1. Indiana’s Prescription Monitoring Program

2. What is INSPECT?  INSPECT is 1 of 34 operational, state-based Prescription Monitoring Programs (PMPs) in the US.  Housed in the Indiana Professional Licensing Agency. Administered by the Indiana Board of Pharmacy.  Pharmacies must report prescription data to INSPECT within seven (7) days of dispensing a controlled substance to a patient.

3. What INSPECT Doesn’t Track  Pseudoephedrine  Morphine/Methadone (less than 72-hour supply)  Physician dispensing  Veteran’s Administration facility dispensing

4.  Rate of Rx abuse above national average  Rate of Rx addiction above national average  Rate of arrests for Rx abuse/diversion below national average Why INSPECT is Necessary?

5. What is Doctor Shopping? When a patient seeks to obtain controlled substances from multiple health care providers, often simultaneously, by either: A. Withholding material facts regarding their past and/or present controlled substance treatment B. Engaging in deceptive practices meant to stymie attempts by their health care providers to better coordinate the provision of care

6. Is Doctor Shopping Illegal?  Although IC 16-42-19 does not use the term “doctor shopping” or “doctor shopping,” it does clearly state that, A person may not do any of the following: 1. Obtain or attempt to obtain a legend drug or procure or attempt to procure the administration of a legend drug by any of the following: A. Fraud, deceit, misrepresentation, or subterfuge. B. The concealment of a material fact. 2. Communicate information to a physician in an effort unlawfully to procure a legend drug or unlawfully to procure the administration of a legend drug. Such a communication is not considered a privileged communication.

7. INSPECT Menu of Services  Rx History Reports  POI Alert Notifications  Practitioner Self-Lookup Tool  Rx Watch Website

8. INSPECT Service Offering #1  Rx Patient Reports Report of all patient controlled substance activities over a given date range. Available online 24/7 to registered users of the INSPECT WebCenter.  We currently process around 2,000 requests per day to a user base of around 9,000 The conditions under which eligible users may obtain data from INSPECT are outlined in statute (IC 35-48-7-11.1).

9. Eligibility for WebCenter Access  Licensing Board: Must be engaged in an investigation of a licensee  Attorney General’s Office: Must be engaged in an investigation, adjudication, or a prosecution regarding a violation of state/federal laws concerning controlled substances  Law Enforcement: Must concern an investigation and/or an adjudication involving the unlawful diversion or misuse of controlled substances.  Practitioners: Must be providing medical or pharmaceutical treatment, or evaluating the need for such treatment to the patient in question.

10. On the drop-down menu, click “New Request” Request Rx History Report: Step 1

11. Enter patient search criteria in the boxes provided Select report format Check certification box Click “Done” Request Rx History Report: Step 2

13. Guidelines for All Users  All info via the web – internet required  No info provided without an account  New users must send in a signed/notarized application to complete registration process

14. Guidelines for Practitioners  YOU ALONE are ultimately responsible for the activity that occurs on your account.  Always Validate the contents of the Rx Report!  Feel free to share information regarding the contents of a patient’s Rx History Report with mutual providers and law enforcement—but DO NOT send along your hardcopy. Advise mutual providers to obtain their own report.

15. Sharing with Law Enforcement  Practitioners in the audience: “Yikes—that definitely sounds like the sort of thing that could easily get me sued.”  Legislation passed during the 2010 General Assembly adds a provision to IC-35-48-7-11.1 stating, (n) A practitioner who in good faith discloses information based on a report from the INSPECT program to a law enforcement agency is immune from criminal or civil liability. A practitioner that discloses information to a law enforcement agency under this subsection is presumed to have acted in good faith.

16. Guidelines for Law Enforcement  Only obtain Rx History Reports for suspects/probationers who are subjects of active, ongoing investigation and/or adjudications – NO FISHING EXPEDITIONS!  The Rx History Report is NOT the evidence! Think of INSPECT as a sort of intelligence service—a means of streamlining your investigation and reducing the time it takes to collect the actual, hardcopy evidence available at the pharmacy level.

17. INSPECT Service Offering #2  Person of Interest (POI) Alert Notifications An unsolicited email notification delivered to practitioners (users and non-users). Two types:  INSPECT-Initiated POI Alert: A patient’s prescriptive activities are found to have exceeded the predetermined dispensing thresholds set forth by the IN Board of Pharmacy  User-Initiated POI Alert: A patient’s prescriptive activities are deemed problematic based on a mutual provider’s review of a patient’s Rx History Report accessed through the INSPECT WebCenter (Note: we plan to make this fully available by March 2011).

18. INSPECT Service Offering #3  Prescriber Self-Lookup Tool Similar to a credit report, this new functionality will allow registered users of the INSPECT WebCenter Indiana to access their full controlled substance prescribing history at set intervals throughout the year. (Note: we plan to make this available by the end of Jan. 2011).

19. INSPECT Service Offering #4  Rx Watch Website New INSPECT Website scheduled for full release in March 2011!!! Functionalities will include:  User-customizable analytic and GIS mapping tools  Periodically-updated (albeit patient de-identified) datasets for upload by researchers  Confidential “tip-submission” area for users  Video learning/training area.

21. Contact Information  To receive a password reset, or if you have a question about the program, please email inspect@pla.in.gov inspect@pla.in.gov  Help-Desk for non-password related inquiries: 317-234-4458  To obtain further information and/or register for an account, please visit www.in.gov/inspectwww.in.gov/inspect

22. Questions???