The Wisconsin Prescription Drug Monitoring Program (WI PDMP) is a program that collects and discloses information relating to the prescribing and dispensing of monitored prescriptions drugs.¹

What is a Monitored Prescription Drug?

Under Wis Admin. Code § CBS 4.02(12)(a), a monitored prescription drug means:

• a controlled substance included in Wis. Stat. section 961/385(1)(ag);
• a drug identified by the Wisconsin Controlled Substance Board as having a substantial potential for abuse (including scheduled II, III, IV, or V in the Federal Controlled Substance Act 21 USC §812(b)(2) to (b)(5) and (c) 21 USC 812(b)(2) to (b)(5) and (c), as changed and updated by 21 CFR §1308); and
• gabapentin.

The board is given broad authority to add or delete controlled substances under Wis. Stat. section 961.11(1).              

History of the Wisconsin ePDMP

The WI PDMP was first introduced in June 2013 to help combat the ongoing prescription drug abuse epidemic in Wisconsin.

An enhanced version of this system launched in January 2017, and is now known as the WI ePDMP, a multifaceted tool in Wisconsin’s efforts to “address prescription drug abuse, misuse, and diversion through clinical decision support, prescribing practice assessment, communication among disciplines, and public health surveillance.”²

In short, the WI ePDMP is now a centralized system that allows prescribers to check their patients' current and past controlled substance prescriptions, and pharmacists to verify if a patient is presenting a suspicious prescription.

Prescription drug dispensing data is submitted into the WI ePDMP by the pharmacy, pharmacist, or any practitioner who dispenses a monitored prescription drug. This data includes information related not only to the dispenser, but also the prescribing practitioner, and the patient.³

All of this information must be uploaded into the ePDMP no later than 11:59 p.m. of the next business day after the monitored prescription drug is dispensed.⁴ If a dispenser fails to compile this data, the board may make a referral to the appropriate licensing or regulatory board for discipline.⁵

Under Wis. Admin. Code section 4.105(1), every time a prescribing practitioner (i.e., physician, dentist, nurse practitioner) issues a prescription for a monitored controlled substance, they are required to access the monitored prescription drug history report for their patient. By accessing this report, the prescribing practitioner will be able to see the patient’s prior prescriptions dispensed, quantity, and date dispensed, as well as the patient’s address.

All of this information is important and can alert a prescribing practitioner to a patient’s potential substance abuse. If a patient is receiving multiple prescriptions for monitored drugs from multiple prescribing practitioners, this could serve as a red flag for potential abuse. Another red flag is if a patient is traveling a great distance to the prescribing practitioner.

As with a dispenser who fails to compile and submit monitored prescription data into the ePDMP, the board may make a referral to the appropriate licensing or regulatory board for discipline if a practitioner fails to review the monitored prescription drug history report about a patient prior to issuing a prescription order.⁶

Licensing and Criminal Implications for Failing to Comply with the PDMP

Prescribing practitioners and dispensers are not the only individuals accessing the monitored prescription drug history reports. The board reviews these reports to determine whether suspicious or critically dangerous conduct or practices have occurred.⁷ The Wisconsin Department of Safety and Professional Services (DSPS) staff may also access these reports when they are investigating dispensers or prescribing practitioners.⁸

Some factors that may result in an investigation by the board or DSPS include when:

• a pharmacist or pharmacy dispenses a high number of monitored prescription drugs;
• a pharmacist dispenses forged prescription orders;
• a practitioner prescribes a potentially dangerous combination of monitored prescription drugs to the same patient; or
• the practitioner dispenses a high amount of monitored prescription drugs.⁹

If the board determines that circumstances indicate suspicious or critically dangerous conduct of a pharmacy, practitioner, or patient, it may disclose monitored prescription drug history reports, audit trails, and PDMP data to a relevant patient, pharmacist, or practitioner, a relevant state board or agency of another state, or a relevant law enforcement agency, including DEA.¹⁰

Should the board determine that a criminal violation may have occurred, a pharmacist, pharmacy, or practitioner may be referred to the appropriate law enforcement agency for investigation and possible prosecution.¹¹ In other words, a dispenser or prescribing practitioner may find themselves facing criminal consequences as well as licensing.

Conclusion: A Strong Tool

The WI ePDMP is a strong tool in helping Wisconsin fight the opioid epidemic. However, it is only useful if both dispensers and practitioners comply with the program’s requirements. Failing to comply not only hurts the people of Wisconsin but can also result in licensing and criminal consequences for the licensed health care professional.

Physicians are encouraged to review the Wisconsin Medical Examining Board’s Opioid Prescribing Guidelines, while pharmacists and pharmacies are encouraged to review the PDMP rules under the Wis. Admin. Code section CSB 4.

When dispensers and prescribing practitioners are familiar with and understand the rules, regulations, and guidelines, it helps keep their patients safe and protects their professional livelihood.

This article was originally published on the State Bar of Wisconsin’s Health Law Blog. Visit the State Bar sections or the Health Law Section webpages to learn more about the benefits of section membership.

Endnotes

1Wis. Admin. Code § CBS 4.01.

2See the Wisconsin ePDMP 2023 Quarter 2 Summary.

3Wis. Admin. Code § CSB 4.04(2).

4Wis. Admin Code. § CSB 4.06(1).

5Wis. Admin. Code § CSB 4.04(4).

6Wis. Admin Code § CSB 4.105(3).

7Wis. Admin Code. § 4.12(cg).

8Wis. Admin. Code § CSB 4.093(2m).

9Wis. Admin. Code § CSB 4.15(2).

10Wis. Admin. Code § CSB 4.15(5).

11Wis. Admin. Code § CSB 4.15(6).