Tennessee. Contact Information. State Registrant Totals and Population. PDMP name: CSMD

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1 Statistics website: Bess, D. Todd - Director, CSMD Program 665 Mainstream Drive Nashville TN Office: (615) Fax: david.bess@tn.gov Tennessee PDMP name: CSMD PDMP region: South Agency responsible: Tennessee Department of Health, Tennessee Board of Pharmacy Agency type: Pharmacy Board PDMP csmd.admin@tn.gov PDMP website: Enrollment website: Query website: Data upload website: Contact Information Sanford, Debora - Clinical Application Coordinator Mainstream Drive Nashville TN Office: (615) Fax: debora.sanford@tn.gov State Registrant Totals and Population Statistics year: 2017 DEA registered prescribers: 34,898 State population: 6,782,564 DEA registered dispensers: 1,758

2 Prescriber access to patient history Prescriber access to own history Prescriber access to patient query history Prescriber access to registrant query history Licensing Board access to patient history Licensing Board access to licensee history Licensing Board access to patient query history Licensing Board access to registrant query history Summary data on/with patient reports Customized reports by user type Peer comparison reports PDMP annual reports Data dashboards Other types of reports: PDMP Available Reports Dispenser access to patient history Dispenser access to own history Dispenser access to patient query history Dispenser access to registrant query history Law Enforcement access to patient history Law Enforcement access to prescriber history Law Enforcement access to dispenser history Law Enforcement access to patient query history Law Enforcement access to registrant query history Statewide statistics Lost/stolen prescription information Drug trend reports Geomapping of prescription data Prescriber report cards Reports that Supervisors can run to monitor anyone they supervise. In addition to identifying high volume prescribers, beginning July 1, 2017 and annually thereafter, the department of health shall identify the prescribers who are in the top 20% of prescribers of opioids for the prior year and, further, that the department shall use the PMP to make the identification PDMP Budget and Staffing Source of Funding and Percent of Total State general fund Licensing fee Controlled substance registration fee Regulatory board fund Agreed settlement Harold Rogers grant CDC grant SAMHSA grant NASCSA grant Other funding Staff Category and Number of FTEs Total Staff: 7.00 # of employees - Operational: 5 # of employees - Technical: 1 # of employees - Analytical: 1 # of employees - Other: 0

3 Reporting frequency: 1 business day Policies and Procedures Legislation enacted: PDMP operational: Initial user access: January 2007 Statute website: Statute citation: TN Code to -311; Regulation citation: TN Comp Regs to.04; Dr shopper statute: TENN. CODE ANN Pill mill statute: Relevant Statutes and Rules Pain clinic statute: Tenn. Code Ann to -314; 2016 Public Chapter 1033; 2016 Public Chapter 829 Disclosure statute: TN Code Opioid guidelines: Key PDMP Dates On-line access: January 2007 Electronic reporting: Data Monitored or Accessible Reporting frequency for veterinarians: Require zero-reporting? Zero-reporting frequency: Daily 14 days Schedule II controlled substances Schedule III controlled substances Schedule IV controlled substances Schedule V controlled substances Authority to monitor other substances Removed from monitoring Naloxone administering information Collectors: Law Enforcement Agency, Emergency Medical Services Reporters: Law Enforcement Agencies Naloxone dispensing information Collectors: Reporters: Marijuana data Collectors: Reporters: Marijuana data available in PDMP Opioid-related drug overdoses or deaths Reporters: Tennessee Department of Health Registrant's disciplinary history/status Patient lock-in information Lost/stolen prescription drug reports Arrest/conviction data ARCOS data Drug manufacturers or distributors data Frequency of reporting: Access method: Data elements: Reciprocal agreements with external data sources: Tennessee Department of Health

4 Mandatory E-Prescribing (EPCS) Payment method captured Patient ID required to be presented to dispenser Patient ID captured ID of person dropping off captured ID of person picking up captured Ability to identify prescriber specialty Patient consent required before data release Required notification to patients Mandated use of advisory group Number of delegates allowed Required enrollment - Prescriber Required use - Prescriber 2 unlicensed; n Frequency unsolicited alerts/reports generated: Delivery method for unsolicited alerts/reports: Veterinarian access to owner's prescription history Criteria for veterinarian queries: Patient access to query list details: Requirements for patients to get own report: Miscellaneous Capabilities and Policies Animal's Name Required PDMP Enrollment and Use Required enrollment - Dispenser Per Tennessee Public Chapter 1002 in 2016 and Public Chapter 1039 in 2018 Required use - Dispenser Ability for users to set thresholds for alert notices Ability for users to do user-led alert notices Ability to search for multiple patients in one query Maximum number of patients in one query: 100 Supervisor review/audit of delegate accounts Ability to de-identify data Authority to release de-identified data Authority to release for epi or educational purposes Engaged in release for epi or educational purposes Healthcare practitioners shall query the PDMP at the beginning of each new episode of treatment and at least annually when that controlled substance remains part of the treatment; when dispensing a controlled substance, all healthcare practitioners shall query the PDMP prior to dispensing certain controlled substances to the patient for the first time at that practice site and at least once every twelve months after the initial dispensing; before prescribing or dispensing, a healthcare practitioner shall query the PDMP if the practitioner is aware or reasonably certain that the person is attempting to obtain a Sch. II V controlled substance for fraudulent, illegal, or medically inappropriate purposes. Nonresidential officebased opiate treatment facilities shall query the PMP upon every visit of the patient with a program physician. Requires medical director of pain management clinic to query the PMP at a minimum upon each new admission and once every six months thereafter. Authority to enforce PDMP mandates: Regulatory/Licensing Board Unsolicited alerts to practitioners not enrolled in PDMP Their provider is allowed to release a report from their medical record

5 Automatic enrollment with license renewal or application PDMP Accounts Enrollment method: Go to URL and choose register and appropriate user type and enter the required information identified by red "*" and hit "Submit". Required information varies by user type. If all information is validated the system automatically sends a user name and temporary password to enter the CSMD. Prescriber account criteria: Dispenser account criteria: Regulatory Board account criteria: Law Enforcement account criteria: Active investigation Subpoena Court order/approval Other: Registration requires: DEA Registration number, TN professional license number, driver s license number, address, phone and other demographic information and personal information Registration requires: TN professional license number, and driver s license number and other personal and demographic information Access is determined by TN law Law Enforcement does not have direct access to CSMD Law Enforcement Requirements Probable cause Search warrant Proper need/upon request Law Enforcement Access Methods On-line/web portal Written request Other method: Minimum data elements: First Name, Last Name, Date of Birth Partial data elements: Optional data elements: Data retention policy All information purged Record retention details: De-Identified data retention details: Training website: Prescriber Dispenser Law Enforcement Regulatory Board Available Training Prescriber information purged Dispenser information purged Attorney General Patient Researcher Criteria to Query PDMP Partial search only allowed within TN PMP, if other states chosen then partial search will return no data to the user. Partial Search of first name would allow one letter and partial search of last name is one letter but DOB is required Middle Name, Gender, Street, City, State, Zip can also be included in the search criteria Data Retention PDMP Requestor Training Prescriber Dispenser Law Enforcement Regulatory Board Patient information purged Drug information purged Training Required Before PDMP Use Attorney General Patient Researcher Other Retain de-identified data Retention time: 1 year Recently passed legislation is minimum of 1 year but can be longer prior to this there was no provision to purge. TN will be looking to put policies in place on data retention.

6 ASAP Versions Accepted ASAP 1995 ASAP 1997 ASAP 3/2005 ASAP 4/2007 ASAP 4-1/2010 ASAP 4-2/2011 Technological Capabilities Electronic data transmission Fax data transmission Other Data Transmission Methods Allowed Mail data transmission Media data transmission Pharmacy in-state Pharmacy out-state/mail order Pharmacy out-state/other Dispensing doctor Veterinarian Veterans Administration Indian Health Services Other: Required Data Transmitters Data collection entity: Vendor Vendor name: Appriss Data storage entity: Vendor Vendor name: Appriss Report generation entity: Vendor Vendor name: Appriss Data access entity: Vendor Vendor name: Appriss Data access method: Web Portal/On-Line Data Collection, Storage, Generation and Access Interstate Data Sharing PMPi Hub RxCheck Hub HIE method Jurisdictions engaged AL, AR, IL, KY, LA, MI, MN, MS, NC, ND, OH, SC, TX, VA, WV Impediments: via Health Information Exchange via Electronic Health Record via Pharmacy Dispensing System Exact match Probablistic match Probablistic/manual match Impediments Impediments: Impediments: Data Integration Patient Matching Department of Defense Other match method for queries TN offers a list of patients for healthcare providers to select appropriate patients to include in the report. An option to select "None of These" is offered if the patients listed are not the healthcare providers patient. Certified as CMS Specialized Registry Require information on e-prescriptions User-friendly interfaces Miscellaneous Data analysis software Online user guides/educational materials

7 Healthcare Regulatory Law Enforcement Public and Private Insurers Other Requestors and Reports Authorized to Generate Requestor Type Prescriber Dispenser/Business (i.e., pharmacy) Dispenser/Person (i.e., pharmacist) Midlevel - Physician Assistant Midlevel - Nurse Practitioner Prescriber Delegate (licensed) Dispenser Delegate (licensed) Prescriber Delegate (unlicensed) Dispenser Delegate (unlicensed) Medical Residents Interns Medical Facility/Institution Patient Drug Treatment Provider Licensing/Regulatory Board State Health Department Peer Review Committee Law Enforcement - Federal Law Enforcement - State Law Enforcement - Local Prosecutorial Authority Correctional Supervision Medical Examiner/Coroner Drug Court Medicaid Fraud and Abuse Medicaid Drug Utilization and Review Medicare Workers Compensation - State Workers Compensation - Insurance Third-party Payer Researchers Marijuana Dispensary Other PDMP Solicited Reports Unsolicited Reports In-State Out-of-State In-State Out-of-State

8 Healthcare Regulatory Law Enforcement Public and Private Insurers Other Requestors and Reports Being Generated Requestor Type Prescriber Dispenser/Business (i.e., pharmacy) Dispenser/Person (i.e., pharmacist) Midlevel - Physician Assistant Midlevel - Nurse Practitioner Prescriber Delegate (licensed) Dispenser Delegate (licensed) Prescriber Delegate (unlicensed) Dispenser Delegate (unlicensed) Medical Residents Interns Medical Facility/Institution Patient Drug Treatment Provider Licensing/Regulatory Board State Health Department Peer Review Committee Law Enforcement - Federal Law Enforcement - State Law Enforcement - Local Prosecutorial Authority Correctional Supervision Medical Examiner/Coroner Drug Court Medicaid Fraud and Abuse Medicaid Drug Utilization and Review Medicare Workers Compensation - State Workers Compensation - Insurance Third-party Payer Researchers Marijuana Dispensary Other PDMP Solicited Reports Unsolicited Reports In-State Out-of-State In-State Out-of-State