Registration for pain management services

Board Rules Chapter 540-X-19 - Official version from Legislative Reference Service (scroll down to 540-X-19)

Also check the bottom of the Administrative Rules page for any proposed or emergency rules



What are "pain management services"?
Who is required to register with the Board?
How do I register?
To determine whether you should register as a provider of pain management services
What do the Board rules require for physicians providing pain management services?
Exemptions


What are "pain management services"?

The provision of pain management services shall mean:
 
(a) A physician practice which advertises or holds itself out to the public as a provider of pain management services*; OR

(b) A physician practice which dispenses opioids; OR

(c) A physician practice in which any of the providers of pain management services are rated in the top three percent (3%) of practitioners who prescribe controlled substances in Alabama in Schedules II, IIN, III, IIIN and IV, determined by the Alabama Prescription Drug Monitoring Database on an annual basis.

*Those medical services that involve the prescription of controlled substances in order to treat chronic non-malignant pain by a physician who treats pain.


Who is required to register with the Board?

Beginning January 1, 2014, and continuing every year thereafter, all physicians who provide pain management services (see definition above) must obtain a pain management registration from the Board -- for initial registration for 2014.  In subsequent years, renewal will occur during the same period as license and ACSC renewals (Oct. - Dec.), and annual registrations will expire Dec. 31 of each year.


How do I register for pain management services?

You should first thoroughly review Board Rules Chapter 540-X-19

  • Download application form
  • Fill out application
  • Send completed application form and payment of fees
  • When your registration is complete, you will receive a registration certificate

 

Pursuant to Rule 540-X-19-.03, the Board requires the following for pain management services registration:

  • A completed application
  • Proof of a current Drug Enforcement Administration (DEA) registration
  • Proof of an Alabama Controlled Substance Certificate (ACSC)
  • Proof of a current registration with the Alabama Prescription Drug Monitoring Program (PDMP)
  • The disclosure of any controlled substances certificate or registration denial, restriction or discipline imposed on the registrant, or any disciplinary act against any medical license of the registrant
  •  Payment of the initial registration fee ($100.00)
  •  A certification listing the current name of the physician who serves as the medical director
  •  The physical address of each location where pain management services are provided
  • A  list of all physicians who work at the practice location, including the name of the physician who will serve as the medical director

 


To determine whether you should register as a provider of pain management services

  1. Do you treat chronic non-malignant pain? If your answer is NO, you do not need to register as a provider of pain management services. If your answer is YES, please proceed to the following question.
  2. Do you advertise or hold yourself out a providing treatment for patients with chronic non-malignant pain? If your answer is YES, you should register as a provider of pain management services. If your answer is NO, please proceed to the following question.
  3. Does the ultimate user (patient) physically leave your medical practice with an opioid? If your answer is YES, you should register as a provider of pain management services. If your answer is NO, please proceed to the following information.
  4. The Board will determine, on an annual basis, the top 3% of prescribers of Schedule II, IIN, III, IIIN and IV controlled substances and inform them of the registration requirement.

    Physicians who meet ANY of the above criteria are required to register with the Board annually beginning January 1, 2014.

To further clarify the Board's intent of Administrative Rule Chapter 540-X-19, please note, these rules do not apply to the treatment of acute pain; physicians are encouraged to be involved in the appropriate care of acute pain.

Additionally, the provisions of this rule shall not apply to a licensed hospice program or any physician providing pain management services for that program, or to any facility maintained or operated by the United States government.


What do the Board rules require for physicians providing pain management services?

  • Pain Management Services must be provided at a location owned and operated by 1) one or more physicians licensed in Alabama; 2) a business entity registered with the AL Secretary of State; or 3) a governmental entity or body, or political subdivision, including state universities and schools
  • Each practice must be under the direction of a medical director who is a physician with a current, unrestricted Alabama medical license
  • Every registrant is required to register with the Department of Public Health's Prescription Drug Monitoring Program

 

Additionally:

  • Medical Directors must meet certain training and on site requirements (see Rule 540-X-19-.05)
  • Board Rule 540-X-4-.08/540-X-19-.09, Requirements for the Use of Controlled Substances for the Treatment of Pain, specifies certain requirements and guidelines for physicians providing pain management services

 


Exemptions

The Pain Management Services rules do not apply to:

  • A hospice program as defined by and licensed by the Alabama Department of Public Health, or any physician while performing work or providing pain management services for that program
  • A facility maintained or operated by the United States or any of its departments, offices or agencies, or any physicians while performing work for that facility
Copyright 2017 The Alabama Board of Medical Examiners
All rights reserved