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Introduction to Prescription
Drug Monitoring Programs
James Giglio
Director, PDMP Training and Technical Assistance Center...
Disclosures
•  James Giglio has disclosed no relevant,
real or apparent personal or
professional financial relationships.
...
Learning Objectives
1.  Outline the history and operation of
PDMPs.
2.  Outline strategies used by PDMPs to
analyze and us...
Agenda
•  History of Prescription Drug Monitoring
Programs (PDMPs)
•  How PDMPs Operate
•  PDMP Best Practices
•  What is ...
Prescription Drug Abuse and Diversion 	
  
History of Prescription Drug
Monitoring Programs (PDMPs)
What is a Prescription Drug
Monitoring Program?
•  A prescription drug monitoring program (PDMP) is
a state program that c...
Status of Prescription Drug Monitoring Programs (PDMPs)
Research	
  is	
  current	
  as	
  of	
  	
  December	
  23,	
  20...
Enactments of PDMPs
Enactments of PDMPs
First Prescription Drug Monitoring Program
• New York State 1918
• Drugs
▫ Cocaine
▫ Morphine
▫ Heroin
• State’s Role
• Do...
Early Prescription Drug Monitoring Programs
•  1939-43
▫  California-1939 (Oldest Continuous
Program)
▫  Hawaii – 1943
•  ...
Early PDMP Characteristics
• Purpose of PDMPs
▫ Law Enforcement
▫ Curtail Diversion
• Collected ONLY Schedule II Drugs
• U...
Early PDMP Characteristics
Paper Era (1939 - 1990)
• Paper Prescriptions
▫ Triplicates
▫ Duplicates
▫ Individually Seriali...
Early PDMP Information Gathering
State	
  PDMP	
  
Issues	
  Rx	
  
Doctor	
  
Prescribes	
  	
  on	
  	
  
triplicate	
  ...
Electronic Era – Breaking New Ground
•  Oklahoma (1990)
▫  First to Require Electronic Transmission of Data
▫  No serializ...
Present PDMPs – Federal Era
•  Harold Rogers Prescription Drug Monitoring
Programs Grant (2003)
  Funds to Plan, Implemen...
History of PDMPs
Year Legislation Enacted
Harold	
  Rogers	
  
Program	
  Implemented	
  
How PDMPs Operate
PDMP System Overview
Data
Submitted
Reports
Sent
Reports
Sent
Reports
Sent
Prescription Information Collected by PDMPs
•  Patient identification:
▫  Name & Address
▫  DOB & Gender
•  Prescriber Inf...
Controlled Substance Schedules
•  Schedule I – Illegal Drugs
•  heroin, marijuana, LSD
•  Schedule II – Most addictive leg...
Data Collected from Pharmacies
•  PDMPs Collect Dispensed Controlled Substances Rx:
•  30 collect Schedules II – V
•  18 c...
PDMP Data
•  Data is Provided to:
•  Doctors and other prescribers
•  Pharmacists
•  Health Professional Licensing
Boards
...
PDMP Report Types
•  Standard Reports - Prescriber, Dispenser,
Patient
•  Specialty Reports – Statistical,
Geographical, T...
Uses by Prescribers/Pharmacists
•  Prescription history of a current or a new patient
–  Misuse or Addiction
–  Multiple P...
Uses by Law Enforcement Agencies
•  Unlawful Sale of Controlled Substances/
Prescriptions
•  Unlawful Prescribing/Dispensi...
Uses by Boards/Licensing Agencies
•  Meeting Standard of Care
•  Improving the Prescribing & Dispensing of Drugs
•  Monito...
OTHER USE OF PDMP REPORTS
•  Public Health
•  Research, Treatment, Prevention & Education
•  Drug Courts
•  Assist in moni...
PDMP Best Practices
PDMP Best Practices
Why Is a New Generation of PDMPs
Needed?
The Prescription Drug Abuse Epidemic
is Increasing
The New Generation of PDMPs
THE PARADIGM SHIFT:
In addition to simply responding to
others’ requests, PMPs need to
proacti...
White Paper on PDMP Best Practices
	
  Prescription Drug Monitoring Programs: An
Assessment of the Evidence for Best Pract...
Improve Data Collection
Being Done:
•  Collect all schedules II to V
•  Use most recent data submission standard,
e.g., AS...
ID Person Picking Up the Prescription
To Be Done:
•  Require pharmacies to submit ID information on who
picks-up each pres...
Remain Current with Technology
To Be Done:
•  Integrate electronic prescribing with PDMP data.
•  Could e-Prescribing beco...
Maintain Data Quality
Being Done:
•  Verify data quality
•  Require pharmacies correct data reported in error
•  Identify ...
User Access and Report Dissemination
Being Done:
•  Provide online access and automated reports - 24/7
•  Allow prescriber...
Increase PDMP Utilization
Being Done:
•  Mandate prescriber enrollment in PDMP
To Explore:
•  Enabling access for appropri...
Unsolicited Reports and Alerts
To Explore:
•  Proactively analyze PDMP data to identify
potential misuse and diversion, e....
Collaboration with Other Agencies
To Be Done:
•  Indian Health Service
•  Department of Veterans Affairs
•  Department of ...
What is Your State Doing?
COMPILATION	
  OF	
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  PRESCRIPTION	
  	
  
MONITORING	
  PROGRAM	
  MAPS	
  
© 2014 Research is current as of Marc...
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Where to Learn More
Email: info@pdmpassist.org
Telephone: (781) 609-7741
Website: www.pdmpassist.org
RESOURCES
Controlled Substances
Agency Resource Directory
State PDMP Contacts
www.pmpexcellence.org
www.namsdl.org
www.pmpalliance.org
www.nascsa.org
Jim Giglio
PDMP Training and Technical Assistance Center
jgiglio@pdmpassist.com
David R. Hopkins
Kentucky Cabinet for Heal...
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Transcript of "Pdmp 1 giglio hopkins"

  1. 1. Introduction to Prescription Drug Monitoring Programs James Giglio Director, PDMP Training and Technical Assistance Center Brandeis University David Hopkins KASPER Program Manager Office of Inspector General Kentucky Cabinet for Health and Family Services
  2. 2. Disclosures •  James Giglio has disclosed no relevant, real or apparent personal or professional financial relationships. •  David Hopkins has disclosed no relevant, real or apparent personal or professional financial relationships.
  3. 3. Learning Objectives 1.  Outline the history and operation of PDMPs. 2.  Outline strategies used by PDMPs to analyze and use collected data to identify drug abuse trends. 3.  Identify strategies for best practices that participants can implement in their state.
  4. 4. Agenda •  History of Prescription Drug Monitoring Programs (PDMPs) •  How PDMPs Operate •  PDMP Best Practices •  What is Your State Doing? •  Where to Learn More
  5. 5. Prescription Drug Abuse and Diversion  
  6. 6. History of Prescription Drug Monitoring Programs (PDMPs)
  7. 7. What is a Prescription Drug Monitoring Program? •  A prescription drug monitoring program (PDMP) is a state program that collects controlled substance prescription records from dispensers (e.g., pharmacies) state-wide and then provides prescription histories and other compiled and/or analyzed data to authorized end-users for use in clinical care, law enforcement, regulation of professional practice, research and evaluation.
  8. 8. Status of Prescription Drug Monitoring Programs (PDMPs) Research  is  current  as  of    December  23,  2013   AK   AL   AR   CA   CO   ID   IL   IN   IA   MN   MO   MT   NE   NV   ND   OH   OK   OR   TN   UT   WA   AZ   SD   NM   VA   WY   MI   GA   KS   HI   TX   ME    MS   WI   NY   PA   LA   KY   NC   SC   FL   VT    WV                        Opera9onal  PDMPs                        Enacted  PDMP  legisla9on,  but                          program  not  yet  opera9onal                        Legisla9on  Pending                          No  Legisla9on   GU   NH   MA   RI   CT   NJ   DE   MD   DC  
  9. 9. Enactments of PDMPs
  10. 10. Enactments of PDMPs
  11. 11. First Prescription Drug Monitoring Program • New York State 1918 • Drugs ▫ Cocaine ▫ Morphine ▫ Heroin • State’s Role • Doctor’s Role • Pharmacist’s Role ▫ Copy to State within 24hrs of Dispensing
  12. 12. Early Prescription Drug Monitoring Programs •  1939-43 ▫  California-1939 (Oldest Continuous Program) ▫  Hawaii – 1943 •  1960-1989 ▫  Illinois (1961) ▫  Idaho (1967) ▫  Pennsylvania (1972) ▫  New York (1972)* ▫  Rhode Island (1978) ▫  Texas (1981) ▫  Michigan (1988)
  13. 13. Early PDMP Characteristics • Purpose of PDMPs ▫ Law Enforcement ▫ Curtail Diversion • Collected ONLY Schedule II Drugs • Use of State Issued Prescriptions • Frequency of Collecting Data ▫ 30 days from time of dispensing
  14. 14. Early PDMP Characteristics Paper Era (1939 - 1990) • Paper Prescriptions ▫ Triplicates ▫ Duplicates ▫ Individually Serialized ▫ Issued by the State ▫ Cost to Prescribers • Copies sent to States ▫ Data entry process
  15. 15. Early PDMP Information Gathering State  PDMP   Issues  Rx   Doctor   Prescribes    on     triplicate  Rx     Keeps    One   Copy   Pa9ent  Brings     2  copies  of     Rx  to   Pharmacy   Pharmacy   Dispenses   Keeps   Original  and   forwards  3rd   copy  to  state   State  PDMP   enters   informa9on   into  database  
  16. 16. Electronic Era – Breaking New Ground •  Oklahoma (1990) ▫  First to Require Electronic Transmission of Data ▫  No serialized prescriptions ▫  Reduced Operational Costs ▫  Increased accuracy and timely submissions ▫  Enabled other States to Consider PDMPs •  Nevada (1995) ▫  First to Require the Reporting of More than Schedule II drugs (Schedules II-IV) ▫  First to provide Unsolicited Reports to Practitioners
  17. 17. Present PDMPs – Federal Era •  Harold Rogers Prescription Drug Monitoring Programs Grant (2003)   Funds to Plan, Implement, Enhance PDMPs   Program Administered by Bureau of Justice Assistance (BJA)   2003-2012: Thirty Three (33) States Enacted PDMP legislation •  SAMHSA (NASPER) •  CDC •  DEA •  ONDCP •  ONC
  18. 18. History of PDMPs Year Legislation Enacted Harold  Rogers   Program  Implemented  
  19. 19. How PDMPs Operate
  20. 20. PDMP System Overview Data Submitted Reports Sent Reports Sent Reports Sent
  21. 21. Prescription Information Collected by PDMPs •  Patient identification: ▫  Name & Address ▫  DOB & Gender •  Prescriber Information •  Dispensing Pharmacy Information •  Drug Information, e.g. ▫  NDC # = name, type, strength, manufacturer ▫  Quantity & date dispensed ▫  Source of payment (some states)
  22. 22. Controlled Substance Schedules •  Schedule I – Illegal Drugs •  heroin, marijuana, LSD •  Schedule II – Most addictive legal drugs; high abuse potential •  oxycodone, methylphenidate, oxymorphone •  Schedule III – Less abuse potential than I or II •  hydrocodone combinations •  Schedule IV – Less abuse potential than III •  benzodiazepines •  Schedule V – least abuse potential •  codeine containing cough mixtures
  23. 23. Data Collected from Pharmacies •  PDMPs Collect Dispensed Controlled Substances Rx: •  30 collect Schedules II – V •  18 collect Schedules II – IV •  1 collects Schedule II & III •  1 collects Schedules II only •  Some Collect Non-Controlled Medications •  8 collect tramadol (Ultram®) •  1 each – Butorphanol, butalbitol w/acetamenophen •  Electronic Data Collection - Batch Reporting •  Reporting Frequency varies – POS, 24 hours, 7-30 days
  24. 24. PDMP Data •  Data is Provided to: •  Doctors and other prescribers •  Pharmacists •  Health Professional Licensing Boards •  Law Enforcement •  Medical Examiners •  Medicaid State Agencies •  Drug Courts
  25. 25. PDMP Report Types •  Standard Reports - Prescriber, Dispenser, Patient •  Specialty Reports – Statistical, Geographical, Trend Analysis •  Solicited vs. Unsolicited Reports
  26. 26. Uses by Prescribers/Pharmacists •  Prescription history of a current or a new patient –  Misuse or Addiction –  Multiple Prescribers/Dispensers –  Drug Interactions – Compliance with Pain Contracts •  Practitioner prescribing history – Fraudulent Scripts – Monitor Patient’s Compliance with Rx Directions
  27. 27. Uses by Law Enforcement Agencies •  Unlawful Sale of Controlled Substances/ Prescriptions •  Unlawful Prescribing/Dispensing •  Organized Forgery Rings •  Organized Doctor Shopper Rings
  28. 28. Uses by Boards/Licensing Agencies •  Meeting Standard of Care •  Improving the Prescribing & Dispensing of Drugs •  Monitoring compliance of prescribers/dispensers currently on probation •  Monitoring compliance of dispensers reporting information to PDMPs
  29. 29. OTHER USE OF PDMP REPORTS •  Public Health •  Research, Treatment, Prevention & Education •  Drug Courts •  Assist in monitoring compliance of participants •  Medical Examiners •  Assist in identifying cause of death in drug overdose cases •  Impaired Professional Programs •  Assist in monitoring compliance of health care professionals •  Medicaid •  Drug Utilization Review Boards •  Identify Other Sources of Drugs (forms of payment) •  Monitor clients restricted to single practitioner/pharmacy 29  
  30. 30. PDMP Best Practices
  31. 31. PDMP Best Practices Why Is a New Generation of PDMPs Needed? The Prescription Drug Abuse Epidemic is Increasing
  32. 32. The New Generation of PDMPs THE PARADIGM SHIFT: In addition to simply responding to others’ requests, PMPs need to proactively confront the epidemic.      
  33. 33. White Paper on PDMP Best Practices  Prescription Drug Monitoring Programs: An Assessment of the Evidence for Best Practices September 20, 2012 at www.pdmpexcellence.org Developed by PMP Center of Excellence at Brandeis University with support from BJA and Pew Charitable Trusts
  34. 34. Improve Data Collection Being Done: •  Collect all schedules II to V •  Use most recent data submission standard, e.g., ASAP version 4.2. •  For each Rx, collect data on method of payment To Be Done: •  Collect prescription data in real time or within 24 hours of dispensing
  35. 35. ID Person Picking Up the Prescription To Be Done: •  Require pharmacies to submit ID information on who picks-up each prescription -- so PDMP knows who actually has the drug. •  Require pharmacies to check photo ID check before dispensing a controlled substance to verify who has the drug. •  Massachusetts PDMP mandated reporting and positive ID for Schedule II prescriptions since 2009. •  Found 38% of the persons who dropped off or picked up the Rx are not the patient. •  Now MA requires reporting and positive ID for all Schedule II to V prescriptions.
  36. 36. Remain Current with Technology To Be Done: •  Integrate electronic prescribing with PDMP data. •  Could e-Prescribing become the source for PDMP data? To Explore: •  Utilize state-issued prescription forms. •  serialized •  single copy
  37. 37. Maintain Data Quality Being Done: •  Verify data quality •  Require pharmacies correct data reported in error •  Identify gaps in data and enforce reporting requirements To Be Done: •  PDMPs should check for obvious anomalies, e.g.; •  Prescribers who have died •  Prescribers whose licenses/registrations are suspended or revoked
  38. 38. User Access and Report Dissemination Being Done: •  Provide online access and automated reports - 24/7 •  Allow prescribers to review their own records •  Allow law enforcement, including prosecutors to have access To Be Done: •  Develop batch requesting for prescribers to request an entire day’s calendar of appointments •  Integrate PDMP reports with health information exchanges (HIE) and electronic health records (EHR)
  39. 39. Increase PDMP Utilization Being Done: •  Mandate prescriber enrollment in PDMP To Explore: •  Enabling access for appropriate users: •  State Medicaid Agencies •  Federal Medicare •  Medical examiners and coroners •  Drug courts, probation and parole officers •  Drug treatment professionals and agencies
  40. 40. Unsolicited Reports and Alerts To Explore: •  Proactively analyze PDMP data to identify potential misuse and diversion, e.g.; •  Potential doctor shopping •  Organized drug rings •  Prescription forgery •  Pill Mills •  Provide analyzed data to those who can intervene •  Prescribers and Pharmacists •  Law Enforcement •  Health Professional Licensing Agencies
  41. 41. Collaboration with Other Agencies To Be Done: •  Indian Health Service •  Department of Veterans Affairs •  Department of Defense •  DOD Facilities •  Tricare •  Medicaid and Medicare •  Private third party payers •  Health insurers •  Workers Compensation
  42. 42. What is Your State Doing?
  43. 43. COMPILATION  OF  STATE  PRESCRIPTION     MONITORING  PROGRAM  MAPS   © 2014 Research is current as of March 2014. In order to ensure that the information contained herein is as current as possible, research is conducted using nationwide legal database software, individual state legislative websites., and direct communications with state PDMP representatives. Please contact Heather Gray at 703-836-6100, ext. 114 or hgray@namsdl.org with any additional updates or information that may be relevant to this document. Headquarters Office: THE NATIONAL ALLIANCE FOR MODEL STATE DRUG LAWS (NAMSDL). 215 Lincoln Ave. Suite 201, Santa Fe, NM 87501. This project was supported by Grant No. G1299ONDCP03A, awarded by the Office of National Drug Control Policy. Points of view or opinions in this document are those of the author and do not necessarily represent the official position or policies of the Office of National Drug Control Policy or the United States of Government.
  44. 44. AK AL AR CA CO ID IL IN IA MN MO MT NE NV ND OH OK OR TN UT WA AZ SD NM VA WY MI GA KS HI TX ME MS WI NY PA LA KY NC SC FL NH MA RI CT NJ DE MD VT WV Prescription Drug Monitoring Programs States With Authority to Monitor Schedule II Substances © 2014 The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 215 Lincoln Ave. Suite 201, Santa Fe, NM. 87501. This information was compiled using legal databases, state agency websites and direct communications with state PDMP representatives.
  45. 45. AK AL AR CA CO ID IL IN IA MN MO MT NE NV ND OH OK OR TN UT WA AZ SD NM VA WY MI GA KS HI TX ME MS WI NY PA LA KY NC SC FL NH MA RI CT NJ DE MD VT WV Prescription Drug Monitoring Programs States With Authority to Monitor Schedule II & III Substances © 2014 The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 215 Lincoln Ave. Suite 201, Santa Fe, NM 87501. This information was compiled using legal databases, state agency websites and direct communications with state PDMP representatives
  46. 46. AK AL AR CA CO ID IL IN IA* MN MO MT NE NV ND OH OK OR TN UT WA AZ SD NM VA WY MI GA KS HI TX ME MS WI NY PA LA KY NC SC FL NH MA RI CT NJ DE MD VT WV *Iowa’s PDMP monitors Schedule III and IV substances that the advisory council and the Board of Pharmacy determine can be addictive or fatal if not taken under the proper care or direction of a prescribing practitioner. Prescription Drug Monitoring Programs States With Authority to Monitor Schedule II, III and IV Substances © 2014 The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 215 Lincoln Ave. Suite 201, Santa Fe, NM 87501. This information was compiled using legal databases, state agency websites and direct communications with state PDMP representatives D.C.
  47. 47. AK AL AR CA CO ID IL IN IA MN MO MT NE NV ND OH OK OR TN1 UT WA AZ SD NM VA WY MI GA KS HI TX ME MS WI NY PA LA KY NC SC FL NH MA RI CT NJ DE MD VT WV 1Tennessee’s law authorizes the monitoring of Schedule V substances which have been identified by the controlled substances database advisory committee as demonstrating a potential for abuse. Prescription Drug Monitoring Programs States With Authority to Monitor Schedule V Substances © 2014 The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 215 Lincoln Ave. Suite 201, Santa Fe, NM 87501. This information was compiled using legal databases, state agency websites and direct communications with state PDMP representatives D.C.
  48. 48. AK AL AR CA CO ID IL IN IA MN MO MT NE NV ND OH OK OR TN UT WA AZ SD NM VA WY MI GA KS HI TX ME MS WI NY PA LA KY NC SC FL NH MA RI CT NJ DE MD VT WV Prescription Drug Monitoring Programs States With Authority to Monitor Non-controlled/Non-Scheduled Substances Please note that although a state may have statutory authority to monitor Non-controlled/Non-Scheduled substances, that state may not currently be monitoring prescriptions for such substances and may in fact require implementation of additional regulations before that monitoring can commence. © 2014 The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 215 Lincoln Ave. Suite 201, Santa Fe, NM. 87501. This information was compiled using legal databases, state agency websites and direct communications with state PDMP representatives. D.C.
  49. 49. AK   AL   AR   CA   CO   ID   IL   IN   IA   MN   MO   MT   NE   NV   ND   OH2   OK   OR   TN   UT3   WA   AZ   SD   NM   VA   WY   MI4   GA   KS   HI   TX   ME    MS   WI   NY1   PA   LA   KY   NC   SC   FL   NH   MA   RI   CT   NJ   DE   MD   VT    WV   Data  Collec@on  Interval   Weekly/7 Days Twice Monthly Monthly Real Time Daily/24 Hours 3 Days 1 New York requires the submission of data in real time by statute, but that has been interpreted by regulation to mean no later than 24 hours after the substance is delivered. 2 Ohio requires submission of data from pharmacies weekly and from wholesalers monthly. 3 Utah requires submission weekly, but for those participating in the statewide pilot program, submission is required daily. 4 Michigan is going to daily reporting in July 2014. D.C. © 2014 The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 215 Lincoln Ave. Suite 201, Santa Fe, NM. 87501. This information was compiled using legal databases, state agency websites and direct communications with state PDMP representatives.
  50. 50. Breakdown  of  Housing  En@@es*   AK   AL   AR   CA   CO   ID   IL   IN   IA   MN   MO   MT   NE   NV   ND   OH   OK   OR   TN   UT   WA   AZ   SD   NM   VA   WY   MI   GA   KS   HI   TX   ME    MS   WI   NY   PA   LA   KY   NC   SC   FL   NH   MA   RI   CT   NJ   DE   MD   VT    WV   Health  Departments,  Single  State  Authority   or  Boards  of  Pharmacy   Law  Enforcement  Agencies   Board  of  Pharmacy  and  Inves9ga9on   Division  of  the  Department  of  Public  Safety   Professional  Licensing   Department  of  Consumer  Protec9on   Narco9c  and  Drug  Agency  at  the  direc9on   and  oversight  of  the  Board  of  Pharmacy   * This information is based on the agency the PMP statute or regulation indicates is required to establish the PMP. © 2014 The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 215 Lincoln Ave. Suite 201, Santa Fe, NM 87501. This information was compiled using legal databases, state agency websites, and direct communications with state PDMP representatives. D.C.
  51. 51. AK   AL   AR   CA   CO   ID   IL   IN   IA   MN   MO   MT   NE   NV   ND   OH   OK   OR   TN   UT   WA   AZ   SD   NM   VA   WY   MI   GA   KS   HI   TX   ME    MS   WI   NY1   PA   LA   KY   NC   SC   FL   NH   MA   RI   CT   NJ   DE   MD   VT    WV   Types  of  Authorized  Recipients  -­‐  Prescribers  and   Dispensers   © 2014 The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 215 Lincoln Ave. Suite 201, Santa Fe, NM. 87501. This information was compiled using legal databases, state agency websites and direct communications with state PDMP representatives. D.C.
  52. 52. AK   AL1   AR   CA   CO   ID   IL   IN   IA   MN   MO   MT   NE   NV   ND   OH   OK   OR   TN   UT   WA   AZ   SD   NM   VA2   WY   MI   GA   KS   HI   TX   ME    MS   WI   NY   PA   LA   KY   NC   SC   FL   NH   MA   RI   CT   NJ   DE   MD   VT    WV   States  that  Require  All  Licensed  Prescribers  and/or  Dispensers  to   Register  with  PMP  Database*   © 2014 The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 215 Lincoln Ave. Suite 201, Santa Fe, NM 87501. This information was compiled using legal databases, state agency websites, and direct communications with state PDMP representatives. * Many states require that persons requesting access to the state PMP database first register as an authorized user. This map and the memorandum located on the NAMSDL website are concerned with only those states that require all practitioners licensed in the state to also register to use the PMP database. 1 Alabama only requires physicians with or seeking a pain management registration to be registered with the PMP. 2 The Virginia provision goes into effect on July 1, 2015. Maine’s statute requires all prescribers in six classes to register by March 1, 2014 if less than 90% of prescribers in each class have not registered to use the PMP by January 1, 2014. Mandatory enrollment
  53. 53. AK   AL   AR   CA   CO   ID   IL   IN   IA   MN   MO   MT   NE   NV   ND   OH   OK   OR   TN   UT   WA   AZ   SD   NM   VA1   WY   MI   GA   KS   HI   TX   ME    MS   WI   NY   PA   LA   KY   NC   SC   FL   NH   MA   RI   CT   NJ   DE   MD   VT    WV   States  that  Require  Prescribers  and/or  Dispensers  to  Access   PMP  Informa@on  in  Certain  Circumstances*   * Please see the accompanying memorandum for specifics as to the circumstances under which a prescriber and/or dispenser is obligated to access the PMP database in each state. 1 The Virginia provision goes into effect on July 1, 2015. © 2014 The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 215 Lincoln Ave. Suite 201, Santa Fe, NM 87501. This information was compiled using legal databases, state agency websites, and direct communications with state PDMP representatives.
  54. 54. AK   AL   AR   CA   CO   ID   IL   IN   IA   MN   MO   MT   NE   NV   ND   OH   OK   OR   TN   UT   WA   AZ   SD   NM   VA   WY   MI   GA   KS   HI   TX   ME    MS   WI   NY   PA   LA   KY   NC   SC   FL   NH   MA   RI   CT   NJ   DE   MD   VT    WV   Types  of  Authorized  Recipients  -­‐  Licensing/Regulatory  Boards   © 2014 The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 215 Lincoln Ave. Suite 201, Santa Fe, NM. 87501. This information was compiled using legal databases, state agency websites and direct communications with state PDMP representatives. D.C.
  55. 55. AK AL2 AR CA CO ID IL IN IA MN MO MT NE NV ND OH OK OR TN UT WA AZ SD NM VA WY MI GA KS HI TX ME MS WI NY PA1 LA KY NC SC FL NH MA RI CT NJ DE MD VT WV Types  of  Authorized  Recipients  –  Law  Enforcement  Officials   Probable cause, search warrant, subpoena, or other judicial process Pursuant to an active investigation Upon request from law enforcement officials May only receive information from professional licensing boards 1 Law enforcement requests must be approved by the Office of the Attorney General. Law enforcement officials do not have direct access. 2 Law enforcement officers must make a declaration that probable cause exists, but there is no judicial process involved. © 2014 The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 215 Lincoln Ave. Suite 201, Santa Fe, NM. 87501. This information was compiled using legal databases, state agency websites and direct communications with state PDMP representatives. D.C.
  56. 56. AK AL AR CA CO ID IL IN IA MN MO MT NE NV ND OH OK OR TN UT WA AZ SD NM VA WY MI GA KS HI TX ME MS WI NY PA1 LA KY NC SC FL NH MA RI CT NJ DE MD VT WV Types  of  Authorized  Recipients  –  Judicial  and  Prosecutorial  Officials   Probable cause, search warrant, subpoena, or other judicial process in criminal cases Pursuant to an active investigation or prosecution Upon request of the grand jury Both judicial process or pursuant to an active investigation Upon request from judicial or prosecutorial officials 1 The Pennsylvania provision pertains only to cases involving criminal investigations into violations of state or federal drug laws, health care fraud, or insurance fraud statutes. Probable cause, search warrant, subpoena, or other judicial process in criminal and civil cases © 2014 The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 215 Lincoln Ave. Suite 201, Santa Fe, NM. 87501. This information was compiled using legal databases, state agency websites and direct communications with state PDMP representatives. D.C.
  57. 57. AK   AL   AR   CA   CO   ID   IL   IN   IA   MN1   MO   MT   NE   NV   ND   OH   OK   OR   TN   UT   WA   AZ   SD   NM   VA   WY   MI   GA   KS   HI   TX   ME    MS   WI   NY   PA   LA   KY   NC   SC   FL   NH   MA   RI   CT   NJ   DE   MD   VT    WV   Types  of  Authorized  Recipients  -­‐     County  Coroners,  Medical  Examiners,  and/or  State  Toxicologists   1 Minnesota has started a pilot program to allow access by county coroners and medical examiners. County coroners and/or medical examiners State toxicologist © 2014 The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 215 Lincoln Ave. Suite 201, Santa Fe, NM. 87501. This information was compiled using legal databases, state agency websites and direct communications with state PDMP representatives. D.C.
  58. 58. AK   AL   AR   CA   CO   ID   IL   IN   IA   MN   MO   MT   NE   NV   ND   OH   OK   OR   TN   UT   WA   AZ   SD   NM   VA   WY   MI   GA   KS   HI   TX   ME    MS   WI   NY   PA   LA   KY   NC   SC   FL   NH   MA   RI   CT   NJ   DE   MD   VT    WV   Types  of  Authorized  Recipients  –  Medicare,  Medicaid  and/or  State  Health  Insurance   Programs  or  Health  Care  Payment/Benefit  Provider  or  Insurer   Medicare, Medicaid and/or State Health Insurance Programs Health Care Payment/Benefit Provider or Insurer and Medicaid, Medicare, and/or State Health Insurance Programs © 2014 The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 215 Lincoln Ave. Suite 201, Santa Fe, NM. 87501. This information was compiled using legal databases, state agency websites and direct communications with state PDMP representatives. D.C.
  59. 59. AK   AL   AR   CA   CO   ID1   IL   IN   IA   MN   MO   MT   NE   NV   ND   OH   OK   OR   TN   UT   WA   AZ   SD   NM   VA   WY   MI   GA   KS   HI   TX   ME    MS   WI   NY  1   PA   LA   KY   NC   SC   FL   NH   MA   RI   CT   NJ   DE   MD   VT    WV   Types  of  Authorized  Recipients  –  Pa@ent,  Parent  or  Guardian  of  Minor   Child,  Health  Care  Agent  or  Aorney  on  Behalf  of  Pa@ent   Patient or parent of minor child Patient or parent of minor child and health care agent Patient or parent of minor child and attorney on behalf of patient Patient or parent of minor child, health care agent and third party with signed consent form Patient or parent of minor child and third party with signed consent form © 2014 The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 215 Lincoln Ave. Suite 201, Santa Fe, NM. 87501. This information was compiled using legal databases, state agency websites and direct communications with state PDMP representatives. D.C. 1  Beginning July 1, 2014, Idaho will change to patient or parent of minor child and third party with signed consent form.
  60. 60. AK AL AR CA CO ID1 IL IN IA MN MO MT NE NV ND OH OK OR TN UT WA AZ SD1 NM VA WY MI GA KS HI TX1 ME MS WI NY PA LA KY NC SC FL NH MA RI CT NJ DE MD VT WV States that Allow Practitioners to Designate an Authorized Agent to Access the PMP Database © 2014 The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 215 Lincoln Ave. Suite 201, Santa Fe, NM 87501. This information was compiled using legal databases, state agency websites, and direct communications with state PDMP representatives. 1 Idaho and South Dakota only allow prescribers to designate an agent at this time. D.C.
  61. 61. AK AL AR CA CO ID IL IN IA MN MO MT NE NV ND OH OK OR TN UT WA AZ SD NM VA WY MI2 GA KS HI TX ME MS WI NY PA LA KY NC1 SC FL NH MA RI CT NJ DE MD VT WV Unsolicited  PMP  Reports/Info  to  Prescribers,  Pharmacists,  Law   Enforcement  and  Licensing  En@@es   To prescribers, pharmacists, law enforcement and licensing entities (20) To prescribers, pharmacists and law enforcement only (4) To prescribers, pharmacists and licensing entities only (2) To prescribers and pharmacists only (5) To law enforcement and licensing entities only (3) To prescribers only (3) Law enforcement only (2) Licensing entities only (2) To prescribers and law enforcement only (1) © 2014 The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 215 Lincoln Ave. Suite 201, Santa Fe, NM 87501. This information was compiled using legal databases, state agency websites, and direct communications with state PDMP representatives. Practitioners and licensing entities only (1) 1 North Carolina provides unsolicited reports to the Attorney General who has the discretion to forward the information to law enforcement. 2 Michigan send alerts to physicians when a patient surpasses the threshold but does not send the actual report. D.C.
  62. 62. AK AL AR CA CO ID IL IN IA MN MO MT NE NV ND OH OK OR1 TN UT1 WA AZ SD NM VA WY MI GA KS HI TX ME MS WI NY PA LA KY NC SC FL NH MA RI CT NJ DE MD VT WV Interstate  Sharing  of  Prescrip@on  Monitoring  Program  Data   Pursuant  to  Statute,  Regula@on,  and/or  Statutory  Interpreta@on   States that share data with other PMPs States that share data with authorized users in other states States that share data with both 1 Oregon will only allow direct access to the PMP to practitioners in CA, ID, and WA. © 2014 The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 215 Lincoln Ave. Suite 201, Santa Fe, NM. 87501. This information was compiled using legal databases, state agency websites and direct communications with state PDMP representatives. D.C.
  63. 63. Where to Learn More
  64. 64. Email: info@pdmpassist.org Telephone: (781) 609-7741 Website: www.pdmpassist.org
  65. 65. RESOURCES Controlled Substances Agency Resource Directory State PDMP Contacts
  66. 66. www.pmpexcellence.org
  67. 67. www.namsdl.org
  68. 68. www.pmpalliance.org
  69. 69. www.nascsa.org
  70. 70. Jim Giglio PDMP Training and Technical Assistance Center jgiglio@pdmpassist.com David R. Hopkins Kentucky Cabinet for Health and Family Services Dave.Hopkins@ky.gov
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