State & Federal Action Notices

OPH State Lab Forms Now Available Electronically: Updated Guidance for COVID-19 Testing at the State Laboratory

The use of Telemedicine Technologies with Established Patient

(LA HAN)--Updated Guidance for COVID-19 Testing at the State Lab & Patient Under Investigation Form

Notice to COVID-19 Temporary Permit Holders

Heroine: A Deadly Resurgeance

Telehealth for Allied Health Care Providers

Continuing Education Tracker Update

Policies

Board Buzz Newsletters

Whistleblowing

Private Radiological Technologists

Podiatrists

Multi-Specialty Conference on Sarcoidosis

25% Decrease in opioid production in 2017

Special Call Meeting

Louisiana Department of Health Reporting Surge of Fatal Drug Overdoses

Scammers claiming to be with the LSBME

Investigations

Application & Instructions for Initial Licensure - Podiatry

Online Board Orientation

COVID-19 CRISIS INFORMATION

Board Approved CME Courses for CDS Requirements

LA State Registers-5 Year Archive

Links

Welcome Medical Psycologists

Frequently Asked Questions

Health Care Resources for the Practitioner

Activity

Application & Instructions for Initial Licensure - Polysomnography Reinstatement

Emergency Temporary Permits for Health Care Practitioners

GETP and PGY Temporary Permits

History

Educational Resources - Physicians

Topics of Interest

Helpful Hints - Physician Licensure

General Instructions

Advisory Opinion FAQ's

Death Certificates

The Impaired Professional

Medical Psychology Practice Act

Frequently Asked Questions - Physician Licensure

Adjudication Process

Athletic Trainer Advisory Committee

Louisiana Telehealth Access Act

Board Orientation On-line Welcome

Email Blast Communications from the LSBME

Unprofessional Conduct Rules

LaMED DashBoard Now Available

LDH Provider Notice: Medical and Surgical Procedures

LSBME Legislative Update - 2019

Updated Interim Guidance on Evaluation and Testing Criteria for Suspected COVID-19 Cases

Interim Guidance on 2019 Novel Coronavirus (2019-nCoV) in Travelers from Wuhan, China

Health Alert Regarding Acute Flaccid Myelitis (AFM)

Medicaid Pharmaceutical and Therapeutics Committee

Hepatitis A Outbreak (Update)

Moonlighting Guidance

CDC Update re: Hepatitis A Outbreak

Guidance For Physicians On Safe Purchase Of Drugs From Pharmaceutical Distributors

Occupational Therapy Assistants

Office Based Surgery

Interstate Medical Licensure Compact

Notice to Physician Assistants

Emergency Temporary Permits

Hydrocodone Combination Products Re-Scheduled

CDC's Interim Guidance for Businesses for COVID-19

Rule Adoptions

Physicians Health Program

Integrative and Complementary Medicine Advisory Committee

Perfusionists Advisory Committee

Integrative and Complementary Medicine Committee

Advisory Committees

Perfusionists Rules

Collaborative Drug Therapy Management

LDH views on off-label prescribing

Respiratory Therapy

Healthcare Resources for the Consumer

Board Meeting - March 23-24, 2020

Infant Formula Recall and Reporting of C ronobacter sakazakii Cases in Infants

Availability of Personal Protective Equipment from your Established Vendor

USMLE Step 3 (Update)

Notice to Licensees re Continuing Education Requirements

LSMS Roundtable Discussion

Guidance for Clinicians Caring for Individuals Recently Evacuated from Afghanistan

LDH - Hepatitis C Announcement

***Scam Alert***

Renewal Notices

Louisiana Health Alert Network (LA HAN)--Steps for Community- and Faith-Based Organizations to Take to Prepare for Coronavirus

Training Matters

Physician Assistant Advisory Committee Vacancy

Zika in the ED: How Emergency Care Staff Can Take Action

Notice of a Large Mumps Outbreak in Northwest Arkansas

CDC's Guideline for Prescribing Opioids for Chronic Pain Webinar

Therapeutic Marijuana Guidance

Background Check Fee

LSBME Legislative Update

LSBME Newsletter-June 2018

Risks of Benzodiazepine Use in Patients with Chronic Pain

, pursuant to LSA-R.S. 42:19(A), that the Louisiana State Board of Medical Examiners (the "Board"), within the Department of Health and Hospitals, State of Louisiana, shall convene a special meeting of the Board at 9:00 a.m., Monday, November 9, 2015, at the offices of the Board, 630 Camp Street, New Orleans, Louisiana. The agenda of such meeting can be found here. 

Special Call Business Meeting

CDC Publishes Guidelines on the Use of Opiods for Chronic Pain

 published certain amendments to the Board’s rules on unprofessional conduct, LAC 46:XLV.7603. The publication inadvertently included wording that the Board had instructed be removed 

 a physician shall “b. not hold himself or herself out as a specialist in an area of medical practice unless the physician has successfully completed a residency or fellowship training program, which is accredited by the American Council on Graduate Medical Education of the American Medical Association, the American Osteopathic Association, or the Royal College of Physicians and Surgeons of Canada.”

The cited language was previously removed from this rulemaking effort by the Board. See: Potpourri Section of the July 2015 edition of the Register (LR 41:1416), whereat the Board noted that “After further review the board has decided to defer proceeding at this time on the amendments original proposed in §7603A.9 (e.g., holding one’s self out as a 

) and proceed only with the proposed amendments to §7603A.11.”

The Register has agree to reprint the corrected Rule removing the cited language, with an explanatory note, in the November edition of the Register.

The LSBME Online Renewal service is now available. Go to 

Online Renewals

**Notice; Physician Assistants—**Act 453 of the 2015 Session of the Louisiana Legislature amended the law governing physician assistants (PAs) to include, among other items, Schedule II CDS within the drugs that could be delegated to a PA by a supervising physician (SP). A rule-making effort to conform the Board’s existing rules to the changes is in development. In the interim, the law supersedes the rules where there is a disparity. A PA whose SP wishes to delegate Schedule II authority should complete and return to the Board an updated Notice of Intent to practice (available on this website).

A new Statement of Position has been issued by the Board regarding 

The Use of Social Media By Physicians and Other Healthcare Providers

Statement of Position

Recent outbreaks of viral meningitis and salmonella in Louisiana have the state’s Infectious disease epidemiology department concerned about the underreporting of certain infectious diseases.  While many of these conditions do get reported to them from labs or the infection control department of hospitals, we would like to remind health practitioners of their individual responsibility in this matter.

Dr. Raoult Ratard, the state epidemiologist realizes that physicians and others are busy professionals and will not report every case of infectious disease.  However, he and his associates in the department of infectious disease epidemiology do hope that health professionals use their common sense.  If, for example, a physician, nurse or PA sees a child with diarrhea and bloody stool and it is mentioned that various children in the class are suffering from the same condition, a call to the hotline is in order.  The faster the department is made aware of a potential problem, the faster it can operate to locate the source of a food borne illness or a dangerous respiratory or other condition and prevent further morbidity and/or mortality.

For further information on what diseases are reportable under the Sanitary Code and how soon they must be reported after diagnoses, go to 

http://dhh.louisiana.gov/assets/oph/Center-PHCH/Center-CH/infectious-epi/EpiManual/sancode042513.pdf

 and download this helpful information.  (You may want to post this one page document in your office.) The 24 hour hotline number to report infectious diseases or suspected outbreaks is 800-256-2748.

Underreporting of Infectious Diseases

GUIDANCE FOR PHYSICIANS ON SAFE PURCHASE OF DRUGS FROM PHARMACEUTICAL DISTRIBUTORS Health care providers can help protect the public health and reduce potential legal liability by avoiding purchasing prescription drugs that do not comply with U.S. regulatory requirements.  To help ensure safe drug purchasing from pharmaceutical distributors, FDA recommends that health care providers and their staff do the following:

MAKE SURE THE DRUGS AND DEVICES YOU DISPENSE IN YOUR PRACTICE COME FROM A STATE APPROVED SOURCE!

Under the Drug Supply Chain Security Act (21 U.S.C. 351 et seq.), as of January 1, 2015, all healthcare providers who dispense or administer prescription drugs to patients are required to purchase their prescription drug products only from authorized trading partners licensed by or registered with the state or federal government. This will help protect patients from being harmed by potentially dangerous and illegal drug products.

The FDA is committed to promoting and protecting the public health by helping to ensure that only safe, effective, and high-quality drugs and devices are available to the American public. Health care providers and patients are encouraged to report any suspicious medical products to FDA's Office of Criminal Investigations 

. Physician offices should be wary of mass advertising campaigns via “blast faxes,” phone calls, direct email, and online marketing for the sale of physician administered drugs and injections.

The Louisiana Board of Wholesale Drug Distributors (LBWDD) is the state agency charged with the responsibility to safeguard life and health and to promote the public welfare by licensing and regulating all entities engaged in the wholesale distribution of controlled or legend drugs or devices in/into the state of Louisiana.

To verify that a vendor you buy drugs or devices from is licensed by the LBWDD, go to:

http://www.lsbwdd.org/wholesaler-license-lookup/

Purchasing Safe Drugs and Devices from an Approved Source

Prescribers:  Please read the following to be properly informed about electronic prescribing of CDS:

Since June 1, 2010, the DEA has allowed electronic prescribing of controlled substances.  However, the electronic transmission of controlled substance prescriptions is not mandatory in Louisiana.

Paper prescriptions for all schedule II-V controlled substances are still permitted.  Telephone authorization for schedules III-V controlled substances are still valid.

Electronic prescriptions for controlled substances, including schedule II, are permitted only when both of the following criteria are met:

1. The prescriber’s software has been authenticated by a DEA–approved certifying organization; and

2. The pharmacy’s software has been authenticated by a DEA-approved certifying organization.

For a list of DEA-approved certifying organizations, go to: 

http://www.deadiversion.usdoj.gov/ecomm/e_rx/thirdparty.htm

Not all prescribers or pharmacies have approved systems.  Prescribers and pharmacies should understand the capabilities and limitations of their current software.   For more information on the various e-prescribing software vendors and their attributes, the LA Board of Pharmacy recommends the following website:  

http://surescripts.com/network-connections/mns/prescriber-software

Physicians should ensure that their prescribing software is approved for this purpose by one of the entities on the DEA certified list above.  In some cases, this may only require an upgrade of the software you are already using.  In the absence of approved software, CDS prescriptions transmitted electronically to a pharmacy are deemed to be “faxed” and will not be filled without an original signature.

1. Have a certification report for the electronic health records (EHR) or electronic prescription application to verify compliance with the DEA rule.

2. Obtain digital “credentials” to electronically sign CDS prescriptions.The prescriber may need to contact the EHR or application provider to determine how to obtain these credentials.

3. Restrict access so that only authorized individuals may electronically “sign” CDS prescriptions.

For further information please review the information available on the DEA website at:  

http://www.deadiversion.usdoj.gov/ecomm/e_rx/index.html

Electronic Prescribing of Controlled Substances

Recent article concerning increased risks associated with the use of benzodiazepines in patients on chronic narcotic therapy. 

This is a message from the Louisiana Department of Health and Hospitals Emergency Operations Center (DHH EOC). To remain current on newly released information about the recent national measles outbreak, visit the Centers for Disease Control and Prevention (CDC) website at 

The Department of Health and Hospitals (DHH) and CDC encourages healthcare providers to consider measles when evaluating a patient with febrile rash and ask about a patient's vaccine status, recent travel history, and contact with individuals who have febrile rash illness.

Measles can be prevented with the MMR (measles, mumps, and rubella) vaccine. In the United States, widespread use of measles vaccine has led to a greater than 99% reduction in measles cases compared with the pre-vaccine era. For additional information on measles vaccination, visit the CDC website at 

http://www.cdc.gov/measles/vaccination.html

Also, please see the letter attached for additional information on measles signs and symptoms and reporting suspected cases.

By Louisiana statue, measles must be reported immediately upon suspicion. Please report suspected measles cases promptly to the Louisiana Office of Public Health Immunization Program at 504-838-5300 or Louisiana Epidemiology Hotline 800-256-2748 after hours.

Alert for Measles in Louisiana and Report Suspected Cases

 During its 2014 session, the Louisiana Legislature established two (2) new categories of providers who are licensed and regulated by the Louisiana State Board of Examiners of Psychologists (LSBEP). As to each, the laws provide a supervisory relationship with a psychologist or medical psychologist (MP).  Specifically, Act 136 established 

licensed specialists in school psychology (LSSP)

provisionally licensed psychologists (PLP)

[W]ho applies his knowledge of both psychology and education during consultation and collaboration with others and engages in specific services for students, such as direct and indirect interventions that focus on academic skills, learning, socialization, and mental health. La. R.S. 37:2352(4).

A LSSP who practices as such but is “working outside of the school system” is required to do so under the clinical supervision of a Louisiana licensed psychologist or MP, who is “administrative, clinically, and legally responsible for all professional activities of the licensed specialist in school psychology . . . and shall be required to sign any final reports. . ..” La. R.S. 37:2356.2.B(1)(b).

[P]rovisionally licensed under this Chapter. La. R.S. 37:2352(7).

A PLP is required to maintain a relationship with a licensed psychologist or MP for purposes of clinical supervision. An MP who has entered into such a relationship “shall have legal functioning authority of the professional activities of the PLP.” La. R.S. 37:2356.2.D.

The LSBEP adopted emergency rules for PLP, which prescribe the supervisory obligations. (

. Vol. 40, No. 8, pp. 1474-1477 (Aug. 2014)). It is likely that rules prescribing obligations for supervisors of LSSP will be issued in due course.

While the LSBEP has no regulatory authority over MPs who do not maintain their license with the LSBEP, the supervisory requirements imposed upon LSSP and PLP by the law and any LSBEP regulations must be met in order for these individuals to lawfully practice their profession. With that in mind, the Board would consider it the professional obligation of any MP who undertakes the supervision of an LSSP or PLP to be aware of and comply with the obligations imposed on such supervisors by law and LSBEP rules. Failure to provide such supervision would work to the detriment of the LSSP or PLP (and clients), who could also be found to be engaged in an improper practice for lack of supervision.

In short, while there may little occasion for an MP to serve as a supervisor for a LSSP or a PLP, an MP who does so should comply with the supervisory obligations imposed by law and LSBEP regulations. To do otherwise may be viewed by the Board as unprofessional conduct or having a professional association with an improper practitioner, which could give rise to disciplinary investigation and/or action by the Board.

Medical Psychology Supervision

This is a message from the Louisiana Department of Health and Hospitals Emergency Operations Center (DHH EOC). To remain current on newly released information about the 2014 Ebola Epidemic, visit the Centers for Disease Control and Prevention (CDC) website at 

The situation in Louisiana has not changed. The Department of Health and Hospitals (DHH) continues to encourage preparedness for safe response to Ebola.

CDC has released new information for monitoring and movement for Ebola response. “Monitoring Symptoms and Controlling Movement to Stop Spread of Ebola” is available 

http://www.cdc.gov/media/releases/2014/fs1027-monitoring-symptoms-controlling-movement.html

 and “Interim U.S. Guidance for Monitoring and Movement of Persons with Potential Ebola Virus Exposure” is at 

http://www.cdc.gov/vhf/ebola/exposure/monitoring-and-movement-of-persons-with-exposure.html

This updated guidance focuses on strengthening how we monitor people who may have been exposed to Ebola and how medical professionals will oversee their care and, when warranted to protect the public health or our communities, limit their movement or activities. Through these changes, CDC and state and local health departments seek to support people who may have been exposed to Ebola, while also continuing to stop Ebola at its source in West Africa through the valor of our health care workers who serve. These changes will help ensure their symptoms are monitored and a system is in place to quickly recognize when they need to be routed to care.

These actions will better protect potentially exposed individuals and the American public as a whole.

Key changes to the movement and monitoring guidance:

• New risk levels are given for people who may have been exposed to Ebola, as well as for those not at risk for the disease.

• The guidance recommends stricter actions for escalating level of risk based on the type of exposure.

• State and local public health authorities are advised to use active monitoring or direct active monitoring rather than having people monitor themselves.

• Specific guidance is given about monitoring health care workers who cared for patients with Ebola in a country with widespread transmission, and people who visited an Ebola Treatment Unit in one of those countries.

• Specific guidance is also given about monitoring health care workers who provided care of patients with Ebola in the United States

“Guidance for Monitoring and Movement of Persons with Potential Ebola Virus Exposure” lists the following factors as possible consequences for further international spread:

• the virulence (ability to cause serious disease or death) of the virus,

• the widespread transmission in communities and healthcare facilities in the currently affected countries, and

• the strained health systems in the currently affected and most at-risk countries.

Be reminded that coordinated public health actions are essential to stop and reverse the spread of Ebola. Health care workers who take care of patients with Ebola are not only helping the nations facing the Ebola outbreak but also protecting people in the United States by helping to fight the outbreak at its source. The risk in this country will only be fully addressed when the current outbreak in Africa is over, and the participation of U.S. and other health care workers from outside of the countries with widespread transmission is essential to control the disease.

For general discussion about Ebola, email the Louisiana Department of Health and Hospitals at 

. Immediately notify the Louisiana Office of Public Health at 504-568-8313 or after hours at 800-256-2748 to discuss a possible exposure, report a suspected case and arrange for laboratory testing.

CDC Guidance for Monitoring and Movement for Ebola Response

The Board has received inquiries regarding the procedure for issuance of an emergency temporary permit in the event of a public health emergency, as declared by DHH. 

The Board continues to receive questions from authorized prescribers concerning the impact of the changes to the CDS classification of Hydrocodone combination products, effective October 1, 2014.  Click 

 to view an advisory, prepared by LAMMICO, that should provide the explanation for how these changes will affect your prescribing practices.

CHANGES IN PRESCRIBING HYDROCODONE COMBINATION DRUGS

LSBME received a request from the Louisiana Department of Health and Hospitals Emergency Operations Center (DHH EOC) to transmit information to healthcare providers regarding the ongoing outbreak of Ebola Virus Disease (EVD), and its potential impact on those that may travel to the region. Click 

DHH EOC Information re: Ebola Virus Disease Outbreak

The LSBME is making prescribers aware of the rescheduling of hydrocodone combination drug products.  Please refer to 

 from the Board of Pharmacy for further details.

A public hearing will be held on Wednesday, September 24, 2014, at 10 a.m. at the office of the Louisiana State Board of Medical Examiners, 630 Camp Street, New Orleans, LA 70130 on the proposed rules 

Physician Collaboration with Advanced Practice Registered Nurses.

Physician Collaboration with Advanced Practice Registered Nurses

On Friday the U. S. Drug Enforcement Administration (DEA) will publish in the Federal Register the Final Rule moving hydrocodone combination products (HCPs) from Schedule III to the more-restrictive Schedule II, as recommended by the Assistant Secretary for Health of the U.S. Department of Health and Human Services (HHS) and as supported by the DEA’s own evaluation of relevant data.  The Federal Register has made the Final Rule available for preview on its website today at 

This Final Rule imposes the regulatory controls and sanctions applicable to Schedule II substances on those who handle or propose to handle HCPs.  It goes into effect in 45 days (October 14, 2014).

The Controlled Substances Act (CSA) places substances with accepted medical uses into one of four schedules, with the substances with the highest potential for harm and abuse being placed in Schedule II, and substances with progressively less potential for harm and abuse being placed in Schedules III through V.  (Schedule I is reserved for those controlled substances with no currently accepted medical use and lack of accepted safety for use.)  HCPs are drugs that contain both hydrocodone, which by itself is a Schedule II drug, and specified amounts of other substances, such as acetaminophen or aspirin. “Almost seven million Americans abuse controlled-substance prescription medications, including opioid painkillers, resulting in more deaths from prescription drug overdoses than auto accidents,” said DEA Administrator Michele Leonhart, “Today’s action recognizes that these products are some of the most addictive and potentially dangerous prescription medications available.”

When Congress passed the CSA in 1970, it placed HCPs in Schedule III even though it had placed hydrocodone itself in Schedule II.  The current analysis of HCPs by HHS and the DEA shows they have a high potential for abuse, and abuse may lead to severe psychological or physical dependence.  Adding nonnarcotic substances like acetaminophen to hydrocodone does not diminish its abuse potential.  The many findings by the DEA and HHS and the data that support these findings are presented in detail in the Final Rule on the website.  Data and surveys from multiple federal and non-federal agencies show the extent of abuse of HCPs.  For example, Monitoring the Future surveys of 8th, 10th, and 12th graders from 2002 to 2011 found that twice as many high school seniors used Vicodin®, an HCP, nonmedically as used OxyContin®, a Schedule II substance, which is more tightly controlled.

Key Links