Bill Would Allow State Medicaid Program to Access Prescription Monitoring Data
TRENTON – Legislation sponsored by Senator Patrick J. Diegnan Jr. that would expand access to the New Jersey Prescription Monitoring Program (NJPMP) cleared the Senate Health, Human Services and Senior Citizens Committee today.
The bill, S-2795, would require the Division of Consumer Affairs to provide online access to the NJPMP to a designated representative of a carrier that provides coverage for prescription drugs and any third-party administrator or pharmacy benefit manager that administers a pharmacy benefit.
The bill would also provide online access to the Director of the Division of Medical Assistance and Health Services and the Commissioner of Human Services, or their designees, for the purpose of identifying whether a recipient of benefits under the Medicaid program, NJ FamilyCare program, or any other person is obtaining a prescription in a manner that may be indicative of misuse, abuse, or diversion of a controlled dangerous substance or a violation of law or regulation or a breach of standards of practice.
“Across the country, nearly 15,000 people die every year as a result of a prescription painkiller overdose. That’s about 40 people every day,” said Senator Diegnan (D-Middlesex). “This bill addresses one shortcoming of the prescription monitoring program that has been vital in the fight against prescription drug abuse and diversion.”
The NJPMP is an electronic system operated by the state to monitor controlled dangerous substances dispensed in outpatient settings. It is available to all licensed healthcare practitioners authorized by the state to prescribe or dispense CDS medications, and shares data with seven other state PMP programs for the purpose of halting the abuse and diversion of prescription drugs.
Currently, the NJPMP does not voluntarily share prescription data with other programs such as the state’s Medicaid program or third-party insurance companies that administer private or state prescription drug plans. Access to NJPMP data to state Medicaid officials is allowable only for bona fide investigations under current statute.
The bill, which would require the sharing of prescription monitoring data with the State Medicaid program and certain other insurers, is based on a recommendation that was included in a report by the Office of the State Auditor in the Office of Legislative Services, issued September 13, 2016.
According to the report, 1.1 million NJPMP prescription records dispensed in May 2015 showed 1,267 Medicaid patients had at least one CDS filled prescription paid in cash while filling other CDS prescriptions with Medicaid insurance. In calendar year 2015, New Jersey Medicaid expended $122 million in CDS prescriptions, but since the state’s Medicaid officials do not have full access to the NJPMP data for its Medicaid recipients, they have no way of detecting any additional prescription abuse patterns.
“Expanding access to the information provided in the prescription monitoring program will help save lives in New Jersey,” added Senator Diegnan.
According to the National Alliance for Model State Drug Laws, there are 14 states which allow less restrictive access by the state’s Medicaid program to its own Prescription Monitoring Program for the records of its recipients.
The bill cleared the Senate Health Committee by a vote of 7-0. It next heads to the full Senate for consideration.