justicedao/ipfs_state_laws huggingface dataset:
847-015-0010 Schedule III or IV Controlled Substances — Bariatrics Practice (1) A licensee shall not utilize a Schedule III or IV controlled substance for purposes of weight reduction, other than in accordance with federal Food and Drug Administration (FDA) product guidelines in effect at the time of utilization and with all the provisions of this rule. (2) A licensee may utilize a Schedule III or IV controlled substance for purposes of weight reduction in the treatment of Exogenous Obesity in a regimen of weight reduction based on caloric restriction, behavior modification and prescribed exercise, provided that all of the following conditions are met: (a) Before initiating treatment utilizing a Schedule III or IV controlled substance, the licensee thoroughly reviews the licensee’s own records of prior treatment, or thoroughly reviews the records of prior treatment which another treating health care professional or weight-loss program has provided to the licensee, that one of the following conditions exist: (A) Patient's body mass index exceeds 30 Kg/M sq; or (B) Patient's body mass index exceeds 27 Kg/M sq and the excess weight represents a threat to the patient's health (as with hypertension, diabetes, or hypercholesterolemia.) (b) Before initiating treatment utilizing a Schedule III or IV controlled substance, the licensee obtains a thorough history, performs a thorough physical examination of the patient, and rules out the existence of any recognized contraindications to the use of the controlled substance to be utilized. (3) Continuation of Schedule III or IV designated as FDA short term use controlled substances beyond three (3) months requires documentation of an average two (2) pound per month weight loss during active weight reduction treatment, or documentation of maintenance of goal weight. Use of Schedule III or IV controlled substances with FDA approval for bariatric therapy and designated for long term use where FDA guidelines are followed may also be used beyond three months. (4) A violation of any provision of this rule, as determined by the Board, shall constitute Unprofessional Conduct as the term is used in ORS 677.188(4)(a), (b), or (c), whether or not actual injury to a patient is established. Statutory/Other Authority: ORS 677.265 Statutes/Other Implemented: ORS 677.188(4) & 677.190(24) History: OMB 8-2016, f. & cert. ef. 7-8-16 BME 4-2001, f. & cert. ef. 1-25-01 BME 17-2000(Temp), f. & cert. ef. 10-30-00 thru 2-28-01 BME 9-1998, f. & cert. ef. 7-22-98 ME 1-1997, f. & cert. ef. 1-28-97 ME 1-1995, f. & cert. ef. 2-1-95 ME 1-1987, f. & ef. 1-20-87
847-015-0015 Maintenance of Controlled Substances Log by Prescribing Practitioners Any practitioner dispensing or administering controlled substances from the practitioner’s office must have a Drug Enforcement Administration registration indicating the address of that office. The practitioner shall maintain an inventory log showing all controlled substances received, and administered or dispensed. This log shall also list for each controlled substance, the patient’s name, amounts used, and date administered or dispensed. This log shall be available for inspection on request by the Oregon Medical Board or its authorized agents. Controlled substances samples are included in this rule. Statutory/Other Authority: ORS 677 Statutes/Other Implemented: ORS 475.165 History: ME 15-1987, f. & ef. 8-3-87
847-015-0020 Maintenance of Controlled Substances Log — Ambulance and Medical Rescue Services Receiving Controlled Substances from Physicians Any physician providing controlled substances for use by ambulance and medical rescue services must have a Drug Enforcement Administration registration for the address where the controlled substances and inventory log are stored. The inventory log at the registered address shall be maintained showing all controlled substances received, or dispensed to the emergency vehicle. The administration log shall also show for each controlled substance, the patient's name and amount used, date, and by whom administered or dispensed, and may be maintained in the emergency vehicle. This log should be reviewed for accuracy on a monthly basis and be readily retrievable for inspection on request by the Board, the ambulance licensing authority as specified in ORS 682.015, or their authorized agents. Statutory/Other Authority: ORS 677.265 Statutes/Other Implemented: ORS 682.245 History: BME 8-2001, f. & cert. ef. 7-18-01 ME 1-1997, f. & cert. ef. 1-28-97 ME 10-1987, f. & ef. 4-28-87
847-015-0025 Dispensing, Distribution and Administration (1) Any actively licensed physician or podiatric physician who dispenses drugs must register with the Board as a dispensing physician before beginning to dispense drugs. (2) At the time of license registration renewal, all dispensing physicians and podiatric physicians must indicate their status as a dispensing physician on the registration renewal form. (3) Dispensing of drugs must be documented in the patient record. Documentation must include the name of the drug, the dose, the quantity dispensed, the directions for use and the name of the physician or podiatric physician dispensing the drugs. The physician or podiatric physician must verbally counsel the patient concerning any new medications and must provide written information on the directions for use. (4) Distribution of samples, without charge, is not dispensing under this rule. Distribution of samples must be documented in the patient record. Documentation must include the name of the drug, the dose, the quantity distributed and the directions for use. The physician or podiatric physician must verbally counsel the patient concerning any new medications and must provide written information on the directions for use. (5) Administering drugs in the physician's or podiatric physician's office is not dispensing under this rule. Administration of drugs must be documented in the patient record. Documentation must include the name of the drug, the dose and the quantity administered. (6) Failure to comply with any section of this rule is a violation of the ORS Chapter 677 and is grounds for a $195 fine. The licensee may be subject to further disciplinary action by the Board. Statutory/Other Authority: ORS 677.265 Statutes/Other Implemented: ORS 677.010, 677.089, 677.510 & 677.515 History: OMB 5-2024, amend filed 01/08/2024, effective 01/08/2024 OMB 32-2013, f. & cert. ef. 10-15-13 OMB 30-2011, f. & cert. ef. 10-27-11 BME 24-2007, f. & cert. ef. 10-24-07 BME 1-2005, f. & cert. ef. 1-27-05 ME 9-1993, f. & cert. ef. 7-27-93 ME 22-1987, f. & ef. 10-29-87
847-015-0035 Attending Physicians Prescribing Medications to Physician-Assisted Death with Dignity Patients Attending physicians prescribing medications pursuant to ORS 127.800–127.897 must: (1) Dispense medications directly, including ancillary medications intended to facilitate the desired effect to minimize the patient's discomfort, provided the attending physician is registered as a dispensing physician with the Oregon Medical Board, has a current Drug Enforcement Administration (D.E.A.) certificate, and complies with the provisions of ORS 677.089, OAR 847-015-0015 and 847-015-0025; or (2) With the patient's written consent: (a) Contact a pharmacist, and inform the pharmacist of the purpose of the prescription; and (b) Deliver the written prescription personally or by mail to the pharmacist who will dispense the medications to either the patient, the attending physician, or an expressly identified patient's agent. Statutory/Other Authority: ORS 677.265 Statutes/Other Implemented: ORS 127.800 - 127.995 History: OMB 29-2012, f. & cert. ef. 11-22-12 BME 10-1998, f. & cert. ef. 7-22-98 BME 3-1998(Temp), f. & cert. ef. 4-8-98 thru 10-5-98
847-015-0040 Collaborative Drug Therapy Management (1) “Collaborative Drug Therapy Management” as used in this section means the participation by a physician and a pharmacist in the management of drug therapy pursuant to a written protocol that includes information specific to the dosage, frequency, duration and route of administration of the drug, authorized by a physician and initiated upon a prescription order for an individual patient and: (a) Is agreed to by one physician and one pharmacist; or (b) Is agreed to by one or more physicians in a single organized medical group, such as a hospital medical staff, clinic or group practice, including but not limited to organized medical groups using a pharmacy and therapeutics committee, and one or more pharmacists. (2) A physician shall engage in collaborative drug therapy management with a pharmacist only under a written arrangement that includes: (a) The identification, either by name or by description, of the participating pharmacist(s); (b) The identification, by name, of the participating physician(s); (c) The name of the physician and principal pharmacist who are responsible for development, training, administration, and quality assurance of the arrangement; (d) A detailed description of the collaborative role the pharmacist(s) shall play, including but not limited to: (A) Written protocol for specific drugs pursuant to which the pharmacist will base drug therapy management decisions for an individual patient; (B) Circumstances which will cause the pharmacist to initiate communication with the physician, including but not limited to the need for new prescription orders and reports of patients’ therapeutic responses or adverse effects; (C) Training requirement for pharmacist participation and ongoing assessment of competency, if necessary; (D) Quality assurance and periodic review by a panel of the participating physicians(s) and pharmacist(s). (e) Authorization by the physician(s) for the pharmacist(s) to participate in the collaborative drug therapy; (f) A provision for the collaborative drug therapy arrangement to be reviewed and updated, or discontinued at least every two years; and (g) A description of the mechanism for the pharmacist(s) to communicate to the physician(s) and for documentation of the implementation of the collaborative drug therapy. (3) Nothing in this rule shall be construed to allow therapeutic substitution. (4) The collaborative drug therapy protocol must be kept on file in the pharmacy and made available to the Board of Pharmacy and the Oregon Medical Board upon request. Statutory/Other Authority: ORS 677.265 Statutes/Other Implemented: ORS 689.005(30) History: OMB 9-2021, amend filed 10/13/2021, effective 10/13/2021 BME 12-1999, f. & cert. ef. 7-23-99
847-015-0050 Expedited Partner Therapy for Sexually Transmitted Infection The Oregon Medical Board recognizes that the adequate treatment of sexually transmitted infections is a public health issue. When identified in a patient, the adequate treatment and prevention of recurrence in the patient often depends upon treatment of the partner or partners of a patient, who may not be available or agreeable for clinical evaluation. (1) As used in this rule: (a) “Expedited partner therapy” has the meaning given in ORS 676.350, the practice of prescribing or dispensing antibiotic drugs for the treatment of a sexually transmitted infection to the partner of a patient without first examining the partner of the patient. (b) “Partner of a patient” has the meaning given in ORS 676.350, a person whom a patient diagnosed with a sexually transmitted infection identifies as a sexual partner of the patient. (2) A physician or physician associate treating sexually transmitted infections, may engage in open discussions with a patient to ascertain the ability for a partner of a patient to access medical services. (3) A licensee, otherwise permitted by law to prescribe or dispense controlled substances, may practice expedited partner therapy for the treatment of sexually transmitted chlamydia and gonorrhea infections. (4) A licensee may initiate expedited partner therapy when the licensee reasonably believes that a partner of a patient will be unwilling or unable to seek treatment within the context of a traditional provider-patient relationship. (5) When initiating expedited partner therapy, a licensee must: (a) Instruct the patient regarding expedited partner therapy and the medications involved. (b) Ensure appropriate information and advice are made available to the partner of a patient, including educational materials for the patient to share with their partner(s) encouraging the partner to consult a health care provider and disclosing potential adverse drug reactions and dangerous interactions between medications. (c) Make reasonable efforts to refer the partner of a patient to appropriate health care professionals. (6) Except as provided in this rule, a licensee may not write prescriptions unless they have conducted an adequate encounter with the patient, and documented this encounter in the medical record. (7) The partner of a patient is considered to be an individual entitled to receive the prescription drug, and nothing in this rule is intended to establish a professional relationship between the physician or physician associate and the partner of a patient. Statutory/Other Authority: ORS 677.265 & ORS 676.350 Statutes/Other Implemented: ORS 676.350 History: OMB 17-2024, amend filed 10/10/2024, effective 10/10/2024 OMB 15-2022, adopt filed 07/12/2022, effective 07/12/2022
847-017-0000 Preamble Licensees of the Oregon Medical Board providing office-based invasive procedures are accountable for the welfare and safety of their patients and responsible for ensuring that the performance of these procedures meets the standard of care. Statutory/Other Authority: ORS 677.265 Statutes/Other Implemented: ORS 677.085, 677.097 & 677.265 History: OMB 33-2013, f. & cert. ef. 10-15-13 BME 23-2006, f. & cert. ef. 10-23-06
847-017-0008 Standard of Practice A licensee performing office-based surgery must have received appropriate training and education in the safe and effective performance of all surgical procedures performed in the office. Such training and education should include: (1) Indications and contraindications for each procedure; (2) Identification and selection of appropriate patients for each procedure; (3) Identification of realistic and expected outcomes of each procedure; (4) Selection, maintenance, and utilization of products and equipment; (5) Appropriate technique for each procedure, including infection control and safety precautions; (6) Pharmacological intervention specific to each procedure; (7) Identification of complications and adverse reactions for each procedure; (8) Standards in surgical medical care; and (9) Emergency procedures to be used in the event of: (a) Complications; (b) Adverse reactions; or (c) Equipment malfunction. Statutory/Other Authority: ORS 677.265 Statutes/Other Implemented: ORS 677.265 History: OMB 33-2013, f. & cert. ef. 10-15-13
847-017-0010 Licensee Use of Office-Based Surgical Facilities A licensee performing office-based surgery must ensure that the facility meets standards to ensure patient safety. (1) Facilities where office-based surgeries are performed must comply with all federal and state laws and regulations that affect the practice. (2) Facilities where Level II or Level III office-based surgeries are performed must be accredited by an appropriate, Board-recognized accreditation agency, including the QUAD A, the Accreditation Association of Ambulatory Health Care (AAAHC), the Joint Commission, the Accreditation Commission for Health Care, Inc. (ACHC), or any other accrediting agency that demonstrates to the satisfaction of the Board that it has: (a) Standards pertaining to patient care, record keeping, equipment, personnel, facilities and other related matters that are in accordance with standards of care as determined by the Board, (b) Processes that assure a fair and timely review and decision on any applications for accreditation or renewals, (c) Processes that assure a fair and timely review and resolution of any complaints received concerning accredited facilities, and (d) Resources sufficient to allow the accrediting agency to fulfill its duties in a timely manner. (3) Licensees of the Board performing Level II or Level III office-based procedures in a new or existing facility, must ensure that facility is accredited within one year of the start date of the office-based procedures being performed. During the period of time the facility is in the accreditation process, the facility will make changes to come into compliance with the Administrative Rules in this Division. (4) Facilities where Level II or Level III office-based surgeries are performed must provide health care personnel who have appropriate education, training and licensure for administration and monitoring of moderate sedation/analgesia, deep sedation/analgesia, general anesthesia or regional block. (5) A licensee who holds a MD or DO degree as well as a DDS (Doctor of Dental Surgery) or DMD (Doctor of Dental Medicine) degree and is an active member of the Oregon Society of Oral Maxillofacial Surgeons (OSOMS) may perform maxillofacial procedures in a facility approved by the OSOMS and function under the administrative rules of the Oregon Board of Dentistry, OAR chapter 818, division 026. For all procedures that are not oral maxillofacial in nature, licensees with medical and dental licenses must follow rules laid out in OAR chapter 847, division 017. Statutory/Other Authority: ORS 677.265 & ORS 679.255 Statutes/Other Implemented: ORS 677.060, ORS 677.265 & ORS 679.255 History: OMB 1-2025, amend filed 01/13/2025, effective 01/13/2025 OMB 15-2023, amend filed 10/09/2023, effective 10/09/2023 OMB 3-2018, amend filed 01/05/2018, effective 01/05/2018 OMB 33-2013, f. & cert. ef. 10-15-13 BME 10-2008, f. & cert. ef. 4-24-08 BME 14-2007, f. & cert. ef. 7-23-07 BME 23-2006, f. & cert. ef. 10-23-06
847-017-0015 Selection of Procedures and Patients (1) The licensee who performs the office-based surgery or anesthetic is responsible for the safety of the patient. (a) The licensee must evaluate and document the condition of the patient and the potential risks associated with the proposed treatment plan; (b) The licensee administering anesthesia for a Level II or Level III procedure must evaluate and document the ASA Physical Status of the patient; (c) The licensee must be satisfied that the procedure to be undertaken is within the scope of practice of the health care personnel, the capabilities of the facility and the condition of the patient; and (d) The licensee must examine the patient immediately before the procedure to evaluate the risks of the procedure and the risks of anesthesia if applicable. (2) Informed consent for the nature and objectives of the anesthesia planned and office-based surgery to be performed must be in writing and obtained from the patient before the office-based surgery is performed. Informed consent is only to be obtained after a PARQ conference and must be documented in the medical record. The informed consent must include a disclosure of the licensee’s specialty board certification through the ABMS, the AOA-BOS, the ABPM, the ABFAS or the NCCPA or lack thereof. The requirement for written informed consent is not necessary for minor Level I procedures limited to the skin and mucosa. Statutory/Other Authority: ORS 677.265 Statutes/Other Implemented: ORS 677.085, ORS 677.097 & ORS 677.265 History: OMB 3-2018, amend filed 01/05/2018, effective 01/05/2018 OMB 7-2016, f. & cert. ef. 4-8-16 OMB 33-2013, f. & cert. ef. 10-15-13 BME 23-2006, f. & cert. ef. 10-23-06
847-017-0020 Patient Medical Records (1) A legible, complete, comprehensive and accurate medical record must be maintained for each patient evaluated or treated. The record must include: (a) Identity of the patient; (b) History and physical, diagnosis and plan; (c) Appropriate lab, x-ray or other diagnostic reports; (d) Documentation of the PARQ conference; (e) Disclosure of the licensee’s specialty board certification through the ABMS, the AOA-BOS, the ABPM, the ABFAS or the NCCPA or lack thereof; (f) Appropriate preanesthesia evaluation; (g) Narrative description of procedure; (h) Intraoperative and postoperative monitoring; (i) Pathology reports; (j) Documentation of the outcome and the follow-up plan; and (k) Provision for continuity of post-procedure care. (2) If the office-based surgery is a Level II or Level III surgical procedure, the patient record must include a separate anesthetic record that contains documentation of anesthetic provider, ASA Physical Status, procedure, and technique employed. This must include the type of anesthesia used, drugs (type and dose) and fluids administered during the procedure, patient weight, level of consciousness, estimated blood loss, duration of procedure, and any complication or unusual events related to the procedure or anesthesia. (3) The patient record must document if tissues and other specimens have been submitted for histopathologic diagnosis. (4) The licensee must ensure that the facility has specific and current protocols in place for patient confidentiality and security of all patient data and information. Statutory/Other Authority: ORS 677.265 Statutes/Other Implemented: ORS 677.085, ORS 677.097 & ORS 677.265 History: OMB 3-2018, amend filed 01/05/2018, effective 01/05/2018 OMB 7-2016, f. & cert. ef. 4-8-16 OMB 33-2013, f. & cert. ef. 10-15-13 BME 23-2006, f. & cert. ef. 10-23-06
847-017-0025 Discharge Evaluation The licensee performing the procedure is responsible for the determination that the patient is safe to be discharged from the office after the procedure. Statutory/Other Authority: ORS 677.265 Statutes/Other Implemented: ORS 677.085, 677.097 & 677.265 History: OMB 33-2013, f. & cert. ef. 10-15-13 BME 23-2006, f. & cert. ef. 10-23-06
847-017-0030 Emergency Care and Transfer Protocols In facilities where Level II or Level III office-based surgeries are performed, the licensee must ensure that a written plan is in place for the provision of emergency medical care as well as the safe and timely transfer of patients to a nearby hospital should hospitalization be necessary. (1) Age-appropriate emergency supplies, equipment, and medication should be provided in accordance with the scope of surgical and anesthesia services provided at the licensee’s office. (2) All office personnel must be familiar with the documented plan for arranging emergency medical services and the safe and timely transfer of patients to a nearby hospital and must be able to take necessary actions. If cardiopulmonary resuscitation (CPR) is instituted, the plan must include immediate contact with emergency medical services. Statutory/Other Authority: ORS 677.265 Statutes/Other Implemented: ORS 677.085, 677.097 & 677.265 History: OMB 33-2013, f. & cert. ef. 10-15-13 BME 23-2006, f. & cert. ef. 10-23-06
847-017-0035 Quality Assessment (1) Office-based surgical practices must develop a system of quality assessment that effectively and efficiently strives for continuous quality improvement. (2) Documentation of complications and adverse incident review must be available. Statutory/Other Authority: ORS 677.265 Statutes/Other Implemented: ORS 677.085, 677.097 & 677.265 History: OMB 33-2013, f. & cert. ef. 10-15-13 BME 23-2006, f. & cert. ef. 10-23-06
847-017-0037 Reporting Requirement (1) Licensees performing office-based surgery must report the following complications and adverse incidents to the Board within ten business days of the event if the complication occurred within 30 days of the procedure: (a) Surgical related death; (b) Emergency transfer of the surgical patient to the hospital; (c) Anesthetic or surgical event requiring cardiopulmonary resuscitation (CPR); and (d) Unscheduled hospitalization related to the office-based surgery. (2) Licensees performing or intending to perform office-based surgery must report any restriction, limitation, loss or denial of privileges in a hospital or accredited outpatient facility within ten business days of the restriction, limitation, loss or denial of privileges. (3) The Board will review reports made under this rule to determine whether an investigation is necessary. Statutory/Other Authority: ORS 677.265 Statutes/Other Implemented: ORS 677.415 History: OMB 33-2013, f. & cert. ef. 10-15-13