Page 19 - Layout 1

LEGISLATIVE WRAP-UP

thanks to HB 3284, it won’t kick in until
March 1, 2020. That gives physicians and
their electronic health record (EHR) ven-
dors time to properly integrate their sys-
tems with the PMP. Plus,
lawmakers appropriated an
additional $5 million for the
Texas State Board of Phar-
macy to spend this year to
make the PMP easier to inte-
grate, as well as to cover the
licensing fees for all state pre-
scribers and pharmacists.
“As it stands now, if I want
to check the prescription
monitoring program, I have
to leave my electronic med-
ical record, log in to a differ-
ent website, type in the patient’s first and last name and birthdate at
a bare minimum, check some boxes, and then click search and then
get a printout,” said
• Senate Bill 748 (Kolkhorst) directs the state to expand preg- San Antonio orthopedic surgeon Adam Bruggeman, MD, who’s
nancy medical home pilots to new sites and to test the use of also board certified in addiction medicine. “That all takes time to
telemedicine, telehealth, and telemonitoring to improve prenatal get in and out of the system.
and postpartum care. “TMA has worked very hard with the legislators, and they’ve
• In the 2020-21 budget, lawmakers approved more than $100 agreed to help pay for physicians to have an integrated prescription
million to help rural hospitals, a portion of which is dedicated monitoring program. We’re not quite there yet, and I think the Sep-
to helping those hospitals retain labor and delivery services. tember date was a little aggressive to get us across the finish line.”
With opioids generating bleak national headlines on a regular
PMP Extension Granted basis, lawmakers seemed focused on limiting opioid prescriptions
When it came to opioids and pharmacy matters, some of the for acute pain to a seven-day supply. But House Bill 2174 (Zerwas)
major pieces of medicine’s 2019 agenda came down to something establishes a 10-day limit instead.
everyone wishes they had more of: time. “It is somewhat of an arbitrary thing to put a particular maximum
Physicians need it to get comfortable with a mandate to check amount of time for opioid prescriptions,” said Dr. Terk. “We felt
the state’s prescription monitoring program (PMP). Patients need like 21 days is probably too long and doesn’t respect the concern
it to make sure the pain medications they’re prescribed do what the about how long it takes for an individual to become dependent on
drugs are supposed to do. these medications. But the [TMA Council on Legislation] reasoned
The legislature listened, and TMA achieved wins on both counts, that [a limit of] 10 days was reasonable for most post-operative and
as well as on increased transparency from pharmacy benefit man- post-trauma patients.”
agers (PBMs). HB 2174 also requires electronic prescribing for opioids begin-
House Bill 3284 (Sheffield) bought the time physicians needed to ning in 2021 (when a similar requirement from Medicare takes ef-
comply with lawmakers’ 2017 mandate to check the state’s PMP be- fect) plus two hours of CME for opioid-prescribing, and generally
fore issuing any prescription for opioids, benzodiazepines, barbitu- prohibits prior authorization for medication-assisted treatment for
rates, or carisoprodol. opioid use disorder.
That mandate was scheduled to go into effect in September. But Increasing drug-pricing transparency from PBMs was another

continued on page 20
visit us at www.bcms.org 19