Massachusetts Medical Society Testifies in Opposition to Proposed Regulations of Prescription Monitoring Program

Physicians offer recommendations to establish "effective and efficient program"

Contact:
RichardP. Gulla
(781) 434-7101
rgulla@mms.org

Waltham, Mass. - March 22, 2013 - Saying that proposed regulations for the state's Prescription Monitoring Program would have an extensive and varied impact on providers and patients alike, the Massachusetts Medical Society (MMS) today testified before the Department of Public Health in opposition to the proposed regulations, raising objections and at the same time suggesting changes and improvements that would "establish a program that is effective and efficient." 

"The Prescription Drug Monitoring Program can be a useful tool in deterring prescription drug abuse," said Richard Aghababian, M.D., president of the 24,000-member physician organization, "and the Massachusetts Medical Society strongly supports an online monitoring system with accurate and up-to-date information for use by prescribers and dispensers. But the regulations as proposed need to be re-drafted to make the program an effective clinical tool."

The Department of Public Health was charged with developing regulations for the prescription monitoring program by Chapter 244 of the Acts of 2012, An Act Relative to Prescription Drug Diversion, Abuse, and Addiction, passed in August.

Specifically, the Medical Society expressed the following objections and recommendations for improvement to the regulations:

  • MMS recommends that the regulations should focus on when, based on a physician's sound clinical judgment, using the monitoring program would have clinical value rather than the current proposal to use the system before every new patient is seen. MMS also recommends that the needs of specialists, such as emergency physicians, pediatricians, and radiologists, and different practice settings be appropriately recognized. 
  • The regulations define "new patient" as "having not received any professional services from the participant within the previous 12 months." MMS recommends that the definition be consistent with Medicare's definition of "having not received any professional services from the physician/non-physician practitioner or another physician of the same specialty who belongs to the same group practice with the previous three years."
  • The regulations narrowly define the circumstances when participants would not be required to use the system, or to submit a written waiver, prior to seeing a new patient. Currently, the regulations only allow for technical failure of the system, when it would result in patient harm, or when a written waiver was applied for and granted. MMS recommends that DPH develop narrow and focused criteria for use of the program, with comprehensive automatic exemptions for large areas of patient care where use of the program is not clinically indicated. 
  • Chapter 244 states that DPH regulations include "a requirement that allows authorized support staff to use the prescription monitoring program on behalf of a registered participant." MMS  recommends that prescribers should be the ones to authorize staff use of their account and that the registration system proposed by the DPH is needlessly complex and restrictive. Improper use of the system, including privacy violations specified by Federal HIPAA laws, should be addressed through actions by state licensing boards and existing patient confidentiality protections.
  • The proposed regulations only apply to physicians, dentists, and podiatrists. MMS recommends that they apply to all prescribers except veterinarians. This would include nurse practitioners, physician assistants, and others who have the authority to prescribe Schedule II through V controlled substances. 
  • Chapter 244 required broad input on the regulations from those in the clinical community and mandates a working group that has yet to be formed to do so. The MMS is urging that this group be formed and provide input into the regulations.   
  • The proposed regulations state DPH's right to require a physician to agree that DPH has the authority to revoke a physician's drug registration for violations of the conditions of participation in the PMP. This violates the statutory provisions of Chapter 244, which charged DPH with making the PMP available to physicians automatically and with no further action on their part.

The Massachusetts Medical Society's complete testimony may be read at www.massmed.org/PMP-testimony.

The Massachusetts Medical Society, with nearly 24,000 physicians and student members, is dedicated to educating and advocating for the patients and physicians of Massachusetts. The Society publishes the New England Journal of Medicine, a leading global medical journal and web site, and Journal Watch alerts and newsletters covering 13 specialties. The Society is also a leader in continuing medical education for health care professionals throughout Massachusetts, conducting a variety of medical education programs for physicians and health care professionals. Founded in 1781, MMS is the oldest continuously operating medical society in the country.

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