Page 16 - Volume 70 Number 2
P. 16

The Legislative History of Public
Acts 248 and 249 of 2017
By Richard E. Burney, MD
The governor signed legislation in late 2017 related to dispensing and prescribing controlled substances in schedules 2 through 5 mandating all physicians to register with the Michigan Automated Prescription System (MAPS) and run MAPS inquiries on any patient for whom a greater than 3-day supply of a Schedule 2-5 drug is being prescribed.
As a reminder, here is how schedule 2-5 (or II-V) drugs are defined on the DEA website:
disciplinary part of the Code to prescribe penalties for not complying with SB 166.
SB 166 was introduced February 15, 2017, by Senator Tonya Schuitmaker (R, 26th District) and referred to the Committee on Health Policy. The original draft of the bill stipulated that:
BEGINNING JANUARY 1, 2020, BEFORE PRESCRIBING OR DISPENSING A CONTROLLED SUBSTANCE TO A PATIENT, A LICENSED PRESCRIBER SHALL OBTAIN A REPORT
CONCERNING THAT PATIENT FROM THE DE- PARTMENT’S ELECTRONIC SYSTEM FOR MON- ITORING SCHEDULE 2, 3, 4, OR 5 CONTROLLED SUBSTANCES ESTABLISHED UNDER SECTION 7333A.
Section 7333A refers to the Section 333.7333 of the Public Health Code, which established an electronic system for monitoring schedule 2,3,4, and 5 controlled substances. In the original draft, hospices and hospital oncology departments were exempted.
The bill as passed by the Senate June 22, 2017, no longer mentioned hospices but created an exemption “if dispensing occurs in a hospital” and is for “patient’s inpatient use.”
Six months later, the bill as passed by the House December 13, 2017, made two important changes and now read as follows:
BEGINNING JUNE 1, 2018, BEFORE PRESCRIB- ING OR DISPENSING 2 TO A PATIENT A CON- TROLLED SUBSTANCE IN A QUANTITY THAT EXCEEDS A 3- 3 DAY SUPPLY,
In addition to repeating, now in a separate
paragraph:
A LICENSED PRESCRIBER SHALL REGISTER WITH THE ELECTRONIC SYSTEM FOR MONITORING SCHEDULE 2, 3,4, AND 5 CONTROLLED SUBSTANCES
The two important changes were 1) moving the implementation date up to June 1, 2018 and 2) allowing the prescribing of a 3-day supply of schedule 2-5 drugs without requiring a MAPS report.
It now exempts dispensing at free-standing surgical outpatient facilities in addition to hospitals, and also veterinarians who might write a prescription for a pharmacy to fill (veterinarians dispense most of their own drugs).
The Senate concurred bill, which passed the same day, added an exemption for dispensing by a veterinarian “if the patient is an animal” and the dispensing occurs “in
 Schedule I, by the way, includes heroin, peyote and other illegal mind-altering substances, but also marijuana, for which there is effectively no limitation on prescribing or purchasing in many states. This is not the time or place to debate the assignment of drugs to the various schedules or why they are always lumped together. They don’t always make sense.
I thought it might be instructive to follow the legislative history of Senate Bills 166 and 167, which eventually became PA 248 and 249. These are written as amendments to the Public Health Code, which regulates medical practice.
A word on why there are two bills: SB 166 amends the Public Health Code to require physicians to do something, in this case to register for the MAPS and use it for certain patient prescriptions. SB167 amends a separate,
16 Washtenaw County Medical Society BULLETIN APRIL / MAY / JUNE 2018












































































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