2016 Public Policy Agenda for Georgia Pharmacists

There are three public policy goals the Georgia Pharmacy Association has identified for 2016, based on responses to a questionnaire given by member pharmacists. Those three areas include (1) changes to Georgia's prescription drug monitoring program, (2) clarifying the role of the pharmacist to patients taking legal cannabis oil in Georgia, and (3) defining the term "direct supervision" in reference to pharmacy technicians.

1. Georgia's Prescription Drug Monitoring Program

In 2011, Georgia became one of the last states in the nation to implement a prescription drug monitoring program (PDMP) as part of the Patient Safety Act. While the program has already helped tremendously in several areas, and addiction rates to lortab, oxycodone, and hydrocodone have dramatically decreased over the past five years, there are other areas in which the PDMP requires critical overhaul. It is particularly addled by funding concerns, limitations on access, and open communications.

a. Funding Issues

The PDMP was initially funded in 2013 through a $400,000 grant from the Bureau of Justice Assistance, so there was no cost to the state of Georgia. Through lean budgeting and a small staff, that money was made to last through September of 2015. The Georgia legislature did approve an additional $250,000 in funding in March of 2015 to keep the PDMP operational, but what happens when that funding runs out? The Georgia Pharmacy Association favors a permanent solution of state funding of $200,000 to $250,000 annually, rather than federal funding through the Bureau of Justice Assistance, which comes with federal reporting requirements.

b. Access Limitations

Currently, only pharmacists are required to enter Schedule II prescriptions into PDMP; accessing the system is voluntary for physicians. This means that patients are still falling through the cracks. The Georgia Pharmacy Association advocates allowing both doctors and pharmacists to delegate responsibility for entering prescriptions into the PDMP, not allowed under the current version of the law.

c. Communication Problems

Georgia law prevents pharmacists and doctors from communicating without court order; this works as a detriment to the goal of identifying those with drug seeking behavior. At the time the law was passed, lawmakers were very concerned with patient privacy issues. Neighboring states allow doctors and pharmacists to see patient records across state lines; the Georgia Pharmacy Association will urge Georgia to do the same by building interoperability into the PDMP.

2. The Role of Georgia Pharmacists with Cannabis Oil

While still illegal under federal law, it is now legal for some Georgia residents to possess cannabis oil. However, there is not currently any role for the pharmacist regarding patients taking cannabis oil. The Georgia Pharmacy Association advocates pharmacist involvement, not pharmacy employment. This means that instead of suggesting cannabis oil be sold through existing pharmacies, will advocate a position that all those who sell cannabis oil in Georgia must employ a pharmacist, to review the use of cannabis oil after reviewing the patient's medication profile, advising on side effects and contraindications, and ongoing monitoring for effectiveness.

3. Supervision of Pharmacy Technicians

The final area of legislative focus for the Georgia Pharmacy Association relates to the supervision of pharmacy technicians. Georgia law requires that pharmacists be present and personally supervise the activities of technicians at all times. A strict interpretation of these laws really makes the supervision laws impossible to comply with, so the Association will be looking to revise the language of the existing laws to allow pharmacists to perform the core functions of their jobs without breaking the law.

CONCLUSION

While those are the three legislative priorities outlined this year by the Georgia Pharmacy Association, they are also continuing to work towards longer term goals, the most important being the continued pursuit of full health care provider status for Georgia pharmacists; with a focus on medically underserved communities. Another long-term focus of the Association is the prior authorization requirements of some insurance companies before a new prescription can be filled; particularly with Medicaid patients. The Association will pursue the implementation of real-time prior authorization systems, so there are no lapses in patient medication. The Georgia Pharmacy Association identifies collaborative practice agreements as a third long term goal, and particularly some clarifications in the language of the rules related to immunization expansion.

With those short term and long term goals identified for 2016, it looks to be one with many positive changes for pharmacists on the horizon. If you are a licensed pharmacist in Georgia and would like more information on Georgia law governing pharmacists, contact the experienced healthcare attorneys at Levy Pruett Cullent today.

New Professional Conduct Rules

New Professional Conduct Rules: Georgia Medical Board Requires Chaperones During Certain Physical Examinations

As of May 2016, it is a violation of professional conduct for a medical professional to perform a "physical examination of the breast and/or genitalia of a patient of the opposite sex without a chaperone present." For all other examinations, a chaperone is suggested but not required. The board recommends that a chaperone be a health professional, but this is not a requirement. It is also important to note, that even though a chaperone is required for the exam, the patient and physician should be allowed an opportunity for private conversations.

SHOULD I ALWAYS PROVIDE A CHAPERONE EVEN IF THE EXAM FALLS OUTSIDE OF THE SCOPE OF RULE 360-3-.02(12)?

The Board does not require a physician to utilize a chaperone if the patient is not of the same sex or if the exam is not a breast or genital exam. Further, the physician will not be penalized for refusing to provide a chaperone if the exam does not fall within the rules' guidelines, even if the patient specifically requests one. So, should you always provide a chaperone?

If we know one thing about today's understanding of gender, it's that there is a growing trend to upend typical/binary gender identities. You've most likely seen heated discussions about transgender bathrooms, and Georgia is no stranger to its own debates regarding the matter. Regardless of how your beliefs relate to this ongoing conversation, your license could depend on being 100% sure of a person's gender, despite how they define themselves, before performing an exam upon the patient's breast or genitalia. Violation of this rule can result in license revocation, suspension, fines and/or reprimands of a physician or a physician's assistant.

Where the nature of the examination does not bring Rule 360-3-.02(12) strictly into play, the Medical Board does make recommendations based on the spirit of the rule. The Medical Board suggests consideration of the following in determining if a chaperone is required. The Physician should:

• Respect the patient's dignity
• Maintain a positive atmosphere
• Encourage patients to request chaperones through clear signage or a conversation
• Honor patient requests to have a chaperone
• Provide clear explanations of exam components
• Provide dressing gowns with full coverage
• Provide a private room for changing

Some of these suggestions may seem obvious, but they do give good indication of the Board's intended purpose.

HOW DO I MAKE SURE I AM ADHERING TO CURRENT PROFESSIONAL CONDUCT RULES IN THE STATE OF GEORGIA?

Seemingly, there are three ways to approach the new rule and the added guidelines provided by the Georgia Composite Medical Board:

1. You could choose only to provide a chaperone for exams involving the breasts or genitalia of the opposite sex but not the same sex;

2. You could choose only to provide a chaperone for exams involving the breasts or genitalia of the opposite sex and provide chaperones for the same sex only if requested or;

3. You could choose to provide chaperones for all patients, regardless of sex, if the exam falls under the Rule 3603-.02(12) requirements.

It seems like an easy answer, but at Levy Pruett Cullen, we know these issues are not black and white. Office dynamics and economics often play out in different ways and what seems like the obvious, failsafe route, may not be your best approach. Our office provides specialized knowledge that works for you. All choices are not created equal, but we have the experience and expertise to help you make the choice that is right for you. It is never too early or too late to contact us.

New Drug Monitoring Program

Georgia Professionals - Keep an Eye on New Drug Monitoring Program

No one will make headlines by claiming that we have a prescription drug problem throughout the country. The issue is already well-known, and solutions to address the problem are myriad. Professionals like doctors and pharmacists are often caught in the middle, sometimes accused of enabling those addicted to these drugs by provided continued access via subscriptions.

Yet, those accusations typically ignore the immense challenges faced by healthcare providers when trying to navigate the complex rules and regulations related to drug monitoring. Luckily, upcoming changes to Georgia monitoring rules will provide more flexibility for professionals and an increase of information on state prescriptions, hopefully leading to a decrease in abuse.

THE PRESCRIPTION DRUG MONITORING PROGRAM (PDMP)

Like virtually all other states, for several years Georgia has had an active state database that monitors prescriptions of certain highly addictive drugs, like oxycodone and hydrocodone. The idea is that the database can raise red flags if suspicious prescriptions are given to a single individual-allowing closer investigation to determine if the patient is abusing the drugs. But the program is not without its flaws.

In Georgia, this Prescription Drug Monitoring Program (PDMP) is under the purview of the Georgia Drugs and Narcotics Agency, and even the head of the agency admits that there are many gaps in the current program. Critics argue that the current rules are too restrictive, severely limiting who can view the database and handcuffing those individuals from warning others about the information contained in the PDMP.

CHANGES TO THE LAW

The Georgia legislature recently updated the law to address many of those problems. The new rules are set to take effect this month, in July 2016, and it is critical for doctors, pharmacists, and other professionals to understand the changes. Some important updates include:

• Licensed staff can now view the PDMP. Under older rules, only actual doctors and pharmacists could look at the data. This created a logistical issue, as busy professionals had to leave patients to physically view the files. The task of checking the PDMP to flag for potential addiction can now be given to others within an office.

• Drug data will be tracked for two years. Previously, data was only tracked for a single year. The increased time frame will provide a larger set of information to help detect more potential problems.

• Law enforcement will have increased access to the PDMP. In the past, officers were required to have a search warrant to view the data. That requirement was a tough burden that limited when law enforcement agencies could realistically act on the warnings of doctors and pharmacists.

Lawmakers and safety advocate admit that an underlying goal of the new law is also to increase actual use by medical professionals in the state. Early estimates suggest that only about 25% of state doctors have set up an account to use the PDMP. Use of the PDMP is not mandatory, and the new law will not change that. However, the loosening of the restrictions may prompt more medical offices to take advantage of the features.

Contact a Georgia Professional Defense Attorney

If you have questions about how this law may affect your practice, be sure to reach out to legal professionals. Our team at Frances Cullen, P.C. provides experienced defense services and counsel to licensed professionals throughout Georgia in all administrative and criminal matters. Contact us today to see how we can help.

Why Choose Levy Pruett Cullen to Help Defend Your Professional License

 

At Levy Pruett Cullen, we are problems solvers. We're very good at looking at a case. We try to take our time initially and really evaluate the case and determine what the best solution is and try to get there in the most expeditious way possible.

Most individuals who are facing a licensing case or a criminal matter or any kind of issue that can threaten their professional livelihood are uncertain and that is very hard to live with. Sometimes it takes a while to resolve these cases - it doesn't require lots of what I call running in circles - what we try to do is look at the best way to resolve a case but also search for the most straightforward solution instead of trying to jump through too many hoops to reach our goal. We work well with others. I think that's our other strength. We have a lot of resources in the community.

Our attorneys have 25_ years of experience and can avail ourselves of resources on both the prosecutorial and defense counsel. We also have the health care resources to aid our clients in reaching their ideal goal. Give us a call today.

Pharmacy Law Explained

Levy Pruett Cullen represents pharmacists, pharmacies, and pharmaceutical companies seeking to become licensed in the state of Georgia. We have represented numerous pharmacists and pharmacies regarding misfilled prescriptions, compounding errors, failing reports on pharmacy audits, licensure issues of varying degrees as well as several out of state pharmacy seeking to become licensed in the state of Georgia.

Pharmacy law is extremely complicated. It involves state and federal laws those rules including rules governed by the federal agencies and state agencies. It also involves work with the Georgia Board of Pharmacy, the Drug Enforcement Agency and Georgia Drugs and Narcotics. We have worked with all of these agencies and have contacts with all these resources to help resolve these kinds of issues. We've worked closely with pharmacists and pharmacies here in the state of Georgia but have also worked extensively with out-of-state companies seeking to become licensed as a wholesaler or distributor here in Georgia. Because the laws and rules are complicated for seeking licensure it requires legal assistance. We can help pharmacists, pharmacies and out of state companies seeking to become licensed here with a host of issues.

We've also worked extensively with those who have failed to become licensed and become cognizant of that and are seeking to resolve that issue with the state of Georgia.

At Levy Pruett Cullen., we try to resolve those issues as quickly and as expeditiously as possible. Call us today!

Requirements for Professional Licensing or Renewal in Georgia

Many applicants for a license, and many licensees who have to meet certain requirements in the state of Georgia to maintain their license, do not meet all requirements. This may be because of past education that doesn't meet current requirements, or current issues that make it impossible to meet the educational requirement of maintaining a license or some other similar related issue.

At Levy Pruett Cullen, we've assisted numerous applicants in obtaining what's called a rule waiver or a variance so that they could become licensed in the state of Georgia. By doing this we use our expertise to demonstrate to the board that you are qualified to meet licensee's requirements even though you may technically fall short of a board rule requirement that would otherwise make you ineligible. We have done many of these board waivers and the variances to assist people to become licensed have been very successful with many of the people we've worked with. It may be the case that you cannot meet a current requirement to renew your license due to a medical issue or other issue wherein you can't meet an educational requirement for example we have worked with individuals and professionals where that's been the circumstance, and we have been successful in having them maintain their license with a rule waiver variance.

At Levy Pruett Cullen, we have the experience, we know how to address these issues. The above is the kind of legal issue that requires a legal professional. Don't take it lightly if you want to maintain your license and your livelihood. At Levy Pruett Cullen we can assist you with this. Call us today!

How Do Physicians Get Licensed in the State of Georgia?

At Frances Cullen P.C., we have represented a number of physicians who have had to take a hiatus from practice for several different reasons and are seeking to become licensed. In one case, I represented a physician who had not practiced for 25 years due to a past criminal conviction. We were able to work toward his goal of becoming licensed and he is now a physician practicing in the state of Georgia.

In another case, I represented a physician who had not worked as a doctor for over 10 years due to impairment issues. We successfully worked together to make sure that we were in the best position possible so that he could reach his goal of becoming a licensed physician again and working as a physician. We know how to handle these type issues. In terms of applicants, we've worked with many from out of state or foreigners who might not meet licensure requirements because of the changes in the licensing requirements over the years in the state of Georgia.

Changes in licensing requirements may often require the assistance of legal counsel due to certain forms that have to be provided and to also make sure that your application will stand out as cleanly as possible and put your best foot forward.

There's an expression that your first impression is your best impression. What we do in terms of applicant cases is make sure that the first impression is the one that the medical board is going to remember and the one that's going to take you through becoming a physician in the state of Georgia. We have worked through so many problems with physicians to obtain their goals and we can work with you to reach your goals.

At Frances Cullen P.C., we go straight to the heart of your matter and we help you achieve your goals. Contact an Atlanta healthcare law attorney today!

How to Report a Board Action to Another State?

As a professional licensing attorney I am often asked what to do about reporting a board action to another state or if you fail to report an action to another state. Each case is individual in making a decision as to how to proceed - on these kinds of issues it's very important to take the right steps if you have an action pending in a state that may have to be reported to other states or if you need to remedy the reporting of a past action that was not reported to another state.

Most states have laws or rules that require reporting of an action on one state to another state within 30 days. But these regulations vary, and have to be looked at individually. Moreover there could be penalties and severe consequences if you fail to report and then try to catch up. It is really best to have an attorney, who is familiar with these issues, look at this for you and do an assessment of what your case is; what needs to be reported; and how and when it should be reported.

You should also be aware that if you have multiple licenses and you have a case pending against you that there will be consequences in the other states that could result in what's called the reciprocal allocation or mirroring of the action that happened in the state where the issue is proceeding.

At our firm we are familiar with these kinds of actions. We have worked with numerous professionals to report actions that are imposed by a state licensing board to other states and to remedy the failure to report in other states. We are familiar with most of the other state laws, rules, and have worked to remedy those kinds of issues. If you need professional advice on this type of reporting, call an Atlanta healthcare attorney at Frances Cullen P.C. and seek legal advice if this is an issue that you're facing.

What Are The Two Types of Medicaid Fraud?

There are two types of medicare fraud cases. There are cases by service providers and those by medicare recipients. At Frances Cullen P.C. we represent healthcare providers and service providers of medicare services in seeking to defend them against potential investigations and actions brought by the state fraud medicaid control unit - also known as MFCU.

We have represented physicians, dentist, pharmacists, pharmacies, psychologists, speech pathologists, dentists and other healthcare providers with these kinds of claims and reached many good conclusions for our clients. Fraud is a crime and could potentially result in a criminal action, a criminal conviction and possible imprisonment. You need to take any potential investigation seriously and act quickly.

At Frances Cullen P.C. we have 25 years of legal experience in representing healthcare professionals and we can help to defend those kinds of actions. Our wide experience in both criminal cases and in medical review cases gives us a very strong background to defend these types of cases better than those who are dedicated to criminal defense only. We bring our medical background to your case as well as a criminal background and we will defend you honestly and efficiently. Give us a call today!

How Can Physicians Defend Themselves Against Peer Review Actions?

A peer review action can affect the rest of your life as a physician. This is something to take seriously. You also need to seriously consider complaints filed by other employees that may affect you because those are the kinds of things that can create a track record for you, and can result later in a peer review hearing.

It will be much harder if you have to defend against several issues rather than one issue. If you become aware that you're the subject of any kind of review action or that you have been asked to come to some kind of medical executive committee meeting, you need to call us right away.

You will need good sound advice on how to deal with these issues and how best to defend yourself. Often physicians think they're so smart that they can defend against these actions themselves and that they can explain away what occurred. It's often not that simple and it's often that there are other people who have gathered information that you may not be aware of. Legal intervention is the best way to address everything out there and define what it is that is really an issue in your case.

At Frances Cullen P.C., we work with numerous physicians to assist them in becoming credentialed at the facility of their choice and working through potential credentialing issues. In one case we worked with a physician where he had been suspended from his medical staff and that it had been reported to the national practitioner database. We were able to resolve that issue and to prove that the issue did not fit and shouldn't rise to the level of suspension and that the suspension was not warranted. We managed to make sure that the physician was placed back on medical staff and that the national practitioner database report was voided.

This is the kind of legal intervention that you need and you need it early on. Instead of waiting until something becomes a serious action that can affect you for the rest of your professional career, you need to reach out quickly and make sure that you address any potential issues. At Frances Cullen P.C. we can help defend against these potential actions. Contact us today.