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Frequently Asked Questions


General PDMP
Information


Defining "Dispenser"
 


Specialty Dispensers
 


Veterinarians
  


Collecting Data
 


Submitting Data
 


Accessing and
Obtaining Data


Using the Data
 


PDMP Operations
 


Submit a Question 
 

 

 General PDMP Information   Top of Page

Q: What is the Prescription Drug Monitoring Program (PDMP)?

A: The PDMP is a statewide program that collects information about monitored prescription drugs that are dispensed to patients in Wisconsin. The PDMP discloses the information to persons who are legally authorized to obtain the information.

Q: Why does Wisconsin have a PDMP?

A: The legislature passed a law in 2010, 2009 Act 362, that directs the Pharmacy Examining Board (PEB) to create the PDMP through rule. The primary purpose of the PDMP is to improve patient care and safety and reduce the abuse and diversion of prescription drugs in Wisconsin while ensuring patients with a legitimate medical need for the drugs are not adversely affected.

Q: How does the PDMP work?

A: By law, dispensers of monitored prescription drugs are required to collect and submit information to the PDMP about each dispensing of a monitored prescription drug. The PDMP stores the information in a secure database and makes it available to healthcare professionals and others as authorized by law.

Q: What are “monitored prescription drugs?”

A: “Monitored prescription drugs” are defined in the administrative rules developed by the PEB. While the PEB may change the definition in the future, the current list of monitored prescription drugs is:

  • State Controlled Substances in Schedule II, III, IV or V that require a prescription order to be lawfully dispensed
  • Federally Controlled Substances in Schedule II, III, IV or V that require a prescription order to be lawfully dispensed
  • Tramadol, a drug identified by the PEB as having a substantial potential for abuse

Q: Do other states have PDMPs?

A: Forty-nine states, including Wisconsin, either have an operational prescription drug monitoring program or have enacted legislation to establish a PDMP and are in the process of creating one.

Q: Is the PDMP fully operational?

A: As of June 1, 2013, the PDMP is fully operational. This means that dispensers are collecting and submitting data to the PDMP at least every seven days and persons authorized by law may access and submit requests to obtain PDMP data for a legally authorized purpose.

Q: Is the Wisconsin PDMP a “real-time” PDMP?

A: Dispensers, practitioners, and their delegates have “real-time” access to the data stored by the PDMP at any given time. However, dispensers have up to 7 days to submit data after dispensing a monitored prescription drug, which means that the data may be up to 7 days old..

Q: Is the prescriber or dispenser of a monitored prescription drug required to notify the patient that information regarding the transaction is submitted to the PDMP?

A: There is no requirement to notify the patient under the law.

Q: How is the PDMP being funded?

A: The PDMP is currently funded by a Harold Rogers PDMP Implementation grant from the Bureau of Justice Assistance of the U.S. Department of Justice. The grant funds will cover the costs to develop and deploy the PDMP.

Q: Do dispensers or practitioners have to pay anything for the program?

A: Licensees will not see any increase in fees or any separate fees to fund the ongoing operations of the PDMP.

Q: How will the effectiveness of the PDMP be assessed?

A: The primary purposes of the PDMP are to improve patient care and safety and to reduce the abuse and diversion of prescription drugs in Wisconsin while ensuring patients with a legitimate medical need for the drugs are not adversely affected. With that in mind, there are numerous ways in which “success” may be measured, including:

  • Increase in the number of healthcare professionals using the PDMP
  • Reduction in reported rate of current non-medical users of prescription drugs
  • Reduction in reported initiation rate of non-medical users of prescription drugs
  • Reduction in reported rate of prescription drug abuse
  • Reduction in the rate of ER admissions for prescription drug overdose
  • Reduction in rate of prescription drug-related deaths

Q: Will the PDMP offer any kind of referrals to treatment programs for suspected prescription drug abusers?

A: The PDMP provides data to healthcare professionals to enable them make more informed decisions about prescribing and dispensing monitored prescription drugs to their patients or potential patients. Healthcare professionals are encouraged to use the data obtained from the PDMP to improve their treatment of patients, including referring patients to substance abuse treatment, if they choose to do so. 

 


Defining "Dispenser"   Top of Page

Q: Who is required to collect and submit information to the PDMP?

A: Dispensers are required to submit information about each dispensing of a monitored prescription drug. “Dispenser” means all of the following:

  • A pharmacy from where a pharmacist dispenses a monitored prescription drug.
  • A practitioner who dispenses a monitored prescription drug.

Q: Who is the “dispenser,” the pharmacy or the pharmacist?

A: Under the law, the pharmacy from where the pharmacist dispenses the monitored prescription drug is the dispenser and is required to collect and submit the data.

Q: Who is the “dispenser,” the practitioner or the employer/clinic/facility?

A: Under the law, the practitioner is the “dispenser” and is responsible for satisfying the data collection and submission requirements. Practitioners may delegate the task to another person, or the employer/clinic/facility may, as a matter of convenience, collect and submit the data on behalf of the practitioners under its control. The practitioner remains responsible for complying with the law.

Q: Is a healthcare professional a “dispenser” if he or she only prescribes and administers monitored prescription drugs and does not dispense them?

A: No. It is the dispensing and not the prescribing of monitored prescription drugs that triggers the data collection and submission requirements of the law. Further, no information needs to be collected or submitted for monitored prescription drugs that are directly administered to patients. Therefore, practitioners who only prescribe and administer monitored prescription drugs to patients are not “dispensers” and do not have to collect or submit any data to the PDMP.

Q: Do practitioners who never dispense monitored prescription drugs have to complete an application for an exemption?

A: No. Practitioners who do not dispense monitored prescription drugs do not need to complete and submit an application for an exemption from the data submission requirements. Licensees who are authorized to dispense monitored prescription drugs but do not dispense them are not bound by the requirements of the PDMP and do not have to file anything with the PDMP.

Q: What should a dispenser do if it decides to cease dispensing all monitored prescription drugs?

A: Dispensers who have dispensed a monitored prescription drug since January 1, 2013 and thereafter cease dispensing monitored prescription drugs must collect the required data and submit it to the PDMP. Once all of the data is submitted to the PDMP, the dispenser may either submit a zero report for each subsequent reporting period or submit an application for an exemption from the data submission requirements. If the dispenser submits an application for exemption, the exemption will remain valid until the dispenser resumes dispensing or until the dispenser’s license expires, at which time the dispenser may renew the exemption as part of the license renewal process.

Q: Are mid-level practitioners required to comply with the requirements?

A: A practitioner’s designation as a mid-level practitioner does not have any bearing on whether it is a dispenser under the law.

Q: Can unlicensed staff be delegated the task of collecting and submitting the data to the PDMP on behalf of a dispenser?

A: Yes. The law allows dispensers to delegate the task and does not require the delegate to be licensed. It is important to remember that the dispenser, whether a pharmacy or practitioner, remains responsible for complying with the law and the actions of its delegate.
 


Specialty Dispensers   Top of Page

Q: In the case of Emergency Departments that dispense starter packs of monitored prescription drugs, who is the dispenser, the dispensing ER practitioner or the hospital pharmacy?

A: First, it is important to note that all outpatient dispensing of monitored prescription drugs, regardless of quantity, frequency, or dosage form, must be reported to the PDMP. This includes starter packs, samples, and single pills. In the case of Emergency Department dispensing, the dispensing practitioner is responsible for reporting the dispensing to the PDMP, even if the practitioner obtains the monitored prescription drug from the hospital pharmacy. The hospital may, as a convenience, collect and submit data for practitioners under its control.

Q: Do assisted living facilities, skilled nursing facilities (SNF), community based residential facilities (CBRF), or other long term care facilities need to report monitored prescription drugs administered to residents on premises?

A: Under most circumstances, the practitioner administering the monitored prescription drug to a resident does not need to collect and submit data to the PDMP. The pharmacy that dispensed the monitored prescription drug to the resident of the facility is the dispenser and, therefore, is responsible for satisfying the data collection and submission requirements of the law. The law does not exempt retail or community pharmacies that only dispense to a patient receiving hospice care or a resident of an assisted living facility, SNF, CBRF, or another long term care facility.

Q: How are drugs administered to in-patients at a hospital treated differently than those dispensed to residents of an assisted living facility, SNF, CBRF, or other long term care facility?

A: Drugs administered to an in-patient at a hospital have not been dispensed, and, therefore, there is no requirement to report the transaction to the PDMP. Conversely, drugs administered to a resident of an assisted living facility, SNF, CBRF, or another long term care facility likely have been previously dispensed to the resident by a retail or community pharmacy.

Q: What if a SNF, CBRF, or other long term care facility has an on-site pharmacy that is managed by the facility and prepares monitored prescription drugs to be administered to residents of the facility?

A: If the on-site pharmacy prepares drugs to be administered to residents of the facility similar to an in-patient hospital pharmacy that prepares drugs to be administered to an in-patient, the drugs are not considered dispensed prior to being administered. In this situation, the drugs would be returned to stock if they are unused. Therefore, there would be no data collection or submission requirements for these transactions.

Similar to a community or retail pharmacy, the on-site pharmacy must still collect and submit data for all monitored prescription drugs that it dispenses. In this situation, the patient could take the drugs with them if they leave the facility.

Q: Are practitioners practicing at critical access hospitals (CAH) exempt from the requirements?

A: The location at which a practitioner practices does not correspond to whether it is a dispenser. In other words, a dispenser who dispenses from a CAH is bound by the same requirements as a dispenser practicing anywhere else. Similarly, a practitioner who practices at a CAH but does not dispense monitored prescription drugs is not a dispenser.

Q: Are monitored prescription drugs delivered via a virtual pharmacy, such as InstyMeds, “dispensed?”

A: Yes. “Virtual pharmacies” dispense pursuant to a pharmacy’s or practitioner’s license, credential, or permit. Therefore, the dispenser whose license, credential, or permit is being utilized is responsible for complying with the data collection and data submission requirements of the law.

Q: Do mail order pharmacies have to comply with the PDMP requirements?

A: Yes. Any pharmacy dispensing to a patient in Wisconsin must be licensed by the State and is bound by the laws of the State, including the laws governing the PDMP.

Q: Do dispensers who have a Wisconsin license, are not located in Wisconsin, and do not dispense monitored prescription drugs to patients in Wisconsin have to submit data, an exemption application, or zero reports to the PDMP?

A: No.

Q: Is a pharmacy or practitioner that is licensed in another state and dispenses a monitored prescription drug to a Wisconsin resident who is physically located in the other state at the time of dispensing required to report to the PDMP?

A: No. If the pharmacy or practitioner is not licensed in Wisconsin and the patient is receiving the services in another state, there is no requirement to submit data to the PDMP.

Q: How will dispensers be notified of updates to the controlled substances schedules or other monitored prescription drugs?

A: As professionals, dispensers are expected to be aware of updates to both the federal and state schedules of controlled substances. Other changes to the drugs designated as “monitored prescription drugs” can only occur through the rule-writing process, which includes many mechanisms and requirements for public notice.

Q: How should pharmacies that do post-consumption billing for medications due to short-cycle requirements submit data to the PDMP?

A: The law requires dispensers to submit data or a zero report to the PDMP every 7 days regardless of the dispenser’s billing or other business practices.

Q: Do monitored prescription drugs supplied to a patient for the time the patient is on PASS need to be reported to the PDMP?

A: Yes. Monitored prescription drugs given to patient while the patient is on PASS are dispensed because they are not directly administered to the patient. Therefore, the dispenser must collect and submit data to the PDMP about the dispensing.

Q: Does a practitioner who stores and periodically delivers monitored prescription drugs to a patient as part of a Community Support Program need to report the transaction to the PDMP if a pharmacy originally dispensed the drugs to the practitioner’s facility/office for safekeeping?

A: No. If a pharmacy dispensed the drugs, the pharmacy is the dispenser and must report the dispensing to the PDMP.

Q: Does a practitioner who gives medications to patients as part of a Patient Assistant Program through which a pharmacy, drug manufacturer, or wholesaler delivers monitored prescription drugs to the practitioner need to report the transaction to the PDMP?

A: If a pharmacy filled the prescription and dispensed the drug, the pharmacy, and not the practitioner, is considered the dispenser and must report the dispensing of the monitored prescription drugs to the PDMP. If, however, the practitioner receives the monitored prescription drugs directly from the drug manufacturer or wholesaler and dispenses the drugs to the patient, the practitioner is considered the dispenser and must report data to the PDMP.

Q: What are the implications for federal Indian Health Services (IHS) and Tribal pharmacies that are not currently licensed by the State?

A: As in other states, IHS pharmacies and dispensers, Tribal pharmacies, and other Tribal dispensers may voluntarily participate in the PDMP. DSPS intends to work in partnership with IHS and individual sovereign Tribes who wish to participate in the PDMP to enable them to do so. As of September 19, 2013, the Department has signed a memorandum of understanding with the following Tribes to enable their participation in the PDMP:

  • Bad River Band of Lake Superior of Chippewa
  • Lac Courte Oreilles Band of Lake Superior Chippewa
  • Lac du Flambeau Band of Lake Superior Chippewa
  • Red Cliff Band of Lake Superior Chippewa
  • Stockbridge-Munsee Community

Q: What are the implications for pharmacies operated by or practitioners employed by the federal Department of Veterans Affairs (DVA)?

A: For some time, DVA healthcare professionals have obtained information from PDMPs. In December 2011, federal law was amended to allow DVA dispensers to submit information to PDMPs pursuant to rules promulgated by DVA. See 
38 U.S.C. 5701 (l). On February 11, 2013, DVA issued interim final rules which allow the DVA dispensers to share dispensing data with state PDMPs. The information about the interim final rules is available here
 


Veterinarians   Top of Page

Q: Are veterinarians “dispensers?”

A: No. Pursuant to the statutory changes in 2013 Act 3, veterinarians are not dispensers as it is defined for the statute enabling the creation of the PDMP. The statutory changes take precedence over the administrative rules, even the provisions specifically intended for veterinarians. Therefore, veterinarians are not bound by the regulations governing the PDMP, do not have to collect data, and do not have to submit data to the PDMP. The Pharmacy Examining Board is considering amendments to the administrative rules to make them compliant with the statutory changes.

Q: Do veterinarians have to submit the data that they have collected since January 1, 2013?

A: No. Veterinarians are not required to submit the data that they have collected since January 1, 2013.

 


Collecting Data   Top of Page

Q: When did dispensers need to begin collecting data?

A: January 1, 2013.

Q: Do dispensers need to collect any data from before the effective date of the law, January 1, 2013?

A: No. Dispensers do not have to retroactively collect information from before January 1, 2013.

Q: What information do dispensers need to collect?

A: Dispensers need to collect specific information about themselves, the patient, the prescriber, and the drug for each monitored prescription drug that they dispense.

Q: “Dispense” is defined, in relevant part, as “to deliver a prescribed drug . . . to an ultimate user . . . by or pursuant to the prescription order of a practitioner, including the compounding, packaging or labeling necessary to prepare the prescribed drug or device for delivery.” What does “by or pursuant to the prescription order of a practitioner” mean?

A: “By or pursuant to the prescription order of a practitioner” means that the dispensing of the monitored prescription drug occurs after and in compliance with the order of a practitioner. By definition, monitored prescription drugs require a prescription order to be dispensed. Therefore, all monitored prescription drugs are prescribed and then dispensed. It is the dispensing, and not the prescribing, that triggers the data collection and submission requirements of the law. This means that practitioners who only write prescriptions for and do not dispense monitored prescription drugs are not required to collect and submit data to the PDMP. Conversely, practitioners who write prescriptions for and dispense monitored prescription drugs are required to collect and submit data regarding each dispensing of a monitored prescription drug to the PDMP.

 


Submitting Data   Top of Page

Q: Can dispensers submit data to the PDMP?

A: Yes.

Q: How often do dispensers need to submit data to the PDMP?

A: Dispensers are required to submit data to the PDMP within 7 days of dispensing a monitored prescription drug. Dispensers are encouraged to submit data as soon and as often as they like.

Q: How can I submit data to the PDMP?

A: Please consult the Dispenser’s Implementation Guide

for an explanation of the data collection and submission requirements and step-by-step guides to submitting data to the PDMP using the approved methods.

Q: Who should I contact if I have technical questions about submitting data to the PDMP?

A: Please contact the Health Information Designs Wisconsin PDMP Help Desk at:

E-Mail: wipdmp-info@hidinc.com

Phone: 1-855-729-8918

Q: If dispensers know in advance that they  will not be dispensing for an extended period longer than seven days, must they still submit a zero report every seven days?

A: A dispenser may submit a zero report for the period during which he or she will not be dispensing monitored prescription drugs. For example, prior to the beginning of an extended vacation, dispensers may submit one proactive zero report for the entire period during which they will not be dispensing while on vacation. The process to submit a proactive zero report for future dates is the same as it is for submitting a weekly zero report.

Q: Does submitting information to the PDMP violate the Health Insurance Portability and Accountability Act of 1996 (HIPAA)?

A: No. HIPAA regulations state that health care providers may disclose protected health information without patient consent if the disclosure is mandated by statute or regulation. Reporting to the PDMP is required by s. 450.19 (2) (a), Stats., and s. Phar 18.05 (1). Therefore, dispensers do not violate HIPAA by disclosing to the PDMP protected health information without patient consent.
 


Accessing and Obtaining Data   Top of Page

Q: Who can access the data?

A: Under s. Phar 18.09, only dispensers, practitioners, and their delegates are able to access the data directly. Under s. Phar 18.11, other users, such as patients, patient delegates, healthcare review organizations, federal and state agencies, DSPS investigatory staff, medical examiners, researchers, and law enforcement authorities, must submit requests for information and provide proof that the information is for a legally authorized purpose.

Q: Can dispensers and practitioners delegate to another person the task of accessing and querying the PDMP for patient data?

A: Yes. Under the law, dispensers and practitioners may delegate the task of accessing and querying the PDMP for information. However, the licensed dispenser or practitioner has to verify the delegation and remains responsible for the delegate’s use of the PDMP.

Q: Can a practitioner query the system using his or her identification information to determine if someone may be fraudulently prescribing drugs using his or her information?

A: Yes.

Q: Can law enforcement agents or agencies obtain data from the PDMP? 

A: Under s. Phar 18.11, law enforcement authorities must provide “a lawful order of a court of record” or provide “evidence satisfactory to the PEB that the law enforcement agency is entitled to the information” to submit requests for data. The other evidence must demonstrate that the information is for purposes allowed under s. 146.82 (2) (a) 11., Stats.

Q: What information should be included in a "lawful order of a court of record"? 

A: Under s. Phar 18.11, the law enables the PEB to disclose PDMP data to a law enforcement officer pursuant to “a lawful order of a court of record.” Therefore, all lawful orders of a court of record will be considered and reviewed for legal sufficiency prior to the disclosure of PDMP data. In order to process a request, the following information should be in a court order accompanying a request from a law enforcement officer:

  • First Name of patient(s)/prescriber(s)/dispenser(s)
  • Last Name patient(s)/prescriber(s)/dispenser(s)
  • Date of Birth of patient(s)
  • Alias/alternate names and dates of birth of the patient(s) included in the request
  • DEA # of prescriber(s)/dispenser(s), if available
  • Date range of data for the request
  • The time period during which the request may be renewed for updated information, if applicable

Q: Does the Wisconsin PDMP blind data that can be used for research purposes?

A: Yes. Upon request through the Researcher Query Page, the PDMP will provide researchers with specific de-identified information.

 


Using the Data   Top of Page

Q: What should a prescriber or dispenser do if they think data from the PDMP indicates that a patient is abusing prescription drugs?

A: Data obtained from the PDMP may be used to make more informed decisions regarding the care given to a patient. However, data from the PDMP is not 100% accurate and should not be the only source of information considered when determining if a patient may be abusing prescription drugs. It is just one piece of information that should not be used in isolation to determine whether a patient is abusing drugs. For information about substance abuse and treatment options, please visit the Wisconsin Department of Health Services’ Substance Abuse Services website.

Q: How can practitioners, patients, or anyone else dispute the information about them stored by the PDMP?

A: Patients or healthcare professionals who believe they have identified an error should ask the pharmacy or dispenser that submitted the data to correct the error. Only the pharmacy or dispenser that submitted the information can correct the error.

Q: Can prescribers or dispensers share PDMP reports with patients?

A: Yes. However, note that PDMP reports contain DEA numbers and other potentially sensitive information. The Board cautions against giving printed reports to patients. Patients wishing to obtain a copy of their report must appear in person at the Wisconsin Department of Safety and Professional Services.

 

PDMP Operations   Top of Page

Q: Is the PDMP an online program and how long does it take for a prescriber to get data about a patient query of the system?

A: It will be online. Dispensers and practitioners are able to query the system in “real-time.”

Q: What is the process for sanctioning individuals for failure to meet PDMP requirements?

A: All disciplinary decisions regarding an individual’s failure to satisfy PDMP requirements and breaches of confidentiality will be made by the board that has jurisdiction over the individual. Additionally, breaches of state and/or federal confidentiality laws may be referred to the Wisconsin Department of Justice or another agency for further action.

Q: Is the data stored by the PDMP secure and confidential?

A: Yes. The information stored by the PDMP is protected as protected health information under the HIPAA “Privacy Rule” and as confidential health care records under the law. Therefore, only authorized individuals will be able to obtain information from the PDMP. Further, the information is explicitly not subject to state open records laws. 

Q: Is there a mechanism for dispensers or practitioners to request data across state lines?

A: The PEB moved to request the DSPS join the National Association of Boards of Pharmacy (NABP) PMP InterConnect to share data with other state prescription monitoring programs.

Q: Is there an online training program for prescribers to take as part of their registration to utilize the program?

A: In May 2012, the National Association of State Controlled Substances Authorities awarded a grant to DSPS to create interactive e-learning tutorials about the PDMP. The tutorials will be available on-demand to train users on how to submit data to and how to obtain information from the PDMP. Completion of the tutorials is not required in order for practitioners and dispensers to access data stored by the PDMP.

Q: Can I request in-person training on how to use the PDMP for my organization?

A: Yes. Requests for in-person training and presentations about the PDMP may be submitted to DSPS at PDMP@wisconsin.gov. In the request, please include possible dates and times, the desired location of the event, audience type (dispensers, practitioners, administrators, etc.), and anticipated audience size.


This project was supported by Award No. 2011-PM-BX-0006 awarded by the Bureau of Justice Assistance, Office of Justice Programs. Points of view or opinions in this document are those of the author and do not necessarily represent the official position or policies of the U.S. Department of Justice.