Current through all regulations passed and filed through September 16, 2024
(A)
As used in this
rule:
(1)
"Hospice care" means the care of a hospice patient as that
term is defined in section
3712.01 of the Revised
Code.
(2)
"Palliative care" has the same meaning as in section
3712.01 of the Revised
Code.
(3)
"Medication assisted treatment" and "substance use
disorder" have the same meanings as in rule
4731-33-01 of the Administrative
Code.
(4)
"Mental health condition" means any mental health
condition, illness, or disorder as determined by the diagnostic criteria in the
"Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Text
Revision" (DSM-5-TR). This is a well-known and readily available text. It may
be found at libraries, bookstores, on the internet at
www.appi.org,
or at the state medical board's office.
(5)
"Emergency
situation" means a situation involving an "emergency medical condition" as that
term is defined in section
1753.28 of the Revised
Code.
(B)
A physician, or a physician assistant who holds a valid
prescriber number issued by the state medical board and who has been granted
physician-delegated prescriptive authority shall comply with the requirements
of federal law governing prescription drugs that are controlled substances to
prescribe, personally furnish, otherwise provide, or cause to be provided a
prescription drug that is a controlled substance to a person.
(C)
When the
physician, or physician assistant who holds a valid prescriber number issued by
the state medical board and who has been granted physician-delegated
prescriptive authority prescribes, personally furnishes, otherwise provides, or
causes to be provided a prescription drug that is a controlled substance during
the provision of telehealth services, the physician or physician assistant
shall comply with all requirements in rule
4731-37-01 of the Administrative
Code.
(D)
The physician, or physician assistant who holds a valid
prescriber number issued by the state medical board and who has been granted
physician-delegated prescriptive authority shall conduct a physical examination
of a new patient as part of an initial inperson visit before prescribing a
schedule II controlled substance to the patient except as provided in paragraph
(E) of this rule.
(E)
As an exception to paragraph (D) of this rule, a
physician or physician assistant may prescribe a controlled substance to a new
patient as part of the provision of telehealth services for any of the
following patient medical conditions and situations:
(1)
The medical
record of a new patient indicates that the patient is receiving hospice or
palliative care;
(2)
The patient has a substance use disorder, and the
controlled substance is FDA approved for and prescribed for medication assisted
treatment or to treat opioid use disorder.
(3)
The patient has a
mental health condition and the controlled substance prescribed is prescribed
to treat that mental health condition;
(4)
The physician or
physician assistant determines in their clinical judgment that the new patient
is in an emergency situation provided that the following occurs:
(a)
The physician or
physician assistant prescribes only the amount of a schedule II controlled
substance to cover the duration of the emergency or an amount not to exceed a
three-day supply whichever is shorter;
(b)
After the
emergency situation ends, the physician or physician assistant conducts the
physical examination as part of an initial in-person visit before any further
prescribing of a drug that is a schedule II controlled substance;
or
(5)
The prescribing of a controlled substance through
telehealth services is being done under an exception permitted by federal law
governing prescription drugs that are controlled substances.
(F)
When
prescribing a controlled substance through the provision of telehealth services
under one of the exceptions in paragraph (E) of this rule, the physician or
physician assistant shall document one of the reasons listed in paragraph (E)
for the prescribing in the medical record of the new patient in addition to the
documentation already required to meet the standard of care in rule
4731-37-01 of the Administrative
Code.
(G)
Nothing in this rule shall be construed to imply that
one in-person physician or physician assistant examination demonstrates that a
prescription has been issued for a legitimate medical purpose within the course
of professional practice.
(H)
A violation of any provision of this rule, as
determined by the board, shall constitute any or all of the following:
(1)
For a
physician:
(a)
"Failure to maintain minimal standards applicable to the selection or
administration of drugs," as that clause is used in division (B)(2) of section
4731.22 of the Revised
Code;
(b)
"Selling, giving away, personally furnishing,
prescribing, or administering drugs for other than legal and legitimate
therapeutic purposes," as that clause is used in division (B)(3) of section
4731.22 of the Revised Code;
or
(c)
"A departure from or the failure to conform to minimal
standards of care of similar practitioners under the same or similar
circumstances, whether or not actual injury to a patient is established," as
that clause is used in division (B)(6) of section
4731.22 of the Revised
Code.
(2)
For a physician assistant:
(a)
"A departure
from, or failure to conform to, minimal standards of care of similar physician
assistants under the same or similar circumstances, regardless of whether
actual injury to a patient is established," as that clause is used in division
(B)(19) of section 4730.25 of the Revised
Code;
(b)
"Failure to comply with the requirements of this
chapter, Chapter 4731. of the Revised Code, or any rules adopted by the board,"
as that clause is used in division (B)(2) of section
4730.25 of the Revised Code;
or
(c)
"Violating or attempting to violate, directly or
indirectly, or assisting in or abetting the violation of, or conspiring to
violate, any provision of this chapter, Chapter 4731. of the Revised Code, or
the rules adopted by the board," as that clause is used in division (B)(3) of
section 4730.25 of the Revised
Code.
(I)
This rule shall
not apply to any prescribing situations specifically authorized by the Revised
Code or Administrative Code.
Replaces: 4731-11-09
