What Is The Prescription Monitoring Program?Medical Defense
The federal Controlled Substances Act went into effect in the United States in 1970. The statute established a framework for the lawful prescribing and dispensing of controlled substances. The law also outlines the criteria that make a prescription for a controlled substance a legal prescription. The law describes how a prescription is to be issued, and it spells out the responsibility of pharmacists to ensure that the prescription is proper before it is dispensed.
Every time a pharmaceutical medication is prescribed for a patient, at least two healthcare professionals are involved: the pharmacist and the prescriber. Both of these professionals are responsible for ensuring that the prescription has been written for a legitimate medical purpose by an individual healthcare provider who is acting in the typical course of his or her professional practice.
HOW MANY STATES MONITOR PRESCRIPTION DRUG DISTRIBUTION?
In forty-nine of the fifty states, prescription drug monitoring programs (PDMPs) are conducted to reduce prescription abuse and to deter diversion. These programs gather and review the drug prescription and distribution data submitted by the state’s pharmacists and dispensing healthcare practitioners.
The data is accessible only to state regulatory boards, law enforcement authorities, pharmacies, and other healthcare practitioners. PDMPs are supposed to protect the public and monitor controlled substance activity without infringing on the legitimate practice of medicine.
Prescription drug diversion, and the drug abuse and criminal activity associated with it, is a growing concern in Texas and across the nation. Many of the controlled substances that have legitimate medical uses also have a high potential for addiction and abuse, and the diversion of these prescription drugs exacerbates that addiction and abuse. PDMPs help authorities to determine where in the distribution chain diversion occurs.
Access to PDMP data is restricted by law in every state. Anyone who knowingly provides, allows, or acquires unauthorized access to PDMP data is subject to stiff criminal penalties. Prescription drug monitoring program information may be accessed only by doctors, pharmacists, and other healthcare professional to verify their own prescription records and to obtain a patient’s prescription history. Additionally, prescription drug monitoring programs can generate insightful statistical information regarding ongoing and emerging trends in prescription drug distribution and use.
HOW DOES THE TEXAS PRESCRIPTION MONITORING PROGRAM WORK?
The Texas Prescription Monitoring Program (PMP) gathers and tracks prescription information for Schedule II, III, IV, and V controlled substances dispensed by all Texas pharmacies or dispensed to Texas residents from pharmacies in other states. The PMP also allows practitioners to monitor patient prescription histories, and it provides for the ordering of Schedule II Texas official prescription forms.
The program was implemented by the Texas Legislature and launched in 1982 to monitor Schedule II controlled substance prescriptions in our state. In 2008, Texas lawmakers expanded the program to include the monitoring of Schedule III, IV, and V controlled substance prescriptions. In 2016, PMP operations were transferred to the Texas State Board of Pharmacy. The program previously operated under the Texas Department of Public Safety.
WHAT IS THE NEW LEGAL REQUIREMENT FOR TEXAS PHARMACIES?
Since September 1, 2017, pharmacies licensed by the state of Texas have been required by law to report all dispensed controlled substances to the Texas Prescription Monitoring Program no later than the next business day after filling the prescription. The reporting obligation applies to all Schedule II, III, IV, and V controlled substances. Previously, Texas pharmacies had seven days to make these reports. Pharmacies failing to report in a timely manner may face a civil, administrative, or criminal penalty.
Pharmacists and prescribers with any questions about Texas law or about the Texas Prescription Monitoring Program should seek the counsel of an experienced Dallas medical license defense lawyer. Any healthcare professional accused of violating the federal Controlled Substances Act or violating any Texas reporting requirement should also seek the advice and services of a Texas medical license defense attorney.
Texas pharmacies that dispense Schedule II, III, IV, and V controlled substances must report prescription data to APPRISS, the contracted vendor for the Texas State Board of Pharmacy, using the prescriber’s DEA number. By law, pharmacies and prescribers must have an up-to-date DEA registration in order to possess, distribute, dispense, or prescribe controlled substances.
All prescriptions issued in the state of Texas for controlled substances must include:
– the date the prescription was issued
– the patient’s full name and address
– the prescribing practitioner’s name and address
– for written prescriptions, the signature of the prescriber on the date of issue
– a valid DEA registration number for the prescribing practitioner
– the drug’s name, strength, the proper dosage, the prescription quantity, the directions for use, and the authorized number of refills
Pharmacists throughout the state of Texas should consider the following list of “red flags” when fulfilling prescriptions that have been issued for Schedule II, III, IV, and V controlled substances.
These red flags are warning signs of potential addiction, abuse, or attempts to divert controlled substances that should prompt a pharmacist to call a prescriber to verify the prescription:
– Multiple persons with the same prescription at approximately the same time
– Multiple persons with prescriptions with the same address
– Multiple persons with prescriptions for the same drug from the same prescriber
– Great geographical distance between the prescriber and the pharmacy or between the pharmacy and the patient’s address on the prescription
– Any mismatch between the prescribed medicine and the stated diagnosis
– A prescriber’s specialty or practice doesn’t match the diagnosis or the patient.
– PMP records indicate multiple prescribers of similar drugs for the same patient.
– Possible legal action is pending against the prescriber.
– The person presenting the prescription appears nervous or impaired. Watch for red eyes, slurred speech, heavy perspiration, or difficulty walking.
– The prescription appears altered or copied or the handwriting does not seem to be the prescriber’s.
Prescribers are responsible for ensuring that a prescription has a legitimate medical purpose. However, under federal law, the pharmacist receiving a prescription also has a responsibility to ensure that a prescription is dispensed for a legitimate medical purpose. Texas pharmacies may occasionally contact a prescriber to verify some aspect of a prescription, especially if the patient is new at the pharmacy or has a prescription for a new controlled substance.
Prescribers should welcome these calls as a responsible way to protect yourself, your patients, and your community. An experienced Dallas medical license defense lawyer can answer the legal questions and concerns of prescribers and pharmacists and provide legal representation if you are accused of violating any federal or state law or reporting requirement regarding controlled substances.