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#Ga. House approves regulations for pain clinics

Ga. House approves regulations for pain clinics

Wednesday, February 20, 2013

ATLANTA — The Georgia House of Representatives has approved a proposal that calls for the state to license and regulate businesses that call themselves pain management clinics.

House Bill 178 is a response to a flood of so-called 'pill mills,' unregulated businesses that are credited with feeding prescription drug abuse. The 150-15 vote sends the measure to the Senate, where similar legislation died last year without a vote.

"We don't have any laws that state law enforcement can use to stop these pill mills from operating in our communities," said Rep. Tom Weldon, R-Ringgold.

Attorney General Sam Olens has championed House Bill 178, as have law enforcement agencies around the state.

A pain clinic is defined in the bill as a medical enterprise where at least half of the patient population is being treated for chronic pain. The bill is not intended to target prescriptions for patients nearing the end of life because of terminal illness or drugs issued to manage short-term pain associated with injuries or specific medical procedures.

Affected businesses would have to get a state license from the Georgia Composite Medical Board beginning in July. The board already licenses physicians in the state. Licenses would have to be renewed every two years.

More significantly, the proposal would require that all new pain clinics be owned by physicians. Existing clinics where non-physicians have ownership shares with physicians would be allowed to remain open but still be subject to all new regulations. Still, the provision drew complaints from the few members who voted against the bill.

Rep. Jay Roberts, R-Ocilla, said limiting ownership to a specific class of citizens is an unnecessary intrusion into the marketplace. He noted that other health-care enterprises — from hospitals to clinics — have a variety of ownership structures, including models where all physicians are merely employees of owners who are not doctors.

Weldon retorted that several neighboring states, including Florida, have the same physician-only ownership requirement. Those rules, he said, have driven out many abusive, non-physician firms.

"We want to control who owns these clinics," Weldon answered to Roberts. "That's a shot to the heart for how organized crime operates these businesses."

Without the law, he said, all enforcement is left to federal authorities. Their resources, Weldon said, are better focused up the supply chain, leaving local law enforcement to enforce state laws addressed at the retail distribution.

In January, a federal grand jury indicted Florida-based owners and a Duluth physician for using a Lilburn pain clinic to sell narcotics to addicts and dealers. The indictment alleges that the owners were not medical professionals and that they directed a physician employee to write prescriptions to customers who were not legitimate patients. Many of the recipients live outside Georgia, according to the government's case.

Lilburn Police Chief Bruce Hedley told lawmakers at a committee hearing earlier this month that he had no recourse to address the problems at the clinic other than to pressure federal authorities.

In separate action Tuesday, the House voted to expand the range of medical professionals who can distribute certain pain killers. House Bill 235 would allow optometrists — who are not medical school graduates — to administer hydrocodone, an opiate given orally.

Current law already allows optometrists to give patients non-narcotic pain killers.

House Bill 235 states that the eye-care professionals could give hydrocodone only for eye pain and for no more than 48 hours without consulting the patient's physician.

The proposal passed 161-2.