new mexico’s prescription monitoring program (pmp) · prescription monitoring program (pmp) peter...

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New Mexico Board of PharmacyPrescription Monitoring Program (PMP)

NMPhA Mid-Winter Meeting – Law Update

January 27, 2018

New Mexico Board of PharmacyPrescription Monitoring Program (PMP)

Peter Ryba, PharmDPMP Director

[email protected]

Maria GonzalesPMP Manager

[email protected]

PRESCRIPTION MONITORING PROGRAM

NEW MEXICO BOARD OF PHARMACY

Agenda

• Prescription Drug Information and Statistics

• What is the PMP?

• PMP Registration Process

• PMP Regulatory Facts

• PMP InterConnect

• PMP AWARxE

• Reports Provided

• Current Projects

• Useful Links



Prescription Drug Information and Statistics

The National Epidemic

• The United States is in the midst

of an epidemic of prescription

opioid overdose deaths, which

killed more than 63,600 people

in 2016 alone.

Source: NCHS Data Brief, Number 294, December 2017 www.cdc.gov/drugoverdose/prescribing/guideline.html




Source: www.cdc.gov/drugoverdose/prescribing/guideline.html



Source: NCHS Data Brief, Number 294, December 2017

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The State of New Mexico

• In 2014, New Mexico had the second highest drug overdose

death rate.

• In 2015, New Mexico ranked #8 with a rate of 25.3.

• In 2016, New Mexico ranked #12 with a rate of 25.2.

Source: www.cdc.gov/drugoverdose/prescribing/guideline.html







Source: NM Department of Health

0

5

10

15

20

25

30

35

40

45

2010 2011 2012 2013 2014 2015

Dea

ths

per

10

0,0

00

peo

ple

West Virginia New Hampshire Kentucky Ohio

Rhode Island Pennsylvania Massachusetts New Mexico

Rates are age adjusted to the US 2000 standard populationSource: National Center for Health Statistics, CDC via CDC Wonder

Drug Overdose Death Rates for the 8 States with the Highest Rates in 2015





Northwest Northeast

San Juan 19 Santa Fe 45

Cibola 10 Rio Arriba 31

Central/Metro

Bernalillo 187

Sandoval 21

Southwest Southeast

Dona Ana 27 Lea 14

Otero 12 Chaves 13





Year Nat’l Rank OD Deaths Rate

2014 2nd 540 27.3

2015 8th 493 25.3

2016 12th 497 25.2

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What is the PMP?

The New Mexico Prescription Monitoring Program is a web-based

electronic database that aids in the collection and reporting of

dispensed controlled substance prescriptions.



What is the PMP?

Mission

To provide practitioners, pharmacists, and other authorized users

the ability to review a patient’s controlled substance prescription

history and assist in the prevention of diversion, abuse, misuse,

and drug overdose deaths of controlled substance prescriptions.



What is the PMP?

• Information in the PMP is only as accurate as the data

submitted by dispensers.

• Disclaimer: “The State of New Mexico does not warrant the

above information to be accurate or complete. This report is

based on the search criteria entered and the data entered

by the dispenser. For more information about any prescription,

please contact the dispenser or the prescriber.”



What is the PMP?

• PMP reports should not be used as evidence or testimony for

any legal proceedings.

• The PMP is a tool for prescribers to use their professional

judgement in prescribing controlled substances.



History of the NM PMP

• July 2004 – NMAC 16.19.29 was adopted which created the

PMP.

• August 2005 – The PMP went live and was operated under the

NM BOP.

• October 2014 – The NM BOP was awarded the 2014 Harold

Rogers grant.

• November 2016 – Appriss began hosting the NM PMP.

• January 2017 – The NM State Legislature enacted new

mandatory PMP use requirements for all practitioners.



PMP Registration Process

Registrants include:

• Healthcare Professionals

• Delegates

• Up to four (4) delegates per practitioner

• A delegate can have an unlimited number of practitioners

• Law Enforcement

• Regulatory Board Agents

• Medicaid Compliance Officers

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• Chiropractor

• Nurse Practitioner/Clinical

Nurse Specialist

• Midwife with Prescriptive

Authority

• Physician Assistant

• Optometrist

• Naturopathic Physician

• Pharmacist with Prescriptive

Authority

• Pharmacist

• Out of State Pharmacist

• Pharmacist in Charge

• Psychologist

• Medical Resident

• Medical Resident with

Prescriptive Authority

• IHS Prescriber

• Pharmacist’s Delegate –

Licensed

• Prescriber Delegate –

Unlicensed

• Prescriber Delegate –

Licensed

• Dispensing Physician

• Dentist

• Out of State Prescriber

• Physician (MD, DO)

• VA Prescriber




1. Create an account at

https://newmexico.pmpaware.net/login.

2. Verify your email by clicking on the link in the auto-generated

email you received when you created an account. The link is

only good for 20 minutes. Contact us to resend if it expires.

3. Upload or email a copy of your driver's license, state issued

photo ID, or a passport. No other forms of identification will be

accepted (for example work badges, Social Security Cards).

4. Complete the required training at

http://nmpmp.org/Training.aspx.




• Only authorized account holder can access the NM PMP.

• Sharing login information is a violation of both federal and

state regulations.



NM BOP PMP Regulatory Facts

Dispensers

• All dispensers (including dispensing practitioners) must report

within one business day if more than 12 doses within a 72 hour

period was dispensed.

• If you do routinely dispense, but do not do so during a specific

reporting period, a “zero report” must be submitted weekly.




Practitioner

• Before a practitioner prescribes or dispenses an opioid for the first

time to a patient, the practitioner shall obtain and review a report

from the PMP for the previous 12 months, and obtain and review

the PMP report from an adjacent state if available.

• A practitioner shall obtain and review a report from the state’s PMP

and adjacent states, no less than once every three months for each

established patient for whom opioids are prescribed or dispensed.




Exceptions for Practitioners

• A practitioner does not have to consult the PMP report before

prescribing, ordering, or dispensing a controlled substance II-V:

• If the dispensed quantity is for a period of 4 days or less,

• To a patient in a nursing facility,

• To a patient in hospice care,

• Or when prescribing, dispensing or administering

testosterone, pregabalin, lacosamine, ezogabine or

stimulant therapy for pediatric patients less than age 14.

https://newmexico.pmpaware.net/login

http://nmpmp.org/Training.aspx

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Pharmacists

• Review PMP reports covering at least one year and another

states’ report if applicable and available.

• PMP reports shall be reviewed a minimum of once every three

months during the continuous use of opioids.




Exception for Pharmacists

• A prescription for an opioid written for a patient in a long term

care facility (LTCF) or for a patient with a medical diagnosis

documenting a terminal illness is exempt from Subsection E of

16.19.4.16 NMAC. If there is any question whether a patient

may be classified as having a terminal illness, the pharmacist

shall contact the practitioner. The pharmacist shall document

whether the patient is “terminally ill” or an “LTCF patient”.




DENTISTRY (DENTISTS, DENTAL HYGIENISTS, ETC.)

16.5.57 NMAC - MANAGEMENT OF PAIN WITH CONTROLLED SUBSTANCES

MEDICINE AND SURGERY PRACTITIONERS

16.10.14 - NMAC MANAGEMENT OF PAIN WITH CONTROLLED SUBSTANCES

MIDWIVES

16.11.2 NMAC - CERTIFIED NURSE MIDWIVES

NURSING AND HEALTH CARE RELATED PROVIDERS

16.12.9 NMAC - MANAGEMENT OF CHRONIC PAIN WITH CONTROLLED

SUBSTANCES




OPTOMETRIC PRACTITIONERS


OSTEOPATHIC MEDICINE AND SURGERY PRACTITIONERS

16.17.5 NMAC - PRESCRIBING AND DISTRIBUTION OF CONTROLLED SUBSTANCES

PHARMACISTS

16.19.4 NMAC - PHARMACIST

16.19.20 NMAC - CONTROLLED SUBSTANCES

16.19.29 NMAC - CONTROLLED SUBSTANCE PRESCRIPTION MONITORING PROGRAM

PODIATRISTS




PMP InterConnect

• The PMP InterConnect (PMPi) facilitates the transfer of PMP

data across state lines.

• PMPi allows participating states across the United States to be

linked, providing a more effective means of combating drug

diversion and drug abuse nationwide.

• Currently, 45 states and jurisdictions have agreed to securely

share PMP data through PMPi.

• There were 15 million interstate transactions a month in 2017.

Source: https://nabp.pharmacy/initiatives/pmp-interconnect/



PMP InterConnect


http://164.64.110.239/nmac/parts/title16/16.005.0057.htm

http://www.nmcpr.state.nm.us/nmac/parts/title16/16.010.0014.htm









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PMP AWARxE













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MyRx

• MyRx gives users that have a DEA number associated with their

account to run a self-report to see what prescriptions have

been filled where they were listed as the prescriber.

• Proactive measure for prescribers to help curb forgeries and

diversion.


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Reports Available

• Quarterly Reports to Licensing Boards

• Prescriber Feedback Report



Quarterly Reports to Licensing Boards

• Total number of patients

• Total number of opioid patients

• Total opioid Morphine Milligram Equivalents (MME) filled

• Total number of benzodiazepine (BZD) patients

• Total BZD Diazepam Milligram Equivalents (DME) filled

• Percent of opioid patients with ≥90 MME/day

• Percent of opioid patients with ≥90 days of opioids in 6 months

• Percent of BZD patients with prescriptions ≥30 DME/day

• Percent of BZD patients with ≥90 days of BZDs in 6 months

• Percent of opioid patients with concurrent BZDs ≥30 days



Quarterly Reports to Licensing Boards

• Controlled substance prescriptions per prescribing day, 3 months

• Percent of estimated required reports requested

• PMP reports required under Board rules (estimated)

• PMP reports requested on patients

• Percent of patients with a total of 5 or more practitioners or

pharmacies in 6 months



Prescriber Feedback Report

Reports reflect top 1% of prescribers with 20 or more patients

receiving controlled substances within 6 month period

• High opioid doses

• Long term opioid patients

• High benzodiazepine (BZD) doses

• Long term BZD patients

• High volume of opioids and BZDs

• High volume prescribing

• Concurrent therapy

• Multiple provider episodes

• No PMP use



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Current Projects

PMP Integration within Workflow

• EDIE

NarxCare

• The Narx Report includes a patient’s NarxScores, Predictive

Risk Scores, Red Flags, Rx Graph and PDMP Data, as well as

access to Resources and Care Team Communications all in a

single, easy-to-use interface.



Useful Links

NM Board of Pharmacy http://www.rld.state.nm.us/boards/Pharmacy.aspx

PMP Registration and FAQs http://www.nmpmp.org/

PMP AWARxE https://newmexico.pmpaware.net/login

Support

Technical Customer Service (24/7/365) 1-844-366-4767

Local Non-Technical (M-F 8a-5p) 505-222-9847

NM BOP PMP Support [email protected]



Questions?

http://www.rld.state.nm.us/boards/Pharmacy.aspx

http://www.nmpmp.org/


mailto:[email protected]

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