Your Academy continues to assess the evolution of the Medical Board of California's Death Certificate Project. In the inaugural phase of this project, the Medical Board of California (MBC) identified deaths in 2012 and 2013, in which the underlying cause and the contributing cause of death was opioid pharmaceutical-related. Through the analysis of data gathered from California’s prescription drug monitoring program, the Controlled Substance Utilization Review and Evaluation System (CURES); the MBC identified the physicians who were prescribing to the deceased individuals and sent the report to expert reviewers to determine if the physicians had inappropriately prescribed to their patients.
Since this initiative began, the MBC has identified over 2,500 deaths, investigated over 500 cases, and has issued 30 accusations against physicians that may have inappropriately prescribed opioids to a, now deceased, patient in 2012 or 2013.
Your Academy shares many of the concerns expressed by some in the medical community regarding the investigation methodologies, and the affect the project has on physicians, their practices, and patients. The Medical Board of California has acknowledged some concerns and has expressed an intention to make modifications to their process to alleviate some of the issues raised. The MBC is likely to begin its next phase of death certificate reviews for deaths in 2016 and 2017, instead of investigating further back, as previously planned.
Noting similar, but less extensive efforts in other states, your Academy is concerned about the precedent that this initiative may set for other states. Through efforts of the State Advocacy Subcommittee and Pain Management and Opioid Task Force, we will continue to proactively monitor this and other comparable initiatives, continue to engage in advocacy efforts with state-based stakeholders and organizations, and continue to educate and inform members, as warranted.
For more information on Your Academy’s activities with respect to opioid prescribing and pain management, please visit our Pain Management page or contact us at healthpolicy@aapmr.org.