The Drug Enforcement Agency ensures compliance with controlled substances laws and regulations, one of which requires physicians to pay a hefty fee, $888, for a registration certificate to cover each location where they dispense controlled substances.
The law considers prescribing a part of dispensing, and the certificate is valid for only three years. Surprisingly, and it seems few are aware of this, A federal law exempts emergency physicians (and other licensed professionals who dispense only in a hospital) from paying this fee.
The exemption is found in the Code of Federal Regulations, the body of rules created by federal agencies. These are not strictly statutes, but they essentially have the same effect. Section 1301.22(c) of title 21 contains the prose that can save those of us working exclusively in hospitals from ever having to pay the fee. It basically says an individual practitioner who is an agent or employee of a hospital or another institution may, in the normal course of employment, administer, dispense, or prescribe controlled substances under the registration of the hospital in lieu of being registered himself.
It has a few provisos, including that the prescribing is done as part of professional practice, that the physician is authorized to do so by his practice jurisdiction, and that the hospital has verified each physician is permitted to prescribe. Hospitals are also required to designate a code number for each practitioner that includes the institution's DEA registration number.
The requirements are rather minimal. The hospital and its pharmacy merely have to keep a list of practitioners working in the ED. The other obligations are done anyway when a hospital credentials a physician.
But this exemption is virtually never used, probably because few physicians know about it and bureaucracies often resist change. But it has essentially no downsides and an $888 upside, and it should be the new standard of DEA registration for emergency physicians and other hospital-based professionals.
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Dr. Newdowis an emergency physician who has worked locum tenens for most of his 42-year career. He is also the medical director and chief of staff at the Jerold Phelps Community Hospital in Garberville, CA.