By law, physicians now must set up an account with the Texas PMP, known as PMP Aware and check the PMP prior to prescribing opioids, benzodiazepines, barbiturates and carisoprodol. An account allows physicians to check a patient’s prescription history for information that indicates illicit activity, drug abuse, drug diversion, or doctor shopping.
Appriss Health, the state’s PMP vendor, provides the software, NarxCare, which is integrated with the EHR so that physicians do not need to leave the EHR to query the PMP. NarxCare, is an analytics tool and care management platform that helps prescribers and dispensers analyze real-time controlled substance data from PMPs and manage substance use disorder. NarxCare automatically analyzes PMP data and a patient’s health history and provides patient risk scores and an interactive visualization of usage patterns to help identify potential risk factors. NarxCare is delivered to the EHR using PMP Gateway. That means authorized prescribers can access PMP data and NarxCare analytics within their daily workflow for clinical decision support.
Not all EHRs are integrated at this time. View the list of EHR vendors that are currently integrated with NarxCare and the PMP database.
When Texas started requiring that physicians check the state’s prescription monitoring program (PMP), the state appropriated funds to cover the licensing fee for the first two years. Effective Sept. 1, however, that fee is no longer covered by the state, and Appriss, the state’s PMP vendor, has begun billing physicians for the annual PMP licensing fee.
To help you document those checks, PMP Aware allows you to download PDFs that you can add to a patient’s medical record.
Texas Prescription Monitoring Program The Texas PMP collects and monitors outpatient prescription data for controlled substances dispensed by a pharmacy in Texas. It is a patient care tool that can be used to inform prescribing practice and to address prescription drug misuse, diversion, and overdose.
This toolkit is designed to assist you in having productive conversations with patients about the Texas PMP and the safe and effective alleviation of pain.
How to Talk to Patients About the PMP (Texas Medicine Today, Jan. 31, 2020)
You Write Scripts? You Better Sign Up With the PMP
Did You Receive an Email Requiring Registration to the State’s PMP?
Not all EHRs are integrated with the Texas prescription monitoring program yet. Check our updated of EHR vendors that are integrated. If your EHR is not listed, contact Appriss by filling out the EHR Integration Request Form. If your EHR is listed, and you did set up a PMP Aware account, but you don’t see the integration when you create a prescription, contact your EHR vendor.
Yes. Physicians and other health care professionals who are required to participate in Medicare’s Merit-Based Incentive Payment System (MIPS) under the Quality Payment Program (QPP) and consult the PMP can claim credit for the MIPS improvement activities category. This category measures participation in activities that improve clinical practice. For the 2020 QPP performance year, you may claim MIPS credit by attesting to: "consultation of the prescription drug monitoring program." For a description of this activity and its requirements, visit the QPP website.
I won’t be surprised if physicians around the state are feeling a little angst and anger over the coming March 1 requirement for physicians to check the Texas prescription monitoring program (PMP) before writing prescriptions for opioids, benzodiazepines, barbiturates, and carisoprodol. I don’t fault them one bit. This is just one more administrative burden placed on physicians. But I want all of you to understand just how much worse it would have been without the intervention of the Texas Medical Association.
In this video recorded at the Texas Medical Association Fall Conference in September, 2019, Troy Fiesinger, MD, Lindsay K. Botsford, MD, and Adam Bruggeman, MD, explained the legal requirements for physicians who prescribe controlled substances, and how clear and consistent office procedures can improve pain management care.
Opioids: The Forgotten Epidemic? (Texas Medicine, Oct. 2020)
Same Old Hurdles: Pharmacy-Mandated Obstacles to Filling Opioid Scrips (Texas Medicine Today, Sept. 18, 2020)
Medicaid Changing Prior Authorization Criteria for Certain Opioid Prescriptions (Texas Medicine Today, Aug. 28, 2020)
TMB Sets Rules on Acute-Pain Scrip Limit, Opioid CME (Texas Medicine Today, July 31, 2020)
TMA to TMB: Let Docs Decide Whether In-Person Visit Needed For Subsequent Opioid Scrips (Texas Medicine Today, Mar. 6, 2020)
Removing the Pain from Prescribing Pain Meds (Texas Medicine Today, Nov. 7, 2019)
Easing the Pain? Opioid Settlement Brings Valuable Funding to Fight Crisis (Texas Medicine, Nov. 2019)
Tapering a Patient’s Opioid Dosage? Follow This Guide (Texas Medicine Today, Oct. 17, 2019)
Physicians Need to Prepare for New Opioid Rules and Best Practices (Texas Medicine Today, Oct. 9, 2019)
The Changing Face of the Opioid Epidemic (Texas Medicine Today, Sept. 27, 2019)
Doctors Drive New Opioid Laws - A 10-day limit and integration of state's PMP among new changes (Texas Medicine, Sept. 2019)
New Laws Improve Opioid Prescription Process in Texas (Texas Medicine Today, Aug. 6, 2019)
When Do New Opioid Prescribing Requirements Take Effect? (Texas Medicine Today, Aug. 2, 2019)
Prescribing Changes in Texas: Know What You Need to Know (Texas Medicine Today, June 28, 2019)
Despite Deadline, New Prescription Forms Still Not Received (Texas Medicine Today, June 11, 2019)
TMA Pushing To Delay PMP Mandate, Buy Time for Integration With EHRs (Texas Medicine Today, Apr. 9, 2019)
Keep Your Patients and Practice Safe from Opioid Prescription Fraud (Texas Medicine Today, Mar. 19, 2019)
Website Glitches Hinder New Opioid Prescription Order Forms (Texas Medicine Today, Sept. 18, 2018)
Are You Ready for Changes to Opioid Prescribing in Texas? (Texas Medicine Today, Aug. 22, 2018)
FDA Says No to Prescription Opioid Cough Meds for Children (Texas Medicine Today, Jan. 17, 2018)
Three Organizations Get Early Approval to Prescribe Cannabis (Action, May 12, 2017)
Opioids: Resources for Prescribing and Addiction Treatment (TMA Practice E-Tips, Jan. 10, 2017)
New Law Expands Access to Naloxone (Action, Sept. 1, 2015)
Guidance on Prescribing Schedule II Hydrocodone Products (Action, Sept. 15, 2014)
Hydrocodone Products Reclassified as Schedule II (Aug. 29, 2014)
Sample Opioid Treatment Agreement (Texas Pain Society)An informed consent and opioid treatment agreement is a contract between a doctor and a patient. The goal of the agreement is to ensure that patients who are taking opioid drugs do so exactly as their doctor has prescribed. This sample agreement can be used as a template for your practice. Once it is signed, be sure to incorporate it into the patient’s record in the EHR. Thank you to the Texas Pain Society for allowing TMA to link to the sample agreement.
Training to Focus on Opioid Prescribing Guidelines (CDC)
Mar. 1, 2020:Checking the Texas PMP Required
Jan. 1, 2021: E-Prescribing of Controlled Substances Required
To better understand what the latest Prescription Monitoring Program (PMP) changes mean for you, register for TMA’s on demand webinar. This webinar is free for TMA members!
Got E-Prescribing questions? Contact the HIT Helpline.
Check this list to find out if your EHR is connected. The information is current as of July 2021.
View the List
Chronic pain is one of the most frequent reasons people seek medical attention in the U.S., according to the CDC. If you prescribe opioids for chronic pain, there are things you need to know to protect your patients.
TMA’s new e-book, Monitoring Opioid Therapy for Chronic Pain, serves as a brief resource for that information and more.
Read the E-Book
The U.S. Department of Health and Human Services published a Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics. The guide covers important issues to consider when changing a patient’s chronic pain therapy, including issues to consider prior to making a change, when initiating a change, and as a patient’s dosage is being tapered.
Read the Complete Guide Here
Get access to information about medication-assisted treatment (MAT) for opioid use disorder.The Substance Abuse and Mental Health Services Administration (SAMHSA) has identified MAT as one of three priority ways to solve the current opioid overdose crisis. Find out more.
Links below provide timely information from fellow health care leaders in addressing the opioid epidemic:
American Academy of Family Physicians (AAFP) Chronic Pain Resources
AAFP Pain Management and Opioid Abuse
American Academy of Orthopedic Surgeons (AAOS)
American Society of Clinical Oncology (ASCO)
American Society of Interventional Pain Physicians (ASIPP)
American Society of Anesthesiologists
American College of Emergency Physicians
American College of Surgeons