WI Health News

The Controlled Substances Board modified rules regarding the use of the Prescription Drug Monitoring Program to align with a recently approved change to the state budget, but rejected other proposals from health systems and doctors.

The proposed rule and emergency rule involve the implementation of laws that recently went into effect, including a requirement that prescribers review patient records before prescribing a controlled substance.

The board approved changes Friday clarifying that prescribers can delegate review of a patient's record and that the board would only refer prescribers to an appropriate law enforcement agency if it determines a criminal violation occurred.

Both changes square with a motion approved by the Legislature's Joint Finance Committee last week. They were also requested by the Wisconsin Medical Society and Wisconsin Hospital Association at the public hearing.

"There's always room for improvement," Mark Grapentine, the society's vice president of government relations, told board members.

But the board pushed back against recommendations to provide more specifics on what has to be contained in a record to satisfy the review requirement. 

Matthew Stanford, the hospital association's general counsel, said they've heard from members who are concerned there isn't a list of information that is required to be in a record that has to be reviewed.

"It's both an issue of regulatory clarity but then where that ultimately becomes a bigger issue is when you start thinking about integrations and options for integration," he said. Having more clarity could help electronic health record vendors connect with the program, he said. 

Board member Dr. Tim Westlake said that, as a prescriber, he didn't want "a checklist of all this."

"I could see this as becoming burdensome," he said. The board decided not to change its current definition of review.

Other speakers at the public hearing raised concerns about the integration of electronic health records with the program. 

Wisconsin Statewide Health Information Network CEO Joe Kachelski said the process to connect with the updated Prescription Drug Monitoring Program, which was launched in January, has been "a little bit bumpy."

"Our validation processes have revealed some substantial data quality completeness issues," he said. "Although we have worked through many of them, some of them do remain."

The board requested the Department of Safety and Professional Services work on ways to better facilitate health system and user adoption of the new version of the program.