Committee Substitute
House Bill 2839 History
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COMMITTEE SUBSTITUTE
FOR
H. B. 2839
(By Delegates Perdue, Boggs, Hatfield, Border,
Moore, Moye and Rodighiero)
(Originating in the House Committee on the Judiciary)
[March 13, 2009]
A BILL to amend and reenact §30-3A-1 and §30-3A-2 of the Code of
West Virginia, 1931, as amended, all relating to the
management of pain by physicians; eliminating the definition
of "intractable pain" and defining the word "pain"; making
conforming amendments to the Management of Pain
Act; and
expanding the definition of "pain-relieving controlled
substance" in the Act.
Be it enacted by the Legislature of West Virginia:
That §30-3A-1 and §30-3A-2 of the Code of West Virginia, 1931,
as amended, be amended and reenacted, all to read as follows:
ARTICLE 3A. MANAGEMENT OF PAIN ACT.
§30-3A-1. Definitions.
For the purposes of this article, the words or terms defined
in this section have the meanings ascribed to them. These
definitions are applicable unless a different meaning clearly
appears from the context.
(1) An "accepted guideline" is a care or practice guideline for pain management developed by a nationally recognized clinical
or professional association or a specialty society or
government-sponsored agency that has developed practice or care
guidelines based on original research or on review of existing
research and expert opinion. An accepted guideline also includes
policy or position statements relating to pain management issued by
any West Virginia board included in chapter thirty of the West
Virginia Code with jurisdiction over various health care
practitioners. Guidelines established primarily for purposes of
coverage, payment or reimbursement do not qualify as accepted
practice or care guidelines when offered to limit treatment options
otherwise covered by the provisions of this article.
(2) "Board" or "licensing board" means the West Virginia Board
of Medicine, the West Virginia Board of Osteopathy, the West
Virginia Board of Registered Nurses or the West Virginia Board of
Pharmacy.
(3) "Intractable pain" means a state of pain having a cause
that cannot be removed. Intractable pain exists if an effective
relief or cure of the cause of the pain: (1) Is not possible; or
(2) has not been found after reasonable efforts. Intractable pain
may be temporary or chronic.
(4) (3) "Nurse" means a registered nurse licensed in the State
of West Virginia pursuant to the provisions of article seven of
this chapter.
(4) "Pain" means an unpleasant sensory and emotional
experience associated with actual or potential tissue damage or described in terms of such damage.
(5) "Pain-relieving controlled substance" includes, but is not
limited to, an opioid or other drug classified as a Schedule II
through V controlled substance and recognized as effective for pain
relief, and excludes any drug that has no accepted medical use in
the United States or lacks accepted safety for use in treatment
under medical supervision including, but not limited to, any drug
classified as a Schedule I controlled substance.
(6) "Pharmacist" means a registered pharmacist licensed in the
State of West Virginia pursuant to the provisions of article five
of this chapter.
(7) "Physician" means a physician licensed in the State of
West Virginia pursuant to the provisions of article three or
article fourteen of this chapter.
§30-3A-2. Limitation on disciplinary sanctions or criminal
punishment related to management of
intractable pain.
(a) A physician shall is not be subject to disciplinary
sanctions by a licensing board or criminal punishment by the state
for prescribing, administering or dispensing pain-relieving
controlled substances for the purpose of alleviating or controlling
intractable pain when if:
(1) In a the case of intractable pain involving a dying
patient experiencing pain, in practicing the physician practices in
accordance with an accepted guideline as defined in section one of
this article the physician and discharges his or her professional
obligation to relieve the dying patient's intractable pain and promote the dignity and autonomy of the dying patient; even though
the dosage exceeds the average dosage of a pain-relieving
controlled substance or
(2) In the case of intractable pain involving a patient who is
not dying and is experiencing pain, the physician discharges his or
her professional obligation to relieve the patient's intractable
pain, even though the dosage exceeds the average dosage of a
pain-relieving controlled substance, if the physician can
demonstrate by reference to an accepted guideline that his or her
practice substantially complied with that accepted guideline.
Evidence of substantial compliance with an accepted guideline may
be rebutted only by the testimony of a clinical expert. Evidence
of noncompliance with an accepted guideline is not sufficient alone
to support disciplinary or criminal action.
(b) A registered nurse shall is not be subject to disciplinary
sanctions by a licensing board or criminal punishment by the state
for administering pain-relieving controlled substances to alleviate
or control intractable pain, if administered in accordance with the
orders of a licensed physician.
(c) A registered pharmacist shall is not be subject to
disciplinary sanctions by a licensing board or criminal punishment
by the state for dispensing a prescription for a pain-relieving
controlled substance to alleviate or control intractable pain, if
dispensed in accordance with the orders of a licensed physician.
(d) For purposes of this section, the term "disciplinary
sanctions" includes both remedial and punitive sanctions imposed on a licensee by a licensing board, arising from either formal or
informal proceedings.
(e) The provisions of this section shall apply to the
treatment of all patients for intractable pain, regardless of the
patient's prior or current chemical dependency or addiction. The
board may develop and issue policies or guidelines establishing
standards and procedures for the application of this article to the
care and treatment of persons who are chemically dependent or
addicted.