Prescription drug monitoring programs can assist practices in the prescribing process.

While we use few controlled substances in eye care, ophthalmologists do occasionally prescribe Schedule II drugs. The Drug Enforcement Administration (DEA) defines Schedule II drugs as those “with a high potential for abuse, with use potentially leading to severe psychological or physical dependence.”¹ Usually prescribed to control pain from procedures or acute injuries, patients sometimes overuse, misuse, or share these drugs.

As a first step in gaining insight and control into opioid use, the DEA provided physicians with the option of writing prescriptions for controlled substances electronically on June 1, 2010.² That option made way for prescription drug monitoring programs (PDMPs).

Understanding PDMPs

A PDMP “is an electronic database that tracks controlled substance prescriptions in a state.”³ PDMPs provide physicians important information regarding a patient’s prescribing history amid North America’s ongoing opioid epidemic. States are at varying levels of incorporating/integrating robust PDMP systems, but almost all are collecting and controlling prescription data with PDMPs.

To facilitate physician access, PDMP query tools may be incorporated into government-certified EHR technologies (CEHRT), or they may be standalone software inquiries performed outside of the EHR. The most efficient PDMPs are integrated tools that physicians can query immediately before prescribing a controlled substance to a patient. Much like the medication formularies incorporated into e-prescribing systems, the most efficient PDMPs appear as another button to click or step in the electronic prescribing process.

PDMP systems connect physicians with retail pharmacy data and ideally a real-time PDMP Summary Report on the patient before prescribing controlled substances, with the goal of reducing overprescribing and ensuring public health.

A potential MIPS requirement

For several years, PDMP use has been a bonus measure for the Quality Payment Program’s traditional Merit-based Incentive Payment System (MIPS) performance. Currently, only one query of the system per year is needed to obtain the bonus, which is worth 10 points.

The 2023 Proposed Medicare Physician Fee Schedule is recommending the PDMP measure become mandatory for 2023 reporting.⁴ It would remain worth 10 points and continue to cover Schedule II drugs but expand to include Schedule III and IV drugs.

Next steps

If your practice has not already integrated PDMP software into your CEHRT, reach out to your EHR vendor to see what options are available. Utilizing PDMPs can help your providers avoid overprescribing controlled substances, improve patient care, and secure additional points for MIPS performance, which is a larger hurdle each year. OP

REFERENCES:

1. United States Drug Enforcement Administration. Drug Scheduling. https://bit.ly/3BqqZhc . Accessed Sept. 9. 2022.
2. Department of Justice, Drug Enforcement Administration. Electronic Prescriptions for Controlled Substances Clarification. https://bit.ly/3qpIp79 . Accessed Sept. 9. 2022.
3. Centers for Disease Control and Prevention. Prescription Drug Monitoring Programs (PDMPs): What States Need to Know. https://bit.ly/3KZAlUp . Accessed Sept. 9. 2022.
4. Centers for Medicare & Medicaid Services. 2023 Proposed Medicare Physician Fee Schedule Rule. https://bit.ly/3KZq3DH . Accessed Sept. 9. 2022.