On November 19, the Ohio Academy of Family Physicians received a formal response to its letter dated October 22, asking the State Medical Board of Ohio (SMBO) to cease sending Ohio Automated Rx Reporting System (OARRS) compliance reports until the integrity of the data used to generate the reports is verified as accurate.
The response, addressed to OAFP President Stan Anderson, MD, is signed by the directors of the SMBO and State of Ohio Board of Pharmacy (SOBP) and reads as follows:
“On October 15, the SMBO sent an email to prescribers advising them of the mandatory use of OARRS (required by Ohio Administrative Code 4731-11-11) and inclusion of ICD-10 codes (required by Ohio Administrative Code 4729-5-30) on controlled substance prescriptions. The compliance information relayed in this email was provided by the SOBP.
- The ICD-10 was appropriately entered into the EHR but was not transmitted to the pharmacy. Large EHRs that have identified this issue include Epic. The SMBO and the SOBP will continue to update this list as we learn more.
- Processes at pharmacies did not include the submission of ICD-10 codes into OARRS. The Board of Pharmacy will be addressing this issue with those pharmacies.
- Prescribers were unclear on the difference between exemptions for OARRS checks and exemptions for the inclusion of an ICD-10 code on controlled substances.
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- OARRS usage exemptions include: VA prescribers; patients in hospice; patients with a diagnosis of cancer; prescriptions issued in a hospital, nursing home, or residential care facility; a prescription of fewer than 7 days’ supply; acute pain from a surgery, other invasive procedure; or a delivery
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- ICD-10 code inclusion exemption: VA prescribers; inpatient prescriptions (often referred to as an order) issued in a hospital, nursing home, or residential care facility
- OARRS data report did not include an automatic integration of prescribers’ license number and email, resulting in some erroneously-reported non-compliance.
Please be advised that prescriptions for Gabapentin that omitted an ICD-10 code were not reported as non-compliant. To clarify, Gabapentin requires the days’ supply but does not require an ICD-10 code and is not counted in the prescriptions missing the code. While the MyRx feature in OARRS is a complete report of a clinician’s prescribing of OARRS drugs (including gabapentin), it does not mean that gabapentin was reported to the SMBO as being non-compliant.
The SMBO and SOBP are dedicated to resolving the scenarios above and appreciate the assistance of their licensees in identifying these opportunities for improvement. We will monitor the progress on these issues before sending out another compliance communication.
- 225 million – decrease in doses of opioids dispensed in 5 years
- 64 million – decrease in doses of benzodiazepines dispensed in 5 years
- 88% – decrease in doctor shoppers since 2011
- 30% – of nation’s total PDMP queries come from Ohio prescribers. That was almost 89 million last year alone. Florida was second-highest with 40 million queries.
By reducing the supply of prescription opioids and other controlled substances, fewer Ohioans will be presented with opportunities to misuse these potentially addictive medications. Our prescribers’ diligence is making a difference and is appreciated.”