216-RICR-20-20-6
216-RICR-20-20-6. Off-Label Prescribing of Medications for COVID-19 (version Adoption, 03/22/2020 to 09/16/2020)
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x.1 Authority
A. These regulations are
promulgated pursuant to the authority conferred under R.I. Gen. Laws
§§ 23-1-1 and 23-1-18, and are established for the purpose
of allowing off-label prescribing to treat COVID-19.
x.2 Definitions
A. Wherever used in this Part,
the terms listed below shall be construed in the following manner:
1. "COVID-19" means
the new disease caused by novel coronavirus SARS-CoV-2.
2. "Off-label
prescribing" means the prescribing of an FDA-approved medication
for reasons other than indicated or approved by the FDA.
3. "Practitioner"
means any person licensed in the state of Rhode Island to provide
health care services and to prescribe medication.
x.3 Off-label prescribing of
medications for treatment or prevention of COVID-19
A. No practitioner shall
prescribe any medication for COVID-19, either for treatment or
prevention, unless treatment or prevention of COVID-19, or similar
infectious disease, is within such practitioner's usual and customary
scope of practice.
B. Any practitioner who
chooses to prescribe an FDA-approved medication for the off-label
purpose of treating COVID-19 shall:
1. Indicate on the
prescription the applicable ICD-10 diagnosis code.
2. Indicate on the
prescription a telephone number at which the dispensing authority
(e.g., pharmacist) may reach the health care provider to address
questions relative to dose and treatment.
3. Document in the associated
patient's medical record that the specific risks and benefits of the
off-label treatment were discussed with the patient.
4. Document in the associated
patient's medical record the clinical rationale for the off-label
prescribing, citing:
a. At least one peer-reviewed
article that justifies the clinical decision for the off-label
prescribing, in the event that the FDA publishes such guidance.
b. Applicable FDA guidance
justifying the clinical decision for the off-label prescribing, in
the even that the FDA publishes such guidance.
C. This Part does not apply to
physicians, licensed to practice medicine in the state of Rhode
Island pursuant to Title 5, Chapter 37 of the R.I. Gen. Laws, who are
board certified in the American Board of Medical Specialties (ABMS)
specialties of Infectious Disease and/or Critical Care.