Patient cap being lifted?

Buprenorphine Post
mattkeene
Posts: 32

Postby mattkeene » Mon Sep 21, 2015 9:25 am

Tell me if I am reading this correctly...but on page 30 of the proposal citing some of the needed criteria to go to 200 patients is:

"employment, or a contractual obligation to treat patients in a setting that has the ability to accept third party payment for costs in providing health services, including written billing, credit and collection policies and procedures, or Federal health benefits"

Is this trying to say that if you are a Doc who does not take insurance, you cannot get waivered to see 200??

entjwb
Posts: 180

Postby entjwb » Mon Sep 21, 2015 9:25 am

NoDrugs4U, it my understanding the DOs have a pathway for board certification also. I may b mistaken. As far as nurse practioners and PS prescribing, I think that will be at the state level. The state's regulate their practice and not federal.

Bruni
Posts: 49

Postby Bruni » Mon Sep 21, 2015 9:25 am

quote:
Originally posted by rickbennettmd

NoDrugs
I remain interested: this new document does indeed allow NP's and PA's to prescribe Suboxone?
Thanks
Rick


Apparently not! The increased limit of 200 pts would be available only to Drs already waivered (by existing rules) under DATA 2000.
I offer this quote from: 42 CFR Part 8 RIN 0930AA22 Medication-Assisted Treatment for Opioid Use Disorders; Federal Register / Vol. 81, No. 61 / Wednesday, March 30, 2016 / Proposed Rules; page 17646, IV-E. Which practitioners are eligible for a patient limit of 200? ( 8.610)
Under routine conditions, a practitioner would qualify for the higher limit in one of two ways: By possessing subspecialty board certification in addiction medicine or addiction psychiatry or by practicing in a qualified practice setting as defined in the rule. In either case, practitioners with the higher limit would have to possess a waiver to treat 100 patients for at least 1 year in order to gain experience treating at a higher limit.


Bruni

mattkeene
Posts: 32

Postby mattkeene » Mon Sep 21, 2015 9:25 am

The only mention of nurses in the 95 page proposal is in the context of providing ancillary support/education to****ist Docs, but NOT to RX Bup

kcairns
Posts: 571

Postby kcairns » Mon Sep 21, 2015 9:25 am

President Obama needs to know that his obvious caring and will to do the right thing has been completely double crossed and sold out behind his back by the establishment to which he has entrusted the details and all those who collaborate w them and deaths and suffering will not decrease and the crisis is now officially enabled from on high. to all the suffering people at risk of death who need me I will just answer - " I should never have allowed the establishment to deceive me one more time - I feel like charley brown w lucy and the football -- the suffering and death for you is what is wanted to happen to you by the establishment and all who collaborate w them, as they have just shown ever once again - I cannot change this, -it can only be changed by people who want to do so as much as it takes... it is true of your lives as those people described by Marquez, in 100 years of solitude - 'our crucial problem has been a lack of conventional means to render our lives believable....this , my friends is the root of our solitude' ...and also as I write this, going thru my mind are words that I am not admitting here to endorsing but I have heard them and do now hear them, ...'El pueblo unido jamas sera vencido!'"

rickbennettmd
Posts: 90

Postby rickbennettmd » Mon Sep 21, 2015 9:25 am

NoDrugs

I remain interested: this new document does indeed allow NP's and PA's to prescribe Suboxone?

Thanks

Rick


NoDrugs4u
Posts: 198

Postby NoDrugs4u » Mon Sep 21, 2015 9:25 am

Now that the ASAM/ABAM has excluded Osteopathic Physicians from their Board Certification (unless they have taken Allopathic residencies) there is no channel for DO's to get certified in Addiction Medicine! This was an appalling decision taken by our "mother" organization.

rickbennettmd
Posts: 90

Postby rickbennettmd » Mon Sep 21, 2015 9:25 am

My casual read****essment:

Complex beaurocratic language, impossible to satifactorily decipher.

The bottom line appears to be that Addiction Medicine Board Certified docs will be eligible to now treat 200 Suboxone patients. Other waivered docs can as well, but the program they are required to set up for this appears to be daunting.

And perhaps the additional requirements for boarded docs are very cumbersome also. This text is simply too complex and undefined in this document. And, for me, too tedious to attempt to decipher, as well.

Am I correct in my brief interpretation?

No Drugs:
re NP's and PA's being allowed to prescribe:
This is indeed in the document? I didn't see it. I share your opinion of such a provision's suitability. Thanks.

Other****essments?



drpasser
Posts: 1404

Postby drpasser » Mon Sep 21, 2015 9:25 am

We must push back against "Noctors," for the pt's sake. Here, we have all lived with and endured all the restrictions and the inspections, for what? To turn it over to those without a Medical Degree? The lowest common denominator for prescribers? The practionors which notoriously Rx too many benzos for too many people?

Come on.....let's get to it. Please post comments regarding letters to respond to the powers that be.

Best,
Kevin

kcairns
Posts: 571

Postby kcairns » Mon Sep 21, 2015 9:25 am

I have a post on this under "april 1 countdown" - but folks have an eye opener --look up on fed registry the title posted above and incredulouly read same.imho for humamity's sake lets then enter our comments


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