PDMP/Opioid Epidemic

Prescriptions
 
Is it illegal in Georgia for patients to “doctor shop?”

Yes, it is illegal in Georgia to obtain a prescription from one physician after obtaining a similar prescription from another physician without disclosing this fact. Georgia law states that a patient must inform a practitioner that they have obtained a similar controlled substance from another practitioner. Breaking this law constitutes a felony punishable by up to eight years in prison and/or a fine of up to $50,000. § 16-13-43

Who can prescribe controlled substances in Georgia?

Click here for chart.

MAG encouraging physicians to review H.B. 249/PDMP overview

The Medical Association of Georgia (MAG) is encouraging every physician in the state to review the following summary of H.B. 249, an omnibus bill by Rep. Kevin Tanner (R-Dawsonville) that Gov. Nathan Deal signed into law on May 4. The bill is designed to address opioid abuse in the state. Note that the bill’s provisions will go into effect at different times.

DPH Transition

H.B. 249 moves the Prescription Drug Monitoring Program (PDMP) from the Georgia Drugs and Narcotics Agency to the Department of Public Health (DPH).  

PDMP Review Delegation 

Under H.B. 249, a prescriber may delegate their authority to check the PDMP to two members of their medical staff. For a prescriber to delegate this authority to unlicensed or unregistered staff (i.e., an office manager or medical assistant), the staff member must submit to an annual registration process that will be administered by the Georgia Board of Pharmacy. A health care facility (e.g., hospital or ambulatory surgery center) may select two employees to serve as delegates per shift or rotation. And at hospitals that provide emergency services, each prescriber may designate two individuals who are employed by that hospital per shift or rotation. 

Any unauthorized use of PDMP data by a delegate can result in civil or criminal liability for the prescriber. Delegates may only use PDMP data for the purpose of providing medical care or to inform the prescriber of a patient’s potential use, misuse, abuse or underutilization of a prescribed medication. 

Mandatory PDMP Enrollment

By January 1, 2018, every prescriber who has a DEA registration number must enroll as a PDMP user. If a prescriber obtains a DEA license after January 1, 2018, they must enroll with the PDMP within 30 days. 

Mandatory PDMP Review 

Between January 1, 2018 and May 31, 2018, the DPH must randomly test the PDMP to confirm it is accessible and operational 99.5 percent of the time. 

Assuming DPH has certified that the PDMP’s accessibility and operational standards have been met, the prescriber or their delegate must review the information from the PDMP when prescribing a controlled substance that is listed in paragraph (1) or (2) of Code Section 16-13-26 (click the link that is at the bottom of this alert for the code sections) or a benzodiazepine beginning July 1, 2018. This review is limited to the first time the prescriber issues a prescription for the given patient and at least every 90 days thereafter. 

Exemptions from the requirement to check the database are as follows…

– Prescriptions for no more than a three-day supply of a covered substance and no more than 26 pills 

– The patient is in a hospital or health care facility, including – but not limited to – a nursing home, an intermediate care home, a personal care home, or a hospice program that provides patient care and whereby the prescriptions are to be administered and used by a patient on the premises of the facility 

– The patient has had outpatient surgery at a hospital or ambulatory surgical center and the prescription is for no more than a 10-day supply of a covered substance and no more than 40 pills 

– The patient is terminally ill or under the supervised care of an outpatient hospice program 

– The patient is receiving treatment for cancer

Medical Record Notations

Prescribers or their delegate must make a notation in the patient’s medical record that the PDMP was consulted and identify the individual who conducted the PDMP patient search. If the PDMP does not allow the prescriber/delegate to gain access to the patient’s information for any reason, the prescriber/delegate should note the time and date and the prescriber/delegate’s name in the patient’s medical record.

Prescribers may now include PDMP prescription information in a patient’s electronic health or medical record. 

GCMB Accountability

If a prescriber fails to check the PDMP as outlined above, he or she will be held administratively accountable to the Georgia Medical Composite Board; however, the prescriber may not be held civilly liable or criminally responsible.  

Required Prescribing Information  

When prescribing an opiate, opioid, opioid analgesic, or opioid derivative, the prescriber must provide the patient with information on the drug’s addictive risks and the options that are available for safely disposing of any unused medications. This information may be provided in either verbal or written form.  

Neonatal Abstinence Syndrome Reporting

A health care provider, coroner, or medical examiner must report all incidents of neonatal abstinence syndrome to DPH, which will submit an annual report – including findings and recommendations on how to reduce the number of infants born with neonatal abstinence syndrome – to the president of the Georgia Senate, the speaker of the Georgia House of Representatives, and the chairs of both the Georgia House and Senate Health and Human Services committees. 

Other Provisions

Other H.B. 249 provisions include codifying Gov. Deal’s executive order to make naloxone available on an over-the-counter basis, annual inspections of narcotic treatment programs, and a requirement that calls for the Department of Community Health and the Department of Behavioral Health and Developmental Disabilities to report the number of patients who are enrolled in or have been discharged from a treatment program. 

Contact MAG Government Relations Director Derek Norton at dnorton@mag.org or 678.303.9280 with questions.  

Click for ‘H.B. 249/PDMP’ Fact Sheet

Click for OCGA 16-13-26 Paragraphs 1 and 2

What is a Prescription Drug Monitoring Program?

Prescription Drug Monitoring Programs (PDMPs) are highly effective tools utilized healthcare professionals for reducing prescription drug abuse and diversion. PDMPs collect, monitor, and analyze electronically transmitted prescribing and dispensing data submitted by pharmacies and dispensing practitioners. The data are used to support states’ efforts in education, research, enforcement and abuse prevention. PDMPs are managed under the auspices of a state, district, commonwealth, or territory of the United States.

What does the Georgia Prescription Monitoring Program (GA PDMP) entail and how does a physician sign up?

All practitioners licensed by the Georgia Composite Medical Board and advanced practice registered nurses who are currently licensed by the Georgia Board of Nursing can now register to access the GA PDMP.* Georgia prescribers will be able to use the GA PDMP to determine which pharmacies fill prescriptions for their patients; which patients obtain controlled substance prescriptions from other physicians; and where each additional prescription is filled. Prescribers will also be able to see a listing of how many controlled substance prescriptions have been filled under their own name or DEA permit number. Click HERE to learn more about the GA PDMP.

Registration

To register for the GA PDMP, follow these steps:

1)     Access the GA PDMP website at:

https://georgia.pmpaware.net/login/

2)     Click on the Create an Account link located on the Left side menu

3)     Enter your email address and create a password

4)     Select your user role

5)     Verify your email address

6)     Complete Application

7)     Once   Application   is   complete,   click   on   the   Submit   Your Registration button located on the bottom left side of the screen

8)     Check for validation requirements

     If your registration is incomplete, you may be required to provide additional information. You will be instructed as to what you need to submit via email or the GAPDMP Registration website.

     You can upload any supporting documents directly into your PMP AWARExE account using the online portal OR you can mail them to the Georgia Drugs and Narcotics Agency

9)     Once all requirements are met, be sure to check your account status to ensure it has changed.

     Until  your  account  is  approved,  the  status  may  read  Pending  Approval.

For a visual step by step guide, please click  HERE.

Patient Research

The PMPAware system maintains controlled substances prescription information it receives, storing it in an electronic database. The database can be reviewed to determine misuse, abuse, and patterns of controlled substance prescribing by looking at each Pati ent Request. A Patient Request is a report that displays the previous prescription drug activity for a specific patient. Once you have completed the registration process and your account is active, you can initiate a patient request by following the steps below:

1)     Log into PMP AWARXE and navigate to RxSearch > Patient Request.

2)     Input patient information. All fields marked with a red asterisk (*) are required.

3)     If available, use the tools provided on the page to save the report as a PDF or CSV data file.

For more information please click  HERE.

*The Georgia Drugs and Narcotics Agency is in the process of obtaining data from the Georgia Board of Pharmacy and the Georgia Board of Nursing to validate delegates that have been granted the authority to access the PDMP system by a delegating prescriber or dispenser who will be responsible for the acts of such delegates.