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In January, 2017 Graff & McGovern, LPA published a news article on the Ohio Medical Board’s aggressive enforcement of compliance with its OARRS system. OARRS is Ohio’s electronic system operated by the Ohio Pharmacy Board for tracking prescription drugs. The prior article reviewed the nearly 13,000 complaints generated against Ohio physicians since September of 2016. In April, 2017 the Medical Board meet again to review the data and its targeted enforcement efforts.

Following the April meeting we now know that of the nearly 13,000 physicians who received the initial letter, thousands of these individuals were identify as having 5 or fewer missed OARRS checks. Those prescribers included prominent members of medical academia and even one Member of the Ohio Medical Board. The first wave of letters also prompted over 1,000 responses from licensed individuals or their offices.

Most Board Members shared the concern raised by Anita Steinbergh, D.O., of Columbus who stated that she found the September, 2016 letter, very threating to the non-compliant physicians. Board Member Andrew Schachat, M.D., of Shaker Heights believes the Board should address the negative reaction to the initial letter through dissemination of a softer public relations message. The Board will likely use its website and Health Scene Ohio to publish articles on the positive trends in OARRS use metrics.

Since January the Board has cited ten physicians for their failure to properly use OARRS, including three during the April, 2017 Board meeting. It remains unclear if the physicians did in fact fail to check OARRS as required or if the data was misinterpreted by the Pharmacy Board.

At the April 13, 2017 meeting, only Amol Soin, M.D., M.B.A., of Centerville, currently the Board President, advocated for some level of grace to the targeted physicians and physician assistants. While admitting that the OARRS data was not awesome, Dr. Soin also questioned the fairness of disciplining physicians for alleged OARRS violations when up until recently, physicians had no access to the specific data anomalies underlying the concerns by law enforcement. To address some of the concerns, the Pharmacy Board modified OARRS to permit prescribers to run practice insight reports. These reports identify flagged prescriptions that lack corresponding review reports. While not conclusive, the enforcement section of the Medical Board has presumed that all flagged prescriptions are dispensed in violation of Ohio law.

Consumer Member, Don Kenney of Westerville urged the Medical Board investigators to be smarter about their reviews, and to only go after the bad guys. Others on the Board believe enforcement is not happening fast enough. Consumer Member Robert Giacalone of Dublin, the Board’s Vice President, vigorously advocated for the suspension of medical practice licenses as a law enforcement response to OARRS violations. We need a stick to let the doctors know that we aren’t messing around, said Mr. Giacalone. Dr. Steinbergh also advocated for a combination of reprimands, probations, and administrative fines, potentially $20,000 per violation.

While the Board failed to reach a consensus on enforcement criteria, the most vocal Members agreed that a $1,000 fine for first time violates was not sufficiently harsh enough.

As the next step in enforcement, on April 3, 2017 the Medical Board sent an undisclosed number of letters to prescribers that OARRS identified as, failed to check OARRS more than 50 times during the month of February. These letters are generic in nature and do not identify dates, prescriptions, or patients.

Under the Ohio Medical Board’s rules, the failure to properly document an OARRS review can be considered the failure to use acceptable methods in selection of drugs or other modalities. The Medical Board may impose a $20,000 fine for each violation and impose any of the following additional sanctions: revocation, suspension, probation and/or practice restrictions.

If you are a health care professional who has been contacted by the Ohio Medical Board or Ohio Pharmacy Board regarding your use of the OARRS system, you could be in risk of a substantial civil penalty or other disciplinary action. You have the right to have counsel present when questioned by a Board investigators. Those licensees who received Notices of Opportunity for Hearing only have 30 days to request a hearing and defend their licenses against sanctions.

If you received a Notice of Opportunity for Hearing, or if you have questions regarding the OARRS system and/or the Ohio Medical or Pharmacy Board requirements, you should consider contacting an attorney at Graff & McGovern, LPA, for a no-cost consultation. Levi Tkach is available to take your call at 614-228-5800, extension 4.