As Passed by the Senate 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
KEARNS-CARNES-WATTS-OELSLAGER-SCHAFRATH 15
17
A B I L L
To enact sections 4731.052 and 4731.283 of the 19
Revised Code regarding the authority of 20
physicians to prescribe, dispense, and 21
administer dangerous drugs for management of 22
intractable pain. 23
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 25
Section 1. That sections 4731.052 and 4731.283 of the 27
Revised Code be enacted to read as follows: 28
Sec. 4731.052. (A) AS USED IN THIS SECTION: 30
(1) "DANGEROUS DRUG" HAS THE SAME MEANING AS IN SECTION 32
4729.02 OF THE REVISED CODE.
(2) "INTRACTABLE PAIN" MEANS A STATE OF PAIN THAT IS 34
DETERMINED, AFTER REASONABLE MEDICAL EFFORTS HAVE BEEN MADE TO 35
RELIEVE THE PAIN OR CURE ITS CAUSE, TO HAVE A CAUSE FOR WHICH NO 37
TREATMENT OR CURE IS POSSIBLE OR FOR WHICH NONE HAS BEEN FOUND. 38
(3) "PHYSICIAN" MEANS AN INDIVIDUAL AUTHORIZED UNDER THIS 40
CHAPTER TO PRACTICE MEDICINE AND SURGERY OR OSTEOPATHIC MEDICINE 41
AND SURGERY. 42
(B) THE STATE MEDICAL BOARD SHALL ADOPT RULES IN 45
2
ACCORDANCE WITH CHAPTER 119. OF THE REVISED CODE THAT ESTABLISH 47
STANDARDS AND PROCEDURES TO BE FOLLOWED BY PHYSICIANS IN THE 48
DIAGNOSIS AND TREATMENT OF INTRACTABLE PAIN, INCLUDING STANDARDS 49
FOR MANAGING INTRACTABLE PAIN BY PRESCRIBING, DISPENSING, OR 50
ADMINISTERING DANGEROUS DRUGS IN AMOUNTS OR COMBINATIONS THAT MAY 51
NOT BE APPROPRIATE WHEN TREATING OTHER MEDICAL CONDITIONS. IN 52
DEVELOPING THE RULES, THE BOARD SHALL CONSULT WITH AND PERMIT 53
REVIEW BY PHYSICIANS WHO ARE EXPERIENCED IN THE DIAGNOSIS AND 54
TREATMENT OF INTRACTABLE PAIN. 55
(C) WHEN A PHYSICIAN DIAGNOSES AN INDIVIDUAL AS HAVING 58
INTRACTABLE PAIN, THE PHYSICIAN MAY TREAT THE PAIN BY MANAGING IT 59
WITH DANGEROUS DRUGS IN AMOUNTS OR COMBINATIONS THAT MAY NOT BE 60
APPROPRIATE WHEN TREATING OTHER MEDICAL CONDITIONS. THE 61
PHYSICIAN'S DIAGNOSIS SHALL BE MADE AFTER HAVING THE INDIVIDUAL 62
EVALUATED BY ONE OR MORE OTHER PHYSICIANS WHO SPECIALIZE IN THE 63
TREATMENT OF THE AREA, SYSTEM, OR ORGAN OF THE BODY PERCEIVED AS 64
THE SOURCE OF THE PAIN. THE PHYSICIAN'S DIAGNOSIS AND TREATMENT 65
DECISIONS SHALL BE MADE ACCORDING TO ACCEPTED AND PREVAILING 66
STANDARDS FOR MEDICAL CARE. THE PHYSICIAN SHALL MAINTAIN A 67
RECORD OF ALL OF THE FOLLOWING:
(1) MEDICAL HISTORY AND PHYSICAL EXAMINATION OF THE 69
INDIVIDUAL;
(2) THE DIAGNOSIS OF INTRACTABLE PAIN, INCLUDING SIGNS, 71
SYMPTOMS, AND CAUSES; 72
(3) THE PLAN OF TREATMENT PROPOSED, THE PATIENT'S RESPONSE 74
TO TREATMENT, AND ANY MODIFICATION TO THE PLAN OF TREATMENT; 75
(4) THE DATES ON WHICH DANGEROUS DRUGS WERE PRESCRIBED, 78
DISPENSED, OR ADMINISTERED, THE NAME AND ADDRESS OF THE 79
INDIVIDUAL TO OR FOR WHOM THE DANGEROUS DRUGS WERE PRESCRIBED, 80
DISPENSED, OR ADMINISTERED, AND THE AMOUNTS AND DOSAGE FORMS FOR
THE DANGEROUS DRUGS PRESCRIBED, DISPENSED, OR ADMINISTERED; 81
(5) A COPY OF THE REPORT MADE BY THE PHYSICIAN OR THE 83
PHYSICIAN TO WHOM REFERRAL FOR EVALUATION WAS MADE UNDER THIS 84
DIVISION.
3
(D) A PHYSICIAN WHO TREATS INTRACTABLE PAIN BY MANAGING IT 87
WITH DANGEROUS DRUGS IS NOT SUBJECT TO DISCIPLINARY ACTION BY THE 88
BOARD UNDER SECTION 4731.22 OF THE REVISED CODE SOLELY BECAUSE 90
THE PHYSICIAN TREATED THE INTRACTABLE PAIN WITH DANGEROUS DRUGS. 92
THE PHYSICIAN IS SUBJECT TO DISCIPLINARY ACTION ONLY IF THE 93
DANGEROUS DRUGS ARE NOT PRESCRIBED, ADMINISTERED, OR DISPENSED IN 94
ACCORDANCE WITH THIS SECTION AND THE RULES ADOPTED UNDER IT. 95
Sec. 4731.283. NOT LATER THAN NINETY DAYS AFTER THE 104
EFFECTIVE DATE OF THIS SECTION, THE STATE MEDICAL BOARD SHALL 105
APPROVE ONE OR MORE CONTINUING MEDICAL EDUCATION COURSES OF STUDY 106
INCLUDED WITHIN THE PROGRAMS CERTIFIED BY THE OHIO STATE MEDICAL 108
ASSOCIATION AND THE OHIO OSTEOPATHIC ASSOCIATION PURSUANT TO 109
SECTION 4731.281 OF THE REVISED CODE THAT ASSIST DOCTORS OF 110
MEDICINE AND DOCTORS OF OSTEOPATHIC MEDICINE IN DIAGNOSING AND 112
TREATING INTRACTABLE PAIN, AS DEFINED IN SECTION 4731.052 OF THE 113
REVISED CODE.