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House would erase pain-clinic rules

Florida House leaders released a prescription-drug proposal Monday that makes a huge bet: If you ban doctors from dispensing painkillers, the state's pill-mill problem will go away.

The proposal, outlined in two draft bills, would kill a controversial prescription-drug database. But it would go much further, repealing a series of regulations that lawmakers have approved during the past two years to try to curb the state's problems with clinics dishing out large quantities of painkillers to addicts and traffickers.

If the proposal passed, pain clinics would no longer be required to register with the state nor submit to inspection.

Lawmakers passed those regulations in 2009 and 2010 to try to police pill mills that have become magnets for drug abusers from across Florida and other states.

Eliminating regulations goes along with a broad philosophical push by Republican legislative leaders to shrink the size of government.

The crux of the House's proposal is to ban doctors from selling drugs in their offices and to force patients to fill prescriptions at traditional pharmacies. While many legitimate doctors dispense drugs to their patients, the practice also has been ripe for abuse in pill mills.

House Health and Human Services Chairman Rob Schenck, R-Spring Hill, said blocking doctors from dispensing drugs eliminates the need for the database and other regulations. House Speaker Dean Cannon, R-Winter Park, described the approach as attacking the pill-mill problem "upstream.''

“Banning doctor-dealers is the only way to do it,” Cannon said Monday, the day before the start of the annual legislative session.

But the House proposal already faces opposition, with Senate President Mike Haridopolos, R-Merritt Island, vowing to continue moving forward with the prescription-drug database. Doctors and a pain-management industry group also objected to the proposed ban on dispensing and the elimination of clinic regulations.

"It's the most irresponsible piece of legislation that I've seen in years,'' said Paul Sloan, president of the Florida Society of Pain Management Providers.

Doctors say they dispense drugs in their offices, at least in part, to help patients who might have difficulty getting to pharmacies and to ensure that patients buy their needed prescriptions.

But dispensing also can provide another source of revenue for doctors. A controversy flared last year when lawmakers passed a bill to limit the cost of drugs dispensed by doctors to workers-compensation patients. Then-Gov. Charlie Crist vetoed the bill, after an outcry by doctors.

About 6,300 doctors are registered to dispense medications in the state, according to a Department of Health presentation to Schenck's committee last month. The state has about 860 pain clinics, which indicates most of the dispensing doctors work in other types of practices.

Jeff Scott, general counsel of the Florida Medical Association, issued a statement Monday that said dispensing physicians "play an important role in the health-care system.''

"We believe the focus should be on the enforcement of the laws that were put on the books in the last two sessions, rather than punishing honest physicians who provide a valuable service for their patients,'' Scott said.

But the House proposal, which will get its first hearing Thursday in Schenck's committee, moves in the opposite direction. Schenck said earlier that he opposed the drug database, likening it to "Big Brother'' --- a position shared by Gov. Rick Scott.

The committee chairman also downplayed concerns that eliminating doctor dispensing would prevent patients from getting the medications they need. He said people will find other ways, such as relying on family members to pick up prescriptions.

Sloan said a doctor-dispensing ban would not solve the drug-abuse problem because bad pharmacists also could supply painkillers. He said the House proposal to eliminate the database and other regulations "undoes everything that is good.''

"The legitimate patient and the legitimate doctor are taking a huge beating,'' Sloan said.

--David Royse of the News Service of Florida contributed to this story.