The Health Law Ticker

Starting October 2, 2018, health care practitioners authorized to prescribe, order, administer, or furnish a controlled substance must query, or consult, the Controlled Substance Utilization Review and Evaluation System (CURES) database and run a Patient Activity Report (PAR) on each patient the first time the patient is prescribed, ordered, or administered a Schedule II-IV controlled substance. First time is defined as the initial occurrence in which a health care practitioner intends to prescribe, order, administer, or furnish a controlled substance to a patient and has not previously prescribed a controlled substance to the patient. (Health and Safety Code (HSC), § 11165.4(a)(1)(B).)

The CURES consult and the PAR must be completed in the 24-hour period, or the previous business day, before prescribing, ordering, administering, or furnishing a controlled substance, unless an exception applies.

Thereafter, practitioners must consult CURES before subsequently prescribing a controlled substance, if the consult was previously exempt, and at least once every four months, if the controlled substance remains a part of the patient’s treatment plan.

Health care practitioners required to consult CURES include¹:

• Allopathic or Osteopathic Surgeon

• Certified Nurse Midwife (Furnishing)

• Dentist

• Naturopathic Doctor

• Nurse Practitioner (Furnishing)

• Optometrist

• Physician Assistant

• Podiatrist

Professional licensing boards have the authority to audit CURES activity to ensure compliance. Failure to comply could result in disciplinary proceedings against a practitioner’s license.

Exemptions

A health care practitioner is exempt from consulting the CURES database before prescribing, ordering, administering, or furnishing a controlled substance in any of the following circumstances:

1.  While the patient is admitted to, or during an emergency transfer between a

• Licensed Clinic, or

• Outpatient Setting, or

• Health Facility, or

• County Medical Facility

2.  In the emergency department of a general acute care hospital, and the controlled substance does not exceed a non-refillable seven-day supply.

3.  As part of a patient’s treatment for a surgical procedure, and the controlled substance does not exceed a non-refillable five-day supply when a surgical procedure is performed at a

• Licensed Clinic, or

• Outpatient Setting, or

• Health Facility, or

• County Medical Facility, or

• Place of Practice

4.  The patient is receiving hospice care.

The Medical Board of California has issued CURES Mandatory Consultation FAQs, located here.

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¹ This requirement does not apply to veterinarians or pharmacists.