PDMP Intent and Compliance Discussed by State Boards

Follows WHA Physician Leaders Council call for additional regulatory clarity

March 17, 2017

The Controlled Substances Board met on short notice March 13 to review and discuss the need for additional clarity on its intent regarding enforcement of the upcoming April 1 requirement created in 2015 Act 266 for a prescriber to review Prescription Drug Monitoring Program (PDMP) records before prescribing certain controlled substances. Under statute, the Controlled Substances Board has rulemaking authority over the PDMP.

Department of Safety and Professional Services (DSPS) staff to the Controlled Substances Board said the meeting was called to address concerns raised by health systems and others seeking clarification regarding the Board’s role. Tim Westlake, MD, chair of the Controlled Substances Board and vice chair of the Medical Examining Board, said there are some real and significant questions and concerns being raised regarding technical compliance.

"We don’t want systems implementing procedures that get in the way of patient care and don’t add benefit," said Westlake. He further said he believed the Controlled Substances Board would be wise to recognize these issues and use some discretion in its enforcement of the PDMP mandate.

To help provide some clarity to practitioners, the Controlled Substances Board adopted the following resolution: "The Board, with the assistance of the Department, recognizes that the priority will be to continue promoting, educating and training practitioners about the benefits of the PDMP and the requirements in 2015 Act 266 regarding a practitioner’s review of PDMP data. Further, the Board recognizes it has discretion in its authority for non-compliance of its rules that implement 2015 Act 266 to refer non-compliant practitioners to the regulatory authority that regulates the profession of the non-compliant practitioner."

DSPS staff also shared with the Controlled Substances Board that Rep. John Nygren is drafting a letter regarding the legislative intent regarding the PDMP mandate that staff believed would further help give clarity to prescribers. Staff indicated the letter has not yet been finalized, but the Controlled Substances Board discussed and made a motion that the letter should be posted on the ePDMP website for prescribers to see when it is received by DSPS.

These actions follow a letter sent by the WHA Physician Leaders Council to the Medical Examining Board (MEB) asking for it to consider providing additional clarity to physicians regarding the MEB’s intent regarding physician discipline and the upcoming PDMP prescriber mandate. As reported in the March 10 edition of The Valued Voice, the letter signed by the chair of the WHA Physician Leaders Council, Steve Kulick, MD, chief medical officer, ProHealth Care, was the result of discussions at the March 2 WHA Physician Leaders Council meeting. A copy of the letter can be found at: /WisconsinHospitalAssociation/media/WHANewsLetters/2017PDF/WHALettertoMEB3-9-17.pdf.

"It is clear that physicians across the state have many questions regarding multiple technical compliance questions regarding the new PDMP mandate and how the Medical Examining Board will be approaching physician discipline related to the April 1 mandate," wrote Kulick. "By articulating a clear and common sense approach that aligns with the intent of the PDMP prescriber mandate, the Medical Examining Board can help physicians focus on the benefits of the PDMP and remove technical compliance concerns of physicians intending to make good faith use of the PDMP tool."

The Medical Examining Board also discussed the PDMP mandate at its March 15 meeting, and its members had a similar discussion as the Controlled Substances Board regarding interpreting the statutory mandate and technical compliance. Consistent with the February Medical Examining Board meeting and the Controlled Substances Board resolution, individual members indicated that their intent is to focus on advancing use of the PDMP by physicians and not to focus on "technical" compliance with the statute. One apparent difficulty the Medical Examining Board faces is a "catch-22" where the Board is being advised that it is not authorized to generally comment on what review is under the statutory mandate.

This story originally appeared in the March 17, 2017 edition of WHA Newsletter