Massachusetts’ Prescription Monitoring Program Takes a New Turn

Posted: October 20th, 2016 | Author: Shauna | Filed under: Controlled Substances, In the News, Standards | Tags: Controlled Substances, DEA, e-Prescribing, e-Prescribing controlled substances, MA PAT, MA PMP, Massachusetts PMP, Massachusetts Prescription Awareness Tool, Massachusetts Prescription Monitoring Program, Massachusetts State Mandate, MassPAT, Opioid Epidemic, Opioids, Patient Engagement, PDMP, PMP, Prescription Drug Monitoring Program, Prescription Monitoring Program, State Mandates, Value Based Care | No Comments »

For the first 6 months of 2016 in Massachusetts, there have been almost 500 confirmed cases of unintentional opioid overdose deaths and an estimated 500 additional cases have not yet been confirmed.

The majority of overdoses found in MA are due to substances such as fentanyl and heroin, but rates of cocaine and benzodiazepines present in opioid deaths have been steady since 2014. Although the rates of heroin and prescription drugs present in opioid deaths have been decreasing due to many efforts that have been implemented across the nation, the rate of fentanyl has been on the rise. This is in large part due to the fact that many opioid addictions start at the hands of a prescriber with a prescription and when the pill bottle runs dry, patients are left seeking other options that produce the same euphoric effect.

With the rapid increase of deaths and devastation by way of the current opioid epidemic plaguing the state, Massachusetts has recently implemented further requirements concerning practitioner’s prescribing protocols. Specifically, with the state’s Prescription Monitoring Program, or PMP.

The PMP serves as a database for all prescription drugs that are dispensed across the state, including those that are highly sought after for non-medical use and represent the highest potential for abuse, better known as Schedule II-V drugs such as narcotics, sedatives, and stimulants.

When properly used, the PMP aids in the identification and prevention of drug misuse, diversion, and potential doctor shopping by providing a patient’s medication history of the past 12 months. It is meant to be utilized as a key clinical decision-making tool that allows providers to receive a big picture view of the patient they are treating in real time.

As a solution to this widespread epidemic, Massachusetts has introduced new legislation and requirements when utilizing the MassPAT (Massachusetts Prescription Awareness Tool).

Effective October 15, 2016, practitioners must abide by the following:

1. A registered individual practitioner must utilize the prescription monitoring program each time the practitioner issues a prescription to a patient EACH time for a narcotic drug in Schedule II or III.
2. A registered individual practitioner must utilize the prescription monitoring program prior to prescribing to a patient for the first time:
   1. A benzodiazepine; OR
   2. Any controlled substance in Scheduled IV or V which the department has designated in guidance as a drug that is commonly abused and may lead to dependence. At this time, there are no drugs that have received this designation.

Prior to the aforementioned requirements, legislation ruled that practitioners, among other factors, need only check the state PMP when prescribing a controlled substance to a patient for the first time, while it is now required for a practitioner to check the system EVERY time when prescribing Schedule II or III drugs.

An example of just how serious Massachusetts is about this crisis, and also believed to be the first agreement of its kind, CVS recently paid almost $800k to the state because pharmacists were not checking prescriptions or the database thoroughly. In exchange, CVS agreed to provide its pharmacists access to the PMP website, train its pharmacists to register for and use the PMP as appropriate, and has further agreed to implement policies that would require pharmacists to consult the PMP before dispensing certain opioids in MA.

Massachusetts and CVS, among many other organizations, recognize the importance of the state’s PMP as a tool to detect and prevent the abuse and misuse of controlled substances. The PMP is not meant to be another government-controlled, green monster hanging on a practitioner’s back at all times; it is meant to serve as a safety extension for practitioners, but most importantly for their patients.

PMP’s can also be most effective when linked with an e-Prescribing solution. Working together, e-Prescribing eliminates the need for paper prescriptions, thus reducing the risk of altered dispense quantities, stolen prescriptions or prescription pads, and the reselling of such prescriptions before they’re filled as a means of lessening the red flags if a patient is doctor shopping.

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DoseSpot is a Surescriptsâ„¢ certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.

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