New Florida Controlled Substance Laws Effective July 1, 2018

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Beginning July 1, 2018, new laws place additional requirements on prescribers when prescribing controlled substances. Failure to comply with these additional laws may result in disciplinary and criminal actions.

E-FORCSE Requirements

Prescribers and dispensers must check E-FORCSE prior to prescribing a controlled substance to a patient over 16 years of age. The checking requirement applies to all schedules and classes of controlled substances prescribed for any purpose. 

Prescribers and dispensers must consult the database regardless of whether the patient was recently seen or the prescription is called in or refilled. While it has always been good practice to check E-FORCSE prior to prescribing, it was not previously required until now.

Acute Pain Requirements

Effective July 1, 2018, Schedule II opioids prescribed for the treatment of acute pain must not exceed a three-day supply.  Acute pain is defined as:

[The] normal, predicted, physiological, and time-limited response to an adverse chemical, thermal, or mechanical stimulus associated with surgery, trauma, or acute illness. The term does not include pain related to:

    1. Cancer.
    2. A terminal condition …“terminal condition” means a progressive disease or medical or surgical condition that causes significant functional impairment, is not considered by a treating physician to be reversible without the administration of life-sustaining procedures and will result in death within 1 year after diagnosis if the condition runs its normal course.
    3. Palliative care to provide relief of symptoms related to an incurable, progressive illness or injury.
    4. A traumatic injury with an Injury Severity Score of 9 or greater.

456.44(1)(a), Fla. Stat. (2018)

[However,] a 7-day supply may be prescribed if:

    1. The prescriber, in his or her professional judgment, believes that more than a 3-day supply of such an opioid is medically necessary to treat the patient’s pain as an acute medical condition;
    2. The prescriber indicates “ACUTE PAIN EXCEPTION” on the prescription; and
    3. The prescriber adequately documents in the patient’s medical records the acute medical condition and lack of alternative treatment options that justify deviation from the 3-day supply limit established in this subsection.

456.44(5)(a), Fla. Stat. (2018)

When prescribing Schedule II opioids for non-acute pain (e.g. chronic nonmalignant pain), prescribers must indicate on the prescription “NONACUTE PAIN.” Chronic nonmalignant pain is not subject to the 3-day/7-day prescribing limitation.

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Mandatory Controlled Substance CE Course

Before January 31, 2019, all Florida licensed health professionals registered with the DEA (physicians, optometrists, podiatrists, and dentists) must complete a two-hour continuing education course on prescribing controlled substances. (For a list of approved courses, visit the Florida Department of Health (DOH) special page.

Following the initial course, these health professionals must complete two hours of CE training on controlled substances prior to each biannual license renewal.

Exempt Pain Clinics Required to Register

Previously, certain pain clinics were not required to register with the DOH. These previously exempt clinics will now be required to register with the DOH and obtain a Certificate of Exemption. See 458.3265 and 459.0137 F.S.  for a list of exempt entities.

Additional Board Rules

The licensing boards will establish additional rules regulating the prescribing of controlled substances for the treatment of acute pain. Rules will include guidelines on patient evaluation, treatment plans, informed consent, controlled substance agreements, consultation, and medical record review. 

Chapman Law Group will provide a copy of these additional rule to clients once the rules are available.

For Controlled Substance Prescribing Matters, Turn to the Florida Healthcare Attorneys at Chapman Law Group

At Chapman Law Group, our Florida health care attorneys can advise you on prescribing controlled substances and complying with state and federal regulations. We handle multistate federal matters regulated and investigated by the Department of Justice; state felony matters; and, where criminal sanctions are possible, investigations commenced by the HHS, FBI, DEA, FDA and DOJ.

We have extensive experience in licensed defending health professionals throughout Florida (including the metro areas for Miami, Sarasota, Orlando, Tampa, West Palm Beach and Jacksonville). Contact us today and let a Florida healthcare attorney from Chapman Law Group help with your legal needs.

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Juan C. Santos, LL.M.

Senior Attorney

Healthcare Compliance, Healthcare Fraud Defense

Miami Office
701 Waterford Way, Suite 340
Miami, FL 33126
Phone: (305) 712-7177

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