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Developments in Michigan Controlled Substance Regulation: New Exceptions for Hospice Patients

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Developments in Michigan Controlled Substance Regulation: New Exceptions for Hospice Patients

New Hospice ExceptionsMotivated by concerns that the requirements of Michigan controlled substance (“CS”) laws might result in hospice patients being denied timely access to necessary pain control drugs in their final days, the Michigan legislature amended the CS laws to benefit hospice patients, effective July 8, 2019. Two new exceptions give providers more flexibility under the bona fide prescriber-patient relationship requirement and the Michigan Automated Prescription System (“MAPS”) query requirement, both explained below, for meeting the pain control needs of hospice patients.

Existing Bona Fide Relationship RequirementPublic Act 247 of 2107, MCL § 333.7303a(2), requires that except as provided in exceptions detailed in administrative rules, a prescriber must be in a bona fide prescriber-patient relationship with a patient before prescribing a schedule 2-5 controlled substance. (“CS”), and provide certain follow-up care to the patient to monitor the efficacy of the CS in treating the patient’s medical condition. Failure to comply with the bona fide relationship and follow-up care requirements may be considered professional misconduct and may subject the prescriber to professional discipline.

NEW Hospice ExceptionPublic Act 43 of 2019 revises MCL § 333.7303a(2) to provide an exemption from the bona fide relationship and follow-up care requirements when prescribing CS for “a patient who is under the care of a hospice.”

Existing MAPS Query RequirementPublic Act  of 2017, MCL § 333.7303(4) requires a licensed prescriber to obtain and review a Michigan Automated Prescription Service (“MAPS”)  report before prescribing or dispensing more than a 3 day supply of CS (any schedule). Exceptions to this MAPS query requirement are made for dispensing in a hospital or freestanding surgical outpatient facility when the CS is administered to the patient at the hospital/freestanding surgical outpatient facility, and for certain prescriptions for animal patients. Failure to comply with the MAPS query requirement may be considered professional misconduct and may subject the prescriber to professional discipline.

NEW Hospice ExceptionPublic Act 42 of 2019 revises MCL § 333.7303(4) to add an exception to the MAPS query requirement “if the patient is under the care of a hospice” and the MAPS report required under the law “was obtained and reviewed at the time the patient was admitted to the hospice.” In short, a new MAPS query need not be obtained before prescribing more than a 3-day supply of CS for a hospice patient, if a MAPS report was obtained and reviewed at the time the patient was admitted to hospice.  

For more information, please contact Kathleen Reed at 231.348.8134 or kreed@dykema.com.