Clinical Experience Assessment Form & Policy

The WMC has implemented the Clinical Experience Assessment (CEA) Policy, effective January 10, 2025, as outlined in policy number
POL2025-01. This policy introduces the CEA form, designed to evaluate the readiness of International Medical Graduates (IMGs) for residency programs in Washington State, in accordance with RCW 18.71.472. Learn More

Rulemaking Notice General Provisions for Opioid
Prescribing and Tapering Rules

The WMC has adopted amendments to their opioid prescribing rules to exclude patients with sickle cell disease, to clarify tapering considerations, and to clarify the use of biological specimen testing. The rules amend WAC 246-918-801 Exclusions, WAC 246-918-870 Periodic Review—Chronic pain, and WAC 246-918-900 Tapering considerations—Chronic pain for physician assistants, as well as WAC 246-919-851 Exclusions, WAC 246-919-920 Periodic Review—Chronic pain, and WAC 246-919-950 Tapering considerations—Chronic pain for allopathic physicians.

The rules add sickle cell disease to the list of exemptions from opioid prescribing limits. To prevent harm from abrupt opioid discontinuation, the rules clarify that not all chronic pain patients need tapering. The rules also state that a single abnormal biological test result should not be the sole basis for discontinuing opioid treatment.

The CR-103 for Permanent Rulemaking was filed on February 18, 2025, as WSR #25-05-091. The WSR document contains the adopted rule language, which will take effect on March 21, 2025.

Telemedicine & Controlled Substance Prescribing

The following rules will become effective on March 21, 2025:

The DEA final rule regarding prescription of buprenorphine via telemedicine which allows DEA-registered health care practitioners to prescribe Schedule III-IV controlled substances for up to six months via telemedicine, including audio-only, to a patient after a PDMP query of the patient’s resident state and verification the patient’s identity prior to dispensing. The final rule significantly streamlines telemedicine prescribing, as the proposed rule limited initial prescriptions via audio-only to 30 days’ supply and required an in-person encounter for subsequent prescriptions.

The Dept. of Veterans Affairs final rule allowing VA practitioners, acting within their scope of practice, to prescribe controlled substances via telehealth to a VA patient without an in-person exam, so as long as another VA practitioner has previously conducted an in-person evaluation of the patient previously. The prescribing practitioner must also review both the patient’s VA electronic health record (EHR), which includes the internal VA prescription database, and the PDMP for the state in which the VA patient is physically located. If either of these are unavailable or inaccessible, the practitioner must limit the prescription to a 7-day supply, and must consult both before continuing to prescribe controlled substances to the patient via telemedicine.