Get Ready for the Mandated Texas Prescription Monitoring Program.
As a Texas dentist, the opioid crisis is a topic of particular relevance to you—whether you prescribe infrequently or frequently.
Opioids are responsible for almost half of all drug overdose deaths in Texas, making the crisis a public health emergency.1 And as a dental provider, you’re in the middle of this national issue.2
- Dentists are the second highest prescribers, after family physicians.
- Dentists are responsible for one-third of opioid prescriptions to adolescents.
- Prescriptions for tooth extractions account for an estimated 1 million unused opioid pills.
Across the U.S., more than 11 million people misused prescription opioids in 2017, Center for Disease Control and Prevention (CDC)’s most recent reports show. The economic impact of opioid abuse is also staggering at $78.5 billion a year. Financial burdens range from healthcare costs to interactions with the criminal justice system.3
Prescribers are being held accountable.
Along with state agencies, The Department of Justice (DOJ) is determined to hold prescribers accountable for their alleged roles in the epidemic. The United States Attorney General’s office developed a task force in 2018 that’s deploying criminal, civil, and regulatory tools.
“The Department of Justice will use every available tool to stop doctors who fail to uphold their legal obligation to prescribe controlled substances properly,” stated Assistant Attorney General Jody Hunt of DOJ’s Civil Division.
As investigations gain traction, dentists and physicians are being charged with unlawful distribution or dispensing of controlled substances. In North Texas, a restraining order was placed on two doctors allegedly prescribing powerful opioids linked to abuse and diversion.
Prescribers are also being charged with healthcare fraud for prescribing and distributing narcotics. The Washington Post reported “dozens of medical professionals in seven states charged with participating in the illegal prescribing of more than 32 million pain pills, including doctors who prosecutors said traded sex for prescriptions and a dentist who unnecessarily pulled teeth from patients to justify giving them opioids.”4
Consequences for overprescribing are significant.
DOJ is also making it clear that consequences of overprescribing are significant. Many defendants face multiple counts, which means each penalty is multiplied. Maximum penalties can reach a 20-year prison sentence.
In California, a 72-year-old neurologist and pain management doctor was arrested and charged with second-degree murder in August after four of his patients overdosed on “prescribed addictive drugs, including Vicodin, oxycodone, OxyContin, Percocet and morphine—at dangerously high levels,” according to California Attorney General Xavier Becerra. He was charged with felony elderly abuse for the death of a fifth patient; and if convicted, faces up to life in prison. His attorney argues the deaths were suicides or accidental overdoses involving drugs the physician did not prescribe.
Be prepared for the new law.
Use of the state’s Prescription Monitoring Program (PMP) becomes mandatory effective March of 2020. Prescribers and pharmacists will be required to check a patient’s PMP history before dispensing or prescribing opioids, benzodiazepines, barbiturates, or carisoprodol.
Here’s what you need to do to be ready by March.
- Register with the State PMP Database.
- Prepare for ePrescriptions. In the 2019 Texas Legislative Session, Governor Greg Abbott signed House Bill 2174, requiring electronic prescribing of controlled substances (CII–CV) beginning January 1, 2021. Ensure your:
- Practice management system has e-prescribe functionality.
- E‐prescribing software is certified per DEA requirements.
- Software’s electronic prescribing for controlled substances (EPCS) functionality is activated in Texas.
- Integrate PMP access with your practice management system, so you can:
- Speed up your PMP history checks.
- See a patient’s prescription history in other states where data sharing is allowed.
- Determine which employees meet HIPAA-compliance mandates and can access the State’s PMP.
2 Katie J. Suda, PharmD, MS; Michael J. Durkin, MD, MPH; Gregory S. Calip, PharmD, MPH, PhD; et al; 2019, “Comparison of Opioid Prescribing by Dentists in the United States and England,” JAMA Network, May 24, 2019
3 “Staggering Statistics About America’s Opioid Epidemic, 2019, ChoosePT
4 Sari Horwitz and Scott Higham, 2019, “Doctors in seven states charged with prescribing pain killers for cash, sex,” The Washington Post