Law requires Texas physicians to query PMP before prescribing opioids

Laura Hale Brockway

(Updated information on the PMP and TMB rules available here.)

by Laura Hale Brockway, ELS

Applies to ALL Texas physicians
Effective September 1, 2019
Includes prescriptions for opioids, benzodiazepines, barbiturates, carisoprodol.

Start preparing now. And yes, we mean you.

A new state law ¹ will require Texas physicians to check the Texas Prescription Monitoring database before prescribing opioids (hydrocodone, oxycodone, etc.); benzodiazepines (alprazolam or diazepam); barbiturates; or carisoprodol. Physicians must check each patient’s prescription history within the database for evidence of doctor-shopping or drug diversion. The law goes into effect on September 1, 2019.

This means that surgeons must query the database before prescribing for their postoperative patients; and, a primary care physician must query the database before prescribing for their sprained ankle patients or their stressed-out patients who need alprazolam.

The law does not apply to physicians prescribing for patients diagnosed with cancer or patients receiving hospice care.

This is a developing issue and changes could be made to this legislation during the 2019 session. TMLT will keep you updated and will provide resources on how to comply with this new requirement.

In the interim, please consider these risk management best practices.

1. Register with the Texas Prescription Monitoring Program (PMP)

The Texas State Board of Pharmacy manages the PMP and automatically creates PMP accounts based on information it receives from the Texas Medical Board. However, prescribers must manually finalize their accounts.

With your finalized account, you can find out if a patient is receiving Schedule II, III, IV, and V controlled substances. You can also receive email notifications when the system finds evidence of suspicious activity.

2. At your discretion, delegate the task of checking the database to trusted staff.

Once you are registered, you can assign medical staff to assist in querying the PMP. It is important that your delegate register for his or her own account in the system. Physicians should never share PMP log-in information with their staff or delegate.

In addition, physicians and staff should only query their own prescribing history or patients with whom they have an established relationship. Querying individuals who are not your patients is a violation of HIPAA.

3. Document when you query the PMP

Current risk management recommendations call for physicians (or delegates) to check the PMP regarding any new patient who is currently taking controlled substances; any existing patient who requests an early refill of a controlled substance; or any patient who triggers concern about abuse of controlled substances. The new law will expand these recommendations.

To show that you are in compliance with these recommendations — and with the new law that becomes effective September 1, 2019 — document in the patient’s chart that you have checked the PMP before prescribing opioids, benzodiazepines, barbiturates, carisoprodol.

We will continue to update you on any developments in the law.