DAR File No. 39151

Commerce, Occupational and Professional Licensing

Section R156-71-202

Naturopathic Physician Formulary

Notice of Proposed Rule

(Amendment)

DAR File No.: 39151
Filed: 02/24/2015 09:00:40 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The Naturopathic Formulary Peer Committee determined that the following changes need to be made to the Naturopathic Physician Formulary rule. The Naturopathic Physicians Licensing Board reviewed the recommendations and affirmed that the subsequent modifications need to be made. It should also be noted that a licensed physician (MD) was added to the peer committee by the legislature under S.B. 193 in the 2014 General Session to ensure the physician-prescribing perspective was included in discussions.

Summary of the rule or change:

Proposed amendments to this section add the following noncontrolled substance legend medications to the Naturopathic Physician Formulary: 1) antibacterials, limited to oral, topical and intramuscular administration; 2) miscellaneous antimycobacterials; 3) heparins; 4) selective serotonin- and norepinephrine-reuptake inhibitors; 5) mast-cell stabilizers; 6) expectorants; 7) mydriatics; 8) anti-inflammatory agents; 9) heavy metal antagonists, limited to Dimercaprol, Edetate Calcium Disodium and Succimer; and 10) oxytocics, limited to Oxytocin.

State statutory or constitutional authorization for this rule:

• Section 58-71-101
• Subsection 58-1-202(1)(a)
• Subsection 58-1-106(1)(a)

Anticipated cost or savings to:

the state budget:

The Division will incur minimal costs of approximately $75 to print and distribute the rule once the proposed amendments are made effective. Any costs incurred will be absorbed in the Division's current budget.

local governments:

The proposed amendments apply only to licensed naturopathic physicians. As a result, the proposed amendments do not apply to local governments.

small businesses:

The proposed amendments apply only to licensed naturopathic physicians. Licensees may work in a small business; however, the proposed amendments would not directly affect the business.

persons other than small businesses, businesses, or local governmental entities:

The proposed amendments apply only to licensed naturopathic physicians. As a result, the proposed amendments do not apply to other persons.

Compliance costs for affected persons:

The proposed amendments should have no increased compliance cost or impact for licensed naturopathic physicians. There may be cost savings to the patients because they may need to see fewer doctors for treatment. Also, there will be a possible increase in revenue to the naturopathic physician, but these savings and revenue increases cannot be estimated due to wide range of circumstances.

Comments by the department head on the fiscal impact the rule may have on businesses:

This filing expands the list of noncontrolled substance legend medications that are within the scope of practice of naturopathic physicians. No compliance costs or other fiscal impact to businesses is anticipated.

Francine A. Giani, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Commerce
Occupational and Professional Licensing
HEBER M WELLS BLDG
160 E 300 S
SALT LAKE CITY, UT 84111-2316

Direct questions regarding this rule to:

• Maria Skedros (Lohse) at the above address, by phone at 801-530-6179, by FAX at 801-530-6511, or by Internet E-mail at mskedros@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

04/14/2015

Interested persons may attend a public hearing regarding this rule:

• 03/30/2015 09:00 AM, Heber Wells Bldg, 160 E 300 S, Conference Room 474 (fourth floor), Salt Lake City, UT

This rule may become effective on:

04/21/2015

Authorized by:

Mark Steinagel, Director

R156. Commerce, Occupational and Professional Licensing.

R156-71. Naturopathic Physician Practice Act Rule.

R156-71-202. Naturopathic Physician Formulary.

(1) In accordance with Subsections 58-71-102(8) and (12)(a) and Section 58-71-202, the naturopathic physician formulary which consists of noncontrolled substance legend medications deemed appropriate for the primary health care of patients within the scope of practice of naturopathic physicians, the prescription of which is approved by the Division in collaboration with the Naturopathic Formulary Advisory Peer Committee, consists of the following legend drugs, listed by category, with reference numbers identified in the American Hospital Formulary Service (AHFS), published by the American Society of Health System Pharmacists, 2008 edition; including the monographs available on AHFS Drug Information website, which is http://www.ahfsdruginformation.com:

4:00 Antihistamines

8:08 Antihelminthics

8:12 Antibacterials, limited to oral, [and ]topical and intramuscular administration[forms only]

8:14 Antifungals, oral and topical forms

8:16.92 Miscellaneous Antimycobacterials

8:18 Antivirals limited to oral and topical dosage forms, excluding:

8:18:08 Antiretrovirals

8:18:20 Interferons

8:18:24 Monoclonal Antibodies

8:18:32 Nucleosides and Nucleotides

8:30.04 Amebicides

8:30.92 Miscellaneous Antiprotozoals excluding those whose primary indication is the treatment of infection in immunosuppressed patients (i.e. Pentamidine and Trimetrexate)

8:36 Urinary anti-infectives

12:12.08.12 Selective Beta 2 Adrenergic Agonists

12:12.12 Alpha and Beta Adrenergic Agonists

12:16 Sympatholytic (Adrenergic Blocking) Agents, limited to ergot derivatives

12:20 Skeletal Muscle Relaxants, excluding scheduled medications

20:12.04.16 Heparins

20:24 Hemorrheologic Agents

24:04.08 Cardiotonic Agents - limited to Digoxin

24:06 Antilipemic Agents

24:08 Hypotensive Agents - limited to oral dosage forms

24:20 Alpha Adrenergic Blocking Agents

24:24 Beta Adrenergic Blocking Agents - limited to oral dosage forms

24:28 Calcium Channel Blocking Agents - limited to oral dosage forms

24:32 Renin-Angiotensive-Aldosterone System Inhibitors - limited to oral dosage forms

28:08 Analgesics and Antipyretics, excluding scheduled medications

28:16.04.16 Selective Serotonin - and Norepinephrine-Reuptake Inhibitors

28:16.04.20 Selective-Serotonin Reuptake Inhibitors

28:16.04.24 Serotonin Modulators

28:16.04.28 Tricyclics and Other Norepinephrine-Reuptake Inhibitors

28:16.04.92 Antidepressants, Miscellaneous

40:00 Electrolytic, Caloric, and Water Balance

40:28 Diuretics

44:00 Enzymes, limited to digestive and proteolytic

48:10.24 Leukotriene Modifiers

48:10.32 Mast-Cell Stabilizers

48:16 Expectorants

52:08 Corticosteroids (oral, topical, and injectable), Anti-Inflammatory Agents [except Ophthmologic Preparations, ]and DMARDS

52:24 Mydriatics

56:22 Antiemetics

56:28 H2 Blockers, Anti-ulcer Agents and Acid Suppressants

56:36 Anti-inflammatory Agents

64:00 Heavy Metal Antagonists, limited to Dimercaprol, Edetate Calcium Disodium and Succimer

68:12 Contraceptives, except implants and injections

68:16.04 Estrogens

68:18 Gonadotropins; limited to Gonadotropin, Chorionic

68:20.02 Alpha-Glucosidase Inhibitors

68:20.04 Biguanides

68:20.08 Insulins

68:20.20 Sulfonylureas

68:24 Parathyroid

68:32 Progestins

68:36[.04] Thyroid and Antithyroid Agents, including Thyroid of glandular extract

72:00 Local Anesthetics

76:00 Oxytocics, limited to Oxytocin

80:00 Serums, Toxoids, Vaccines

84:00 Skin and Mucous Membrane Agents, excluding Depigmenting and Pigmenting Agents (reference number 84:50)

84:92 Skin and Mucous Membrane Agents, Miscellaneous, excluding Isotretinoin

88:00 Vitamins

92:00 Miscellaneous Therapeutic Agents, limited to Antigout, and Bone-Resorption Inhibitors (limited to Raloxifene), and Botulinum Toxin type A (limited to superficial injections)

(2) In addition, the following items or substances, although not listed in Subsection (1), are approved for primary health care:

(a) Amino Acids;

(b) Minerals;

(c) Oxygen;

(d) Silver Nitrate;

(e) DHEA (dihydroepiandrosterone);

(f) Pregnenolone; and

(g) Allergy Testing Agents.

(3) In accordance with Subsections 58-71-102(8) and (12)(a) and Section 58-71-202, the naturopathic physician formulary includes a single controlled substance with the reference number identified in the AHFS, published by the American Society of Health System Pharmacists, 2008 edition:

68:08 Testosterone.

(4) New categories or classes of drugs will need to be approved as part of the formulary prior to prescribing/administering.

(5) The licensed naturopathic physician has the responsibility to be knowledgeable about the medication being prescribed or administered.

 

KEY: licensing, naturopaths, naturopathic physician

Date of Enactment or Last Substantive Amendment: [August 16, 2010]2015

Notice of Continuation: October 20, 2011

Authorizing, and Implemented or Interpreted Law: 58-71-101; 58-1-106(1)(a); 58-1-202(1)(a)