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Mass. Physician Advocates Seek Changes in Prescription Monitoring Program

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Patient advocates and representatives of the medical community in Massachusetts are submitting comments to the state Board of Public Health to address regulations that aim to curb prescription drug abuse.

Signed into law by Governor Deval Patrick in 2012, An Act relative to prescription drug diversion, abuse and addiction, requires prescribers of pain killers to enroll in the state’s now-voluntary Prescription Monitoring Program upon renewal of their medical licenses. Currently about 1,700 prescribers in Massachusetts are enrolled in the program.

Dr. Madeleine Biondolillo, Director of the Bureau of Health Care Safety and Quality at the Department of Public Health, said “we want to encourage and require as much as the PMP as is practical and effective to try and stem the tide of the epidemic of deaths and disability from the diversion and abuse of particularly the opioids.”

As part of the process to craft the regulations, the Department of Public Health recently held a public hearing on the draft regulations, where a variety of advocates and opponents voiced their opinions.

The bill is designed to prevent patients from “doctor shopping” – in cases where patients seek multiple prescriptions from separate doctors. Under the draft regulations, “new patients” are defined as “having not received any professional services from the participant within the previous 12 months.”

Dr. Richard Aghabaian, President of the Massachusetts Medical Society, said that that definition should be revised.

“Just because you haven’t seen someone for 12 months doesn’t mean you have to start all over again. The Medicare definition is 3 years,” said Aghababian.

New patients would require doctors to check with a PMP database for information regarding past prescriptions.

Other groups are also concerned with the “new patient” definition. The Massachusetts College of Emergency Physicians said that new patients should be considered “unless a patient is presenting for an emergency condition.”

Other groups, including Atrius Health, which represents several community healthcare organizations in Central and Eastern Massachusetts, also commented on the draft regulations’ potential to prove cumbersome for busy doctors.

The US Pain Foundation also submitted testimony claiming that the draft regulations policy of monitoring addictive Schedule I-IV drugs is commendable, but said that restricting Schedule V drugs would create unnecessary access issues for patients.

Schedule V drugs classified by the federal Controlled Substances Act  are defined as having a lower potential for abuse relative to drugs than drugs or other substances in Schedule IV. Wendy Foster, Patient Ambassador  for the US Pain Foundation advocated not to block access to those “with chronic painful conditions such as fibromyalgia, painful diabetic peripheral neuropathy, and many other conditions.”

Dr. Madeline Biondolillo of the DPH said she welcomed the comments submitted at Friday’s hearing.

Biondillo that the comments will be brought back to the state’s Public Health Council where the regulations will be reconsidered. She estimated the final regulations to be released in 1 to 2 months.

The deadline for written comments on the draft regulations for the revised Prescription Monitoring Program is Friday, March 29th.

Lucas Willard is a reporter and host at WAMC Northeast Public Radio, which he joined in 2011.
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