Attention Psychiatrists in All States

On April 27, 2021, the US Department of Health and Human Services (HHS) issued new practice guidelines regarding the waiver process for medical providers wishing to prescribe buprenorphine to patients with opioid use disorder.

Please be advised that this change still requires a prescriber to obtain a DEA X-waiver to prescribe buprenorphine for opioid use disorder.

For more information:

HHS FAQ: https://www.samhsa.gov/medication-assisted-treatment/practitioner-resources/faqs

Quick Start Guide: https://www.samhsa.gov/sites/default/files/quick-start-guide.pdf

Federal Register: Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder


Attention Idaho Psychiatrists

Senate Bill #1093

Effective July 1, 2021, the requirements for oversight of Physician Assistant (PA) practice have become less specific and fall into two basic categories: pre-existing licensing and credentialing processes or collaborative practice agreements. For licensed health care facilities with licensing, credentialing and oversight processes, the by-laws or procedures of that facility must define the degree and nature of collaboration between physician and PA. For those facilities or practices without these processes, a collaborative practice agreement must be written by either the employer, group or hospital service. The law is nonspecific regarding requirements for the collaborative practice agreements. It places the responsibility on the facility or group to ensure that the medical services provided by the PA are within the PA’s scope of education, experience and competence. Also, each physician is only able to collaborate with a PA within the PA’s scope of training and experience. The PA must consult with an appropriate physician based on the condition of the patient, the education, competence and experience of the PA and the community standard of care. Collaborative physicians do not need to be named if more than one physician works in the facility or group.

The PA, not the collaborating physician, is responsible for the medical acts and care provided by the PA. However, the collaborating physician is responsible for ensuring that the medical services performed by the physician assistant are within the physician assistant’s scope of education, experience, and competence.

Physician assistants are responsible for the care they provide and are tasked with obtaining professional liability insurance if not provided by their employer.


Attention Maryland Psychiatrists

Physician Assistant (PA) Delegation Agreement: Keep A Copy Now or You May Pay Later

The Maryland Board of Physicians encourages licensees to make a copy of delegation agreements (for PAs) before mailing these applications to the Board. PAs and supervising physicians must always maintain a copy of delegation agreements at their place of employment. Requesting a copy of any application from the Board is considered a Public Information Act (PIA) request. Under the PIA, the Board has 30 days to respond to requests, and there may be a charge for the requested materials. The Board requests that all applicants and licensees keep a copy of any items mailed to the Board.


Attention Michigan Psychiatrists

Mandatory Implicit Bias Training

Effective June 1, 2022, implicit bias training will be required in Michigan for the licensure or registration of health care professionals. New applicants for licensure or registration will need to complete a minimum of 2 hours of training, and applicants for renewal will need to complete a minimum of 1 hour of training each year. The annual training curriculum can cover a variety of topics related to implicit bias but must incorporate strategies to reduce disparities including the administration of self-assessments.


Attention Missouri Psychiatrists

Statewide Prescription Drug Monitoring Program (Senate Bill 63)

The Bill establishes a statewide prescription drug monitoring program. Under the bill, patient data would be purged on a rolling basis and could only be kept for three years. In addition, information in the system cannot be used by law enforcement to prevent someone from obtaining a firearm or as probable cause to obtain a search warrant or arrest in a criminal investigation.


Attention Ohio Psychiatrists

ICD-10 Code Reminder

Ohio prescribers are required to include the diagnosis code on all controlled substance prescriptions per 4729:5-5-15 of the Ohio Administrative Code.


Attention Oregon Psychiatrists

Prescription Refill Authority and Delegation

To streamline and assist providers with heavy workloads, some employers have offered to allow – or in some cases mandated – prescription refills be taken care of by other medical staff. In some cases, licensees are being told to delegate their authority rather than review their own refill requests. Here’s what Oregon licensees need to know:

  • If the prescription is in the licensee’s name, they can and should exert whatever authority to review and approve refills as they see fit. This privilege may not be taken away.
  • A licensed prescriber can authorize refills on the original prescription, up to a certain limit – usually one year’s worth for non-scheduled medications.
  • A licensed prescriber may authorize assistant staff members to enter refills under their name, but only under case-specific instructions.
  • The licensee is ultimately responsible for ensuring patient safety for all refills. For instance, licensees may need to check in with their patients or review recent blood work.

Physician Assistant Modernization Bill

In 2021, the Oregon Legislature passed House Bill 3036, which modernizes Physician Assistant (PA) practice in Oregon. The bill’s effective date of June 23, 2021 allows the Oregon Medical Board to start working on implementation of the bill. The actual changes to PA practice provided in HB 3036 are operational in phases on January 15, 2022, and July 15, 2022 (see HB 3036 sections 9, 20, and 21). The summary below does not include every provision of HB 3036, but highlights areas that will be addressed in OMB rulemaking. Section numbers are provided for reference to HB 3036, along with operational dates for each section. Please review HB 3036 for detailed information.

Operational January 15, 2022:

  • Updates PA requirements to dispense prescription drugs.
  • Removes requirement that PAs include supervising physician information on each prescription.
  • Removes requirement that PAs practice within the scope of practice of a supervising physician.
  • Updates the degree of autonomous judgment that a PA may exercise and allow that to be determined at the PA’s primary practice location, according to the community standard of care and the PA’s education, training, and experience.
  • Adds a telemedicine license for PAs, which authorizes those licensees to provide care to Oregon patients via telemedicine when the PA is physically located outside of the state.

Information about HB 3036, operational changes for July 2022, and the Board’s implementation process, including rulemakings and public input opportunities will be available on the Board’s HB 3036 webpage.


Attention Washington Psychiatrists

Peer-to-Peer Consultation Across State Lines

Senate Bill 5423 clarifies the exemptions in statute RCW 18.71.030. This bill allows peer-to-peer consultation across state lines regarding the diagnosis or treatment of patients.

The question has frequently arisen whether an out-of-state physician can consult within Washington State. This bill gives the Washington Medical Commission (WMC) clear statutory authority to say, “Yes, doctors can consult with another physician on care even if that person is not licensed in Washington.”

New Standards for Continuing Medical Education (CME)

Senate Bill 5229 adopts new standards for continuing medical education (CME). The bill requires that by January 1, 2024, the Department of Health, in consultation with the Washington Medical Commission and other boards and commissions, adopt rules for CME programs to address bias, racism, poverty and other elements that manifest as health inequities. These CME programs are not additional and can count towards the 200 hours per cycle already required.


Attention West Virginia Psychiatrists

Physician Assistant Practice Act (SB 714)

The act that went into effect July 2021, addresses licensure eligibility, prescribing authority and the regulation of active Physician Assistant (PA) practice. The bill phases out practice agreements with specific collaborating physicians. While PAs will continue collaboration with physicians, collaboration with physicians in all practice settings will require the submission of a practice notification to the Board. PAs who currently are practicing in collaboration with a physician pursuant to a practice agreement may continue to do so until it terminates or until June 1, 2022, whichever is sooner. By June 1, 2022, all PAs practicing in West Virginia must have an active practice notification with a health care facility. PAs with active practice notifications may perform medical acts and procedures in collaboration with physicians which are commensurate with their education, training and experience, the collaborating physician’s scope of practice, and any credentialing requirements of the health care facility with which they have an active practice notification.

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