Best Practices for Writing Prescriptions

The dental attorneys at Nardone Limited in Columbus, Ohio, continuously strive to research and identify possible legal issues that may arise for our dental clients. Our dental attorneys have found that one subject area that impacts our clients involves the best practices requirements as they relate to prescribing, record keeping, and the potential exposure of over prescribing. This article will discuss best practices for writing prescriptions and ensuring regulatory compliance within your practice.

What are the best practices?

To be valid, a prescription must be issued for a legitimate medical purpose by a practitioner in the usual course of his professional practice. In addition to being issued in the usual course of the practice, prescriptions must be written within a practitioner-patient relationship that is for the purpose of maintaining and advancing the patient’s well-being. Additionally, the practitioner must conform to certain minimum standards of care, such as taking an adequate medical history, doing physical or mental status examinations and documenting the findings. This rule applies to any prescription, issued by any means, including the internet or other electronic process. Prescribing that does not meet these requirements is unlawful. To the extent the dentist fails to follow the best practices, the dentist runs the risk of violating both federal and state law, causing certain enforcement actions to be taken.

What could happen if best practices are not followed?

To the extent a dentist fails to abide by the requirements of proper diagnosis and medical necessity for a particular prescription, or if they over prescribe, they may expose themselves to certain civil enforcement actions. Even in a situation where a practitioner validly prescribed the correct dosage of narcotics, if the practitioner fails to properly document the exam and diagnosis, he may be subject to civil or criminal liability. Practitioners may be subject to investigation by the state dental board. Those actions could include the practitioner’s state dental board taking disciplinary action or loss of various state and federal licenses or prescribing. If the dental board finds that the particular infractions rise to the level of criminality, offending practitioners may be subject to criminal liability under state and federal regulations.  Additionally, the Drug Enforcement Administration (“DEA”) registers and monitors all health professionals entitled to dispense controlled substances. DEA registrants must comply with a series of regulatory requirements relating to drug security, records accountability, and adherence to standards. If the DEA determines that the dentist improperly prescribed narcotics, and that the conduct rises to the level of criminality, the DEA’s determination may result in a recommendation of criminal charges.

What should be done if a violation is suspected?

Education is key. It is important that every member of the dental practice be aware of the documentation requirements and possible risks involved with overprescribing controlled substances. Practitioners need to be educated on how to treat patients with substance abuse problems and proper use of medical prescription records. Additionally, the office should implement a regular audit process of its patients and prescriptions. In certain circumstances, it may be necessary to terminate a patient relationship and the employment of certain practitioners, but legal counsel should be consulted first to ensure the termination comports with the state dental board as well as contract and labor laws.

The dental attorneys at Nardone Limited can provide education and training to you and your staff on the best practices for prescribing controlled substances. Nardone Limited, a Columbus, Ohio law firm, provides specialized dental practice representation across the state of Ohio and the United States. The dental attorneys at Nardone Limited specialize in representing dentists in such diverse areas as: (i) dental practice business succession planning; (ii) dental practice purchases and sales; (iii) dental board matters; (iv) real estate matters, including lease agreements and commercial real estate purchases; and (v) employment-related matters. Contact Nardone Limited for more information related to our employee education and training programs.