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AB 679 (Allen, Chapter 778, Statutes of 2015) was signed into law by Governor Brown and is effective immediately. This bill amends existing law that requires all health care practitioners that are authorized to prescribe, order, administer, furnish or dispense Schedule II, III, or IV, later expanded to include Schedule V, controlled substances and pharmacists to be registered with CURES by January 1, 2016, and extends the registration date to July 1, 2016. As such, physicians now have until July 1, 2016 to register with CURES.

What is the CURES System?

California's Prescription Drug Monitoring Program (PDMP), Controlled Substance Utilization Review and Evaluation System (CURES), allows authorized physicians, law enforcement, and regulatory agencies to view information on Schedule II - V controlled substances dispensed to patients in California. Pharmacists and direct dispensers are required to report information on all Schedule II - V controlled substances dispensed and must do so within one working day of dispensing. The information is then uploaded into CURES. The CURES system has provided prescribers and dispensers with Schedule II - V prescription data via an online web portal since 2009. The system, as currently configured, provides authorized prescribers and dispensers who have registered on the system with prescription detail for an individual patient's prescription records (Patient Activity Report, or PAR), which includes the patient's name, date of birth, and address; drug name, form, strength, quantity, dispensing pharmacy name and license number; prescriber DEA Certificate number; prescriber name, prescription number; refill number; and date of dispense. A physician can use this information for multiple purposes, including identifying a patient who may be a "doctor shopper," viewing medications dispensed to the patient that were prescribed by other physicians, and providing a complete picture of Scheduled drugs dispensed to a patient.

The CURES system can be an extremely helpful tool for physicians who are prescribing controlled substances. The Medical Board's newly revised Guidelines for Prescribing Controlled Substances for Pain emphasizes that physicians should use the CURES PDMP to identify patients who obtain drugs from multiple sources as part of the Patient Evaluation and Risk Stratification process. The Guidelines also recommend that physicians document, in their medical records, that they requested a Patient Activity Report (PAR) from CURES and the outcome of such report.

Upgrading CURES: CURES 2.0

Recently, the Department of Justice (DOJ) upgraded the CURES system. CURES 2.0 enhances the information that a physician can obtain from the system. In addition to the functionality of the prior system, CURES 2.0 provides an improved user interface and an analytics engine that will provide physicians with critical information regarding at-risk patients. An example of a new feature with the upgraded CURES 2.0 is that prescribers will be able to specify patients with whom they have pain management agreements to signal to other providers that additional prescribing of controlled substances to these patients could be potentially counter-productive or harmful. The new CURES 2.0 also provides alerts to physicians if a patient meets certain criteria, such as a patient who has obtained prescriptions from six or more prescribers or six or more pharmacies during the last six months. These alerts are viewable on the physicians' dashboard when they sign on to the CURES 2.0 system.

Requirement to Register by July 1, 2016

Pursuant to Health & Safety Code section 11165, a physician authorized to prescribe, order, administer, furnish, or dispense Schedule II, Schedule III, or Schedule IV controlled substances must have submitted an application to the DOJ for registration into the CURES system by July 1, 2016.