LAW AND MPDR UPDATES 2021 - MARCIE BOUGH, PHARMD EXECUTIVE OFFICER NIKKI GRIFFIS, PHARMD MPDR PROGRAM MANAGER - UNIVERSITY ...
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Law and MPDR Updates 2021 MARCIE BOUGH, PharmD EXECUTIVE OFFICER NIKKI GRIFFIS, PharmD MPDR Program Manager March 7, 2021 Recent Drug Developments and Law Update 2021 University of Montana Skaggs School of Pharmacy
Disclosure The presenters declare no actual or potential conflict of interest in relation to this presentation.
Objectives 1. Review legislative and regulatory updates related to the practice of pharmacy in Montana 2. Understand changes to the new Montana Prescription Drug Registry (MPDR)
Questions When does MCA 37-7-1515, mandatory MPDR use for prescribers of opioids and benzodiazepines go into effect? A. 1/1/2022 B. 7/1/2021 C. It went into effect on 10/1/2019 D. 12/1/2021 Which state did the MPDR most recently connect with for Interstate Data Sharing? A. Wyoming B. California C. Texas D. Alaska
Board of Pharmacy Members Tony King, Pharmacist, President Starla Blank, Pharmacist, Vice-President Marian Jensen, Public Member, Secretary Courtney Bahny, Certified Pharmacy Technician Paul Brand, Pharmacist Jeff Nikolaisen, Pharmacist Charmell Owens, Public Member
Board of Pharmacy
Contact Information and Meetings
General Contact Information
Marcie Bough, PharmD, Executive Officer
Emails:
406-841-2371, mbough@mt.gov
dlibsdpha@mt.gov
dlibsdmpdr@mt.gov
Mark Klawitter, RPh, Board Inspector
406-459-8847, mark.klawitter@mt.gov
Websites:
www.pharmacy.mt.gov
Genine Pitts, PharmD, Board Inspector www.mpdr.mt.gov
406-431-1952, gennine.pitts@mt.gov
Phone Numbers:
Nikki Griffis, PharmD, Program Manager Office: 406-841-2300
Montana Prescription Drug Registry (MPDR) Customer Service: 406-444-6880
406-841-2240, nikki.griffis@mt.gov
dlibsdmpdr@mt.gov
2021 Board Meetings
March 12
June 18
September 24
December 3
New Webpage: www.pharmacy.mt.gov
Law Updates 2021
House Bill (HB)
Senate Bill (SB)
Senate Resolution (SR)
Montana Code Annotated (MCA)
Administrative Rules of Montana (ARM)
Access at:
https://boards.bsd.dli.mt.gov/pharmacy/regulations/Montana Legislature: https://leg.mt.gov
HB 250, Revise Immunization Requirements for
Pharmacists
Sponsor: Rep. Casey Knudsen (R-Malta)
Status: 2/9/21 hearing; 2/22/21 amended in Committee but vote failed; tabled
in Committee
• Goal was to:
– Expand patient access to vaccines from pharmacists/interns
– Add new immunization authority for pharmacy technicians
– Clarify education and training requirements
– Expand type and age range of immunization provided
– Revise documentation and communication requirements
– Align with current federal COVID-19 immunization authority
• Current status of pharmacist immunization authority remains as
outlined in 37-7-105, MCA, in addition to current federal COVID-19
authorityOther Bills of Interest
• SB 357, Generally revise requirements related to telehealth
Sen. Jen Gross (D-Helena)
– Amends the term “Practice telepharmacy” to “Practice pharmacy by means
of telehealth” as referenced in 37-7-101(39) and 37-7-201(2)(l)(iv)
– Does not impact community pharmacy telepharmacy licensing authority
– 2/26/21 hearing, passed; 3/2/21 passed Senate, transmitted to House
• SR 71. Confirm Governor’s appointees to various health-related boards
Rep. David Howard (R-Park City)
– Includes Board of Pharmacy appointments and timeline of terms:
– Tony King (2025)
– Starla Blank (2024)
– Paul Brand (2024)
– Jeff Nikolaisen (2025)
– 2/10/21 hearing, adopted; 2/20/21 Senate adopted; 2/26/21 Filed with
Secretary of StateOther Topics of Interest
• Scope of Practice
– Proposed changes to healthcare licensing scope of practice laws and rules would be reviewed
by Board of Medical Examiners.
• Physician/Prescriber Dispensing
– Create new dispensing authority for physicians, other prescribers, and naturopathic physicians;
similar to North Dakota authority.
• Insulin Access
– Establish insulin safety net program providing 30-day supply one-time/year; similar to
Minnesota program.
• Drug Price Transparency
– SB 137 and HB 345 tabled in committees.
• PBM licensure/reform
– Montana Pharmacy Association: Working with the State Auditor’s office on licensing PBMs and
enforcing current laws.
NOTE: PBM issues generally relate to drug price transparency, reimbursement, and/or other
pharmacy business issues that are not related to Board of Pharmacy activity or authority. Contact
the Montana Pharmacy Association.Future Rule Topics
Next Proposed Rule
• New device license type, medical gas, prescription transfers, continuing
education programs, drug kits, drug distribution institutional facilities,
definitions, listing of controlled substances, and collaborative practice
Future Rule Topics
• Wholesale drug distributors, third-party logistics providers, repackagers, and
manufacturers
• Facility requirements, endorsements, and inspections
• Compounding, outsourcing facilities, documentation/record keeping, limited
service pharmacies, and others
Subcommittee Topics
• Automated dispensing systems/machines
• TechniciansTHANK YOU
Page 15
Questions
When does MCA 37-7-1515, mandatory MPDR use for prescribers of
opioids and benzodiazepines go into effect?
A. 1/1/2022
B. 7/1/2021
C. It went into effect on 10/1/2019
D. 12/1/2021
Which state did the MPDR most recently connect with for Interstate
Data Sharing?
A. Wyoming
B. California
C. Texas
D. AlaskaPage 16
Questions
When does MCA 37-7-1515, mandatory MPDR use for prescribers of
opioids and benzodiazepines go into effect?
A. 1/1/2022
B. 7/1/2021
C. It went into effect on 10/1/2019
D. 12/1/2021
Which state did the MPDR most recently connect with for Interstate
Data Sharing?
A. Wyoming
B. California
C. Texas
D. AlaskaMontana Prescription Drug Registry (MPDR) Updates 2021 • MPDR Accomplishments • MPDR Stats • New Software Vendor • Next Steps
MPDR Next Steps - Accomplished from 2020
✓ Hire new pharmacist position for MPDR Program Manager
✓ Issue Request for Proposal for a new MPDR system vendor and
migrate to a new online platform
– Improve functionality, provide integration and new clinical tools for
frontline users, increase use, and improve administrative procedures
– Mandatory Use Statute MCA 37-7-1515 effective July 1, 2021.
✓ Collaborate with boards, state agencies, associations, and other
stakeholders on outreach/education
✓ Continue to implement recommendations from Legislative Audit and
engage MPDR Advisory Group
✓ Continue to collaborate on MPDR data research with Department of
Public Health and Human Services and other stakeholdersMPDR New Software Vendor Appriss • Appriss Clearinghouse- Software for prescription dispensation data reported by pharmacies • PMP AWARxE- Software application for searching patient prescription history • NarxCare- Clinical tools available on patient history reports • Gateway- Integration platform
MPDR Enhancements • Patient Profile Matching- Both automated and manual way of consolidating patient profiles (i.e. Robert Jones, Bobby Jones, Robby Jones) • Data Integrity through Appriss Clearinghouse- Ensuring prescription information is valid and pharmacy compliance. • Batch Searching- By manual entry of a patients or upload of spreadsheet • NarxCare Scores and Graphs • Patient Clinical Alerts
NarxCare
NarxCare – Narx Scores
• The last digit of each score represents the number of active
prescriptions of that type. For example, a Narx Score of 504 indicates
the patient should have four active narcotic prescriptions according to
dispensation information in the PMP.
• The scores correspond to the number of literature-based risk factors
that exist within the PMP data. These risk factors include:
• The number of prescribers, pharmacies, amount of medication dispensed (often
measured in milligram equivalencies) and the number of times prescriptions of a
similar type overlap from different prescribers
• The time elapsed for any risk factor serves to decrease its contribution to the score. For
example, 1000 MME dispensed within the last month will elevate the score more than
1000 MME dispensed one year ago.
• The distribution of Narx Scores for patients on controlled substance drug
therapy is approximated as follows:
• 35% score less than 200
• 55% score between 200 and 500
• 10% score more than 500
• 1% score more than 650NarxCare – Narx Scores cont.
• The Narx Scores were designed such that:
• Patients who use small amounts of medication with limited provider
and pharmacy usage will have low scores.
• Patients who use large amounts of medications in accordance with
recommended guidelines (single provider, single pharmacy, etc.) will
have mid-range scores.
• Patients who use large amounts of medications while using many
providers and pharmacies, and with frequently overlapping
prescriptions, will have high scores.NarxCare- Overdose Risk Score
• The number of pharmacies visited per unit
time
• Maximum morphine milligram equivalency
(MME) in the last year
• The number of prescribers in the last two years
• Various slopes of opioid and sedative use
• Various slopes of prescriber usageNarxCare – RX Graph
Clinical Patient Alerts
Clinical Patient Alerts • Prescriber & Dispenser Thresholds • Four or more prescribers and four or more pharmacies in 60 days. • Daily Morphine Milligram Equivalent (MME) Threshold • ≥90 MME/Day • Excludes treatment drugs • Concurrent Opioid and Benzodiazepine Prescriptions
MPDR Next Steps
• Feedback on new software system- Users and MPDR Advisory Group
• Integration through Gateway coming soon
• Electronic Health Records, Health Information Exchange, and
pharmacy dispensing systems
• Veteran Affairs and Military Health Systems
• DPHHS considering potential funding with federal grant dollars
• Mandatory Use Statute MCA 37-7-1515 effective July 1, 2021.
• Continued Outreach and Education to MPDR Users and Data Submitters
• Increase registration, pharmacy compliance auditing, and statisticsResources
Webpage: www.mpdr.mt.gov
MPDR PMP AWARxE Registered User Guide- includes NarxCare
information
MPDR Clearinghouse Data Submission Guide for Dispensers
Montana Statutes and Rules
Contact Information:
Nikki Griffis, PharmD
Program Manager, Montana Prescription Drug Registry
Montana Board of Pharmacy
dlibsdmpdr@mt.gov
406-841-2240You can also read
