Resources & Information

Controlled Substances CME requirement

Why is NCMB implementing a controlled substances CME requirement?

NCMB’s primary goal is to ensure that licensees who prescribe controlled substances, particularly opioids, do so in a manner that is safe, appropriate and consistent with current standards of care. Requiring CME in controlled substances prescribing and related topics is one way of supporting this.


Who is subject to the requirement?

Physicians and physician assistants who prescribe controlled substances


What is the requirement for physicians?

The rule requires physicians to complete three hours of eligible CME during each three year cycle. See questions below for further information on content to satisfy the requirement.


What is the proposed requirement for physician assistants?

The rule requires physician assistants to complete two hours of eligible CME during each two year CME cycle. See questions below for further information on content to satisfy the requirement.


When will the requirement be in effect?

The new requirement is effective July 1, 2017. Any licensee whose CME cycle renews in 2017 and whose birthday is on or after July 1, 2017 will be required to fulfill the new CME requirement. The date on which you renew your license does not affect whether you are required to fulfill the new CME requirement.


How do I find out where I am in my CME cycle or how many hours I have completed?

Physicians can login to NCMB’s Licensee Information portal using their FileID# and date of birth. The tab “Preferences/CME” will display the number of CME hours in the current cycle. PAs can either review their renewal confirmation page, or email the renewal coordinator for information on their CME cycle: .(JavaScript must be enabled to view this email address)


Is this a one-time requirement or will licensees be required to earn CME in controlled substances prescribing on an ongoing basis?

This is an ongoing requirement.


May I claim credit for CME hours I have already completed if the course content fulfills the requirements stated in the rule?

Yes. If the CME course is completed during a cycle that renews on or after July 1, 2017, then the credit can be claimed even if the course was taken prior to July 1, 2017 (Note: again, the course must have been completed within that CME cycle).


What if I am at the end of my CME cycle when the rule takes effect but I have not completed any CME that fulfills the requirement?

Licensees are expected to fulfill the CME requirement if the CME cycle ends on or after July 1, 2017, even if they have otherwise fulfilled their requisite CME credits.

If the licensee’s CME cycle ends before July 1, 2017, then the licensee will NOT be expected to have completed eligible CME during that cycle.  Your CME cycle renews on your birthday of the last year of your cycle. The date on which you renew in 2017 does not affect whether you are required to fulfill the new CME requirement.


When does my CME cycle end?

Your CME cycle renews on your birthday of the last year of your cycle (three years for physicians, two years for physician assistants).


How should a physician assistant (PA) determine his or her two-year CME cycle for the purpose of complying with the new controlled substances CME requirement?

PAs who maintain NCCPA certification, and are exempt from the general requirement to report CME hours to the Board, may use their current NCCPA two year cycle. 

PAs who currently report CME hours to the Board should use the two year cycle that started the first birthday after they obtained state licensure.

The most important thing is to obtain the required CME, and to be consistent with the two year cycle you choose to follow for the purpose of recording and reporting CME.


Will any licensees be exempt from the new CME requirement and, if so, who?

Yes. Licensees who have not prescribed ANY controlled substances (opioid or non-opioid) since they last renewed and physicians holding a Resident Training License are exempt from the requirement.


How do I request exemption from the requirement if I believe I qualify?

It is not necessary to request exemption. However, NCMB will continue to conduct random CME audits to verify exempt status.


I don’t prescribe any medications in my current clinical role. Do I have to comply with the CME requirement?

No. Only licensees who prescribed controlled substances (including non-opioids) during their most recent CME cycle are subject to the requirement.


I prescribe medications but I do not prescribe any controlled drugs. Do I have to comply with the requirement?

No. Only licensees who prescribed controlled substances (including non-opioids) during their most recent CME cycle are subject to the requirement.


I prescribe medications, including controlled substances (e.g. hormones, stimulants), but I do not prescribe ANY opioids. Do I have to comply with the requirement?

Yes. The requirement applies to physicians and PAs who prescribed ANY controlled substances (including non-opioids) during their most recent CME cycle.


I prescribe controlled substances but only occasionally prescribe opioids to my patients. Do I have to comply with the requirement?

Yes. The requirement applies to physicians and PAs who prescribed ANY controlled substances (including non-opioids) during their most recent CME cycle.


I am retired and do not treat patients or prescribe, but I do maintain an active license and am required to complete CME. Will I need to comply with the new requirement?

No. If you did not prescribe any controlled substances in your most recent CME cycle, you are not subject to the requirement. However, as previously required, retired physicians or PAs who maintain an active license will still need to comply with the general CME requirement currently in place.


How will licensees find CME courses that fulfill the requirement?

There are many existing online and in-person CME courses that appear to meet the requirement. Licensees may select any course that is ACCME Category 1 or similar that covers “controlled substances prescribing practices, recognizing signs of the abuse or misuse of controlled substances, and controlled substance prescribing for chronic pain management,” as stated in the revised rule.


Will the Board publish a list of recommended CME courses?

Yes. The Board provides links to high quality free and low cost opioid prescribing courses on its website as it becomes aware of them. Check http://www.ncmedboard.org/safeopioids.

It would not be possible for the Board to maintain a current and complete list of available courses that meet the CS requirement. Please understand that NCMB does not maintain an exhaustive list of courses that meet the new requirement. Licensees are responsible for ensuring courses meet the content requirements to fulfill the CME requirement.


Will the Board offer a free CME course that will count towards the new controlled substances requirement?

Yes. The Board is partnering with Wake AHEC to develop a free webinar and a live panel presentation that will count towards the CME requirement. This course should be available starting in late 2016/early 2017. NCMB is also exploring other options for providing free CME credit that will help fulfill the requirement.


I prescribe non-opioid controlled substances and therefore must comply with the new requirement. Will the Board accept CME that deals with appropriate prescribing of controlled substances in my area of practice?

Possibly. If the instruction is focused on your specific area of practice, but the primary topic of the instruction is controlled substances prescribing practices, recognizing signs of the abuse or misuse of controlled substances or controlled substance prescribing for chronic pain management, then that instruction will count towards the requirement. However, the total hours of CME taken to fulfill the proposed requirement ultimately must cover all three topics.


There are different types of pain patients (acute pain, chronic pain, cancer patients, hospice), all with different needs. Will NCMB encourage licensees to complete CME that is most relevant to the patient populations they serve?

The total hours of CME taken to fulfill the requirement, not individual courses, ultimately must cover all three topics. As approved, the requirement stipulates only that courses cover “controlled substances prescribing practices, recognizing signs of the abuse or misuse of controlled substances, and controlled substance prescribing for chronic pain management.” As long as the collective CME taken meets these three basic requirements, licensees are encouraged to choose courses they think will be most practice relevant.


I am continuously engaged in a recertification program from an ABMS, AOA or RCPSC specialty board. Am I exempt from the requirement?

No. All physicians licensed by the Board (other than those holding a Residency Training License) who prescribe controlled substances must satisfy the controlled-substance prescribing CME requirement set forth in 21 NCAC 32R .0101. 

Any physician who qualifies for the MOC exemption in 21 NCAC 32R .0103 and who, as part of their MOC process, completed CME that specifically satisfies the requirement in 21 NCAC 32R .0101 is not required to take controlled-substance prescribing CME beyond that included in their MOC process. 

Licensees whose MOC activities do not include controlled substance prescribing CME as required by 21 NCAC 32R .0101 must complete additional CME that satisfies the requirement. All physicians subject to 21 NCAC 32R .0101 will be asked to affirm that they have completed the required CME, but will not be required to submit documentation of courses completed unless this is specifically requested by the Board.


Will the Board do a mass mailing or communication to educate licensees?

Yes. NCMB will post regular updates and guidance on its website, on social media and in the quarterly licensee newsletter, the Forum.  NCMB will also email licensees who are at the end of their CME cycles to remind them of the new requirement. NCMB staff members are available to respond to emails or calls. Email .(JavaScript must be enabled to view this email address) or call 919.326.1100.


Does the new requirement apply to physician and PA license applicants?

No. The rule applies to current licensees. A newly licensed physician’s three year CME cycle begins on the physician’s first birthday following initial licensure.  A newly licensed PA’s two year CME cycle begins on the PA’s first birthday following initial licensure.


What education topics must be covered for courses to count towards the new CME requirement?

There are three topics that must be covered:

• Controlled substances prescribing practices
• Recognizing signs of the abuse or misuse of controlled substances
• Controlled substance prescribing for chronic pain management

The total hours of CME taken to fulfill the proposed requirement, not individual courses, must cover the three topics. In other words, each course must cover at least one of the required topics to count. It is not necessary for each course completed to cover all three of the required topics.


Does each CME course have to cover all three of the required topics, "controlled substances prescribing practices, recognizing signs of the abuse or misuse of controlled substances, and controlled substance prescribing for chronic pain management?”

No. The total hours of CME taken to fulfill the new requirement, not individual courses, must cover the three topics. In other words, to count towards the requirement each completed course must cover at least one of the required topics; All three of the required topics must be covered during a given three hour CME cycle.