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Military Health System Prescription Drug Monitoring Program Procedures

Overview

The misuse and diversion of opioids and other controlled substances continues to result in addiction and deaths across the United States. An essential tool in fighting this epidemic has been implementing and using Prescription Drug Monitoring Programs (PDMPs).

PDMPs track controlled substance prescription information to include: drug name and strength, quantity, prescriber, pharmacy, and payment type. These programs aim to protect public health and safety, assist providers and pharmacists in identifying potential prescription medication misuse, and aid in preventing drug diversion.

The Military Health System (MHS) PDMP is an electronic database that collects prescription data on controlled medications dispensed to TRICARE beneficiaries within the MHS.

The goal of the MHS PDMP is to ensure a patient's complete controlled substance medication history is available to a prescriber or pharmacist regardless of where the medication is prescribed or dispensed (purchased/civilian care) or how the medication was paid for (via insurance, credit, or cash).

In accordance with 10 USC 1074(g): Pharmacy benefits program, the MHS PDMP enhances the management of prescribing opioids and supports providers in:

  • Accessing the legitimate medical use of prescribed controlled substance medications;
  • Identifying, deterring, or preventing drug misuse and diversion; and
  • Recognizing patients who may be engaging in misuse of prescribed controlled substance medications and offering intervention and treatment.

Background

The Defense Health Agency (DHA) recognizes the need to share dispensing information of controlled substance medications at military pharmacies with civilian providers to ensure that a patient's complete controlled substance medication history is available to a prescriber or pharmacist regardless of where or how the patient had the prescription filled.

In January 2019, the MHS entered an agreement with the National Association of Boards of Pharmacy (NABP) to establish a connection with their Prescription Monitoring Program (PMP) Interconnect® SystemNABP PMP InterConnect, which allows for the transfer of prescription data across state lines. The MHS PDMP is the first non-state or territory PDMP permitted to become a part of NABP's Interconnect® System.

The DHA is committed to building a PDMP that connects with every state or territory. Each state or territory can decide if they only want to access (one-way sharing) or share (bi-directional sharing) their prescription data with the MHS PDMP.

The MHS PDMP is administered by the current TRICARE Pharmacy contractor, Express Scripts, Inc. They are responsible for validating and registering credentialed MHS providers and pharmacists, as well as their delegates. They are also responsible for updating the MHS PDMP data and ensuring data integrity.

Registration

Registration is required for many MHS providers and pharmacists.

MHS PDMP users will register with the required information:

  1. Government email (.mil or .gov)
  2. NPI number
  3. License number (or National Commission on Certification of Physician Assistants (NCCPA) for non-state licensed Physician Assistants)
  4. State of licensure (noted as home state when registering for the MHS PDMP)
  5. User Role (see Frequently Asked Questions for role descriptions and which roles are required to register)

Register for MHS PDMP

Other registration requests:

  1. MHS PDMP registration is not open to military law enforcement, public health officials, or veterinarians.
  2. Requests for MHS PDMP information may be submitted to the MHS PDMP Administrator for further processing in conjunction with the DHA legal department.

User Registration Process Tutorial

Heat Map

Heat Map


Frequently Asked Questions

Questions and Answers about the Prescription Drug Monitoring Program

Q1:

What roles are available in MHS PDMP?

A:

There are eight different roles that MHS staff can register for:

  1. MHS Prescriber with NPI number - licensed, credentialed, and privileged staff who are authorized to prescribe controlled substances for outpatient use, including, but not limited to, doctors of osteopathy, doctors of medicine, doctors of dental surgery, doctors of podiatric medicine, and nurse practitioners
  2. Physician Assistants - licensed (or NCCPA certified), credentialed, and privileged Physician Assistants who are authorized to prescribe controlled substances for outpatient use
  3. MHS Pharmacist with NPI number - all pharmacists (outpatient, inpatient, and clinical) with a NPI number; pharmacists without a NPI number may register as a MHS Pharmacy delegate
  4. Optometrist - optometrists that are licensed, credentialed, and privileged to prescribe controlled substances for outpatient use
  5. Psychologists - psychologists that are licensed, credentialed, and privileged to prescribe controlled substances for outpatient use
  6. Medical Interns - interns and residents with a doctor of medicine or doctor of osteopathy degree, but not licensed, credentialed, and privileged to prescribe independently
  7. Pharmacy delegate - pharmacy technicians or pharmacists without a NPI number
  8. Prescriber delegate - all other staff, to include, but not limited to, corpsmen, independent duty corpsmen, independent medical corpsman, registered nurses, midwives, or other medical staff that cannot register in the MHS PDMP as of the provider roles
Q2:

What roles are required to register in the MHS PDMP?

A:

MHS Prescribers with NPI, Physician Assistants, and MHS Pharmacists with NPI are required to register in the MHS PDMP, regardless of location (CONUS or OCONUS).

Q4:

What do I do if the state my MTF is in is not sharing with the MHS PDMP?

A:

In accordance with DHA-Procedural Instruction 6010.02, providers and pharmacists may apply for access to the state or territory PDMP for which the MTF is located. Providers and pharmacists should consult with servicing legal counsel regarding state or territory PDMP terms and conditions, or other requirements, that may cede disciplinary authority to the state or territory.

Q5:

Am I required to utilize the MHS PDMP, and if so, how often?

A:

In accordance with DHA Procedural Instruction 6010.02, Military Health System Prescription Drug Monitoring Program, providers and pharmacists are required to conduct a PDMP search to the greatest extent possible when there is a suspicion of patient misuse or diversion.

Providers are recommended to check the MHS PDMP:

  • When the patient is new to the provider and a DEA Schedule II-IV controlled substance is prescribed
  • When a new or renewal DEA Schedule II-IV controlled substance is prescribed for an acute condition
  • No less frequently than every 3 months when prescribing controlled substances

Pharmacists, or pharmacy delegates, should check the MHS PDMP when processing a new or renewed DEA Schedule II-IV prescription except:

  • When the quantity is prescribed for a 72-hour or less supply
  • When the prescription is for a patient under the care of an oncologist or for a terminal patient who has discontinued curative treatment
  • At the discretion of the pharmacist based on the patient’s consistent therapy, consistent provider (or provider team), and on-time controlled substance prescription filling

Providers and pharmacists should check the MHS PDMP when a beneficiary is restricted as part of the Prescription Monitoring Program. This includes:

  • MHS GENESIS Sole Provider Alert for providers who intend to prescribe a restricted medication
  • “LOCKED IN” warning of at the time of prescribing in AHLTA
  • Pharmacy warning (in CHCS) or reject (in MHS GENESIS) indicating the beneficiary is locked into a prescriber or pharmacy
Q7:

When I register for my MHS PDMP account it asks for my home state, what should I enter for this field?

A:

When registering for your MHS PDMP account please enter the state of your active professional license in the "Home State" field.

Q8:

What can I do as a MHS PDMP user?

A:
  • View your patient's controlled substance prescription history by submitting a Patient Request.
  • Select from a broad list of states to include prescriptions paid with cash or processed under other health insurance.
  • Approve a delegate to assist with review of your patient reports.
  • Use the bulk patient report function to expedite review.
  • View your prescribed controlled substance history using your NPI within the MyRx report function.
  • Access the MHS User Guide for help navigating the system; under Menu, click AWARxE User Guide.
Q9:

Who do I contact with PDMP registration and utilization questions?

A:

Contact the Express-Scripts Prescription Drug Monitoring team at mhspmp@express-scripts.com.

Q10:

Who do I contact with technical issues?

A:

For technical support, contact 1-833-275-2050 or submit a new request.

Q11:

How is the prescription data of TRICARE beneficiaries protected within the MHS PDMP?

A:

The MHS PDMP is a secure, confidential, and data-encrypted database that requires user authentication before granting access. Similar to other health care data, prescription data within the MHS PDMP is subject to the Health Information Portability and Accountability Act (HIPAA) and is only accessed by authorized users during their professional duties. Furthermore, it complies with the federal standards set by NIST 800-53.

Q12:

How does the MHS PDMP differ from PMP?

A:

The MHS PDMP is a web-based search tool similar to state PDMPs. The Prescription Monitoring Program is a tool internal to the Military Health System used to identify (and if necessary restrict) patients who potentially have "drug seeking behavior." The TRICARE Pharmacy contractor provides monthly and quarterly PMP reports to specified MTF points of contact, as well as Managed Care Support Contractors, per the TRICARE Operations Manual.

Q13:

When did the MHS PDMP begin sharing data?

A:

The MHS PDMP began pushing out data on Dec. 20, 2018. On Jan. 16, 2019, Virginia became the first state to share its data with the MHS.

Q14:

What states are currently sharing their data?

A:

Refer to the current status sharing map above.

Q15:

Who will have access to the prescription data within the MHS PDMP?

A:

Civilian providers who practice in states that have agreements with the Department of Defense will be able to access MHS PDMP data as long as they’re authorized in their state.

Q16:

As a health care provider how do I validate information I may have a question on that is within the PDMP?

A:

Health care providers and pharmacists will need to contact the health care provider who issued the prescription of question, as noted within the PDMP.

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Last Updated: March 27, 2024
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