Florida Enacts Opioid Prescribing Restrictions

Optum Workers' Comp
| Mar 22, 2018

On March 19 the Florida Governor signed into law, legislation containing numerous provisions aimed at curbing and controlling the opioid crisis in Florida. This legislation, House Bill 21, includes several provisions called for, and supported by the Governor since efforts to address opioids failed in 2017, and is seen as a first step for Florida against the opioid scourge.

The bill includes key provisions restricting days’ supply of opioids for prescriptions written to treat acute pain as well as other requirements working in conjunction with the prescribing limitations to address opioid addiction. House Bill 21 redefines standards of practice for treatment of acute and chronic pain while maintaining exceptions for opioid utilization in treating pain associated with cancer, end-of-life and palliative care.

New Prescribing Restrictions
For treatment of acute pain, a prescription for an opioid drug listed as a Schedule II controlled substance may not exceed a 3-day supply, except that up to a 7-day supply may be prescribed if:

  • The prescriber in his/her professional judgment, believes that more than a 3-day supply is medically necessary to treat the patient’s pain as an acute medical condition, and
  • The prescriber indicates “ACUTE PAIN EXCEPTION” on the prescription, and
  • 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

For treatment of pain other than acute pain, a prescriber must indicate “NONACUTE PAIN” on a prescription for an opioid drug listed as a Schedule II controlled substance.

Other Bill Provisions
HB 21 also imparts numerous other requirements and restrictions. The bill authorizes the co-prescribing of an opioid antagonist when an opioid classified as a Schedule II controlled substance is prescribed to treat the pain of a traumatic injury with an Injury Severity score of 9 or greater. Additionally, the bill requires continuing education for licensed practitioners, permits ePrescribing of controlled substances and modifies existing PDMP program reporting protocols to bring greater transparency across prescribing and dispensing of opioids and other controlled substances. The bill also establishes similar opioid days’-supply controls when the prescriber is also the dispensing practitioner, and it implements new licensure and registration protocols for pain clinics.

The opioid prescribing and dispensing restrictions – along with other segments of the bill not subject to rule-making – take effect as of July 1, 2018. A copy of the bill can be viewed here.

The Optum Workers’ Compensation and Auto No-Fault Government Affairs Team supported bill efforts during the legislative session, and we applaud the Legislature and Governor for taking these steps to address the opioid crisis. As more and more states are moving forward to address the opioid problem, we will continue to monitor and communicate public policy developments on this key topic and the impact to the workers’ compensation marketplace. Should you have any questions on this or any other public policy issue, please contact Kevin Tribout, our Executive Director of Government Affairs, at kevin.tribout@optum.com.

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