The Controlled Substance Utilization Review and Evaluation System, also known as CURES 2.0, comes from California’s Health and Safety Code Section 11165.1.
Effective Oct 2, 2018, all doctors, prescribing schedule II, III and IV to patients for the first time must consult the CURES system no earlier than 24 hours before prescribing (or the previous business day). They are also required to check the CURES system at least once every 4 months thereafter if the controlled substance remains part of the treatment plan of the patient.
Doctors, if you don’t already have a login, you can register at this link.
Potential Impact on Mental Health Organizations
Organizations that provide medication support services may want to be prepared for a number of changes. These are among the things we think you will want to consider and prepare for:
- Allocate more time for initial medication evaluations and for medication follow ups, as all doctors will need to check the CURES database when they prescribe a controlled substance.
- The doctor will also need to check the CURES database prior to prescribing each/any new controlled substance medication.
- A system may need to be implemented that flags the patient’s chart or set a reminder for the doctors to check the CURES database every 4 months for those patients taking controlled substances. This will need to occur for as long as the patients are taking the same controlled substance as part of their treatment plan.
- Doctors covering for other doctors prescribing or providing a refill of a controlled substance, will have to check the CURES database as it will count as their first time prescribing a controlled substance to that patient.
- For potential auditing purposes, it is highly recommended that the prescriber document the CURES database check in the patient’s chart, or place the Patient Activity Report (PAR) from the CURES database in the patient’s chart.
- Only the prescribing doctor can check the CURES database when prescribing a controlled substance. Support staff can be identified as “Delegates” by the prescribing doctor, but they can only request the PAR for the prescribing doctor to review. The report will be posted to the prescribing doctor’s dashboard where only she/he will be able to view it and print.
- The CURES requirement also applies to out-of-state doctors providing telemedicine/telepsychiatry services to patients living in California.
There are exemptions to this requirement, including certain treatment settings and emergency scenarios. If you think you may qualify for an exemption, we suggest that you first get confirmation from the California Department of Justice. However, our recommendation would be to always check the CURES database as part of your risk management practices.
To better understand the CURES program and its effects, we reviewed a number publications and spoke by phone to representatives at the California Department of Justice and the California Medical Board. Please be aware that your practice or organization may be impacted differently.