By Dan Schulte, J.D.
MDA Legal Counsel
From the October 2013 issue of the Journal
Question: I was contacted by an investigator for the Michigan Department of Licensing and Regulatory Affairs. Apparently, a new patient of mine has gotten controlled substance prescriptions from three MDs over the last year or so. Not knowing this, I prescribed a controlled substance for pain as part of my treatment of this patient. How can this happen? What could I or should I have done to not have become a part of this?
Answer: This is an all-too-common scenario, one that has occurred a great deal for a very long time. Patients (as a result of necessary medical treatment or otherwise) become addicted to one or more controlled substances. Instead of buying the drugs on the street, they sometimes “doctor shop” and/or take advantage of opportunities to obtain as many new prescriptions/refills as they can. Alternatively, the patient may not be an addict and instead pose as a patient telling you a fake story to get a prescription — and then sell the drugs on the street.
You can protect yourself and help prevent this from happening by using Michigan’s Automated Prescription System (“MAPS”). MAPS is Michigan’s prescription monitoring service that is made available to dentists and other licensed health care professionals, law enforcement officials and certain other state agencies. On the first and 15th of each month (this is the minimum required reporting — reporting could be made on a weekly, daily, etc., basis) pharmacies and others legally able to dispense Schedule 2 through 5 controlled substances are required to report information to MAPS. The information reported includes the patient’s name, the name of the drug, dosage, etc., of the drug dispensed, the prescriber, the date the drugs were dispensed and other information that would easily enable someone to determine if doctor-shopping or the otherwise illegal procurement of controlled substances was occurring.
Any Michigan dentist may use MAPS. In order to do so you must first register online by going to http://sso.state.mi.us. Once registered, you will be able to obtain patient-specific reports. The law requires that you only request MAPS reports on your current bona fide patients. You will be asked to certify that this is the case each time you request a MAPS report. You should not use MAPS to request information on anyone who is not a bona fide current patient.
All of the data maintained by MAPS is securely stored by the state of Michigan in a way that (according to the state) complies with HIPAA’s security requirements. Since the data will only be released to you or others that certify they are the patient’s current dentist or other licensed health care professional the disclosure does not violate HIPAA.
In addition to using MAPS to prevent patients from illegally obtaining prescriptions for controlled substances, you can use MAPS to determine whether prescriptions are being illegally written or renewed in your office. I often have clients who have discovered their office personnel are, without the dentist’s knowledge, calling in or otherwise transmitting prescriptions for themselves, family members, and so on. If these unauthorized prescriptions are for controlled substances they will be reported to MAPS as though you prescribed them when dispensed by a pharmacy. It is a good practice to periodically request a MAPS report on yourself and to make sure your office staff members know that you are doing so. This report will contain all prescriptions for controlled substances supposedly written by you. A review of the report would enable you to determine whether prescriptions are being written without your authorization.
Regular use of MAPS will prevent prescription drug abuse in your practice.