Physician assistants treating acute and chronic pain are on the front lines of the national opioid crisis. It’s no surprise that part of the North Carolina Medical Board (NCMB) response to this crisis includes mandatory controlled substance CME for PAs that prescribe controlled substances. If you haven’t heard about this requirement or studied 21 NCAC 32S .0216, you’re not alone. The requirement went into effect July 1, 2017, so PAs in North Carolina are just now getting used to what this means for reporting their CME. Here are the five essential facts you need to know about this new requirement for PAs in North Carolina.
1. What’s the new NCMB controlled substance CME requirement for PAs?
You’ll need 2 credits every 2 years related to controlled substances.
2. When is my controlled substance CME due to the North Carolina Medical Board?
It’s due on the same schedule as the rest of your CME.
▪ If you’re NCCPA certified, use your NCCPA two-year cycle.
▪ If you’re not NCCPA certified, use a two-year cycle starting with the first birthday following your initial licensure to report CME.
3. How do I submit my controlled substance CME to the NCMB?
You don’t. Check out your annual license renewal questionnaire from the NCMB. If you prescribe controlled substances, you’ll need to attest that you’ve finished your controlled substance CME. However — and this is important — the NCMB encourages you to keep your certificates on file. They’re allowed to audit you at any time, where they’ll ask you to submit all of your certificates.
If you maintain certification through the NCCPA, you don’t have to report CME hours to the NCMB at all.
4. What qualifies as controlled substance CME for PAs?
You’ll need Category 1 Credit, which includes AMA PRA Category 1 Credit™, the type of credit you should be using for all of your CME anyway.
To qualify for controlled substance CME, make sure your hours specifically cover these topics required by the NCMB:
1. Controlled substance prescribing practices
2. Recognizing signs of the abuse or misuse of controlled substances
3. Controlled substance prescribing for chronic pain management
There’s no other specific requirement on what’s allowed for controlled substance CME.
5. How do I leverage Orbit to efficiently earn and track controlled substance CME?
There are a variety of free online CME opportunities listed by the NCMB here. Be sure to store your certificates for possible audits later, and set a reminder on your calendar to complete more CME when your new cycle comes up.
If you’re looking for a more streamlined experience that keeps your certificates ready for audit reports, Orbit’s plugin ($9.99 per month) lets you earn and track unlimited Category 1 CME for the web browsing that you’re already doing on shift. This means that you’ll get 0.5 credit hours for each article you reference on shift without taking personal time to finish this requirement. Since Orbit automatically tracks your visits to eligible peer-reviewed sites, you’ll earn both your controlled substance credits and the rest of your NCCPA-accepted Category 1 CME in the process. It’s also super easy to generate an audit report in Orbit — with one click you’ve answered any audit request — either from the NCMB or the national boards.
To earn controlled substance CME on Orbit, sign up for Orbit Standard. Once you’re logged in, use PubMed to seach for peer-reviewed articles that cover the three required CS topics (prescribing practices, recognizing abuse, chronic pain management). Orbit’s plugins will automatically track your searches and award 0.5 credits per reference. For example, here are some opioid-related articles that Orbit’s providers in North Carolina are finding useful for the CS requirement:
Opioid Prescribing for Opioid-Naive Patients in Emergency Departments and Other Settings. Topics: Prescribing practices. [Fulltext]
Physician Guide to Appropriate Opioid Prescribing for Noncancer Pain. Topics: Prescribing practices, recognizing abuse, treating chronic pain. [Fulltext]
Predictors of Sustained Prescription Opioid Use After Admission for Trauma in Adolescents. Topics: Recognizing and predicting abuse. [Fulltext]
Each CS-relevant article that you reference earns 0.5 Category 1 controlled substance credits through Orbit. You’ll only need to reference two articles through Orbit per year to stay up to date, so choose articles that are relevant, meaningful, and updated.
When you redeem your credits for these articles on your Orbit Feed, select the Controlled Substance tag, to let Orbit know you want these articles to count for your CS requirement. You’ll be able to print your CS certificate and a complete audit report instantly from the Dashboard.
The NCMB’s new controlled substance requirement is a checkbox with the possibility of an audit, but it’s also a rallying cry for all providers to stay current in the ways we approach opioid addiction. Let’s take this requirement seriously and review the most current peer-reviewed articles in opioid management. Our patients and their families are counting on us to make a difference.
21 NCAC 32S .0216 CME requirements for physician assistants, including the new controlled substance requirement.
Ram Srinivasan MD PhD is a practicing physician and engineer in Palo Alto. His team designed Orbit as the most seamless way for physician assistants in North Carolina and beyond to earn, track, and report controlled substance and other Category 1 CME while focusing intensely on patient care. Get started with your controlled substance CME today. Register now for Orbit Standard at orbitcme.com.