[NP-Clinical] Narcotics, HIPPA and the Law

[David Mittman]

Barbara:
It¹s been awhile since I looked at patients rights but I know that forging
prescriptions is not one of them. These people are addicts and I feel for
them. With no other offences I would presume but do not really know, that
they would get probation as long as they submitted to a treatment program.
Making copies of RXs is illegal.
Dave
On 8/1/07 10:49 PM, "Barbara C. Phillips" <bphillips at olderwiserwomen.com>
wrote:

> What would you do?
>  
> 1.       You are treating a 67 year old man for chronic back pain after
> several failed surgeries. You see that his pain is not adequately controlled,
> yet he does not want to increase is medication (Vicodin). Several months
> later, you find out he was some how making copies of your prescriptions and
> taking them to various pharmacies around townŠnever hitting the same one more
> than once a month (getting about three times what you prescribed). He agrees
> to go to treatment. He gets no further pain medication ­ at least not from
> you.  Would you have reported this to the police?
>  
> 2.      59 year old man with chronic pain and PKD has been on oxy¹s for
> several years and is documented by his previous providers as having no
> problems with medications. Documentation includes formal pain assessment,
> stating treatment is appropriate. You get a call today from a pharmacy 2 hours
> away that he just filled a prescription ­ ³brand name please² (and paid cash).
> However, when investigating, he just got that script at the appropriate
> pharmacy the day it was writtenŠin town. And it turns out he filled a script
> for nearly the same medication from a physician 3 hours away (we had a nice
> long chat). Further investigation shows multiple pharmacies, providers and
> three counties. In this last incident (today), I¹ve notified all involved
> pharmacies and providers, and faxed a copy of the discharge latter to the
> nephrologists. But do I notify the police?
>  
> Does a patient retain the right to confidentiality in these scenarios? I do
> have medication contracts for controlled substances, but you knowŠit does not
> say anything about legal action if it is violated (which I will correct
> immediately). 
>  
> I feel like not doing something essentially allows the patient to see the next
> provider and start all over again.
>  
> I¹m looking forward to your comments.
>  
>  
> Barbara C. Phillips, NP
> www.NPBusiness.ORG <http://www.npbusiness.org/>
>  
> 
> 
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