As Reported by the Senate Health 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-MASON- 11
CORE-MOTTL-SYKES-CAREY-PADGETT-SAWYER-OGG-MEAD-HOUSEHOLDER- 12
REID-JOHNSON-BEATTY-HEALY-CATES-STAPLETON-VERICH-ROMAN- 13
JONES-MILLER-SALERNO-SENATORS DRAKE-GILLMOR-NEIN-HAGAN 14
16
A B I L L
To enact sections 4731.052 and 4731.283 of the 18
Revised Code regarding the authority of 19
physicians to prescribe, dispense, and 20
administer dangerous drugs for management of 21
intractable pain. 22
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 24
Section 1. That sections 4731.052 and 4731.283 of the 26
Revised Code be enacted to read as follows: 27
Sec. 4731.052. (A) AS USED IN THIS SECTION: 29
(1) "DANGEROUS DRUG" HAS THE SAME MEANING AS IN SECTION 31
4729.02 OF THE REVISED CODE.
(2) "INTRACTABLE PAIN" MEANS A STATE OF PAIN THAT IS 33
DETERMINED, AFTER REASONABLE MEDICAL EFFORTS HAVE BEEN MADE TO 34
RELIEVE THE PAIN OR CURE ITS CAUSE, TO HAVE A CAUSE FOR WHICH NO 36
TREATMENT OR CURE IS POSSIBLE OR FOR WHICH NONE HAS BEEN FOUND. 37
(3) "PHYSICIAN" MEANS AN INDIVIDUAL AUTHORIZED UNDER THIS 39
CHAPTER TO PRACTICE MEDICINE AND SURGERY OR OSTEOPATHIC MEDICINE 40
AND SURGERY. 41
(B) THE STATE MEDICAL BOARD SHALL ADOPT RULES IN 44
ACCORDANCE WITH CHAPTER 119. OF THE REVISED CODE THAT ESTABLISH 46
2
STANDARDS AND PROCEDURES TO BE FOLLOWED BY PHYSICIANS IN THE 47
DIAGNOSIS AND TREATMENT OF INTRACTABLE PAIN, INCLUDING STANDARDS 48
FOR MANAGING INTRACTABLE PAIN BY PRESCRIBING, DISPENSING, OR 49
ADMINISTERING DANGEROUS DRUGS IN AMOUNTS OR COMBINATIONS THAT MAY 50
NOT BE APPROPRIATE WHEN TREATING OTHER MEDICAL CONDITIONS. IN 51
DEVELOPING THE RULES, THE BOARD SHALL CONSULT WITH AND PERMIT 52
REVIEW BY PHYSICIANS WHO ARE EXPERIENCED IN THE DIAGNOSIS AND 53
TREATMENT OF INTRACTABLE PAIN. 54
(C) WHEN A PHYSICIAN DIAGNOSES AN INDIVIDUAL AS HAVING 57
INTRACTABLE PAIN, THE PHYSICIAN MAY TREAT THE PAIN BY MANAGING IT 58
WITH DANGEROUS DRUGS IN AMOUNTS OR COMBINATIONS THAT MAY NOT BE 59
APPROPRIATE WHEN TREATING OTHER MEDICAL CONDITIONS. THE 60
PHYSICIAN'S DIAGNOSIS SHALL BE MADE AFTER HAVING THE INDIVIDUAL 61
EVALUATED BY ONE OR MORE OTHER PHYSICIANS WHO SPECIALIZE IN THE 62
TREATMENT OF THE AREA, SYSTEM, OR ORGAN OF THE BODY PERCEIVED AS 63
THE SOURCE OF THE PAIN. THE PHYSICIAN'S DIAGNOSIS AND TREATMENT 64
DECISIONS SHALL BE MADE ACCORDING TO ACCEPTED AND PREVAILING 65
STANDARDS FOR MEDICAL CARE. THE PHYSICIAN SHALL MAINTAIN A 66
RECORD OF ALL OF THE FOLLOWING:
(1) MEDICAL HISTORY AND PHYSICAL EXAMINATION OF THE 68
INDIVIDUAL;
(2) THE DIAGNOSIS OF INTRACTABLE PAIN, INCLUDING SIGNS, 70
SYMPTOMS, AND CAUSES; 71
(3) THE PLAN OF TREATMENT PROPOSED, THE PATIENT'S RESPONSE 73
TO TREATMENT, AND ANY MODIFICATION TO THE PLAN OF TREATMENT; 74
(4) THE DATES ON WHICH DANGEROUS DRUGS WERE PRESCRIBED, 77
DISPENSED, OR ADMINISTERED, THE NAME AND ADDRESS OF THE 78
INDIVIDUAL TO OR FOR WHOM THE DANGEROUS DRUGS WERE PRESCRIBED, 79
DISPENSED, OR ADMINISTERED, AND THE AMOUNTS AND DOSAGE FORMS FOR
THE DANGEROUS DRUGS PRESCRIBED, DISPENSED, OR ADMINISTERED; 80
(5) A COPY OF THE REPORT MADE BY THE PHYSICIAN OR THE 82
PHYSICIAN TO WHOM REFERRAL FOR EVALUATION WAS MADE UNDER THIS 83
DIVISION.
(D) A PHYSICIAN WHO TREATS INTRACTABLE PAIN BY MANAGING IT 86
3
WITH DANGEROUS DRUGS IS NOT SUBJECT TO DISCIPLINARY ACTION BY THE 87
BOARD UNDER SECTION 4731.22 OF THE REVISED CODE SOLELY BECAUSE 89
THE PHYSICIAN TREATED THE INTRACTABLE PAIN WITH DANGEROUS DRUGS. 91
THE PHYSICIAN IS SUBJECT TO DISCIPLINARY ACTION ONLY IF THE 92
DANGEROUS DRUGS ARE NOT PRESCRIBED, ADMINISTERED, OR DISPENSED IN 93
ACCORDANCE WITH THIS SECTION AND THE RULES ADOPTED UNDER IT. 94
Sec. 4731.283. NOT LATER THAN NINETY DAYS AFTER THE 103
EFFECTIVE DATE OF THIS SECTION, THE STATE MEDICAL BOARD SHALL 104
APPROVE ONE OR MORE CONTINUING MEDICAL EDUCATION COURSES OF STUDY 105
INCLUDED WITHIN THE PROGRAMS CERTIFIED BY THE OHIO STATE MEDICAL 107
ASSOCIATION AND THE OHIO OSTEOPATHIC ASSOCIATION PURSUANT TO 108
SECTION 4731.281 OF THE REVISED CODE THAT ASSIST DOCTORS OF 109
MEDICINE AND DOCTORS OF OSTEOPATHIC MEDICINE IN DIAGNOSING AND 111
TREATING INTRACTABLE PAIN, AS DEFINED IN SECTION 4731.052 OF THE 112
REVISED CODE.