(a) A clinic may apply to be designated as a "Gold
Designated Practice." In order to be eligible for a "Gold Designated
Practice" status, a clinic must:
(1) a Board-approved application form;
(2) Provide a Medical Home Agreement, written collaborative,
coordinated care agreement or memorandum of understanding to provide
management and treatments of pain, that describes measures that it
provides and may be used for reduction of pain such as, but not limited
to:
(A) multimodal treatment such as surgery, injections,
pain pumps, osteopathic manipulation, epidurals, trigger point injections,
dry needling, and topical creams or patches;
(B) multi-disciplinary practices such as medication
assisted tapering and weaning, computer-based training pain coaching,
acupuncture, chiropractic, physical therapy, massage, and exercise/movement;
or
(C) collaborative care or other behavioral health integration
services such as evidenced-based cognitive behavioral therapy interventions
for mental health and pain reduction, medication management and opioid
weaning, patient-centered education, regular monitoring and assessments
of clinical status using validated tools, assessment of treatment
adherence, motivational interviewing, and a structured approach to
improving the biopsychosocial aspects of pain management; and
(3) In addition to providing a Medical Home Agreement,
written collaborative, coordinated care agreement or memorandum of
understanding to provide management and treatments of pain described
above, the clinic must either:
(A) Meet the standards for exemption under Section
168.002(7) of the Act, including the clinic is operated by a majority
of physicians who currently hold or previously held ABMS or AOA Board-certification
or subspecialty certification in pain management; and
(i) have a majority of physicians perform or properly
supervise delegates in providing other forms of treatment besides
qualifying pain management prescriptions to a majority of the patients
at the clinic;
(ii) the clinic's providers utilize a Medical Home
Agreement signed by the primary prescriber and the patient; or
(iii) have a written collaborative, coordinated care
agreement or a memorandum of understanding with the patient's primary
physician for treating and managing the patient; or
(B) Be a Certified Pain Management Clinic (PMC) that
is operated by physicians who previously held an ABMS or AOA Board-certification
or sub-specialty in pain management or hold a ABMS or AOA Board-certification
in an area that is eligible for a pain management subspecialty; and
(i) have a Medical Home Agreement signed by the primary
prescriber and the patient; or
(ii) a written collaborative, coordinated care agreement
or memorandum of understanding providing that each physician who prescribes
qualifying prescriptions will consult with a pain specialist for the
patient.
(b) The designation may be verified by an initial audit
and is valid for five years.
(c) No further audits or inspections will be conducted
during the five-year "Gold Designated Practice" period, unless:
(1) A complaint is received or initiated by the Board
concerning operation of the clinic or operators at the clinic;
(2) The clinic changes location; or
(3) The clinic's ownership structure changes to a majority
of new owners.
(d) Practices that only treat pain patients as part
of cancer care, or that provide only palliative care, hospice or other
end-of-life care, are exempt under the Act from certification requirements
as a PMC, but do not qualify for the "Gold Designated Practice" status.
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