The Meeting Summary provides brief descriptions of selected actions taken by the NC Medical Board during its most recent meeting or hearing. Actions are listed by committee, where applicable.
For a full account of the Board’s proceedings please check the meeting minutes, which are posted approximately two months after the meeting date. You can subscribe to our Meeting Minutes RSS feed to be notified when the minutes are posted.
Summary of the Board Meeting held Jan. 18-20, 2017
Advanced Practice Providers and Allied Health Committee (formerly Allied Health)
The Board approved a committee recommendation to change the name of the Allied Health Committee to the Advanced Practice Providers and Allied Health Committee to more accurately reflect the makeup of the medical professionals who fall under the scope of the committee’s work.
The Board voted to pursue rule changes that will refine investigative selection criteria for NCMB’s opioid investigations program, the Safe Opioid Prescribing Initiative (SOPI). The changes are expected to improve the sensitivity of the results received from the NC Controlled Substances Reporting System and reduce the number of “false positive” results that identify licensees who did not, in fact, prescribe opioids sufficient to negatively impact a patient. The Board proposed changes to existing criteria and also voted to establish new investigative criteria designed to identify practitioners whose practices are consistent with “pill mill” style opioid prescribing.
Revised investigative criteria (proposed)
Top two percent prescribing 100 milligrams of morphine equivalents (MME) per patient per day.
Top two percent prescribing 100 MMEs per patient per day in combination with any benzodiazepine and within the top one percent of all controlled substance prescribers by volume.
Prescribers with two or more patient deaths within a 12–month period due to opioid poisoning AND who authorized 30+ tablets of an opioid to the decedent AND scripts were written within 60 days of the patient’s death.
New criteria (proposed)
Prescribers who meet at least three of the following criteria*:
1. At least 25 percent of the prescriber’s patients receiving opioids reside at least 100 miles from the prescriber’s practice location;
2. The prescriber has more than 30 patients receiving the same opioid and benzodiazepine combination;
3. A majority of the prescriber’s patients receiving opioids self-pay for the prescription;
4. The prescriber allows an early refill of an opioid prescription more than twice in the last 12 months on any patient;
5. More than 50% of the prescriber’s patients receive opioid doses of 100 MME or greater per day; or
6. The prescriber has more than ten patients who use three or more pharmacies within a year to obtain opioids.
*The Board would investigate only prescribers whose practices meet all characteristics.
Update on the Interstate Licensure Compact – The committee received an update of the progress to date of the Interstate Medical Licensure Compact. NCMB is not a participant in the compact. The Board voted to direct the staff to continue to monitor this initiative, and provide the committee with an update at the January 2018 Board Meeting.
Perfusionist Advisory Committee member reappointed – The committee was informed that Ms. Jayne Byrd has been reappointed to the Perfusionist Advisory Committee.
Changes to license application questions - The Board voted to make revisions to physician and physician assistant license application questions. The purpose for these changes is to streamline the application process, while ensuring that the Board is collecting relevant and accurate information.
The most significant change is removing the question asking applicants to disclose criminal arrests and convictions. All license applicants are subject to a criminal background check, which provides a much more efficient, accurate, and complete report of an applicants’ criminal history. Staff recommended removing disclosure of arrests and convictions because applicants frequently, and inappropriately, report arrests and convictions that have been expunged, or fail to report minor and distant arrests. These applications cannot be processed until the staff resolves questions and discrepancies, which delays licensure decisions by the Board. NCMB is unaware of any instance where an applicant disclosed an arrest or conviction on the license application that was not disclosed on the applicant’s criminal background check.
In the section requesting information regarding prior history with regulatory agencies, the Board voted to remove the requirement for applicants to list prior history with NCMB. The existing question specifies that NCMB history should be included even though the Board has this information on file. The Board decided that this approach wastes applicant and staff time, slows the application process and does not yield meaningful information to assist with license application reviews.
NCMB professional outreach hit an all-time high in 2016 – The Board received a report on outreach to professional groups in 2016. The Board presented to 46 organizations, including professional meetings, practice groups, hospital and health system meetings, medical schools, PA schools and stakeholder groups including risk managers and health care attorneys. These talks reached nearly 1,000 individuals. The Board is continuing to experience strong interest from professional groups, especially about NCMB’s opioid initiatives.
Public outreach a priority for 2017 – NCMB is proactively seeking opportunities to present to community groups in 2017. The Board received information that NCMB has scheduled six public presentations so far, including engagements at local Rotary Clubs and senior centers.
NCMB-WakeAHEC Webinar on opioid prescribing – The Board received a report on NCMB’s collaboration with WakeAHEC to produce a webinar and related panel discussion series on responsible opioid prescribing that may be completed to satisfy the new controlled substances CME requirement that will be in effect as of July 1. The webinar will be recorded in February and made publicly accessible by early spring (e.g. March). To satisfy the terms of the grant that supports this project, the webinar must be deployed and all panel sessions conducted by the end of May. WakeAHEC and NCMB will publicize the webinar and panel sessions to encourage robust licensee participation.
Board adopts CDC opioid guidance - The Board voted to adopt the CDC Guideline for Prescribing Opioids for Chronic Pain. This document, which was developed in 2016 by the U.S. Centers for Disease Control and Prevention, replaces the Board’s previous opioid position statement, effective immediately. Prescribers are advised to read the Board’s comments on the CDC guidelines, which note that the recommendations contained in the CDC policy may not meet the needs of all patients. The Board encourages licensees who prescribe opioids to familiarize themselves with the CDC policy and use it to guide - but not dictate - their treatment decisions. NCMB’s primary goal relative to opioid prescribing is to prevent inappropriate prescribing, not to disrupt the treatment of patients with a legitimate need for pain management. Access the CDC policy and the Board’s comments on it in the position statements section of the NCMB website. This is most easily accessed from the home page, under Resources (bottom left).