Legislators inadvertently give 'pill mills' a break

TALLAHASSEE -- In their zeal to slow down government regulations, Florida lawmakers have inadvertently halted an effort to regulate so-called ``pill mills'' that fuel an epidemic of prescription drug abuse.

The regulations were set to take effect Sunday for most pain clinics. But they are stalled by a new law intended to crack down on expensive state regulations. The law requires legislative approval of rules that have a significant fiscal impact.

That means the regulations could be in limbo until next spring when the 2011 legislative session convenes, according to state health officials.

``I would like legislators to explain the fact that the drug epidemic continues to grow while they remain silent,'' said Lynn Locascio, a Crystal Beach woman who founded Parents Against Prescription Drug Addiction. ``We feel like we're back to square one banging our heads against the wall.''

Locascio's 26-year-old son, Robert Palmisano, has been clean from pills since 2006. Before that, he was one of hundreds of addicts who went from doctor to doctor to get their fix of pain meds such as Oxycodone.

The new regulations provide basic standards for pain clinics, including how patients are evaluated and the physical specifications of offices. The rules also require unannounced inspections each year. Many clinics are currently unregulated because they don't accept health insurance.

``If you accepted only cash, there were no regulations,'' said Paul Sloan, who runs a Venice-based pain clinic and heads an association that supports the rules. ``An inspector can't go in and say, `Gee, you don't meet the rules' when there are no rules.''

The new law regarding agency rule-making -- enacted last week when the Legislature overrode a veto by Gov. Charlie Crist -- requires legislative approval of new rules that cost more than $1 million over five years.

There are now roughly 600 rules proposed by agencies that have not yet taken effect. It's difficult to know how many of those will require final legislative approval because agencies have to prepare a more comprehensive cost estimate.

The state Board of Medicine will discuss the pain clinic regulations at a Dec. 3-4 meeting in Orlando.

Afterward, the board will review an updated cost estimate to see if the new rules must be ratified by lawmakers.

Under the new law, if a proposed rule needs legislative approval if it has more than a $1 million adverse impact over five years on economic growth, competitiveness, employment, investment, job creation, or regulatory costs.

So what will happen in the meantime?

``What's going to happen is nothing,'' said Sen. Mike Fasano, R-New Port Richey. ``And seven more people will die each and every day until the Legislature ratifies these rules that are being approved by the Board of Medicine and the Department of Health.''

Fasano was a lead supporter of pill-mill regulations and also voted against overriding Crist's veto of the bill last week, arguing it needed more study.

Sponsors of the rule-making bill stood behind their decision to enact the law, saying it was needed to reduce regulations.

Although much of the focus of the law is on the cost to regulated businesses, House sponsor Rep. Chris Dorworth, R-Lake Mary, portrayed it as an effort to save tax dollars.

``Our goal is to get a firm grip on rules that have a high level of expense for state government,'' he said.

Cracking down on prescription drug abuse has received wide support in the Legislature.

The new drug regulations were passed in 2009, and lawmakers approved setting up a statewide database this spring to track drug purchases and monitor ``doctor shopping'' by addicts.

The database was supposed to be in place Dec. 1, but has stalled because of a contract dispute. There is only enough money to run the database for a few months because lawmakers ordered it to operate solely on donations.

``We need to start checking on these pain clinics that are operating illegally and start shutting them down,'' said Bruce Grant, director of the state Office of Drug Control and an advocate of ``pill mill'' regulations. ``It's not in the interest of Florida to have these pain clinics operating without any guidelines. Any help we could get would be appreciated.''

Tallahassee Bureau chief Steve Bousquet contributed to this report. Lee Logan can be reached at llogan@sptimes.com or (850) 224-7263.

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