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NCMB is seeking approval for rule changes to establish a third set of investigative criteria for the Safe Opioid Prescribing Initiative, which screens opioid prescribing data from the NC Controlled Substances Reporting System to identify potentially unsafe prescribing practices. The new criteria would look at a variety of patient and prescriber characteristics and behaviors commonly associated with inappropriate opioid prescribing to identify additional licensees for investigation. The Board will accept written feedback through end of business hours on Aug. 17 at rules@ncmedboard.org. NCMB will hold a public hearing at its offices in Raleigh at 10 a.m. on Aug. 17 to receive feedback on the proposed investigative criteria.

Under the proposed rule change, licensees would be investigated if they meet three or more of the following criteria, when there are at least five patients for each criterion:

1. At least 25 percent of the prescriber’s patients receiving opioids reside at least 100 miles from the prescriber’s practice location;
2. The prescriber had more than 25 percent of patients receiving the same opioids and benzodiazepine combination;
3. The prescriber had 75 percent of patients receiving opioids self-pay for the prescriptions; The prescriber had 90 percent or more of patients in a three-month period that received an opioid prescription that overlapped with another opioid prescription for at least one week;
4. More than 50 percent of the prescriber’s patients received opioid doses of 100 MME or greater per day excluding office-based treatment medications; and
5. The prescriber had at least 25 percent of patients who used three or more pharmacies within a three-month period to obtain opioids, regardless of the prescriber.