September 2018
Your monthly news & updates
KCMS Partners with San Joaquin Valley College's Externship Program

Are you looking for medical office staff? KCMS is proud to announce we have partnered with San Joaquin Valley College's Externship Program. Medical Office and Medical Assisting students who are in the last 5 weeks of their programs complete 120 hours of on-the-job training at participating medical offices. This allows the student to obtain hands on experience. If the office has a current position available, it allows the hiring manager to observe a potential candidate in the work environment for 5 weeks. If you are interested in learning more about the externship program, please call Fonda Winslow at 661-325-9025 or email at fwinslow@kms.org .

Requesting Nominations for the 2018 KCMS Outstanding Physician Award

KCMS is requesting nominations for the 2018 KCMS Outstanding Physician Award.

All nominees must be a KCMS Member. Criteria for this award should include one or more of the following. Please indicate this when submitting your nomination.

1. Has gone beyond the call of duty to devote time and participate in one or more activities
   of the Medical Society.

2. Has devoted time to a special project or service that served to promote the welfare and/or
   healthcare of the community.

3. Has made unique contributions by donating services and efforts towards the advancement
  of medicine. 

The award will be presented at the KCMS Annual Membership Meeting on Tuesday, September 25, 2018.

Submit your nomination no later than Friday, September 21, 2018 by calling Fonda Winslow at 661-325-9025 or email at fwinslow@kms.org .


Are you ready to check CURES?
Starting October 2, all physicians must consult database before prescribing controlled substances

By Katherine Boroski

Effective October 2, 2018, physicians must  consult California’s prescription drug monitoring database  (the Controlled Substance Utilization Review and Evaluation System, or CURES) – prior to prescribing Schedule II, III or IV controlled substances. All individuals practicing in California who possess both a state regulatory board license authorized to prescribe, dispense, furnish or order controlled substances and a Drug Enforcement Administration Controlled Substance Registration Certificate must be  registered to use CURES.
Because of the critical importance of adequate technical support for physicians who will have to rely on CURES as a part of their prescribing workflow, the California Medical Association (CMA) negotiated into the final legislation a requirement that the mandate could not take effect until the California Department of Justice (DOJ) certified that the database was ready for statewide use and that the department had adequate staff to handle the related technical and administrative workload.
On April 2, 2018—two years after the law was enacted—DOJ finally certified that CURES was ready for statewide use. The certification began a six-month transition period, with the duty-to-consult taking full effect on October 2, 2018.
What Physicians Need to Know
Under the new mandate, physicians must consult the database prior to prescribing controlled substances to a patient for the first time, and at least once every four months thereafter if that substance remains part of the patient’s treatment. Physicians must consult CURES no earlier than 24 hours or the previous business day prior to the prescribing, ordering, administering or furnishing of a controlled substance to the patient.

The law provides, however, that the requirement to consult CURES would not apply if doing so would result in the patient’s inability to obtain a prescription in a timely manner and adversely impact the patient’s conditions, so long as the quantity of the controlled substance does not exceed a five-day supply.

Physicians are also not held to this duty to consult when prescribing controlled substances to patients who are:
  • Admitted to a facility for use while on the premises;
  • In the emergency department of a general acute care hospital, so long as the quantity of the controlled substance does not exceed a seven-day supply;
  • As part of a surgical procedure in a clinic, outpatient setting, health facility or dental office, so long as the quantity of the controlled substance does not exceed a five-day supply; or
  • Receiving hospice care.

In addition, there are exceptions to the duty to consult when access to CURES is not reasonably possible, CURES is not operational or the database cannot be accessed because of technological limitations that are beyond the control of the physician.
CMA Fights for CURES Protections
CMA worked closely with the bill's author and other stakeholders to reach mutually agreeable language, which was reflected in the final version of the bill (SB 481, Lara). Among the negotiated amendments are liability protections related to the duty to consult the database and changes to ensure that health care providers can meet the requirements under state and federal law to provide patients with their own medical information without penalty. The bill also clarifies that health care providers sharing the information within the parameters of HIPAA and the Confidential Medical Information Act, including adding the CURES report to the patient’s medical record, are not out of compliance with the CURES statute.
CMA recently co-hosted a live CURES webinar with DOJ and the medical board regarding the new CURES duty-to-consult requirement. The webinar provided an overview of the new mandate and the requirements imposed by the law when checking CURES. It also includes an overview of the registration process and key features of the CURES database. The webinar is now available for on-demand viewing—free to all interested parties—at cmadocs.org/webinars

For More Information
For more information, see CMA On-Call document #3212, “ California’s Prescription Drug Monitoring Program: The Controlled Substance Utilization Review and Evaluation System (CURES) .” On-Call documents are free to members at  cmadocs.org/health-law-library . Nonmembers can purchase documents for $2 per page.

Additional Resources:
·          CURES website: oag.ca.gov/cures
·          CURES FAQ: oag.ca.gov/cures/faqs
·          Medical Board CURES webpage: mbc.ca.gov/cures
·          CMA CURES webpage: cmadocs.org/cures
·          CMA Safe Prescribing webpage: cmadocs.org/safe-prescribing

CMA will continue to provide educational resources and work with DOJ to ensure a smooth implementation of the new requirement. Physicians who experience problems with the CURES database should contact the DOJ CURES Help Desk at (916) 227-3843 or  cures@doj.ca.gov .

Sidebar 1: CMA publishes safe prescribing resources for physicians
The California Medical Association (CMA) has published a members-only resource page to provide physicians with the most current information and resources on prescribing controlled substances safely and effectively to relieve pain, while simultaneously reducing the risk of prescription medication misuse, addiction and overdose.
The page includes two CMA white papers on opioid prescribing, links to CMA’s health law library resources on the topic, the Medical Board of California’s "Guidelines on Prescribing Controlled Substances for Pain," a listing of continuing medical education courses and webinars on pain management and safe prescribing, as well as the latest information on the state's prescription drug monitoring database.
Members can find the page at  cmadocs.org/safe-prescribing .

Sidebar 2: Join CMA today!
The California Medical Association (CMA) offers leadership opportunities, discounts, education and more! Explore why over 43,000 California physicians have joined CMA to advocate for patients, the medical profession and the future of health care. Visit cmadocs.org/join for more information.

Katherine Boroski is Senior Director of Communications for the California Medical Association. 


Not a member of KCMS/CMA? Join today and and receive 15 months of membership for the price of 12. Click here to join.
Upcoming Events
September 3 - KCMS is closed in observance of Labor Day

September 10 - KCMS 3rd quarter Board Meeting 6pm KCMS Business Office

September 13-15 - 2018 NEPO Summitt





Happy Birthday

RIchard Alexan-Shirabad, MD
Sabina Bera, MD
Alan Cartmell, MD
Wendy Crenshaw, MD
Jess Diamond, MD
Armando Gonzalez, MD
Omid Hakimian, MD
Douglas Hoffman, MD
Patrick Leung, MD
Anthony Levins, MD
Samantha Madziarski, MD
Olga Meave, MD
Mark Mishkind, MD
Lee Richards, MD
Keith Seidenstricker, MD
Peter Shaw, MD
Tonny Tanus, MD
Stanley Teeten, MD
Raymond Tsai, MD
Kern County Medical Society | 661-325-9025| 661-328-9372 | www.kms.org