Prescription Monitoring Programs(PMP)

       The purpose of a PMP is to keep track of controlled substances in order to detect illicit prescribing and dispensing and identify patients who are obtaining prescriptions from multipal DR's and hospitals.
     These programs depend on the electronic sharing of information from pharmacies. The information which is supplied from a patients prescription gets entered into the program which then makes it accessable under certain circumstances to law enforcement agencies and health practitioners.
      The goal of such a program is to prevent diversion and abuse of narcotic prescriptions while still ensuring the medications stay available for the legetamite medical use.

The first question most if us have is if this accesability to prescription information is a violation of our patient confidentiality?
      The answer that has been given is that all of these programs include safeguards to prescription information through regulation and statuets.  And that those who have the ability to acess this information through a PMP already have the authority to do so. They state that this information doesnt include a case but only makes the "collection" of information less intrusive and easier.
        It is important to note also that those who do have access to the information in these programs are not privy to futher individual information not already supplied by the program itself. The process of  pharnacy and case investigations(investigations into a specific individuals prescription activity) has been in the past tedious as the only information available at the retail level for controlled substances was through paper copies of the prescriptions. The PMP now allows these authorities acess to view the information, and obtain it from many different locations instead of visiting each pharmacy individually.

   The benefits to thes programs are that they are able to identify illegal activity like prescription forging, indiscriminate prescribing and DR shopping(which is a felony in most states).
Most of these programs provide patient specific information upon request of the patients physician and pharmacy.  Some state programs proactivly notify physicians when there patients are seeing multipal prescribers for the same class of drugs.
   It also states that an indirect benefit of the PMP is that it can identify those patients in need of a drug program due to abuse or addiction and also assist physicians whose patients may not be recieving adequite pain treatment and thus seeing multipal practitioners in order to obtain addictional medication.
(I'm sure that benefit still remains to be seen)

   Because patients that are usually found out og this typr of illegal activity move to a bordering state to continue recieving prescriptions which they are no longer able to get in there own state, this program does allow the bordering state to acess this information if the states regulations allow.  The National Alliance for Model State Drug Laws has been able to help assist those states that do not have the system already in place to recieve authorization to recieve prescripton information across state lines.  There is also a project funded by the Bureau of Justice Assistance(BJA) for The Integrated Justice Information Systems(IJIS) to develop a system where sharing of information state to state would be available.
  So those states that have not been able to put this program into effect are working twords being able to still access the PMP information if needed.

     There are two of these programs that exist. NASPER(Naional All Scheduals Prescription Electronic Reporting Act of 2005) put into place within the Department of Health and Human Services and signed into law by President Bush in 2005. The other program called The Harold Rogers Prescription Monitoring Grant Program which is placed within the Department of Justice. While very similair the Harold Rogers Grant Program allows states to establish there own requirements with regard to schedual monitoring, they ENCURAGE information sharing and ENCURAGE accessability to the program information. They also ENCURAGE information collection for all II,III, IV and V schedual prescriptions.
       The NASPER requires states to meet requirements in order to recieve funding. They REQUIRE the sharing of information state to state and they REQUIRE the state to collect information for schedual II, III and IV.

So while one program only encurages and allows states to set up there own regulations the other REQUIRES that certain regulations be put into place.

There are currently 35 states with legislation enabling a PMP:

  Alabama, Arizona, California, Colorado, Connecticut, Hawaii, Idaho, Illinois, Indiana, Iowa,  Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Mississippi, Nevada, New Mexico, New York, North Dakota, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia, Vermont, Washington, West Virginia and Wyoming.
New York and Texas require not only the PMP data but a single copy of patient controlled substance prescriptions

Fourteen other states are in the process of proposing or preparing:

Alaska, Arkansas, Deleware, Florida, Georgia, Kansa, Mayland, Missouri, Montana, Nebraska, New Jersey, New Hampshire, Oregan and South Dekota.
But while these states are in the process or proposal phase it doesnt mean that these staes have not had access or authority to data sharing from there bordering states.
I am also unclear as to when this information was included or last updated. Some of these states may now have these programs either up and running or close to beginning.


Information found at:  http://www.deadiversion.usdoj.gov/faq/rx_monitor.htm#2


For those of us who do not have a substance abuse problem and thus do not DR shop or pharmacy hop,  this program could benefit those of us who do suffer from CP and hopefully work to improve how we are seen by the government, society and even others in the medical community.
  
But indirectly this program can only benefit those who have become addicted to prescription medication or are attempting to get prescriptions from DR's, Pharmacies and Hospitals in order to sell or abuse the drugs, as it will flag activities inabling physicians and other authorities to refer people to treatment programs and rehabilitation for those effected by the disease of addiction.


But on the other hand this program does inable the government to breath even closer down the neck of the prescribing DR...