Pmpm Reporting and Data Submission Guidelines

To submit your PMPM reporting, you'll need to follow the guidelines set by your payer. These guidelines typically include the required data elements and formats for submission.

The most common data submission formats are CSV, XML, and XLSX. Make sure to check with your payer to confirm their specific requirements.

Your reporting must be submitted on a timely basis, usually within a specific timeframe after the end of each quarter. This is crucial for accurate reimbursement and to avoid any potential penalties.

Data accuracy is key to successful PMPM reporting. Ensure that all data is complete, accurate, and up-to-date to avoid any errors or discrepancies.

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Data submission and integration are crucial aspects of PMPM reporting. Mandatory reporting began on October 7, 2011, in Washington State, requiring dispensers to report Schedule II, III, IV, and V controlled substances and drugs of concern.

The Prescription Monitoring Program (PMP) has specific rules for dispenser reporting, which were established by the Washington State Department of Health. To integrate your Electronic Health Records (EHR) system with the PMP, you have two options: OneHealthPort (OHP) and approved direct integration options like Bamboo Health's PMP Gateway.

If you choose to integrate through OHP, you can fill out their HIE Support Request form, selecting "Other" and indicating interest in PMP integration. For direct integration with Bamboo Health's PMP Gateway, visit their PMP Integration Request page and fill out the form.

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In Washington State, required data submission for controlled substances began on October 7, 2011, as part of the Prescription Monitoring Program (PMP) created by RCW 70.225.

Dispensers are required to report Schedule II, III, IV, and V controlled substances and drugs of concern dispensed in Washington State or to an address in Washington to the WA PMP.

Veterinarians have separate reporting requirements from pharmacies and other dispensing prescribers, which include frequency of reporting, ability to mail/fax records, and different required data fields.

Veterinarians are required to report the dispensing of controlled substances (Schedule II-V) and drugs identified by the board of pharmacy, dispensed for more than a fourteen-day supply to Washington's Prescription Monitoring Program (PMP).

Online reporting is available for convenience, and submitting reports directly online is quick, easy, and hassle-free.

To submit reports online, follow the instructions in the WA Data Submission Dispenser Guide (PDF), which includes creating your uploader account and submitting reports online.

Veterinarians are required to report controlled substance dispensing activity to the NYS DOH Bureau of Narcotic Enforcement (BNE) within 24 hours, and they can find more information on data submission and review of critical errors by clicking here.

Here's a summary of the reporting requirements for veterinarians:

If you're a healthcare provider with ten or more prescribers, you're likely aware of the PMP-EHR Integration Mandate. This mandate requires facilities to integrate their Electronic Health Records (EHR) systems with the Prescription Monitoring Program (PMP).

The legislation that led to this mandate was Substitute Senate Bill 5380, passed during the 2019 Legislative Session. This bill added RCW 70.225.090, which outlines the integration requirement.

The state's Health Information Exchange, OneHealthPort (OHP), and approved direct integration options are the two ways to integrate a Health Care Organization's EHR with the PMP.

If you want to integrate through OHP, you can fill out their HIE Support Request form, selecting "Other" and indicating interest in PMP integration. Someone from OHP will follow up after the form is submitted.

Bamboo Health's PMP Gateway is another approved direct integration option. To learn more, visit the Bamboo Health PMP Integration Request page and fill out the form. You'll receive an email inviting you to a product overview webinar, and can also email account support with questions about the integration process.

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Prescription monitoring programs are an essential tool for healthcare providers to track and prevent the abuse and misuse of prescription drugs. They provide a secure and direct access to a patient's prescription history, allowing practitioners to better evaluate their treatment and identify potential issues.

The National Alliance for Model State Drug Laws, National Association of State Controlled Substances Authorities, and PDMP Training and Technical Assistance Center are organizations that support and promote the use of prescription monitoring programs.

Practitioners can access the Prescription Monitoring Program Registry, which is available 24 hours a day, 7 days a week, via the Health Commerce System (HCS). This allows them to view a patient's dispensed controlled substance prescription history for the past year.

Some states, like New York, require prescribers to consult the PMP Registry when writing prescriptions for Schedule II, III, and IV controlled substances. This helps to prevent the misuse of prescription drugs and ensures patient safety.

In Texas, the PMP is integrated with electronic health records and pharmacy management systems, allowing for faster review of a patient's controlled substance prescription history. This simplifies the process and allows healthcare providers to focus on patient care.

To stay up-to-date on prescription monitoring programs, you can subscribe to the DOH subscription topics, email the program, send a fax to 360-236-2901, or mail program staff at Prescription Monitoring Program, P.O. Box 47852, Olympia WA 98504-7852.

Here are some additional resources for prescription monitoring programs:

The Prescription Monitoring Program (PMP) is governed by the Washington Legislature, which passed a law (RCW 70.225) in 2007 authorizing the program.

The Department of Health owns the PMP and has made rules (WAC 246-470) that took effect on August 27, 2011, after a public hearing and comment period.

The Department will write rules to create a waiver application process for facilities, entities, offices, or provider groups with 10 or more prescribers to exempt them from integrating their Electronic Health Records (EHR) systems with the PMP.

These facilities can apply for a waiver if they can demonstrate economic hardship, technological limitations, or other exceptional circumstances.

The waiver will be time-limited and available for those who meet the criteria.

The Department will hold stakeholder meetings to gather feedback on the rules.

The waiver process was established by Substitute Senate Bill 5380, which was passed during the 2019 Legislative Session.

In Washington State, most prescribers are required to consult the PMP registry when writing prescriptions for Schedule II, III, and IV controlled substances, starting from August 27, 2013. Each prescriber and authorized designee must have an individual Health Commerce System (HCS) account to gain access to the PMP.

To comply with the mandate in Texas, physicians must document in the patient's medical record that they checked the PMP, and review a full controlled substance history report for every patient, every time. Pharmacists must also review a full controlled substance history report for every patient, every time.

In Washington State, two new roles are available on the Health Commerce System (HCS) under the Hospital organization: PMP DESIGNEE and PMP DESIGNEE REVIEWER. The PMP Designee role allows unlicensed residents/interns of a medical teaching facility to access the Prescription Monitoring Program (PMP) Registry on behalf of the institution, and the PMP Designee Reviewer role allows employees of the medical teaching facility to monitor the use of the PMP application by unlicensed residents/interns.

Note: Residents/interns working in multiple facilities need to be assigned to the PMP Designee role by a coordinator from each facility.

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As a practitioner, it's essential to understand the requirements for accessing the Prescription Monitoring Program (PMP) registry. Effective August 27, 2013, most prescribers are required to consult the PMP registry when writing prescriptions for Schedule II, III, and IV controlled substances.

Each prescriber and authorized designee must have an individual Health Commerce System (HCS) account to gain access to the PMP. Practitioners may authorize designees to check the registry on their behalf, but each must have their own account.

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To access the PMP, prescribers and pharmacists are required to check the Texas Prescription Monitoring Program before prescribing or dispensing opioids, benzodiazepines, barbiturates, or carisoprodol. They must document in the patient's medical record that they checked the PMP.

In some integrated electronic health records, only a patient score is shown, rather than a full report. However, viewing the patient score alone is not enough to comply with the mandated PMP lookup requirement.

Here are the roles available on the Health Commerce System (HCS) under the Hospital organization:

Residents/interns working in multiple facilities need to be assigned to the PMP Designee role by a coordinator from each facility.

As a veterinarian, you have specific requirements when it comes to reporting controlled substance dispensing activity. You are required to report controlled substance dispensing activity to the NYS DOH Bureau of Narcotic Enforcement within 24 hours.

You have the option to submit reports online, which is quick and easy. Online reporting is available for your convenience.

Veterinarians in Washington state are required to report the dispensing of controlled substances, but they have different reporting requirements than pharmacies and other dispensing prescribers. You should submit reports as often as possible to keep the data relevant, but are required to report quarterly at minimum.

To submit your data online, you can follow the instructions in the WA Data Submission Dispenser Guide (PDF). The guide is available on page 12 for creating your uploader account and on page 34 for submitting reports online.

For more information on data submission, you can click here. There are also Frequently Asked Questions for Veterinarians for the NYS PMP Data Collection Tool (PDF, 155KB) available.

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As a pharmacist, you'll need to have an individual Health Commerce System (HCS) account to access the PMP Registry, which is available to NYS licensed pharmacists.

To get started, you can apply for your HCS account by following the application instructions found on the link provided. This will give you access to the PMP Registry, where you can review critical errors and submit data.

The PMP Registry is a valuable tool for pharmacists, and it's available now. You can access the registry through your HCS account.

To access the HCS Log in, click on the link provided. This will take you directly to the login page where you can enter your credentials and access the registry.

Here are the key resources you'll need to access the PMP Registry: