The Prescription Monitoring Program (PMP) is receiving attention from the legislature and Governor LePage in the face of data released from the Program indicating that only 7% of those prescribers registered for the Program are regularly using it. While the 7% figure is subject to analysis and explanation, legislators are likely to consider proposals to mandate use of the PMP as a tool for preventing doctor shopping rather than just mandating registration. The PMP now has been in operation for more than a decade and with the opioid/heroin crisis still a serious public health problem, legislators and the Governor are expected to take some action.
In the event that legislation mandating use is considered, MMA has prepared an alternative proposal sponsored by Senator Roger Katz (R-Kennebec) that would direct the health professional licensing boards to mandate use by amending existing Joint Rule 21, Use of Controlled Substances for the Treatment of Pain which already provides guidelines when prescribing controlled substances for pain. By using the rulemaking process at the licensing boards, physicians would have an opportunity to provide input during a reasonable period of time. MMA also has suggested that the effective date for any such mandate not be before July 1, 2017 in order to give all prescribers an opportunity to be educated to the new standard.
The 7% figure is suspect because the denominator now includes all licensed health professionals who have prescribing privileges even if they do not have a DEA number and thus do not prescribe controlled substances. If only prescribers who are regularly prescribing controlled substances are included, the 7% number would be much higher. In addition, the usage number is diminished by virtue of the fact that some prescribers in a system of care may use delegates to access the PMP and assign those delegates to more than one physician. Nonetheless, not all prescribers are using the PMP who should be. And, over-prescribing continues to be an issue, as well.
The Katz bill and a bill being presented by the Governor are both expected to be printed and presented to the Legislature this coming week. The Governor's bill is likely to be very far-reaching and limiting the prescribing of opiate based medication as well as mandating education and regular use of the PMP.
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