COVID: West Virginia Board of Pharmacy Issues Emergency Rule Limiting Prescriptions for Chloroquine and Hydroxychloroquine

West Virginia Board of Pharmacy Issues Emergency Rule Limiting Prescriptions for Chloroquine and Hydroxychloroquine 

Written by Luke Schmitt, Flaherty Sensabaugh Bonasso PLLC

On March 21, 2020, the West Virginia Board of Pharmacy proposed an emergency rule pursuant to its general rulemaking authority seeking to ensure that chloroquine and hydroxychloroquine – two drugs thought to be potentially helpful in the treatment of COVID-19 – are only dispensed to individuals currently in need of these drugs. The emergency rule, Section 15-1-26.1, provides:

26.1 No prescription for chloroquine or hydroxychloroquine may be dispensed except if all the following apply:

26.1.a. The prescription bears a written diagnosis from the prescriber consistent with the evidence for its use;

26.1.b. The prescription is limited to no more than thirty (30) tablets, unless the patient was previously established on the    medication prior to the effective date of this rule; and

26.1.c. No refills may be permitted unless a new prescription is furnished. This requirement does not apply to the patient previously established on the medication prior to the effective date of this rule.

This rule has been approved by the West Virginia Secretary of State and is now in effect.

Both nationally and in West Virginia, some prescribers have begun writing prescriptions for these drugs for family, friends, and coworkers in anticipation of the further spread of COVID-19. This rule limits the ability for persons to obtain prescriptions for these medications by requiring that all new prescriptions for these medications contain a written diagnosis from the prescribing health care provider that is consistent with the medication’s use, limiting the supply to 30 days, and prohibiting refills on prescriptions for these medications.

Today, March 23, 2020, the West Virginia Board of Medicine indicated in its notification "Emergency Rule Regarding Chloroquine and Hydroxychloriquine" that licensees should conform their prescribing practices to align with this emergency rule.

COVID: West Virginia Board of Medicine and West Virginia Board of Osteopathic Medicine Responding to Address COVID-19 Crisis

West Virginia Board of Medicine and West Virginia Board of Osteopathic Medicine Responding to Address COVID-19 Crisis

Written by Luke Schmitt, Flaherty Sensabaugh Bonasso PLLC

In response to the COVID-19 pandemic and in anticipation of the challenges to come, the West Virginia Board of Medicine (the “Board”) this week has taken specific measures to prepare and to assist healthcare providers during this unprecedented time. The Board issued a COVID-19 Information Update on March 20, 2020.

First, the Board has announced that it recognizes the need to facilitate the influx of available health care practitioners into West Virginia and is taking efforts to try to expedite the process. The Board has announced that it is working to streamline the licensure approval process for COVID-19 providers and to maximize practice authorizations for physician assistants. However, the Board has not yet released specific details regarding its anticipated changes.

In addition, the Board in its March 20, 2020, update encouraged the use of telemedicine technologies, to provide flexibility for licensed health care professionals to respond to this emergency and expected patient volume surges. Specifically, the Board has stated that physicians who are evaluating and/or triaging COVID-19 patients are providing emergency care that falls within a statutory exception to the requirement for a face-to-face (in person or video) initial encounter to establish a physician/patient relationship. These providers may, consistent with the standard of care, conduct such evaluations through an audio-only encounter. The Board cautioned, however, that all non-COVID-19 telemedicine practice must continue to comply with the requirements prohibiting the establishment of a physician/patient relationship via audio-only communication.

Finally, the Board has stated that physician assistants with authorized Practice Agreements and/or active Practice Notifications may practice via telemedicine in collaboration with physicians even if the Practice Agreement and/or Practice Notification does not specifically identify telemedicine as an authorized practice modality. The Board further stated that physician assistants who are likewise evaluating and/or triaging COVID-19 patients may similarly conduct initial patient encounters through audio-only measures even though the establishment of a physician/patient ordinarily must occur via a face-to-face (in person or by video) initial encounter. Again, regular practice requirements continue to govern in situations not involving the treatment of COVID-19 patients.

Following is the complete language posted by the Board regarding its recommendations on telemedicine services in West Virginia: 

Telemedicine:  (New 3-18-2020)

 In an effort to ensure maximum flexibility for our licensees and to surge the response to this emergency,  the Board encourages the use of telemedicine technologies, consistent with the standard of care, where appropriate.  

Physician Telemedicine Practice for COVID-19 Emergency 

For physicians who are evaluating and/or triaging COVID-19 patients, this emergency care falls within a statutory exception to the requirement for a face-to-face (in person or via video) initial encounter to establish a physician/patient relationship and may, consistent with the standard of care, occur through an audio-only encounter.  All non-COVID-19 telemedicine practice must continue to comport with the requirement that a physician-patient relationship may not be established via audio-only.    

Physician Assistant Telemedicine Practice for COVID-19 Emergency and Non-COVID-19 Practice 

Physician assistants with authorized Practice Agreements and/or active Practice Notifications may practice via telemedicine, where appropriate and in collaboration with physicians, even if the PA’s Practice Agreement and/or Practice Notification does not specifically identify telemedicine as an authorized practice modality.   For physician assistants who are evaluating and/or triaging COVID-19 patients, this emergency care falls within a statutory exception to the requirement for a face-to-face (in person or via video) initial encounter to establish a practitioner/patient relationship and may, consistent with the standard of care, occur through an audio-only encounter.  All non-COVID-19 telemedicine practice must continue to comport with the requirement that a practitioner/patient relationship may not be established via audio-only.

Likewise, the West Virginia Board of Osteopathic Medicine has indicated that it is in the process of reviewing its licensing and renewal requirements and its authority to make changes to those requirements in emergencies. While specific measures have not been announced, the Board has stated it will initiate every possible action to ensure that qualified individuals can efficiently obtain a license so that they can assist in responding to this unfolding health care challenge.

WVBOM: Policy Statement - Guidelines for Physicians in Collaborative Relationships with Advanced Nurse Practitioners

On May 10, 2010, the West Virginia Board of Medicine has issued a new Policy Statement - Guidelines for Physicians in Collaborative Relationships with Advanced Nurse Practitioners or Certified Nurse Midwives; Standard of Practice.

The new Policy Statement provide West Virginia physicians with guidance on the role and responsibility they play in the collaborative relationship with advanced nurse practitioners and certified nurse-midwifes. In summary, the guidance provides:

A. The physician must be permanently and fully licensed in West Virginia without restriction or limitation.

B. There should be a written collaborative agreement should should include certain specific provisions as outlined in the Policy Statement.

C. Other considerations that are outlined in the Policy Statement

The Policy Statement indicates that the failure by a physician to adhere to these minimum requirements and guidelines may result in discipline by the Board of Medicine.