R414-29-6. Changes in Restriction Case Manager or Restriction Pharmacy

  (1) When a client requests a change in the Restriction Case Manager or the Restriction Pharmacy, the request may be verbal or written. Before placing the new Restriction Case Manager on the client's case record, the Department must verify that the proposed Restriction Case Manager agrees to the responsibilities of the Restriction Case Manager.

  (2) The Department must approve all changes in the Restriction Case Manager or the Restriction Pharmacy before the client may use a different Restriction Case Manager or Restriction Pharmacy. Circumstances under which the Department may approve such a change are:

  (a) client, Restriction Case Manager, or Restriction Pharmacy moves location;

  (b) Restriction Case Manager or Restriction Pharmacy discontinues or limits practice;

  (c) Restriction Case Manager, or Restriction Pharmacy requests a change;

  (d) Department Staff Physician recommends a change, when a periodic assessment of the use of services reveals indications of possible overutilization by the restricted client, the Restriction Case Manager, or both.

  (3) The Department may mandate a change in the Restriction Case Manager or Restriction Pharmacy whenever it determines that the client:

  (a) continues to overutilize services despite being under restriction; or

  (b) is not receiving appropriate care while being managed by the Restriction provider.