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New Prescription Monitoring Program Changes Effective Dec. 5, 2014

The Massachusetts Public Health Council has approved final regulations on utilization of the state Prescription Monitoring Program.
We would like to provide MACEP members with a summary of the new regulations.  In sum, PMP use is mandatory for any new prescriptions of opioid and benzodiazepine medications. However, there are exclusions for patients treated in the ED who receive less than a five days’ supply of medication. MACEP worked closely with the Department of Public Health to secure  this exemption. However, MACEP strongly suggests that emergency providers do still use the PMP whenever possible.
Effective Dec. 5, all PMP users must utilize the PMP prior to prescribing a schedule II or III medication or a benzodiazepine to a patient for the first time.
The final regulations include the following specific changes to individual prescribers’ responsibilities when prescribing certain drugs:
  •   Automatically grants authority to use the PMP to registered individual practitioners holding a Mass. Controlled Substance Registration.
  • All such registered individual practitioners must use the PMP prior to prescribing for the first time: (a) a schedule II or III controlled substance; (b) a benzodiazepine; or (c) a schedule IV or V controlled substance outlined in any DPH-issued guidance;
  • Requires using the PMP prior to prescribing commonly abused and addictive Schedule II and III drugs as outlined in any DPH issued guidance; and
  • Removes the requirement for physician assistants to include the name of the supervising physician on written prescriptions, although the physician assistant must still work under the supervision of a physician.
  • Enables naloxone to be prescribed to someone other than the direct user so that person can have it on hand in the event that a known drug user overdoses. Presumably, such a prescription is intended for friends or family members of known drug users. When a bystander prescription is written, the end-user patient’s name and address is not required; the prescriber may write in the name of the person taking delivery of naloxone.
The final regulations do provide several exceptions to the mandated PMP review, including providers who:
  • Only prescribe/dispense Schedule VI drugs;
  • Care for only hospice, inpatient, or immediate treatment;
  • Treat patients in the emergency department and either do not expect to write a prescription for, or will provide a prescription for, a five-day or less supply of a Schedule II-V controlled substance;
  • Are unable to use the system due to operational/system level failures;
  • Care for patients under 5 years of age;
  • Meet other exceptions as issued by DPH.
Link to DPH PDMP related materials including full regulations.

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