Mark S. Armstrong, JD
In response to the opioid epidemic, many states, including Texas, created prescription drug monitoring programs to monitor high-risk patients and provider behaviors. The Texas Prescription Drug Monitoring Program (“PMP”) is managed by the Texas State Board of Pharmacy and is the only statewide electronic database that currently collects, manages, and stores outpatient prescription data for all Schedule II through Schedule V controlled substances dispensed by a Texas pharmacy. PMP helps inform prescribing practices and addresses prescription drug misuse, diversion, and overdose. In addition, PMP assists prescribers and pharmacists to avoid potentially life-threatening drug interactions, decide when to make referrals to specialty treatment providers, and identify individuals obtaining controlled substances from multiple health care providers and pharmacies. PMP can also be used to verify a practitioner’s own records and prescribing history, as well as to inquire about patients.
Texas-licensed pharmacies are presently required to report all dispensed controlled substances records to PMP no later than the next business day after the prescription is filled. If the pharmacy does not dispense a controlled substance prescription during a period of seven consecutive days, then the pharmacy must submit a zero report indicating that the pharmacy did not dispense any controlled substances during that period.
Effective March 1, 2020, prescribers and pharmacists will be required to access PMP, with respect to a patient, before prescribing or dispensing opioids, benzodiazepines, barbiturates or carisoprodol; provided, however, that neither a prescriber nor a pharmacist is required to access PMP if the patient has been diagnosed with cancer or if the patient is receiving hospice care. Prescribers or pharmacists may access PMP with respect to a patient before prescribing or dispensing any controlled substance. After the effective date, a prescriber or pharmacist in Texas who fails to access PMP with respect to the patient prior to prescribing or dispensing opioids, benzodiazepines, barbiturates or carisoprodol may be subject to disciplinary action by the regulatory agency that issued a license, certification or registration to the individual who committed the violation (i.e. Texas Medical Board, Texas State Board of Dental Examiners, Texas Board of Nursing, Texas State Board of Pharmacy).
Individuals who are provided access to PMP and who are subject to the new requirements regarding accessing PMP prior to prescribing or dispensing opioids, benzodiazepines, barbiturates or carisoprodol include, but are not limited to:
- Advance Practice Nurses
- Physician Assistants
Prescribers and pharmacists are further permitted to designate an unlimited number of delegates to access patient prescription data and generate reports on their behalf. Every individual is required to register with PMP as a separate user, however all delegate queries are attributed to the prescriber or pharmacist for whom they generate the report. Eligible prescriber delegates include nurses, medical residents, administrative staff, etc. Pharmacists may only delegate this responsibility to pharmacy technicians.
Prescribers, and their delegates, who are not currently registered with PMP, should do so prior to March 1, 2020, so that they are positioned to access PMP, with respect to a patient, before prescribing opioids, benzodiazepines, barbiturates or carisoprodol.