Texas Legislature’s Committee Releases Prescription Monitoring Program Recommendations

The Texas Legislature created a joint committee of the two bodies following the 2017 Legislature to address the future of the state’s September 1, 2019 mandate for physicians to check the state’s prescription monitoring program (PMP) before prescribing certain drugs. The committee, which is co-chaired by Senator Charles Schwertner, MD (R-Georgetown) and Representative JD Sheffield, DO (R-Gatesville), released its recommendations earlier today. Click here to view the report.

The committee made the following recommendations for the 2019 Legislature:

  1. Fund TSBP’s Exceptional Item request for enhancements to the PMP, including the integration of the system into electronic health record systems.The state should pursue opportunities for federal funding for these items. The enhancements will drastically increase the efficiency of the system.
  1. Delay the effective date for requiring prescribers and dispensers to check the PMP prior to prescribing for Schedules III-V, but maintain the September 1, 2019 effective date for schedule II prescriptions.This will allow prescribers and dispensers time to adjust to using the system, and will allow TSBP time to integrate the system with electronic health record systems, if the Exceptional Item is funded.
  1. Appoint an advisory committee to TSBP comprised of prescribers and dispensers.This advisory committee would examine data accuracy, data integrity, best practices, and address system weaknesses and workflow challenges.
  1. The Legislature and veterinarian stakeholders should continue to collaborate to ensure veterinarian dispensing of controlled substances is incorporated appropriately into the PMP within 30 days of dispensing.
  1. Establish legal penalties for wrongful access and misuse of the PMP and direct TSBP to increase financial penalties.Current penalties for inappropriate use of the PMP are in the form of fines ranging from $1,000 to $2,500.
  1. Continue integrating Texas’s PMP with other states’ systems.Texas’s system is currently integrated with the following states: Alabama, Arizona, Arkansas, Connecticut, Georgia, Idaho, Kansas, Louisiana, Maine, Massachusetts, Minnesota, Mississippi, Montana, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, and Virginia.
  1. Make PMP data available to a minor patient’s parent/guardian on behalf of the minor child.Texas is one of eight states that currently does not have a process for this.
  1. Provide legal immunity to practitioners not submitting data or accessing the PMP.Thirty other states have legal immunity in place to protect practitioners from civil lawsuits.
  1. Allow a state entity that is also a Centers for Medicare & Medicaid Services (CMS) Qualified Entity (QE) to access the PMP data for research and analysis. QEs are entities certified by CMS to meet the highest standards in analysis of health data, including protected health information. Currently, only TSBP has the ability to analyze PMP data. This recommendation would allow the data to be analyzed in relation to claims data to study rates and patterns.

TOA will be working on this issue in the 2019 Texas Legislature.