Starting January 1, 2019, all Hoosier healthcare providers who hold a controlled substance registration (CSR) are required to register for Indiana’s INSPECT Program, a Central Repository for Controlled Substances Data, and practitioners in hospital emergency departments and pain management clinics are required to check the database before prescribing an opioid or benzodiazepine to a patient.
An updated act passed by the Indiana legislature and signed into law by Governor Eric Holcomb on April 18, 2019, clarifies the program’s requirements, as well as moving it from a Title 35 criminal statute to a Title 25 professional licensing statute.
The updated law, for instance, allows practitioners to look up a patient’s controlled substance history from the INSPECT database itself, or through the patient’s integrated health record. A practitioner’s agent also may check the INSPECT program reports on behalf of the practitioner. As well, for patients under a pain management contract, practitioners need to query the database only once every 90 days. Then there are the provisions for when a practitioner is not required to make an inquiry, including the following:
- If the practitioner has obtained a waiver from the board because the practitioner does not have access to the Internet at the practitioner’s place of business.
- If the patient is recovering or in the process of completing a prescription that was prescribed by another practitioner while still being treated as an inpatient or in observation status.
- If the INSPECT database is suspended or is not operational, as long as the practitioner documents in writing or electronically the date and time in the patient’s medical record that the practitioner attempted to use the database.
Perhaps the biggest change in the new version of the law is the change in penalties. Since the new law is under Title 25 as a professional licensing statue, most violations of the law now fall under civil liability, whereas in the earlier version, all offenses were considered Class A Misdemeanors.
For instance, if a practitioner checks the INSPECT database prior to prescribing an opioid or benzodiazepine, and then acts in accordance with the information available, she is immune from civil liability for an injury, death, or loss to a patient. However, according to the statute, “The civil immunity described in this subsection does not extend to a practitioner if the practitioner receives information from the INSPECT program … and then negligently misuses this information.”
As well, not all threat of criminal penalties has been removed from the law. Section 25 of the law mandates that a person who knowingly or intentionally releases confidential information obtained from the INSPECT database in an unauthorized manner commits a Class A misdemeanor.
Finally, the updated law confirms the timeline for bringing all providers under the look-up requirement. As mentioned above, clinicians in emergency departments and pain clinics are required to query INSPECT as of January 1, 2019. All other practitioners who provide services in hospitals must begin querying INSPECT by January 1, 2020, and all remaining Indiana providers must come on board by January 1, 2021.
For more information about the INSPECT program, visit INSPECT online. If you are a healthcare provider who holds a controlled substance registration and have not registered for INSPECT, check out the Registration Information page. For more information about the new law, HEA 1294, you can review the law in its final form, or learn more about earlier versions, House and Senate votes on the bill, and more at the Indiana General Assembly’s webpage for the bill.
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