INDIANAPOLIS – The Medical Licensing Board of Indiana voted Thursday to adopt a new rule concerning physicians who prescribe addictive pain medications to nonterminal patients.

Indiana Attorney General Greg Zoeller said the rule aims to ensure patients are well informed about their prescriptions and physicians closely monitor patients to identify cases of misuse and abuse. A recent study by Trust for America’s Health revealed the number of deaths caused by overdoses in Indiana has quadrupled since 1999.

This year, the Indiana General Assembly passed legislation charging the board with developing new rules regarding prescribing controlled substances and strengthening the authority of the Attorney General’s office to inspect physician records in overprescribing cases. The two emergency rules stem in part from recommendations made by the Indiana Prescription Drug Abuse Task Force which Zoeller launched last year.

“Thanks to the hard work by the state’s Medical Licensing Board and to the Indiana Prescription Drug Abuse Task Force, Indiana is making great strides in the battle against prescription drug abuse,” Zoeller said. “By ensuring physicians are educating and closely monitoring patients and Hoosier patients are well informed, we can help stop cases of doctor shopping and even overprescribing.”

Beginning Dec. 15, physicians will be required to monitor certain patient’s history via the state’s drug monitoring system called INSPECT which reveals what medications have been prescribed to a patient. Zoeller said this check can prevent someone from “doctor shopping” or obtaining multiple prescriptions for the same drug from different physicians.

The board also adopted a new rule giving the Attorney General’s office the ability to more efficiently review physician records regarding controlled substances. Zoeller said this helps his office during investigations of physicians who may be overprescribing.

Since January of last year, Zoeller’s office has filed complaints or summary suspensions against more than 15 doctors for overprescribing.

The goal of the task force is to significantly reduce the abuse of controlled prescription drugs and to decrease the number of deaths associated with these drugs in Indiana. The task force also makes recommendations for new rules, regulations and state statutes to the Indiana General Assembly.

The task force in conjunction with the Indiana State Medical Association will soon release a physician toolkit which will help doctors navigate the new emergency rules. Zoeller’s office will also host the fourth annual Prescription Drug Abuse Symposium on Nov. 1 where health officials will discuss Indiana’s prescription drug abuse epidemic and learn more about the impact of the new rules.

Zoeller also thanked the Indiana State Medical Association for their work on developing the emergency rules and physician toolkit.

This year, Zoeller and the task force launched a new website, www.BitterPill.IN.gov, and a statewide public awareness campaign which includes radio and TV commercials about prescription drug abuse. The website serves as a one-stop-shop for consumers to find information about the epidemic and how to get help.

By John Krull
TheStatehouseFile.com

Editor’s note: This column originally posted on Oct. 23. The following day, after events changed, writer John Krull updated it to reflect action by Attorney General Greg Zoeller.

John Krull, publisher, TheStatehouseFile.com

INDIANAPOLIS – The latest squabble between Indiana Superintendent of Public Instruction Glenda Ritz and, oh, well, just about every Republican in the state raises an intriguing question.

Is there one single sane functioning adult to be found at work anywhere at any level of state or federal government?

Ritz, a Democrat, filed suit Tuesday against the state Board of Education, all of the members of which had been appointed by Republican governors. Ritz argued that the board violated the state’s open door law by drafting and sending to Republican legislative leaders a letter last week urging them to take the controversial A-F school grading process out of her hands.

Ritz said that the board members didn’t even tell her about the letter, even though she’s supposed to be the board’s chair.

This Indiana playground donnybrook follows on the heels of a federal government shutdown that stretched on for more than two weeks, drained $24 billion out of the economy and slowed job growth across the country. That shutdown and resulting economic disaster came as a result of carefully thought-out strategy by tea party Republicans in the U.S. House of Representatives and Senate.

The right-wingers’ finely tuned plan was to stamp their feet and hold their breath until the rest of the country gave them their way.

This battle over who controls education policy is every bit as mature as the shutdown fight was.

At the heart of this kindergarten tussle is an inconvenient election – for Republicans and self-proclaimed education reformers, anyway.

Last fall, Ritz defeated a heavily favored and heavily funded incumbent, Tony Bennett. Bennett was one of the darlings of the education reform movement, a fire-breather in favor of school choice, standardized school and teacher assessments and market-driven approaches to learning in general.

Bennett’s defeat was such an unwelcome development for the school choice and accountability crowd – in part because it undermined one of their basic arguments, namely that their approach was what the people wanted – that they pretty much decided to pretend it never happened.

Ever since Ritz got elected, the state’s Republican hierarchy has worked to ignore the new superintendent or thwart her if the circumstances didn’t allow them to ignore her.

The fact that, in addition to ignoring or thwarting her, they also were ignoring or thwarting the majority of the voters who placed her in office seems not to have occurred to the GOP deep thinkers and their appointees.

They have continued on their course even after a series of stories by the Associated Press revealed that, before he left office, Bennett altered the assessment process of the A-F school grading system to get the outcome he wanted for a specific school, one he had touted as a model for his approach to education. That revelation delivered a devastating blow to Bennett’s career and reputation and forced state officials to re-examine the whole A-F system.

When the revelations about Bennett’s manipulation of school grading system hit, Republicans and Democrats settled into another protracted set of squabbles. Republicans blamed Ritz for leaking the information that damaged Bennett and the A-F system. Democrats did their best to make Bennett the poster boy for everything bad in schools, state government and life in general.

The partisan pushing, shoving and jostling now have exploded into a full-scale playground brawl.

In addition to sending the signal to parents all over Indiana that their children will not be under anything resembling adult supervision as long as these leaders are on the job, the suit creates other interesting problems.

Attorney General Greg Zoeller, for example, makes it a point of pride to say that he is the state’s lawyer. Who does he line up with on this one – the schools chief elected by the voters or the state board of education appointed by the governor?

Zoeller refused to comment on the suit when it broke, but since has challenged Ritz’s suit on procedural grounds. He said that, as attorney general, only he gets to serve as the lawyer for state officials. That position may force him to answer the question of which part of state government he’ll choose to serve..

Thoughtful Hoosiers doubtless will ponder what all these folks could accomplish on behalf of the state’s students if they spent half – nay, a quarter – as much time and energy on improving kids’ learning experiences as they do trying to stick it to each other.

But that would require someone in a leadership position to show some maturity.

That, too, raises a question: Who’s going to be the grown-up, perhaps the only one around, in state government?

John Krull is director of Franklin College’s Pulliam School of Journalism, host of “No Limits” WFYI 90.1 FM Indianapolis and publisher of TheStatehouseFile.com, a news website powered by Franklin College journalism students.

While session may have ended in April, I have still been working as a member of interim study committees in preparation for this upcoming year. One of the committees that I had the privilege of serving on is the Health Finance Commission. Having spent nearly my entire life in the health care field, it is something that I am very passionate about.

Study committees allow us more time to really dig into the weeds of the issues that are impacting our state the most. After months of study, the Health Finance Commission has made five recommendations for possible legislation to be heard during the 2014 legislative session. One of these recommendations, which I was extremely pleased to see, concerns treatment of traumatic brain injuries.

The committee is recommending that by September 1, 2014, the State Department of Health shall adopt rules that establish a license and provide regulations for a facility that provides specialized treatment and services for traumatic brain injuries. Our state currently lacks traumatic brain services, specifically post-acute care facilities.

Hoosiers who experience traumatic brain injuries are forced to go out of state for care. We heard testimony from individuals who talked about the hardships they faced having to travel to someplace else to receive care and being away from family and friends during that difficult time. Additionally, this can pose a serious financial burden. If our taxpayer dollars are already going towards funding licensed facilities in other states, I think it’s time that we developed one here in Indiana.

The next recommendation deals with electronic health data. The commission is recommending that the State Department of Health and the Office of the Secretary of Family and Social Services be required to establish a work group which would study uniform access to electronic health data by health providers. If this were to become a reality, patients with multiple providers would be able to have all of their health information made available to the physician currently treating them as their patient. This would not only increase safety but also lower costs.

They are also recommending that the Commission for Higher Education be required to study and make recommendations concerning the issue of the high costs of dental education and the high level of debt incurred by individuals attending dental school. This would be done in consultation with the State Board of Dentistry and the Indiana University School of Dentistry.

The commission also made two other recommendations that I am still currently weighing. One of these recommendations would change the law regarding minors and tanning devices. Under current law, a person who is under 16 years of age must be accompanied by a parent or guardian when using a tanning device in a tanning facility. The committee has recommended that the current provision be repealed and replaced with a provision prohibiting anyone under the age of 16 from using any tanning device at a tanning facility.

The final recommendation deals with biosimilar drugs, or generics, as they are more commonly known.  The committee is recommending that a pharmacist be allowed to substitute an interchangeable biosimilar product for a prescribed biological product if certain conditions are met.  For instance, the pharmacist would have to inform the customer of the substitution, the prescribing practitioner would then have to be notified within five calendar days and both the pharmacy and the practitioner would have to retain a record of the substitution for at least five years.

As you can see, we tackled a wide variety of issues in this committee. I appreciate all of the valuable information that was shared with us throughout the course of our meetings. Now that we have an idea of what we may be looking at during the next session, I want to hear your opinions as well. Do you have experience in these matters? What are your thoughts on these recommendations? I can be reached by phone at 317-232-9509 or via email ath75@iga.in.gov. I look forward to hearing from you as I continue to independently explore these issues!