With the recent flurry of activity regarding our Sunset Bill, as well as the passage of the Pharmacy Board Sunset Bill, there has been some confusion as to the requirements for dentists and the Prescription Monitoring Program (PMP). The PMP actually has been in place for some time. From the Pharmacy Board website:
The Texas Prescription Monitoring Program (PMP) collects prescription data on ALL Schedule II, III, IV and V controlled substances dispensed by a pharmacy in Texas or to a Texas resident from a pharmacy located in another state. The Texas Prescription Program (TPP) was created by the 67th Texas Legislature in 1981 becoming effective January 1, 1982, to monitor Schedule II controlled substance prescriptions. Effective September 1, 2008, the Texas Legislature expanded the TPP to include the monitoring of Schedule III through V controlled substance prescriptions. Beginning September 1, 2016, the PMP transferred from the Texas Department of Public Safety to the Texas State Board of Pharmacy. Although controlled substances have valid medical uses, they also have potential for abuse and addiction. Diversion of prescription drugs is a significant abuse problem, and this program was created to be an efficient, cost effective tool for investing and preventing drug diversion. Federal controls monitor the substances from manufacture through distribution to retail facilities. The program seeks to educate and control misuse by following controlled substances to the ultimate user. The PMP may be used by practitioners and pharmacists to verify their own records and inquire about patients. In addition, the program may be used to generate and disseminate information regarding prescription trends. Pharmacies that dispense Schedule II, III, IV, and V are required to report the information directly to the Texas State Board of Pharmacy’s contracted vendor, APPRISS. Prescription data is reported by the prescriber’s Federal (DEA) number. Prescribers and pharmacies are required by statute to have a current Federal (DEA) registration in order to possess, administer, prescribe or dispense controlled substances. Pharmacies are required to submit data to the PMP no later than the 7th day after the prescription is completely filled. However, pharmacies may submit more frequently. Pharmacies, who fail to report, are subject to an administrative, civil, or criminal penalty. Access to the prescription data is statutorily restricted. The information is available to practitioners and pharmacies who are inquiring about their own prescribing or dispensing history on their patients. State regulatory boards have access as well. A person who knowingly gives, permits or obtains unauthorized access to this information, is subject to criminal penalty.
The initial recommendation from the Sunset Committee was to require dentists to use PMP to query each patient, each time, a controlled substance is prescribed to help curb opioid abuse tendencies. This language was never introduced into the Dental Board Sunset Bill, but it WAS PASSED with the Pharmacy Board Sunset Bill. According to HB 2561 (Pharmacy Board Sunset Bill) Sec.481.0764 of the Texas Health and Safety Code shall be amended to read:
DUTIES OF PRESCRIBERS, PHARMACISTS, AND RELATED HEALTH CARE PRACTITIONERS.
(a) A person authorized to receive information under Section 481.076(a)(5), other than a veterinarian, shall access that information with respect to the patient before prescribing or dispensing opioids, benzodiazepines, barbiturates, or carisoprodol.
(b)A person authorized to receive information under Section 481.076(a)(5) may access that information with respect to the patient before prescribing or dispensing any controlled substance.
This “person” the new law refers to is you. The language is slightly vague, as it doesn’t specifically mention the PMP, but the intent is clear. If you write a prescription for the above-mentioned drugs, you will be required to use the PMP to query the patient for each RX. The good news is the implementation of this new law has been pushed back to September 1, 2019. One thing that merits mention; the information contained in the PMP database is sensitive and not public record, therefore you must use the information only as intended or you could face criminal penalty. DO NOT get nosy and search for the prescription patterns of your ex, your neighbor, your children’s teacher, etc. Although we have access to this information, this would be considered misuse…the fall out could be severe.
There are some recent TSBDE rule changes that are currently in effect as of December 2016
Texas Administrative Code, Title 22, Part 5, Chapter 111
Each dentist who is permitted by the Drug Enforcement Agency to prescribe controlled substances shall complete every three years a minimum of two hours of continuing education in the abuse and misuse of controlled substances, opioid prescription practices, and/or pharmacology. This continuing education may be utilized to fill the continuing education requirements of annual renewal.
Each dentist who is permitted by the Drug Enforcement Agency to prescribe controlled substances shall annually conduct a minimum of one self-query regarding the issuance of controlled substance through the Prescription Monitoring Program of the Texas State Board of Pharmacy.
Access to the PMP is available through the Pharmacy Board website (https://www.pharmacy.texas.gov/PMP/)
By Jonathon R. Kimes, DDS