24.1. Each
OBMAT program shall develop, implement, and maintain current policies and
procedures, patient protocols, treatment plans, or treatment strategies, and
profiles for the treatment of patients seeking treatment for
medication-assisted treatment.
24.2. The program physician or physician
extender shall conduct an assessment meeting the following requirements.
24.2.1. The assessment may include, but not
limited to, an appropriate history and physical, mental status exam, substance
use history, appropriate lab tests, pregnancy test for women of childbearing
years, toxicology tests for drugs and alcohol, hepatitis B and hepatitis C
screens, an inquiry to and report from the Controlled Substances Monitoring
Program database, an inquiry whether the patient is being treated at any other
opioid treatment OBMAT program, the diagnosis of all conditions, including a
diagnosis of substance use disorder, including signs and symptoms, the dates,
amounts, and dosage forms for any drugs prescribed, dispensed, and
administered, and any other tests as necessary or appropriate in the treatment
provider's discretion; and
24.2.2.
For other than the toxicology tests for drugs and alcohol, appropriate history,
substance abuse history, hepatitis B and hepatitis C screens, and the pregnancy
test, the physician may satisfy the assessment requirements by reviewing
records from a physical examination of the patient that was conducted by a
physician within a reasonable period of time prior to the visit not to exceed
30 days and a copy of the report by the referring physician and any medical
records from other providers, if applicable.
24.2.3. The post-admission assessment may
include laboratory tests conducted by the OBMAT program or by other reliable
sources.
24.3.
Continuing Assessments.
Subsequent patient assessments shall include periodic patient
evaluations. Patients shall be seen at reasonable intervals based upon the
individual circumstance of the patient. Periodic assessment is necessary to
determine compliance with the dosing regimen, effectiveness of treatment plan,
and to assess how the patient is responding to the prescribed medication. Once
a stable dosage is achieved and urine or other toxicology tests are free of
illicit drugs, less frequent office visits may be initiated for patients on a
stable dose of the prescribed medication who are making progress toward
treatment objectives. Continuation or modification of therapy shall depend on
the physician's evaluation of progress toward stated treatment
objectives.
