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It’s been nearly two months since a law requiring doctors to take additional steps before writing prescriptions for opioids went into effect, though some of the questions and concerns raised by doctors about the law are only now just starting to be answered...A subcommittee formed specifically to address concerns related to the implementation of the law grappled with some of the areas of uncertainty at a recent meeting with the goal of ultimately clarifying the exact steps doctors must take when writing a prescription for painkillers and figuring out what punishment they should face should they fail to do so. But to what extent that clarification can or should be codified into state regulations will be up to the Board of Pharmacy, which will discuss the matter at a meeting early next month...Though the law, AB474, applies to any prescriber of opioids — from advanced practice registered nurses to dentists — most of the concerns about the law have come from medical doctors, who have lamented the extra time obtaining an informed consent and making a “good faith effort” to obtain a patient’s medical records. Some have even said they won’t write any more prescriptions for painkillers in response to the law and will direct patients instead to pain doctors...The Board of Medical Examiners is responsible for creating any disciplinary regulations they deem appropriate, but the law leaves any other clarifying regulations up to the Board of Pharmacy.

...the University of Nevada, Reno just announced the launch of their new department of surgery...With this new department, there's a greater chance medical students taught here, will stay local to practice...This department launch comes as an effort to keep up with the growing demand of interest in surgical careers from their medical students...The new department has been about two years in the making. With the school's community based mission, local surgeons and practitioners will now get to actively teach these students...Medical students will now experience training from community partners like Renown and the local VA and surgeons' offices throughout Reno...The university says establishing this department will help with retention; teaching Nevadans who will stay in Nevada and help Nevadans. Berg explains, "The majority of people locate 25 miles within their residency, so if we're trying to make sure that we train doctors here and we keep doctors here, that we establish strong competitive residency programs."

Nevada is taking steps toward leaving the federal healthcare.gov and setting up a separate exchange operated by the state...the Legislative Interim Finance Committee...authorized state officials to spend $1 million to prepare a request for proposals and find a private provider...Heather Korbulic, executive director of the state system, says changes are needed because healthcare.gov is steadily raising the rates it charges states that link their front-end systems to the federal exchange...Korbulic says the federal rate increases by 2019 will leave the state with almost nothing to run the front-end system...Nevada tied its state exchange to the site after...using Xerox as a contractor failed, but Korbulic says several vendors now have proven systems.

Nevada's new opioid prescription law is only days old but doctors already are worried about how it might be implemented...physicians, lawyers and others expressed concerns this week to the state medical and dental boards over draft disciplinary rules for doctors who write improper prescriptions for pain medications...Under the proposed rules, doctors who violate the new law five times would lose their licenses. The threshold on losing a license would be reduced to three violations by 2020...Several doctors who attended the meeting say the proposed rules don't specify the exact conduct that could lead to penalties or the loss of medical licenses...The doctors voiced concerns that they could be punished for relatively minor mistakes or employee errors.

Drug-toting travelers now have a place to trash their stash before boarding a flight at McCarran International Airport...Green metal bins have popped up at the nation’s eighth-busiest airport, creating a safe space for airline passengers to dispose of marijuana before boarding a flight...Even though recreational marijuana is legal in Nevada, the drug is banned inside Clark County’s network of airports and security checkpoints operated by the Transportation Security Administration...About 20 “amnesty boxes” were installed over the past week outside high-traffic areas of McCarran, Henderson Executive and North Las Vegas airports, bearing a sign citing the local law that prohibits pot within airport property...The move comes after Clark County’s Board of Commissioners banned marijuana possession and advertising on airport property as a way to comply with existing federal laws...

• Reappointment of Jason Penrod
• A New Era for Compounding Inspections
• Senate Bill 59 Makes Changes in Reporting to the Nevada PMP
• PMP Data Submission Accuracy Data

National Pharmacy Compliance News First Quarter 2018

• FDA Draft Guidance Addresses Delayed Enforcement of DSCSA Requirements for Product Identifiers
• Amount of Prescribed Opioids Remains High, Reports CDC
• AMA Opioid Task Force Encourages Co-Prescribing Naloxone to At-Risk Patients
• Opioid Addiction Medications Should Not Be Withheld From Patients Taking Benzodiazepines or CNS Depressants
• New Study Shows Substantial Variation in the Availability of Pharmacies Across the Country
• Consent Decree Entered Against Outsourcing Facility Isomeric Pharmacy Solutions
• FDA Issues Warning on Alcohol Pads or Benzalkonium Chloride Antiseptic Towelettes Made by Foshan

Sierra Nevada Health Center is one of Carson City's two federally-qualified health care centers that were hoping for renewed funding at the beginning of this month, but are instead still waiting on Congress to extend the Community Health Centers Fund program that expired on Sept. 30, 2016...Nevada's six federally-qualified health care centers provide care to around 89,000 patients across the state. Sierra Nevada Health Center and Carson City School-based Health Center provide care to Carson City and Carson Valley residents and are hanging in a balance after the deadline to extend the funding passed...Nevada's health centers are among more than 1,300 community health centers across the U.S. that receive funding from the CHCF program. Today, Nevada's health centers employ more than 60 medical professionals...Earlier this month, Nevada Health Centers CEO and board chairs sent a letter to Nevada's congressional delegation to encourage action on funding for community health centers...addressed to Republican Sen. Dean Heller, Democratic Sen. Catherine Cortez Masto, Democratic Rep. Dina Titus, Republican Rep. Mark Amodei, Democratic Rep. Jacky Rosen and Democratic Rep. Ruben Kihuen, the CEO and board chairs asked for unity between political parties and a solution to health care funding...The letter encourages Nevada congressional members "to develop a long-term, fiscally responsible funding plan that ensures the success of our country's greatest public health asset."

Nevada health officials confirmed...they cut ties with UNLV’s mental health clinic, after...the university continued placing mentally ill clients in an unlicensed home previously closed by the state because of filthy conditions...“We weren’t satisfied with their response in terms of assurance that people were placed in homes that were credentialed and that were safe,” said Richard Whitley, director at the Nevada Department of Health and Human Services. “I did not see a sense of urgency demonstrated by (Mojave Mental Health) to ensure that people were placed in appropriate environments.”...The contract termination comes after...Mojave placed at least seven men with severe mental illness inside an unlicensed home at 724 N. Ninth Street a year after the state shut it down. The men were living in tiny rooms filled with trash, broken glass, rodents, expired medication and rotten food. The state shut down the home again this month...On Feb. 9 the state served Mojave, a subsidiary of the UNLV School of Medicine, a 30-day termination notice. The state will relocate Mojave patients who are living in noncertified homes...Roughly 210 patients will be affected, though it’s unclear how many will have to move...

As Nevada’s suicide rate has jumped to No. 5 in the nation and to its highest level since the late 1990s, the state’s doctors are being asked to be the frontline in recognizing suicidal tendencies of their patients and get them help before they take their lives...The effort is part of a state law passed in 2017 requiring physicians in all specialties to receive two hours of training on suicide prevention as a way to deal with the epidemic. The training for Southern Nevada started on Jan. 23 when Dr. Lesley Dickson, executive director of the Nevada Psychiatric Association addressed more than 90 doctors, medical residents and medical students in a presentation called “Suicide Prevention: How to Save a Life.”...“Interventions by mental health professionals are very important, but many suicidal individuals never see a therapist,”...“It’s important that all people who interact with a suicidal person know how to help.”...Nevada had 650 suicides — just under two a day — and a suicide rate of 22.1 per 100,000, in the latest numbers from the American Association of Suicidology. That’s up from 2015’s 558 deaths and 19.3 rate per 100,000 when Nevada was ranked 11th. The state is typically in the top 10...

The pharmaceutical industry largely snubbed Democrats when it came to doling out campaign contributions last year after the Democrat-controlled Legislature passed a bill to increase drug-pricing transparency in June...Only four Democrats — two members of Assembly leadership and the chairs of the Assembly and Senate health committees — received any contributions from the industry last year while 19 received industry contributions in 2016. By contrast, 19 Republican lawmakers and candidates and four Republican PACs or committees received donations from pharmaceutical companies in 2017, roughly comparable to 2016 trends...The $17,000 in pharmaceutical donations Democrats received represented about 1 percent of the more than $1.4 million the industry spent in Nevada in 2017. Republicans received 67 percent of the industry’s contributions, while the remaining 32 percent went toward funding the industry’s opposition, through the Healthy Nevada PAC, to the insulin pricing transparency bill sponsored by Democratic Sen. Yvanna Cancela in 2017.

TOP 10 PHARMA MONEY RECIPIENTS:

• Republican State Leadership Committee: $914,000
• Attorney General candidate Wes Duncan: $8,500
• Assembly Speaker Jason Frierson: $8,250
• Sen. Ben Kieckhefer: $6,500 (including $1,250 to his PAC)
• Sen. Joe Hardy: $6,250 (including $1,250 to his PAC)
• Assemblyman James Oscarson: $5,000
• Gubernatorial candidate and Attorney General Adam Laxalt: $3,500
• Assemblyman Mike Sprinkle, 2017 chair of the Assembly health committee: $3,250
• Assemblyman Chris Edwards: $3,000
• Assembly Minority Leader Jim Wheeler: $2,850