The Drug Enforcement Agency ensures compliance with controlled substance laws and regulations, one of which requires physicians to pay a hefty fee, $888, for a registration certificate covering each location where they dispense controlled substances.
The law plans to prescribe part of the dispensation and the certificate is only valid for three years. Surprisingly, and it seems few people are aware of it, a federal law exempts emergency physicians (and other licensed professionals who dispense only in a hospital) from paying these fees.
The exemption is found in the Code of Federal Regulations, the set of rules created by federal agencies. They are not strictly laws, but they have essentially the same effect. Section 1301.22(c) of Title 21 contains the prose that can save those of us who work exclusively in hospitals from having to pay the fees. It basically says that an individual practitioner who is an officer or employee of a hospital or other institution may, in the ordinary course of his or her employment, administer, dispense or prescribe controlled substances under the registration of the hospital instead of being registered himself.
It contains a few conditions, including that the prescription be done in the course of professional practice, that the doctor be authorized to do so by their jurisdiction of practice, and that the hospital has verified that each doctor is authorized to prescribe. Hospitals are also required to designate a code number for each practitioner that includes the facility’s DEA registration number.
The requirements are rather minimal. The hospital and its pharmacy simply have to keep a list of practitioners working in the emergency room. The other obligations are met anyway when a hospital accredits a doctor.
But this exemption is hardly ever used, probably because few doctors know about it and bureaucracies often resist change. But it has essentially no downside and an $888 upside, and it should be the new DEA registration standard for emergency physicians and other hospital-based professionals.
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Dr Newdowis an emergency physician who has worked as a locum for most of his 42-year career. He is also Medical Director and Chief of Staff at Jerold Phelps Community Hospital in Garberville, California..