Opioid Management and New Provider Requirements
The Michigan legislature has enacted a set of laws that address the opioid crisis impacting our communities, our patients and our providers. We continue to work with state regulators and lawmakers to gain clarity as the legislation goes into effect. Please be aware that consequences for non-adherence with these new requirements range from fines and probation to license suspension or revocation.
Substance Use Disorder – March 27, 2018
- A physician who treats a patient for an opioid-related overdose is required to provide information to the patient on substance use disorder (SUD) services, which include, early intervention and crisis intervention counseling services, referral services and planned treatment services for individuals with dependence or abuse of alcohol or drugs.
Direct Administration of Controlled Substance – March 27, 2018
- Before dispensing or prescribing buprenorphine, or a drug containing buprenorphine or methadone, to a patient in a substance use disorder program, a prescriber shall obtain and review a MAPS report. In addition, for dispensing prescribers, individuals must report data into MAPS.
Consents (specific to opioids) – June 1, 2018
- Subject to some exceptions, when prescribing a controlled substance that is an opioid, patients must be informed of:
- The risks of addiction and overdose
- Increased risk to individuals suffering from mental or substance use disorders
- The dangers of combining opioids with benzodiazepine, alcohol, or other CNS depressants
- The risk of neonatal abstinence for an individual of child-bearing age or someone who is pregnant
- Subject to some exceptions, when prescribing a controlled substance that contains an opioid to a minor, a separate “Start Talking Consent” is required.
- When the patient is a minor and the consenting adult is not the parent or guardian, the prescriber will not provide more than a 72-hour quantity.
- LARA is in the process of developing these consent forms for statewide use.
Mandatory MAPS (Michigan Automated Prescribing System) – June 1, 2018
- Subject to some exceptions, all licensed prescribers in Michigan will be required to check and review a MAPS report when prescribing more than a 3-day supply of controlled substance (schedule 2-5), including stimulants for ADHD.
- All providers must register for MAPS by June 1, 2018
Quantity Limits – July 1, 2018
- When treating a patient for acute pain, the prescriber cannot prescribe more than a 7-day supply of an opioid within a 7-day period.
Bona Fide Relationship – 2019
- A licensed prescriber shall not prescribe any controlled substance (schedule 2-5) unless the prescriber is in a bona fide prescriber/patient relationship with the patient, defined as one where the prescriber has reviewed the patient’s relevant medical records and completed an assessment of the patient’s medical history and current medical condition, including a relevant medical evaluation conducted in person or via telehealth.
- Prescribers must provide follow-up care or facilitate follow-up care with a primary care physician.