California Doctors Must Check Patient Database Before Prescribing Most Drugs

Speaking of new rules, we’ve written about this before, and if you work in healthcare then you already know.

As of October 2, doctors and other healthcare providers must check a statewide database before prescribing any Schedule II-IV drug. It’s called CURES: the Controlled Substance Utilization Review and Evaluation System. It’s a prescription-drug monitoring program to curb pill-popping and doctor-shopping.

The law also applies to dentists, nurse practitioners, physician’s assistants, and others.

In the 24 hours before you write a prescription (or the prior business day), you must log in to CURES and run a report on the patient. You must do it the first time you prescribe the drug and every four months after that during treatment. If you don’t do it the first time because an exemption applies, you have to do it the next time unless an exemption applies again. The Medical Board will audit the system to assess compliance.

The exemptions apply if you prescribe in the following situations:

• As part of hospice care.
• While the patient is admitted to a licensed clinic or hospital.
• In an emergency room, if it’s for a non-refillable, seven-day supply.
• As an extension of surgery, including dental surgery, if it’s for a non-refillable, five-day supply.
• If CURES is down or not accessible, as long as you do whatever you can to restore access or get back online.
• If it’s not reasonably possible to check CURES beforehand, no other doctor or practitioner is around to do it either, and it’s a non-refillable, five-day supply. But you’ve got to document this exemption in the file.
• If you deem that denying or delaying the prescription would adversely impact the patient’s medical condition, and it’s a non-refillable, five-day supply. But you should document this as well.

For more information, here’s the Medical Board’s webpage, flyer, and FAQs sheet on the mandatory rule.

Can you be sued for not checking CURES? No.

But you can get in trouble with the Board, so tread carefully.