Before the Joint Committee on Public Health
The MMS must object to another legislative attempt to dictate clinical practice for physicians. This bill, in its entirety, states:
“Chapter 94C of the General Laws is hereby amended by adding the following section:- Section 50. A physician practicing in an emergency room shall not be permitted to provide to a patient seeking emergency care more than 72 hours worth of a controlled substance as defined by this chapter.”
We suspect this is another anti- drug abuse bill. However, controlled substances are defined in Massachusetts as anything requiring a prescription. So, that would include antibiotics or any of thousands of medications which would be prescribed for a fourteen day period or longer. It would also include blood pressure medications, insulin and many other well established treatments which require long term use.
It isn’t clear what is meant by the prohibition on “providing” more than a 72 hour supply. Does this mean that a prescription may not be issued? Does it mean that the medications may not be dispensed? Chapter 94C limits dispensing now to the amount required for immediate treatment, or until a prescription may be filled. This is further defined in regulations to constitute seventy two hours. Therefore this bill is redundant when applied to dispensing medication. If it applies to all prescriptions it is a major prohibition of practicing medicine according to appropriate standards of care by limiting all prescriptions to 72 hours of treatment, while standards of care for many patients would dictate treatment plans of much longer duration.
For example, does the legislature really intend to require every patient who visits an emergency room to follow up with a primary care visit to receive the same diagnosis and an additional prescription for the balance of a course of treatment? Does the legislature expect MassHealth, Medicare and insurers to pay for this additional visit to a physician and pharmacy? Clearly the answer must be no.
Since the bill limits only physicians, does that mean the intent is to allow extended provision by nurse practitioners, physician assistants and others in the emergency room?
The MMS respectfully asks the Committee on Public Health to leave prescribing decisions to emergency department staff. They have earned the respect and the gratitude of the Commonwealth and the world. Let them do their jobs and please reject H 3359 and all similar legislation.
