered individual practitioner has made a valid oral prescription for a controlled substance in Schedules III-V by conveying all the required prescription information to the practitioner's agent, that agent may telephone the pharmacy and convey that prescription information to the pharmacist." This does not apply to Schedule II controlled substances. The Statement adds "An agent may not call in an oral prescription for a Schedule II controlled substance on behalf of a practitioner even in an emergency circumstance."
Individual practitioners may choose to designate and authorize one or more persons at one or more locations within or outside their practice to act as their agent. Likewise, an individual may act as an authorized agent for multiple individual practitioners depending upon the circumstances. A sample agreement designating the agent of practitioner for communicating controlled substance prescriptions to pharmacies is provided in the Statement.
AMDA staff is reviewing the Statement and will publish more details shortly. In addition, AMDA continues to partner with other associations to provide guidance to our respective memberships.
To read the DEA Statement, click here.
Impact of Health Care Reform Law on Long-Term Care
On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (H.R.3590) into law. The comprehensive health care reform bill was passed by the House of Representatives on March 21, 2010, and by the Senate on December 24, 2009. The bill fails to address the upcoming 21% physician pay cuts that are scheduled for April 1, 2010, however, Congressional leaders have agreed to continue working on the issue after health care reform legislation is final. As of March 25, the Senate was still deliberating the changes that House of Representatives passed that amended H.R.3590. Depending on whether the Senate can pass the amendments without any changes, it will be signed by the President. If they make any changes to the amendments, it will go back to the House of Representatives for another vote. As it currently stands and is likely to remain, the bill contains many provisions the affect long-term care. (Click here to read more and to download PowerPoint presentation by Dr. Nazir, INMDA President).
Free Resource: Tip Sheet on Controlled Substance Prescribing in LTC
Medical societies seeking to ensure compassionate and high quality care for long term care patients joined together to develop a "Tip Sheet on Prescribing for Controlled Substances in Long Term Care." The document is designed to assist physicians and other prescribers in their efforts to ensure proper controlled substances prescribing in long term care, and deal with aggressive enforcement actions by Drug Enforcement Administration agents. View Tip Sheet