California’s Controlled Substance Utilization Review and Evaluation System, or C.U.R.E.S. (CURES) for short, is a prescription monitoring program aggregating DEA Schedule II, II and IV prescriptions. Maintained by the California Department of Justice and primarily used by physicians, podiatrists, dentists, physician assistants, optometrists, nurse practitioners, pharmacies and pharmacists, C.U.R.E.S. represents a massive, relatively unguarded and unprotected healthcare database.
The C.U.R.E.S. 2.0 medication database was certified as ready for statewide use on April 2, 2018. Six months later, starting October 2, 2018, all California physicians and other prescribing health care professionals were mandated by California Medical Board rules to consult C.U.R.E.S. C.U.R.E.S. must be consulted the first time a patient is prescribed a controlled substance and at least once every four months if a controlled substance prescription continues as part of a patient’s treatment plan. If a patient is admitted to certain healthcare facilities, or receiving a short course of medication for emergency or surgical care, a physician may not be required to consult C.U.R.E.S. The rules regarding the mandatory requirement to consult cures are found in California Health and Safety Code section 11165.4.
Any patient who wishes to access their C.U.R.E.S. report may do so by filing a C.U.R.E.S. Information Practices Act Request Form with the California Department of Justice. If a patient detects an error in the C.U.R.E.S. report, they must contact the reporting pharmacy. Only the reporting pharmacy for the original prescription may correct the prescription with the California Department of Justice.
C.U.R.E.S. as an Investigative Tool
California state health care licensing agencies, such as the Medical Board of California, are authorized to use C.U.R.E.S. as an investigation tool. In everyday practice, this means the Medical Board can access patient and provider records without getting a required signed release under H.I.P.A.A. The Medical Board has used this tool to get a foothold in suspected overprescribing cases – to identify patients who can then be the subject of disciplinary actions. Medical Board investigators can mine C.U.R.E.S. for evidence of physician mental health issues, drug abuse or alcohol abuse. For example, the presence in a prescription history of Antabuse (disulfiram) or Revia (naltrexone), which address cravings for alcohol or drugs, or antipsychotic drugs such as Abilify (aripiprazole) or Seroquel (quetiapine) would lead investigators to dig for evidence of physician mental illness.
Additionally, the Medical Board of California has launched its “Death Certificate Project” to investigate patient deaths to detect overprescribing of controlled substances. Public death records, combined with use of the C.U.R.E.S. reports, provide Division of Investigation investigators with powerful new tools to seek out physician and other prescribers as disciplinary targets.
Board investigations of health care licensees such as physicians and nurse practitioners are serious matters that can lead to license probation and license revocation. Hiring an attorney is an important step for a physician or other healthcare practitioner to defend their license and livelihood.