At their regular bi-monthly meeting held Saturday, March 18 in Greenville, the North Carolina Medical Society (NCMS) Board of Directors discussed pending legislation before the General Assembly including the STOP (Strengthen Opioid Misuse Prevention) Act, HB243/S175, aimed at curbing the state’s opioid poisoning epidemic.
Rep. Greg Murphy, MD, (R-Pitt) a sponsor of the STOP Act, co-chair of the House Health Committee and the only physician in the General Assembly met with NCMS Board members over dinner on Friday night before the Board meeting. Watch Dr. Murphy discuss why it is important for physicians to support this legislation.
The Board expressed concern about provisions in the bill including the mandate that physicians or their delegate check the state’s Controlled Substance Reporting System (CSRS) before prescribing a controlled substance; the drugs covered by the mandate; the daily limit for first prescriptions related to acute, post-operative pain and the requirement to use e-prescribing.
NCMS Senior Vice President for Advocacy, Chip Baggett, explained that the STOP Act is the result of broad, bipartisan work by legislators and the State Attorney General’s Office. The multi-faceted effort to curb the opioid abuse epidemic includes holding physicians accountable as prescribers. It is highly likely to be passed by the legislature this session. The NCMS is supporting the STOP ACT and working with legislators to make changes to achieve the bill’s intent while ensuring that its implementation is realistic in practice and not overly burdensome to physicians.
“We are working to make sure that when these new mandates become operational they do not have a huge negative impact on your practice,” he said. “But they will affect your practice.”
Based on feedback from members on how these new policies might play out, the NCMS is working to:

  • Clarify what specific drugs and drug schedule(s) would be covered by the mandate. Currently, it appears controlled substances like Adderall and Ritalin are included in the bill language. The NCMS is asking that drugs not currently identified as contributing to the opioid poisoning crisis be excluded from the mandate to query the CSRS before prescribing and certain other bill provisions.
  • Refine the language around e-prescribing since small practices may not currently have the necessary e-prescribing technology nor the financial resources to acquire it.
  • Ensure the CSRS is functioning properly and is interoperable with other states’ prescription drug monitoring systems before the mandate would take effect.
  • Time the mandate to coincide with the connection of the CSRS with the NC Health Information Exchange (HIE). This will enable prescribers to access the most current information in their electronic medical record and the CSRS simultaneously.

The bill has been discussed in the House Health Committee, and will likely be brought up again as the changes are negotiated over the next few weeks.
The NCMS Board will meet next in May in Chapel Hill. If you have a policy matter you’d like them to address, you may submit a Board contact form.