As Reported by the House Health, Retirement and Aging Committee 1
122nd General Assembly 4
Regular Session Sub. H. B. No. 187 5
1997-1998 6
REPRESENTATIVES THOMAS-VAN VYVEN-BRADING-TAYLOR-TERWILLEGER- 8
MYERS-MOTTLEY-GARCIA-HARRIS-CORBIN-LEWIS-OPFER-O'BRIEN- 9
GRENDELL-LUCAS-BENDER-FORD-OLMAN-FOX-TAVARES-LAWRENCE- 10
THOMPSON-PRENTISS-LOGAN-BOYD-VESPER-WILLIAMS-PATTON 11
13
A B I L L
To enact sections 4731.052 and 4731.283 of the 15
Revised Code regarding the authority of 16
physicians to prescribe, dispense, and 17
administer dangerous drugs for management of 18
intractable pain. 19
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 21
Section 1. That sections 4731.052 and 4731.283 of the 23
Revised Code be enacted to read as follows: 24
Sec. 4731.052. (A) AS USED IN THIS SECTION: 26
(1) "DANGEROUS DRUG" HAS THE SAME MEANING AS IN SECTION 28
4729.02 OF THE REVISED CODE.
(2) "INTRACTABLE PAIN" MEANS A STATE OF PAIN THAT IS 30
DETERMINED, AFTER REASONABLE MEDICAL EFFORTS HAVE BEEN MADE TO 31
RELIEVE THE PAIN OR CURE ITS CAUSE, TO HAVE A CAUSE FOR WHICH NO 33
TREATMENT OR CURE IS POSSIBLE OR FOR WHICH NONE HAS BEEN FOUND. 34
(3) "PHYSICIAN" MEANS AN INDIVIDUAL AUTHORIZED UNDER THIS 36
CHAPTER TO PRACTICE MEDICINE AND SURGERY OR OSTEOPATHIC MEDICINE 37
AND SURGERY. 38
(B) THE STATE MEDICAL BOARD SHALL ADOPT RULES IN 41
ACCORDANCE WITH CHAPTER 119. OF THE REVISED CODE THAT ESTABLISH 43
STANDARDS AND PROCEDURES TO BE FOLLOWED BY PHYSICIANS IN THE 44
DIAGNOSIS AND TREATMENT OF INTRACTABLE PAIN, INCLUDING STANDARDS 45
FOR MANAGING INTRACTABLE PAIN BY PRESCRIBING, DISPENSING, OR 46
2
ADMINISTERING DANGEROUS DRUGS IN AMOUNTS OR COMBINATIONS THAT MAY 47
NOT BE APPROPRIATE WHEN TREATING OTHER MEDICAL CONDITIONS. IN 48
DEVELOPING THE RULES, THE BOARD SHALL CONSULT WITH AND PERMIT 49
REVIEW BY PHYSICIANS WHO ARE EXPERIENCED IN THE DIAGNOSIS AND 50
TREATMENT OF INTRACTABLE PAIN. 51
(C) WHEN A PHYSICIAN DIAGNOSES AN INDIVIDUAL AS HAVING 54
INTRACTABLE PAIN, THE PHYSICIAN MAY TREAT THE PAIN BY MANAGING IT 55
WITH DANGEROUS DRUGS IN AMOUNTS OR COMBINATIONS THAT MAY NOT BE 56
APPROPRIATE WHEN TREATING OTHER MEDICAL CONDITIONS. THE 57
PHYSICIAN'S DIAGNOSIS SHALL BE MADE AFTER HAVING THE INDIVIDUAL 58
EVALUATED BY ONE OR MORE OTHER PHYSICIANS WHO SPECIALIZE IN THE 59
TREATMENT OF THE AREA, SYSTEM, OR ORGAN OF THE BODY PERCEIVED AS 60
THE SOURCE OF THE PAIN. THE PHYSICIAN'S DIAGNOSIS AND TREATMENT 61
DECISIONS SHALL BE MADE ACCORDING TO ACCEPTED AND PREVAILING 62
STANDARDS FOR MEDICAL CARE. THE PHYSICIAN SHALL MAINTAIN A 63
RECORD OF ALL OF THE FOLLOWING:
(1) MEDICAL HISTORY AND PHYSICAL EXAMINATION OF THE 65
INDIVIDUAL;
(2) THE DIAGNOSIS OF INTRACTABLE PAIN, INCLUDING SIGNS, 67
SYMPTOMS, AND CAUSES; 68
(3) THE PLAN OF TREATMENT PROPOSED, THE PATIENT'S RESPONSE 70
TO TREATMENT, AND ANY MODIFICATION TO THE PLAN OF TREATMENT; 71
(4) THE DATES ON WHICH DANGEROUS DRUGS WERE PRESCRIBED, 74
DISPENSED, OR ADMINISTERED, THE NAME AND ADDRESS OF THE 75
INDIVIDUAL TO OR FOR WHOM THE DANGEROUS DRUGS WERE PRESCRIBED, 76
DISPENSED, OR ADMINISTERED, AND THE AMOUNTS AND DOSAGE FORMS FOR
THE DANGEROUS DRUGS PRESCRIBED, DISPENSED, OR ADMINISTERED; 77
(5) A COPY OF THE REPORT MADE BY THE PHYSICIAN OR THE 79
PHYSICIAN TO WHOM REFERRAL FOR EVALUATION WAS MADE UNDER THIS 80
DIVISION.
(D) A PHYSICIAN WHO TREATS INTRACTABLE PAIN BY MANAGING IT 83
WITH DANGEROUS DRUGS IS NOT SUBJECT TO DISCIPLINARY ACTION BY THE 84
BOARD UNDER SECTION 4731.22 OF THE REVISED CODE SOLELY BECAUSE 86
THE PHYSICIAN TREATED THE INTRACTABLE PAIN WITH DANGEROUS DRUGS. 88
3
THE PHYSICIAN IS SUBJECT TO DISCIPLINARY ACTION ONLY IF THE 89
DANGEROUS DRUGS ARE NOT PRESCRIBED, ADMINISTERED, OR DISPENSED IN 90
ACCORDANCE WITH THIS SECTION AND THE RULES ADOPTED UNDER IT. 91
Sec. 4731.283. NOT LATER THAN NINETY DAYS AFTER THE 100
EFFECTIVE DATE OF THIS SECTION, THE STATE MEDICAL BOARD SHALL 101
APPROVE ONE OR MORE CONTINUING MEDICAL EDUCATION COURSES OF STUDY 102
INCLUDED WITHIN THE PROGRAMS CERTIFIED BY THE OHIO STATE MEDICAL 104
ASSOCIATION AND THE OHIO OSTEOPATHIC ASSOCIATION PURSUANT TO 105
SECTION 4731.281 OF THE REVISED CODE THAT ASSIST DOCTORS OF 106
MEDICINE AND DOCTORS OF OSTEOPATHIC MEDICINE IN DIAGNOSING AND 108
TREATING INTRACTABLE PAIN, AS DEFINED IN SECTION 4731.052 OF THE 109
REVISED CODE.