(a)
(1) A physician shall not be subject to disciplinary action by the Arkansas State Medical Board solely for prescribing dangerous or controlled drugs for the relief of chronic intractable pain.
(2)
(A)
(i) Any allegation of improper prescribing determined to require a board hearing shall be referred to the Pain Management Review Committee before any board hearing or action.
(ii)
(a) However, in exceptional limited substantive instances requiring immediate action to protect the public health, an emergency action under § 25-15-211(c) may be implemented.
(b) The implementation of an emergency action under § 25-15-211(c) shall in no way be used by the board to circumvent, void, supplant, or otherwise limit the role of the committee as provided in this subchapter.
(B) The board shall provide the committee all necessary documentation for the review process in a timely manner.
(3) The board shall direct the committee to use the criteria under subsections (d) and (e) of this section to review a physician's conduct in regard to prescribing, administering, ordering, or dispensing pain medications and other drugs necessary to treat chronic intractable pain.
(4)
(A) If the board determines that an allegation or a question regarding a physician's prescribing does not justify a board hearing, in lieu of a board hearing, the board may refer a physician to the committee for review and recommendations to the board.
(B) The review and recommendations under subdivision (a)(4)(A) of this section shall not adversely affect the physician's license or licensure status.
(b) The board shall:
(1) Make reasonable efforts to notify healthcare providers under its jurisdiction of the existence of this subchapter;
(2) Inform any healthcare provider licensed by the board and investigated regarding the provider's practices in the management of pain of the existence of this subchapter; and
(3)
(A) In a disciplinary hearing, present opinion evidence from a full-time active practice physician in direct patient care who is knowledgeable in pain management.
(B) The physician has the right to present testimony from a full-time active practice physician in direct patient care who is knowledgeable in pain management.
(c)
(1) In lieu of a finding of gross and ignorant malpractice, the board after a hearing may incrementally impose sanctions as follows:
(A) Monitor prescribing habits of the physician not to exceed six (6) months;
(B) Require the physician to voluntarily surrender his or her United States Drug Enforcement Administration license to the board for a specified period of time not to exceed three (3) months;
(C) Suspend the physician's license, stay the suspension, and require monitoring of prescribing habits;
(D) Revoke the physician's license, stay revocation, and require monitoring of the physician's prescribing habits for a specified time; and
(E) Revoke the physician's license for serious violations of statutes and rules.
(2) With a finding of severe violation of statutes and rules, the board may initially impose the more severe sanctions.
(3) At any level of sanction, the board may require continuing medical education hours in proper prescribing habits.
(d) Based upon evaluation and management of a patient's individual needs, a physician may:
(1) Treat a patient who develops chronic intractable pain with a dangerous or controlled drug to relieve the patient's pain;
(2) Continue to treat the patient for as long as the pain persists;
(3) Treat the pain by managing it with dangerous or controlled drugs in amounts or combinations that may not be appropriate for treating another medical condition;
(4) Administer large doses of dangerous or controlled drugs for pain management if the benefit of relief outweighs the risk of the large dose; and
(5) Administer a large dose of a dangerous or controlled drug even if its use may increase the risk of death if the purpose is not to cause or assist in a patient's death.
(e) A physician may not:
(1) Prescribe or administer dangerous or controlled drugs intended to manage chronic intractable pain to treat a patient for chemical dependency on drugs or controlled substances;
(2) Prescribe or administer dangerous or controlled drugs to a person the physician knows to be using drugs for nontherapeutic purposes;
(3) Prescribe or administer dangerous or controlled drugs to a person for other than legitimate medical purposes; or
(4)
(A) Cause or assist in causing the suicide, euthanasia, or mercy killing of any individual.
(B) However, causing or assisting in causing the suicide, euthanasia, or mercy killing of any individual does not include prescribing, dispensing, or administering medical treatment for the purpose of alleviating pain or discomfort even if that use may increase the risk of death so long as the treatment is not furnished for the purpose of causing or assisting in causing the death of the individual.