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Georgia Pain Clinic Rules

The Pain Rule only applies to those patients needing essentially daily opioid medications for more than90 days to treat chronic pain. These guidelines DO NOT apply to in-patients, terminal patients, hospice patients, those in nursing homes or a patient who just needs intermittent medications (as opposed to daily) for a non-terminal condition. Attention all Surgeons — these rules DO NOT apply to any pain problems being treated by you during any peri-operative period (such period may last 2-6 months depending on the actual condition being treated), which allows surgical care to be unhindered.
Need an H&P. This is what we do everyday. We need to make an attempt to get records from previous physicians and any imaging studies. We need to actually perform a physical exam, which the ‘pill mill’ doctors rarely did.
When prescribing Schedule II and III controlled substances for chronic pain, noting the above exceptions, these patients need to be seen at least once every 3 months. The patient must have also signed a treatment (opioid) agreement or “pain contract”
When prescribing Schedule II and III controlled substances for chronic pain, these patients need to be monitored using body fluids (typically urine drug testing or ‘UDT’) to make sure the medications you are prescribing are indeed in the patient’s system, and other non-prescribed medications or street drugs are not present. This just makes sense and will serve to protect YOU.
The Board recognizes there will be the occasional hardship. Thus, they made a provision to relax the rules a bit as long as the specific hardship is documented. (ie-pt has had a catastrophic CVA and is wheelchair-bound, making it very difficult for transportation. Or a patient is taking less than 30mg hydrocodone or 20mg oxycodone total dose per day). In these cases, the patient could be seen only once or twice per year and monitored once per year.
https://www.mdatl.com/2015/08/new-pain-management-laws-and-rules-in-georgia/