Highlight on Washington, DC: Prescription Drug Reporting, Licensing, and Exchange Laws Adopted in 2014

Pharmacists and other dispensers of controlled substances in the District of Columbia will have to provide specific information  to a new database on the substance prescribed and the person to whom the medication was prescribed under legislation adopted in 2014.  Another piece of legislation adopted by the City Council would regulate an additional nine professions including home health and assisted living administrators.  The Omnibus Health Regulation Amendment Act of 2013 would also require additional certification for dentists and dental facilities where anesthesia is administered.  Finally the City Council adopted legislation that provides definitions of key  phrases in the Health Benefit Exchange Authority Act of 2011.   Upcoming proposals having to do with health care will be treated differently in 2015, as the City Council is combining the Health Committee and the Human Services Committee.

Prescription Drug Monitoring Program

Effective February 22, 2014 dispensers of medications licensed by the District of Columbia will have to report information within 24 hours on each prescription  dispensed for a schedule II, III, IV or V controlled substance to the Prescription Drug Monitoring Program.  The patient’s name, address, date of birth, and gender as well as the dispenser’s and prescriber’s identification number, the date the prescription was written, the date the prescription was dispensed, the prescription number, the quantity dispensed, the source of payment and other information needs to be reported.  Hospitals, nursing facilities, hospices, and drug wholesalers are exempt from the act as are prescriptions provided by a licensed narcotic maintenance programs.

The report of the City Council’s Health Committee stated that this legislation is designed to “reduce the diversion of prescription drugs in an efficient and cost effective manner.” The committee reported that prescription drug abuse has become a nationwide problem with nearly one-third of people 12 years of age or older began abusing drugs by using a prescription drug for a non-medical purpose. Typically it will be pharmacists who will be checking the database and reporting data to the database and not physicians.  Pharmacists have the power to deny a request to fill a prescription, but without this database pharmacist have a difficult time obtaining information to make that decision.

Licensed Professionals

Dentists and dental facilities that administer anesthesia in the District of Columbia will have to obtain an additional certification under the provisions of the Omnibus Health Regulation Amendment Act of 2013, adopted on January 7, 2014 and effective on March 26, 2014.  In addition teachers of dentistry hygiene and dentistry will also have to be licensed in the District of Columbia.

While home health care agencies in the District  of Columbia have been licensed for a number of years they will now be required to provide both a skilled nursing services and a therapeutic services that includes physical, speech, or occupation therapy, medical social services, or personal care services. This definition will be in conformance with federal law and will minimize inconsistencies among oversight agencies, according to a report prepared by the City Council’s Health Committee on this legislation.

Home healthcare administrators, assisted living administrators, assistants in the practice of speech language pathology and audiology, as well as speech language pathology clinical fellows will need to be licensed. Prior to this legislation health professionals were regulated by 18 health occupation boards and four registration programs.

Health Insurance Exchange

The Better Prices, Better Quality, Better Choices for Health Care Coverage Amendment Act of 2014 provided key definitions for the regulation and operation of the District of Columbia’s health insurance exchange.  The Act would require insurers to offer plans at the bronze, silver and gold level on their exchange and require standardization of at least one plan at each metal level. The District of Columbia’s exchange acts more as a clearinghouse and contracts will all qualified health plans who want to offer insurance on their exchange instead of only offering pre-selected health plans with negotiated premiums prices, according to a Health Committee report.  The Act defines terms such as metal level, navigator, standardized plan, accurate attestation, prescription drug formularies, and essential health benefits.  The District of Columbia established its exchange with the Health Benefit Exchange Establishment Act of 2011.

Future Activity

The District of Columbia’s City Council may be more active in 2015 than it was in 2014.  It begins a new two year legislative session  on January 2, 2015, and the City Council will  be reducing the number of committees it has from ten to eight, according to a recent press release.  Most notably the Health and Human Services Committees will be combined into one committee which will be chaired by the former Chair of the Health Committee, Councilmember Yvette Alexander.  This combination could have a significant impact on how and what types of legislation will be adopted by the District of Columbia’s City Council on health care related issues in 2015 and 2016.