DEA: Separate registration for multistate practices

Physicians have until Feb. 7 to comment on the agency's proposed rule.

By Andis Robeznieks, AMNews staff. Jan. 17, 2005.

Physicians who prescribe controlled substances and practice in more than one state soon could have more fees to pay, more paperwork to fill out and more numbers to identify themselves by.

The U.S. Drug Enforcement Administration wants these physicians to obtain separate DEA controlled substance prescribing registration for each state in which they practice, according to an item posted in the Federal Register on Dec. 7, 2004. Although the amendment is supposed to clarify existing regulations, one physician who practices in western Kentucky and southern Illinois said it would cause only headaches and confusion.

"It is definitely not the greatest thing in the world, and I don't see how it will have any advantage at all," said Laxmaiah Manchikanti, MD, medical director of the Pain Management Center of Paducah and the Ambulatory Surgery Center of Paducah in Kentucky. "I don't know why the DEA is so worried about this. It should keep the system the way it is."

It is very common for Kentucky physicians in Paducah or Louisville to also practice in Ohio, Indiana or Illinois, said Dr. Manchikanti, who is president of the American Society of Interventional Pain Physicians. He estimated that about 20% of the society's 3,000 members practice in more than one state.

Dr. Manchikanti said this was not just a concern for pain specialists. He said the change also would affect primary care physicians, psychiatrists and pediatricians.

The Federal Register stated that the DEA would take public comments on the proposed rule change until Feb. 7. There were no other dates or schedule information given related to the proposal. "The process will take whatever time is required," said DEA spokeswoman Rogene Waite. "DEA does not impose timelines."