Alabama Administrative Code › Title 540 - ALABAMA BOARD OF MEDICAL EXAMINERS › Chapter 540-X-19 - PAIN MANAGEMENT SERVICES › Section 540-X-19-.02 - Definitions

Current through Register Vol. 42, No. 9, June 28, 2024
The following definitions shall apply to the rules in this
				chapter:
(1) ACUTE PAIN. The normal,
			 predicted, time-limited physiological response to nociceptive stimuli such as
			 injury, trauma or illness.
(2)
			 APPLICANT. A person who has submitted or who is in the process of submitting a
			 registration under this article.
(3) BOARD. The Alabama Board of Medical
			 Examiners.
(4) CHRONIC
			 NON-MALIGNANT PAIN. Chronic pain that is not associated with active cancer and
			 does not occur at the end of life.
(5) CHRONIC PAIN. A state in which pain
			 persists beyond the usual course of an acute disease or healing of an injury
			 (e.g., more than three months), and which may or may not be associated with an
			 acute or chronic pathological process that causes continuous or intermittent
			 pain over a period of months or years.
(6) CONTROLLED SUBSTANCE. A drug, substance,
			 or immediate precursor identified, defined, or listed in §§
								20-2-20 to
			 20-2-32,
Code of Ala.
			 1975
, as amended, inclusive.
(7) DISPENSE. To provide, distribute or give
			 to a patient for the patient's use any controlled substance, except prepackaged
			 samples and/or starter packs, where such controlled substances are purchased by
			 the physician or osteopath for resale to a patient whether or not a separate
			 charge is made for the controlled substance. Prepackaged samples and starter
			 packs shall mean those controlled substances which are packaged and labeled by
			 the manufacturer in individual or small dosage units and which are intended to
			 be distributed to patients for consumption or administration within a limited
			 period of time. Controlled substances which are consumed by or which are
			 administered to patients while being treated in the physician's office, clinic,
			 hospital or other facility are not considered to be dispensed for the purposes
			 of this rule. Dispensing occurs when a physician or osteopath provides, gives
			 or distributes controlled substances for consumption or administration by
			 patients off the premises of the clinic, hospital or other facility where the
			 physician or osteopath practices, without respect to whether such controlled
			 substances are purchased by an individual physician or osteopath, a
			 professional association or professional corporation, a for-profit or
			 not-for-profit corporation, a hospital, clinic or other medical facility. For
			 purposes of this Chapter, dispensing shall not apply to the dispensing of
			 controlled substances to patients treated in any hospital emergency room
			 provided that (a) the patient has registered for treatment in the hospital
			 emergency room and was treated by the emergency room physician on duty and (b)
			 the controlled substances dispensed are subject to inventory, accounting and
			 security controls and policies of the hospital pharmacy or the emergency room
			 department. For purposes of this definition, a controlled substance is any drug
			 or substance listed in Schedules II through IV of the Alabama Uniform
			 Controlled Substance Act,
Code of Ala. 1975
,
			 §§
								20-2-1, et seq.
(8) HOSPITAL. A health care institution
			 licensed by the Alabama Department of Public Health and has the same definition
			 as provided in Chapter 420-5-7 of the Alabama Administrative Code. The term
			 shall include any outpatient facility or clinic that is separated from the
			 hospital that is owned, operated, or controlled by the hospital.
(9) PAIN MANAGEMENT SERVICES. Those medical
			 services that involve the prescription of controlled substances in order to
			 treat chronic non-malignant pain by a physician who treats pain. For the
			 purposes of this rule, the provision of pain management services shall mean:
(a) A physician practice which advertises or
			 holds itself out to the public as a provider of pain management services;
			 OR
(b) A physician practice which
			 dispenses opioids; OR
(c) A
			 physician practice in which any of the providers of pain management services
			 are rated in the top three percent (3%) of practitioners who prescribe
			 controlled substances in Alabama in Schedules II, UN, III, IIIN, and IV,
			 determined by the Alabama Prescription Drug Monitoring Database on an annual
			 basis.