Those of you who missed the original January 1 deadline can breathe a sigh of relief! The new deadline is July 1, 2016.
But don’t make the mistake of thinking you can ignore CURES—California’s Controlled Substance Utilization Review and Evaluation System. All healthcare practitioners who prescribe Schedule II-IV controlled substances must register with the new CURES 2.0 database. This includes hospital-based anesthesiologists.
The latest version of CURES will launch on January 8. And the really good news is this: The application can be completed entirely online. No notary is required!
Previously, you had to download a printable version of your application and have it notarized along with a copy of your Drug Enforcement Administration (DEA) certificate and a government-issued form of identification. Beginning January 8, all credentialing will be verified internally within two to three days of submitting an online application. No uploading of documents will be required. Upon approval, the applicant will receive an email verifying CURES registration with a temporary password for initial access of the database.
Though all practicing anesthesiologists who give narcotics to patients will need to register with CURES, the program requires reporting only when a prescription is dispensed. It doesn’t require us to report in-hospital administration of controlled substances. This is a good thing for those of us in the OR suites. Just imagine the anesthesia workflow issues if every patient having surgery required a CURES inquiry!
In essence, CURES is California’s prescription drug monitoring program (PDMP). Similar programs have been established in 49 states, and are considered to play a crucial part in stemming prescription drug abuse by patients and the over-prescribing of pain medications.
In most states, the Pharmacy Board oversees PDMPs. In California, oversight is the responsibility of an agency within the Department of Justice (DOJ). In 1999, CURES replaced the California Triplicate Prescription Program, which had been in place since 1939. Legislation in 2005 eliminated the triplicate requirement for Schedule II controlled medications. CURES added the PDMP component as a searchable client-based resource in 2009.
Most recently, in 2013, Governor Brown signed Senate Bill 809 (DeSaulnier and Steinberg) into law. This legislation increased state funding for CURES, and upgraded the program resources for physicians, prescribers and dispensers who have reason to submit an inquiry. The Medical Board of California now collects an additional six dollars per year on physician license applications and renewals. The three-million-dollar system upgrade promises the following enhancements:
- Upgraded capability to allow real-time updates and 24/7 accessibility
- Ability to integrate with health information systems
- Accommodation of large increases in usage
- Better collaboration among PDMP users (prescribers, dispensers, criminal justice system)
- Interstate information sharing through the Prescription Monitoring Information Exchange (PMIX)
- Improved analytics
- Streamlined PDMP registration process
- Advanced privacy and security standards
In reality, PDMPs are simple in concept, but complex to implement. The well-publicized epidemic of prescription opioid-related deaths, now greater than those from heroin and cocaine combined, is driving the push for effective PDMPs.
Last October, the ASA announced its participation in a government-led effort to address the opioid epidemic. This effort is part of ASA’s continued focus on patient safety and ongoing work to promote the safe use of prescription opioids.
“As leaders in patient safety, we are proud to join this partnership as we continue our work to encourage physicians to register and use prescription drug monitoring programs; enhance physicians’ education on effective, evidence-based prescribing of opioids; and encourage physicians to consider co-prescribing naloxone,” said J.P. Abenstein, MD, MSEE, the ASA’s immediate past president.
Any questions? Call the CURES Help Desk at (916) 227-3843, which offers multiple phone lines to handle calls during business hours from 8 to 5. After hours, you may contact a representative of the DOJ, who will take your contact information and submit a ticket to the Help Desk. You may expect a call the next day.
Beginning January 8, 2016, the application process will be a fully automated process. Just go online and register! You should receive confirmation within a week.
Per the CURES Help Desk: If you submitted an online application prior to January 8 and haven’t yet had the printable version notarized, you don’t need to bother. You can resubmit your application online after the new system goes live.
If you prefer to mail in your application, documentation should be sent to:
Bureau of Criminal Identification and Investigative Services
Attn: PDMP Registration
P.O. Box 160447
Sacramento, CA 95816
Learn more about CURES 2.0 at: https://www.oag.ca.gov/cures-pdmp