I mentioned recently to one of my physician practice clients that all indications suggest to me that in-office dispensing of drugs by physicians is likely to become a target for increased regulation and enforcement. It seems like at least once a week we hear in the news about another tragedy involving prescription drug addiction. In fact, only this week I saw a documentary spotlighting the newest illegal drug epidemic sweeping the northeast: prescription pain pills purchased from doctors in Florida and trafficked up the route 95 corridor for sale on the street. With a street value of up to $80 per pill, prescription meds may be more profitable and easier to obtain than cocaine.
As an indication that a regulatory correction is just around the corner, a recent New York Times article casts a spotlight on the huge mark-up on prescription drugs that physicians are able get under state workers compensation programs and efforts by state legislators to control the associated costs. (See Insurers Pay Big Markups at http://www.nytimes.com/2012/07/12/business/some-physicians-making-millions-selling-drugs.html?_r=2&pagewanted=all).
So what should physicians with in-office dispensaries be doing to make sure they stay on the right side of the law? For one thing, keep a sharp eye out for changes in the law which could impact your arrangements. I don’t think it’s a matter of if new regulations are coming but rather when they will come.
Next, develop policies and procedures for how prescription pads are handled, prescriptions are filled and refilled and drugs are handled in the office. It’s also a good idea to have policies on how "problem" patients will be handled. If your practice dispenses pain medication, you should expect to have patients seeking drugs between refills and they may not take "no" for an answer. Staff should be trained on how to handle these patients – including on when to involve law enforcement.