State Politics

New rules place more limits on pain clinics

For the second straight year, Florida lawmakers have approved strict new rules for pain clinics, this time limiting the number of pills that can be sold to cash-paying patients, curbing advertising and imposing tougher standards for doctors and clinic owners.

Lawmakers hope the new rules passed Thursday will cripple South Florida’s flourishing pain-clinic industry, the prime source of illegal prescription drugs in the eastern United States. These clinics, which number almost 1,000 statewide, have also been blamed for a statewide epidemic of prescription-pill overdoses.

Gov. Charlie Crist is expected to sign the bill, which passed unanimously in both chambers.

“The crime rate has skyrocketed where these places have sprung up,” said Rep. John Legg, R-Port Richey, a chief sponsor of the reforms in the House of Representatives.

‘‘Hopefully once and for all we’ll shut down the Flamingo Express, as it’s known in other states.”

Until last year, many freestanding clinics offering painkillers or prescriptions operated with virtually no state oversight.

These clinics routinely attract drug couriers from Kentucky, Tennessee, Ohio, and other states seeking powerful painkillers such as oxycodone. One commercial flight from West Virginia to Fort Lauderdale was so popular with drug couriers that narcotics investigators dubbed it the “O.C. Express.”

The measure passed Thursday bans clinics from promoting narcotics in any ads. The bill prohibits doctors at these clinics from dispensing more than a 72-hour supply of narcotics to patients who pay by cash, check or credit card without insurance, and requires increased training for pain-management doctors by 2012.

“Finally they are doing something about this problem,” said Dr. Harold Cordner, president of the Florida Society of Interventional Pain Physicians, a group of about 200 doctors that pushed for the tougher rules. “I think this legislation will set the standard for all other states.”

The 72-hour limit is among the strictest in the country. Doctors in New Jersey, for example, may not dispense more than a seven-day supply of medication, and a handful of other states don’t allow doctors to dispense any drugs.

But Paul Sloan, the manager of a pain-management practice in Venice, worries that the 72-hour limit goes too far, creating obstacles for poor and uninsured patients with legitimate needs.

“This legislation will have serious consequences for pain clinics — both legitimate and illegitimate,” Sloan said. “You are going to solve one problem, but you are going to create another.”

The new legislation also requires pain clinics to be either licensed by the state, or owned by a doctor or group of doctors. A Miami Herald investigation last year found many pain clinics owned by people with no medical background, including a Davie clinic whose owner was twice convicted of fraud.

The bill also includes criminal penalties for both those operating clinics without state approval, and for doctors writing prescriptions at unregistered clinics.

The reforms will also expand the use of a prescription-monitoring program scheduled to be in place by the end of the year. The program, approved by lawmakers in 2009, will create a database to track narcotics prescriptions and prevent patients from getting pills from multiple doctors, a practice known as “doctor shopping.”

Under Thursday’s bill, the Department of Health will be able to pass on to

law-enforcement agencies any information from the prescription database suggesting illegal activity. When the database was first proposed last year, lawmakers omitted a similar proposal because of concerns over patient privacy. If signed by the governor, the bill will take effect Oct. 1.

Herald/Times staff writer Lee Logan contributed to this report from Tallahassee.

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