House Bill 1530

AN ACT TO CREATE THE CHRONIC PAIN TREATMENT ACT; TO DEFINE CERTAIN TERMS OF THE ACT; TO PROVIDE THE DUTIES OF CERTAIN BOARDS AS THEY RELATE TO ENFORCING THE ACT; TO CREATE THE PAIN MANAGEMENT REVIEW COMMITTEE AND PROVIDE ITS DUTIES; TO PROVIDE THE SCOPE OF THE ACT; TO PROVIDE IMMUNITY FROM PROSECUTION FOR HEALTH CARE PROVIDERS IN CERTAIN SITUATIONS WHEN PROVIDING CARE FOR CHRONIC PAIN; AND FOR RELATED PURPOSES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1. This chapter shall be known and may be cited as the Chronic Pain Treatment Act.

SECTION 2. The purpose of this chapter is to inform health care providers regarding the following:

(a) That pain management plays an important role in good medical practice;

(b) That health care providers should recognize the need to make pain relief accessible to all patients with chronic pain; and

(c) That health care providers should view pain management as a regular part of their medical practice for all patients with chronic pain.

SECTION 3. As used in this chapter, the following words and phrases shall have the meanings ascribed in this section, unless the context clearly otherwise requires:

(a) "Board" means the Mississippi Board of Medical Licensure, the Mississippi Board of Nursing, the Mississippi State Board of Dental Examiners or the Mississippi State Board of Pharmacy.

(b) "Chronic pain" means pain that persists beyond the usual course of a disease, beyond the expected time for healing from bodily trauma, or pain associated with a long-term incurable or intractable medical illness or disease.

(c) "Controlled substance" means any CFR substance defined, enumerated or included in federal or state statutes or regulations such as 21 CFR, Sections 1308.11-15 or Sections 41-29-115 through 41-29-121, or any substance that may hereafter be designated as a controlled substance by amendment or supplementation of the regulations and statutes.

(d) "Disciplinary action" means any remedial or punitive sanctions imposed on a licensed health care provider by the board.

(e) "Patient" means a person seeking medical diagnosis and treatment.

(f) "Physician" means a licensee of the State Board of Medical Licensure.

(g) "Nurse" means any nurse licensed by the Mississippi Board of Nursing, including nurse practitioners or advanced practice nurses.

(h) "Dentist" means any dentist licensed by the Mississippi State Board of Dental Examiners.

(i) "Podiatrist" means any podiatrist licensed by the State Board of Medical Licensing.

(j) "Pharmacist" means any pharmacist licensed by the Mississippi State Board of Pharmacy.

(k) "Health care provider" means a licensed professional defined in paragraphs (f), (g), (h), (i) or (j) of this section.

SECTION 4. (1) A health care provider shall not be subject to disciplinary action by the State Board of Medical Licensure solely for prescribing controlled substances for the relief of chronic pain. The board shall direct the Pain Management Review Committee to use the criteria under subsections (7) and (8) of this section to review a health care provider's conduct in regard to prescribing, administering, ordering or dispensing pain medications and other drugs necessary to treat chronic pain.

(2) The board shall have the following duties:

(a) To make reasonable efforts to notify health care providers under its jurisdiction of the existence of this chapter; and

(b) To inform any health care provider licensed by the board who is investigated regarding the provider's practices in the management of pain of the existence of this chapter.

(3) In a disciplinary hearing, the following evidence and testimony are to be presented:

(a) The board shall present opinion evidence from a full-time active health care provider in direct patient care who is knowledgeable in pain management; and

(b) The health care provider has the right to present testimony from a full-time active practice health care provider in direct patient care who is knowledgeable in pain management.

(4) Only if the board finds, after a full hearing, and by recommendation of the Pain Management Committee, gross and ignorant malpractice, the board may incrementally impose sanctions as follows:

(a) Monitor prescribing habits of the health care provider not to exceed six (6) months:

(b) Require the health care provider to voluntarily surrender his or her United States Drug Enforcement Agency registration to the board for a specified period of time not to exceed three (3) months;

(c) Suspend the health care provider's license, stay revocation, and require monitoring of the health care provider's prescribing habits for a specified time;

(d) Revoke the health care provider's license, stay revocation and require monitoring of the health care provider's prescribing habits for a specified time; and

(e) Revoke the health care provider's license for serious violations of statutes and regulations.

(5) With a finding of severe violation of statutes and regulations, the board may initially impose more severe sanctions.

(6) At any level of sanction, the board may require continuing medical education hours in proper prescribing habits.

(7) A health care provider may, based on the evaluation and the management of a patient's individual needs, do the following:

(a) Treat a patient who develops chronic pain with a controlled substance to relieve the patient's pain;

(b) Continue to treat the patient for as long as the pain persists;

(c) Treat the pain by managing it with controlled substances in amounts or combinations that may not be appropriate for treating another medical condition;

(d) Administer large doses of controlled substances for pain management if the benefit outweighs the risk of the large dose; and

(e) Administer a large dose of a controlled substance even if its use may increase the risk of death, if the purpose is not to cause or assist in a patient's death.

(8) A health care provider may not do the following:

(a) Prescribe or administer controlled substances solely to treat a patient for chemical dependency, except when a patient is being treated for substance abuse;

(b) Prescribe or administer controlled substances to a person for other than legitimate medical purposes; or

(c) Cause or assist in causing the suicide, euthanasia or mercy killing of any individual; however, causing or assisting in causing the suicide, euthanasia or mercy killing of any individual does not include prescribing, dispensing or administering medical treatment for the purpose of alleviating pain or discomfort, even if that use may increase the risk of death, so long as the treatment is not furnished for the purpose of causing or assisting in causing the death of an individual.

SECTION 5. (1) There is created the Pain Management Review Committee, which shall be appointed by the State Board of Medical Licensure.

(2) The committee shall consist of five (5) full-time active health care providers in direct patient care members, two (2) of whom may be board certified pain management specialists and three (3) of whom may be health care providers with significant pain management in their practices or with a degree in pharmacy, who shall be appointed by the board from a list provided by the Mississippi Osteopathic Medical Association , the Mississippi Medical Society and the Mississippi Pain Society.

(3) In lieu of a disciplinary hearing, the board must refer a health care provider to the committee for review and recommendations.

(4) The committee shall have the following duties:

(a) To develop guidelines for investigations of complaints regarding conduct in violation of this chapter, in cooperation with the Mississippi Osteopathic Medical Association, the Mississippi Medical Society and the Mississippi Pain Society.

(b) To review complaints on an individual patient need basis regarding health care providers treating chronic pain in violation of this chapter; and

(c) To provide an objective critique to the board for board determination in a timely manner and, if determined, before the board's disciplinary hearing.

SECTION 6. This chapter does not condone, authorize or approve mercy killing or euthanasia, and no treatment authorized by this chapter may be used for mercy killing or euthanasia.

SECTION 7. No health care provider shall be subject to criminal prosecution for prescribing or administering controlled substances under appropriate criteria in the course of treatment of a person for chronic pain.

SECTION 8. Sections 1 through 7 of this act shall be codified as a new chapter in Title 41, Mississippi Code of 1972.

SECTION 9. This act shall take effect and be in force from and after July 1, 2004.