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On Tuesday, Dec. 5, the ND Board of Medicine presented three proposed rule changes to the ND Legislative Administrative Rules Committee. The following rules were reviewed by the committee and will go into effect January 1, 2018:
- The administrative medical license rule allows a license for physicians who do not choose to practice clinical medicine, but wish to be licensed for administrative or managerial purposes.
- The special license requirement rule changes address situations where the board may issue a medical license to an applicant who does not meet all technical eligibility requirements and to outline the considerations the board shall make in issuing a special medical license.
- The Prescription Drug Monitoring Program (PDMP) rule requires physicians to request PDMP reports under certain circumstances. This rule also mandates that physicians register with the PDMP.
Due to recent feedback, the ND Board of Medicine proposed to table discussion on the telemedicine rule changes until the upcoming March Administrative Rules Committee meeting.
Regarding the telemedicine proposed rules, two concerns were raised by regulated physicians.
First, prohibiting prescription of opioids by telemedicine has unintended consequences of prohibiting the prescribing of medication assisted treatment (MAT) for opioid use disorder by telemedicine. The ND Department of Human Services submitted testimony stating that this may have the unintended consequence of limited treatment in the rural areas, where opioid use disorder treatment is needed the most.
The second concern was submitted by the national telemedicine provider, Teledoc. The proposed telemedicine rule requires that in the establishment of the patient physician relationship (first visit) through telemedicine, online questionnaires or audio conversation will not be considered to meet the standard of care. It is Teledoc’s position that the initial patient physician relationship may be established by static/online questionnaires with asynchronous store and forward technology. |