AB474 Toolkit

AB474 Toolkit – Your resource for prescribing controlled substances under new Nevada law.

New prescribing requirements have been established from the 2017 legislative session (AB 474 and SB 59). Review the below reference guides for details.

Background of the new law:

The Basics:

The bill has five (5) major requirements our Nevada Physicians (including residents) and Physician Assistants need to know:
STARTING JANUARY 1, 2018
  1. Two units of CME per licensing cycle required for all licensed prescribers: misuse, abuse of controlled substances, prescribing of opioids or addiction- may satisfy ethics and general requirements.
  2. Mandated Registry and Use of PMP: Every initial Prescription and every 90 days during course of treatment.  All licensed prescribers must self-query every 6 months.
  3. New Prescriptions Requirements: All RXs for Controlled Substances must include: Patient’s DOB, ICD-10 code, minimum number of days to consume the prescribed medication, prescriber’s DEA license must be clearly identified.
  4. New Prescribing Guidelines for Controlled Substances.   
  5. COMING IN 2018 – Overdose Reporting NOT required on January 1, 2018 but coming soon. NSMA will continue to track this progress.

AB474 Prescribing Flowchart with Form Requirements

Download your copy of the above flowchart here. (PDF / editable)

Best Practices:

  • Register for the Nevada PMP Here.
  • Consider outreach and contact your patients.
  • Ensure printed prescriptions are legally valid. Here is a sample letter to EHR/EMR vendors (PDF / Word) for your use.  Effective January 1, 2018, AB 474 requires that every prescription for a controlled substance, in addition to the components currently listed in NAC 453.440, must include the following:
    • – Patient’s Date of Birth
    • – International Classification of Diseases Tenth Revision (ICD-10) diagnosis code for the disease being treated with the CS
    • – The fewest number of days necessary to consume the quantity of the CS dispensed to the patient if the patient consumes the maximum dose of the CS authorized by the prescribing practitioner.
    • – Practitioner’s Drug Enforcement Administration (DEA) number

Forms:

  • Informed Consent (PDF / Word) – Coming Soon!
  • Prescription Medication Agreement (PDF / Word)

Risk Assessment Tools:

Overdose Reporting:

On January 16, 2018, Governor Sandoval certified an Emergency Regulation providing guidance for the reporting of overdoses as required in AB474.

The Emergency Regulations, Frequently Asked Questions (FAQs) and Reporting Form are accessible here.

Emergency Regulations are effective for 120 days.

During this time, the Board of Health will be promulgating permanent regulations.  NSMA will be working with the regulators to revise these regulations.  To provide feedback on the overdose reporting regulations, please contact NSMA’s Executive Director at Catherine@nvdoctors.org or (775) 825-6788.

Disclosure: The information and forms contained on this website is for informational purposes only and does not constitute legal advice.  Neither the Nevada State Medical Association, its executive director, employees, nor members are acting as your attorney.  Although every effort has been made to ensure accuracy, NSMA makes no claims, promises or guarantees about the accuracy, completeness, or adequacy of the information contained herein. Nothing that you read or is provided on this web site should be used as a substitute for the advice of competent legal counsel.  If you have any questions, feel free to contact NSMA at (775) 825-6788

Other Resources:

  • Training for DOs by the Board of Osteopathic Medicine HERE.
  • Project ECHO: ECHO is a simple telehealth linkage connecting university-based faculty specialists to primary care providers in rural and under-served areas to extend specialty care to patients with chronic, costly, and complex medical illnesses.
  • Do you prescribe to California patients? Learn more about and register for the California PDMP (CURES) Here.

 


PMP button smaller

More information on the PMP and how to register here.


State Seeks Input on Controlled Substance Abuse Prevention Act Regulations

Small businesses in Nevada are asked to submit feedback by Jan. 24, 2018

The Division of Public and Behavioral Health is asking Nevada businesses with 150 or fewer employees to provide feedback on the draft regulations under development to enforce Assembly Bill 474, the Controlled Substance Abuse Prevention Act. As part of the bill, the Board of Health will be adopting regulations requiring the reporting of drug overdoses to the State’s Chief Medical Officer. Before holding a workshop on the proposed regulations, the Division of Public and Behavioral Health is required to solicit input from small businesses on the anticipated costs and benefits to the proposed regulation. The survey and draft regulations can be accessed and completed online at prescribe365.nv.gov or by clicking below. Please provide your feedback no later than 5 p.m. on January 24, 2018.

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Still confused about the opioid law implementation?

At NSMA’s request, the Nevada Department of Health and Human Services has set up an Frequently Asked Questions hotline.  You can email your question about AB474 to AB474FAQs@health.nv.gov and the answer will be published.   Feel free to copy Catherine@nvdoctors.org on your query and Catherine will ensure your question is answered.

For more resources provided by State of Nevada, Division of Public and Behavioral health, visit prescribe365.nv.gov

Bookmark this page for toolkit and updates.