CALL TO ACTION
The Wyoming Legislature adopted and Governor Mark Gordon signed two pieces of opioid-related legislation during the 2019 Session. Those two bills became law July 1, 2019. WMS is seeking input from members in guiding our efforts to advocate on rule promulgation related to the implementation of the laws. Please contact Sheila Bush with the WMS office and ensure that your thoughts are passed to the WMS Opioid Working Group, WMS Board and considered as we continue working on your behalf on these issues.
Final 2019 Legislation
- Senate File 46
Rx Limits: prohibits the prescription or dispensing of any opioid or combination of opioids to an opioid naive patient for more than a seven day supply in a seven day period
Board Authority: authorizes the State Board of Pharmacy to establish reasonable exceptions in consultation with other professional licensing boards that license practitioners, including exceptions for chronic pain, cancer treatment, palliative care and other clinically appropriate exceptions.
Opioid Naive: is defined as a patient who has not had an active opioid prescription in the preceding 45 day period.
- Senate File 47
Mandated CME: requires the boards of specified health care professionals (i.e. the State Board of Medicine) to require continuing education in responsible prescribing of controlled substances or treatment of addiction.
E-Prescribing: mandates that all controlled substances be prescribed using electronic prescriptions beginning January 1, 2021.
PDMP Monitoring: requires practitioners to search the prescription tracking program for prior prescriptions issued to a patient before first issuing a prescription to the patient, and to repeat the search every three months thereafter for as long as the controlled substance remains a part of the patient’s treatment.
WMS Opioid Working Group
Formed in spring of 2018, the WMS Opioid Working Group represents providers from across Wyoming with varying backgrounds. It was convened to review legislative proposals and create potential solutions for board recommendation and consideration. WMS members are welcomed and encouraged to contact any member of this committee to voice concern or propose ideas to be carried to the WMS Board of Trustees. Recommendations were made by this working group and submitted to the WMS Board of Trustees for consideration at the August 4, 2018, WMS Board of Trustees quarterly meeting in Cheyenne where the board voted unanimously to accept the recommendations and set guiding policy for WMS advocates.
|Lisa Finkelstein, DO||Jackson||Surgeon||WMS President||307-739-7690|
|Dean Bartholomew, MD||Powell||Family Medicine||WMS Past President||307-764-3721|
|Kris Schamber, MD||Sheridan||Internal Medicine||Sheridan County Trustee||307-672-1079|
|Natalie Winter, MD||Cheyenne||Anesthesiology||WMS Member||307-638-7757|
|Thor Hallingbye, MD||Cheyenne||Anesthesiology||WMS Member – BoM Member||307-638-0300|
|John Mansell, MD||Gillette||Anesthesiology||Campbell County Trustee||307-696-2996|
|Kenneth Jarmen, PharmD||Jackson||Pharmacist||St. John’s Hospital||307-739-7656|
|Dan Surdam, MD||Cheyenne||Emergency Medicine||WMS Member||307-514-9888|
Legislative Opioid Addiction Task Force.
Senate File 78 passed by the legislature and signed by Governor Mead during the 2018 Legislative Session established the Legislative Special Task Force on Opioids. The current Task Force is comprised of two senators and two representatives with one additional representative serving as alternate in addition to the Director of the Department of Health, or his designee; The Chairman of the Advisory Council on Palliative Care and eight other members appointed by the Governor. The other members appointed by Governor Mead include Paul Beaupre, MD, Melinda Carroll, PharmD, Alexia Harist, MD, Gregory Marino, DO, Scott Matheny, Art Merrell, MD, Peter Michael, JD, Mary Phillips, FNP, and Brenda Upton, PharmD. The current members of the task force are provided below, along with contact information:
|Eli Bebout||Senate President – Task Force Chairemail@example.com||307-856-0375|
|Albert Sommers||Representative – Task Force Vice Chairfirstname.lastname@example.org||307-360-7060|
|Fred Baldwin, PA-C||Senatoremail@example.com||307-877-3687|
|Tim Hallinan, MD||Representative – Task Force Alternatefirstname.lastname@example.org||307-686-6542|
|Tom Forslund||Director – WDHemail@example.com||307-777-7656|
|Paul Beaupre, MD||CEO – St. John’s Medical Centerfirstname.lastname@example.org||307-739-7525
|Melinda Carroll, PharmD||Member – Board of Pharmacyemail@example.com||307-851-1691|
|Alexia Harrist, MD, PhD||State Health Officerfirstname.lastname@example.org||307-777-7716|
|Gregory Marino, DO||WMS Member- Hematology/Oncologyemail@example.com||307-751-7745|
|Scott Methany||Campbell County Sherifffirstname.lastname@example.org||307-687-6160|
|Art Merrell, MD||WMS Member – Psychiatryemail@example.com|
|Peter Michael||Wyoming Attorney General||307-777-7841|
|Mary Phillips, FNP||Nurse Practitioner – Cody, WY||307-586-5487|
|Brenda Upton, PharmD||Pharmacist – Walmart|
|Natalie Winter, MD||WMS Member – Anesthesiologyfirstname.lastname@example.org||307-638-7757|
The Legislative Task Force met for the first time on July 9, 2018, in Riverton, WY. Minutes from that meeting are not yet available, but will be on the state Legislative Service Offices website when they are posted. The following legislative proposals resulted from the July meeting, and were on the agenda at the August, 29, 2018 meeting in Cheyenne, WY.
Legislative Proposals (August 2018)
Original language mandated three hours of opioid CME every two years for all physicians, PAs, APRNs, and Dentists. The amended version of the bill mandates three hours of controlled substance and substance abuse treatment CME every two years for physicians and PAs who hold a Wyoming Controlled Substance Registration, all licensees and certificate holders of the Board of Nursing, Dentists, Podiatrists, Veterinarians and Optometrists.
Original language limited opiate and opiate combination prescriptions to not exceed one hundred (100) morphine milligram equivalents per day and to not exceed a seven-day supply in a seven day period with latitude for the board of pharmacy to make exceptions. The amended version removes the MME limits and extends the 7 day limit to a 14 day limit for acute pain treatment of opioid naive patients based on a 45 day look back.
Original language mandated all prescriptions for opiates to be submitted electronically starting January 1, 2022. The amended version expanded e-prescribing requirements to all controlled substances.
Original language mandated that all prescriptions be reported to the PDMP by close of business on the business day immediately following the day the controlled substance was prescribed. Required prescribers to check the PDMP prior to first issuing a prescription for a controlled substance Schedule II-IV and then check the database every six months thereafter. The amended version removes the requirement to report prescriptions to the PDMP at the time of writing the prescription, extends the covered controlled substances to Schedule V prescriptions and requires searching the PDMP no less than every three months after the initial prescription is written for as long as the controlled substance remains part of the patient’s treatment plan.