Prescription Drug Monitoring Program

Frequently Asked Questions

Review the Program Facts and choose the FAQ by your profession below.

By profession:Prescribers Dispensers Law Enforcement Public

Program Facts

What is the North Dakota Prescription Drug Monitoring Program (NDPDMP)?
The PDMP, is a secure and HIPAA compliant online database of controlled substances (C II - V) and drugs of concern, that is used to improve patient therapy and the state's ability to identify and inhibit medication diversion in an efficient and cost effective manner that should not impede the appropriate utilization of these drugs for legitimate medical purposes.

Most states in the U.S. have a Prescription Monitoring Program (PDMP), and more studies are showing their effectiveness. They are intended to improve public health, enhance patient care, and protect public safety.

What information does a report provide?
The report will contain:

The patient's names, date of birth, gender and address
The summary table of prescriptions, prescribers, pharmacies, private pay, and active daily morphine milligram equivalents.
The prescription details, such as filled dated, written date, drug name and strength, quantity, days' supply, prescription number, refills, MME/D, payment method, and the state PDMP of origin
The prescribers name, address, and (if available)phone number
The dispensers name, address and phone number
The administrative disclaimer

Who is able to request information?
For a list of able requestors and the reasons they are able to access the information, please refer to NDCC Chapter 19-03.5-03 Access to prescription information

Users obtaining information for illegitimate reasons are in violation of the terms of account use agreement and statute, and my face penalties including, but not limited to, 5 years in prison and/or up to $10,000 in fines.

For what period of time can historical prescription records be accessed?
Information for up to the three previous years, from today's date, can be provided.

What are the drugs included?
All controlled substances, schedules II, III, IV, V and drugs of concern. For a complete list please visit the DEA list of controlled substances at https://www.deadiversion.usdoj.gov/schedules/

From where is the patient data gathered?
Prescription records are gathered from all outpatient pharmacies, assisted living facilities, nursing homes, practitioner's offices, most Indian Health Service (IHS) facilities, and Veterans Administration. Opiate Treatment Programs (OTP) do not report to the PDMP due to 42CFR Part 2.

How long after requesting a report will it be returned?
Online access is available 24/7 to all direct access users and results are instant for every user type except law enforcement who must provide a valid case number before receiving results. When requesting information from multiple states it should take up to 10 seconds (max) for reports to be gathered and displayed.

What is the data collection interval?
A prescription filled may take 24 hours to appear in a report unless there are error corrections; data is collected daily. Some out-of-state pharmacies can obtain a waiver to report weekly or monthly depending on the volume of prescriptions dispensed (must be less than 15 per year). Some federal IHS facilities report weekly and are not required under state jurisdiction to report daily.

How should providers use these reports?
Reports should be used to supplement a patient evaluation or investigation, to confirm a patient's drug history, or document compliance with a therapeutic regimen.

PDMP does not guarantee any report to be wholly accurate or complete. The report is based on the search criteria entered and the data submitted by the dispenser. For questions about any record in an PDMP report or to verify a prescription, contact the dispenser directly. If there are any concerns about data provided, contact the North Dakota Prescription Drug Monitoring Program by calling 701-877-2410 or sending an email to pdmp@ndboard.pharmacy include the prescription number, date filled, patient name and date of birth by voice message or if emailing please include the pharmacy name and location so that we can contact them directly. Do not e-mail patient confidential information or redistribute the reports.

How is patient privacy protected?
TThe PDMP is HIPAA compliant. It has built in security features designed to protect patient information. The HIPAA privacy regulations permit disclosure of protected health information, without authorization or opportunity to agree or object, in certain specified instances. These include disclosures for a covered person's own treatment, payment of claims, and health care operations of the covered entity. In addition, state laws may also address privacy concerns with regard to confidentiality of patient information. In some instances, state law may provide for more stringent restrictions on release of patient information than the HIPAA privacy regulations; in those cases, the state law takes precedence.

Further, HIPAA privacy rules permit disclosure of protected health information to law enforcement, without authorization or opportunity to agree or object, provided such disclosure is limited to investigation or conduct of an official inquiry into a potential violation of law, or prosecutions arising from these violations. Even in those circumstances when disclosure to law enforcement is permitted by the rule, the privacy rule does not require covered entities to disclose any information. However, some other federal or state law may require a disclosure, and the privacy rule does not interfere with the operation of these other laws. The PDMP is an example of one of these state laws.

Is training available?
Training can be presented at your facility or function by request; please contact pdmp@ndboard.pharmacy for scheduling and details. A user guide and videos are available in the AWARE platform; after logging in at https://northdakota.pmpaware.net, click on Menu, and go to the Training section; there are NarxCare, Overdose Risk Score, AWARxE and other trainings readily available as well as the user guide.

Are you able to merge patient accounts together?
Yes, with the technology of PDMP, some account consolidation is automatically performed as you're requesting patient information. However, because it is an automated consolidation process and we error on caution there are some missed account consolidation opportunities, which can lead to missed intervention opportunities. For example, patients with a maiden or hyphenated last name may need to have their accounts manually consolidated. For example, John Doe-Johnson (01/01/2000) may also have a profile as John Doe Johnson (01/01/2000) or even John DoeJohnson (01/01/2000). Another example is if Jane Johnson may also have a profile with her maiden name Jane Doe. If you notice multiple accounts for a patient and have to look them up separately, please contact PDMP directly at 701-877-2410 or pdmp@ndboard.pharmacy to combine the records to pull up one report. For other errors in reporting data contact the data dispenser directly. They must re-submit the corrected data to the PDMP database for it to display correctly in your report. No one besides the original data submitter has access to edit their records, not even the state administrator(s).

Prescribers

Am I required to have an account?
Under 19-03.5-09 "Authority to adopt rules", each professional licensing board that is responsible for the licensing of individuals authorized to prescribe or dispense controlled substances for human consumption shall adopt rules under chapter 28-32 to require licensed individuals under that board's jurisdiction who prescribe or dispense controlled substances to humans to utilize the prescription drug monitoring program.

Utilization Guidelines:
- Board of Medicine: https://www.ndbom.org/practitioners/PDMP.asp
- Board of Nursing: https://www.ndbon.org/NurseLicensure/APRN/RXDrugMonitoringProgram.asp
- Board of Dental Examiners: https://www.nddentalboard.org/laws-and-rules/

What steps are necessary to obtain direct access?
Go to https://northdakota.pmpaware.net and click on Create An Account and follow the on-screen instructions. Note: No duplicate accounts are allowed; if your information has changed (email address, place of employment, etc.) you will need to update the existing account with the new information rather than creating a new account. Contact pdmp@ndboard.pharmacy from your existing accounts email address or call 701-877-2410 if you no longer have access to your email.

Is there a way to access PDMP within the ND Health Information Network (HIN)?
Yes. You can access the PDMP from within the HIN. NDHIN PDMP Access (386 KB PDF) Access to these reports in the NDHIN cannot be delegated away from the prescriber. For full reports of up to three years, access the ND PDMP site directly at https://northdakota.pmpaware.net.

Can PDMP access be delegated to assistive personnel?
Yes, a prescriber can delegate the authority to an individual that works for them or works for the same employer if the individual obtains their own "delegate account" by the same process the prescriber would use to gain access. It's imperative that login information is not given out to other individuals, per the Terms of Account Use Agreement signed when applying for access. Each account is individual specific. The "supervisor/Practitioner" must create their account before a delegate can create and link the two accounts together. All delegate access must be manually approved by logging into the AWARxE platform and then going to Menu>User Profile>Delegate Management. Eligible practitioner delegates would be a Registered Nurse (under the Heathcare Role choose 'Prescriber Delegate - Licensed'), Licensed Practical Nurse (under the Heathcare Role choose 'Prescriber Delegate - Licensed'), or Unlicensed Individual (under the Heathcare Role choose 'Prescriber Delegate - Unlicensed')

Adding and Removing a Delegate
For questions relating to delegate management, refer to Section 5.3 of the user manual.

Do practitioners need to report to the PDMP if controlled substances are dispensed from an office?
Yes. Each dispenser shall submit to the board by electronic means information regarding each prescription dispensed for a controlled substance. Dispenser means an individual who delivers a controlled substance to the ultimate user but does not include a licensed hospital pharmacy that provides a controlled substance for the purpose of inpatient hospital care or a licensed health care practitioner or other authorized individual in those instances when the practitioner administers a controlled substance directly to a patient.

Can reports be printed for office or record keeping purposes?
Yes, however copying or providing this data to an outside entity is strictly prohibited. The Board encourages collaboration between healthcare professionals regarding report details; however each provider should obtain their own copy.

Should practitioners document PDMP information in their notes?
Documentation is recommended for adequate patient records.

Is information from other states visible?
Yes, if the out-of-state pharmacy is shipping medications into North Dakota they are required by law to be licensed with the Board and report to the PDMP. With direct access to the program prescribers may also request information from other states through the Multi-State Query feature. The majority of other states have their own program, which may vary greatly from ND's PDMP. For details on other programs, please contact the National Association of State Controlled Substance Authorities (NASCSA) by going to www.nascsa.org or use their contact list to reach out to the state you're interested in knowing more about. PDMPs can slightly differ on reporting frequency (daily vs. weekly), the substance tracked (II-V & drugs of concern vs. II-IV), and who they allow to access their files (licensed delegates vs. unlicensed delegates). For more information on the variances of PDMPs please visit NAMSDL's PDMP website http://www.namsdl.org/prescription-monitoring-programs.com.

Is there a delay in reporting?
There may be a lag of up to one week. Our state laws indicate that daily reporting is a requirement by all licensed dispensers in or out-of-state, however some federal facilities voluntarily report weekly. Keep this delay in mind when reviewing the patient's history.

If there is a potential error in the report, who should be contacted?
Contact the dispensing pharmacy or dispensing practitioner to verify the information they reported is correct, contact pdmp@ndboard.pharmacy with the prescription number, date filled, and pharmacy name and location if there is missing records, or law enforcement if a crime has been committed.

How should a provider interpret the reports?
Interpretation should be in the context of a complete patient assessment, which may include:

History of risk factors for prescription opioid abuse.
Physical examination for drug abuse.
Justification for chronic opioid therapy (benefits are outweighing risks, patient is compliant).
Urine drug screen, preferably a quantitative test that can distinguish prescribed from non-prescribed opioids.
Documenting pill count (actual - expected) and early refills.
Consultation from specialists when indicated or required by the pain management rules.
Review of outside medical records or contacting other providers.
Interviews with significant others.

What are the clinical steps in response to concerns raised by a report?
Talk with your patient. Attempt to determine the reasons for the concerning behavior. Reasons could include:

Changing providers because of insurance coverage.
Under-treatment of pain.
Misunderstanding your pain management rules.
Prescription drug abuse.
Illegal behavior (diversion, fraud, etc.).
Administer a brief intervention. Express concern over behavior patterns; discuss risks of misuse and its negative consequences. Clarify expectations (using one pharmacy, receiving controlled medications from only one provider, etc.).
Increase patient monitoring and limit-setting. Support patient-provider communication with a Patient Treatment Agreement.

If a problem is found, are we required to explain what we found to the patient?
No, it is up to the discretion of the provider. A printed copy of the report can be logged in the patient medical record and shown to the patient. However, if a patient wants a copy of the report under NDCC 19-03.5-03 they are required to request their own copy.

How do I change my Healthcare Specialty if it appears to be incorrect?
The healthcare specialties listed were self-identified by the PDMP user when registering. In order to change your healthcare specialty, log into your account then click through to Menu>MyProfile>Add a Healthcare Specialty>Save Changes.

Can I have multiple Healthcare Specialties selected?
Yes. This is used to generate the Prescriber Report which will compare your prescribing activity against other prescribers who share the same primary Healthcare Specialty. On the My Profile page, your primary Healthcare Specialty is designated by a crown icon in the upper left.

How can I view a list of my prescriptions that were included in my Prescriber Report?
Within the PDMP site, click RxSearch, and then click MyRx. Enter the date range [enter dates], and select the DEA number associated with your Prescriber Report. This will allow you to see a full list of prescriptions that were included within the Prescriber Report metrics.

What if I believe that there is an error on the MyRx prescription history?
If you believe that one or more of these prescriptions are incorrect, you may contact the dispensing pharmacy for additional details about the prescription in question. If you believe that there may be fraudulent activity associated with your DEA, please contact the local police department.

How will communication and tutorials be shared?
Via e-mail updates and posted on the PDMP Dashboard when available.

Updating Employment Information
All prescribers must notify the PDMP if their place of employment changes. An email with the updated information will suffice if it matches the email address on file with the PDMP for that prescriber. If the prescriber no longer has access to that email, he/she will need to call the ND PDMP at 701-877-2410.

Test Patient Accounts
The PDMP has developed several test patients to serve as examples of what a concerning patient report might look like. Enter in the following information as you would any real patient.

Test, Tester / DOB 10/01/1989 / Date Range: 08/01/2017 - 04/30/2018
Test, Test / DOB 01/01/1979 / Date Range: 09/01/2016 - 12/31/2017
Tester, Test / DOB 01/01/1950 / Date Range: 08/01/2015 - 05/31/2016

Dispensers

Am I required to have an account?
Please read the rules below to determine if you are required to have an account.
61-12-01-04. Required use for certain dispensing situations.

Prior to dispensing a prescription, each dispenser licensed by a regulatory agency in the state of North Dakota who dispenses a controlled substance to a patient, for the treatment of pain or anxiety shall, at a minimum, request and review a prescription drug monitoring report covering at least a one-year time period or another state's report, or both reports, when applicable and available, if the dispenser becomes aware of a person currently:
1. Receiving reported drugs from multiple prescribers;
2. Receiving reported drugs for more than twelve consecutive weeks;
3. Abusing or misusing reported drugs (i.e., over-utilization; early refills; appears overly sedated or intoxicated upon presenting a prescription for a reported drug; or an unfamiliar patient requesting a reported drug by specific name, street name, color, or identifying marks);
4. Requesting the dispensing of a reported drug from a prescription issued by a prescriber with whom the dispenser is unfamiliar (i.e., the prescriber is located out-of-state or the prescriber is outside the usual pharmacy geographic prescriber care area); or
5. Presenting a prescription for reported drugs when the patient resides outside the usual pharmacy geographic patient population.
After obtaining an initial prescription drug monitoring report on a patient, a dispenser shall use professional judgment based on prevailing standards of practice in deciding the frequency of requesting and reviewing further prescription drug monitoring reports or other state's reports, or both reports, for that patient.
In the rare event a report is not immediately available, the dispenser shall use professional judgment in determining whether it is appropriate and in the patient's best interest to dispense the prescription prior to receiving and reviewing a report.
For the purpose of compliance with subsection 1, a report could be obtained through a prescription drug monitoring program integration with software or also a board-approved aggregate tool, for which the NARxCHECK will be an approved tool. The national association of boards of pharmacy foundation's NARxCHECK service is a risk assessment tool for health care providers and pharmacists that accesses patient prescription information from prescription drug monitoring databases, analyzes the data, and provides a risk-based score that includes prescription drug monitoring program data and graphical analysis to assist in prescribing and dispensing decisions.

History: Effective October 1, 2014.
General Authority: NDCC 19-03.5, 19-03.5-09, 43-15-10(12)
Law Implemented: NDCC 19-03.5

What steps are necessary to obtain direct access?
Go to https://northdakota.pmpaware.net and click on Create An Account and follow the on-screen instructions. Note: no duplicate accounts are allowed; if your information has changed (email address, place of employment, etc.) you will need to update the existing account with the new information rather than creating a new account. Contact pdmp@ndboard.pharmacy from your existing accounts email address or call 701-877-2410 if you no longer have access to your email.

Is there a way to access PDMP within the ND Health Information Network (HIN)?
Yes. You can access the PDMP from within the HIN. NDHIN PDMP Access (386 KB PDF) No other state's data is included, just ND's data. Access to this report cannot be delegated away from the pharmacist. For full reports of up to three years and including other states, access the ND PDMP site directly through https://northdakota.pmpaware.net.

Can PDMP access be delegated to assistive personnel?
Yes, a pharmacist can delegate the authority to an individual that works for them or works for the same employer if the individual obtains their own "delegate account" by the same process the pharmacist would use to gain access. It's imperative that login information is not given out to other individuals, per the Terms of Account Use Agreement signed when applying for access. Each account is individual specific. The "supervisor/pharmacist" must create their account before a delegate can create and link the two accounts together. All delegate access must be manually approved by logging into the AWARxE platform and then going to Menu>User Profile>Delegate Management. Eligible pharmacist delegates would be Technician-in-Training (under the Heathcare Role choose 'Pharmacist Delegate - Unlicensed'), Pharmacy Student (under the Heathcare Role choose 'Pharmacist Delegate - Licensed'), or Pharmacy Technician (under the Heathcare Role choose 'Pharmacy Technician').

Adding and Removing a Delegate
For questions relating to delegate management, refer to Section 5.3 of the user manual.

Can reports be generated for pharmacy or record keeping?
Yes, however copying or providing this data to an outside entity is strictly prohibited. The Board encourages collaboration between healthcare professionals regarding report details.

Is it necessary to document PDMP records?
Documentation is not required but is recommended.

Is information from other states visible?
Yes, if the out-of-state pharmacy is shipping medications into North Dakota they are required by law to be licensed with the Board and report to the PDMP. With direct access to the program prescribers may also request information from other states through the Multi-State Query feature. The majority of other states have their own program, which may vary from ND's PDMP. For details on other programs, please contact the National Association of State Controlled Substance Authorities (NASCSA) by going to www.nascsa.org or use their contact list to reach out to the state you're interested in knowing more about. PDMPs can slightly differ on reporting frequency (daily vs. weekly), the substance tracked (II-V & drugs of concern vs. II-IV), and who they allow to access their files (licensed delegates vs. unlicensed delegates). For more information on the variances of PDMPs please visit NAMSDL's PDMP website at http://www.namsdl.org/prescription-monitoring-programs.cfm. The maps are extremely helpful to see a full national scale comparison quickly.

How should a report be interpreted?
Interpretation should be in context of a complete patient assessment, which may include:

History of risk factors for prescription opioid abuse.
Documenting pill count (actual - expected) and early refills.
Consultation from specialists when indicated or required by the pain management rules.
Review of outside medical records or contacting other providers.

What are the clinical steps in response to concerns raised by a report?
Talk with your patient. Attempt to determine the reasons for the concerning behavior. They can include:

Administrative (change provider, etc.).
Under-treatment of pain.
Misunderstanding the pain management rules.
Prescription drug abuse.
Illegal behavior (diversion, fraud, etc.).
Administer a brief intervention. Express your concern over behavior patterns; discuss risks of misuse and its negative consequences. Clarify your expectations (using one pharmacy, receiving controlled medications from only one provider, etc.).
Increase patient monitoring.

If a problem is found, is it required to share the information with the patient?
No, it up to the discretion of the pharmacist to determine what information should be shared with the patient. You are able to print the information and show the patient, however if they want their own copy they must contact the PDMP directly to fill out a notary form and have the report mailed to them.

How will communication and tutorials be shared?
Via e-mail listserv updates and posted on http://www.nodakpharmacy.com/PDMP-index.asp when available.

Updating Employment Information
All dispensers must notify the PDMP if their place of employment changes. An email with the updated information will suffice if it matches the email address on file with the PDMP for that dispenser. If the dispenser no longer has access to that email, he/she will need to call the ND PDMP at 701-877-2410.

Test, Tester / DOB 10/01/1989 / Date Range: 08/01/2017 - 04/30/2018
Test, Test / DOB 01/01/1979 / Date Range: 09/01/2016 - 12/31/2017
Tester, Test / DOB 01/01/1950 / Date Range: 08/01/2015 - 05/31/2016

Law Enforcement

Do I need an online account to access the PDMP?
Yes, if you are an in-state law enforcement officer/agent you must register online to access the PDMP data.

How does the NDPDMP assist law enforcement?
It enhances existing authorized methods of information gathering. PDMP allows law enforcement to access prescription dispensing information from a single source. This will assist in curtailing pharmaceutical drug diversion.

PDMP helps to:

Increase efficiency and effectiveness in conducting investigations.
Reduce travel time and expenses to collect information from multiple dispensers.
Locate and retrieve information with minimal or no intrusion on prescribers and pharmacies.
Identify and evaluate the seriousness of the allegations, resulting in better prioritization of drug diversion cases.

Where do we collect this data?
Prescription records are gathered from all outpatient pharmacies, assisted living facilities, nursing homes, practitioner's offices, Indian Health Service (IHS) facilities, Department of Defense, and Veterans Administration. Opiate Treatment Programs (OTP) do not report to the PDMP due to 42CFR Part 2.

Under what circumstances can information requests be submitted?
The law allows an authorized law enforcement entity to request information only for an open investigation. A case number is required to process a request.

Where are the out-of state forms to request information for a case?
You can locate the appropriate form by going to the PDMP website or by clicking here.

Is information from adjacent states shown?
No. Unless the pharmacy is shipping medications in from out of state to a ND resident the pharmacy does not need to be licensed with the ND Board of Pharmacy and is not required to report. If the pharmacy is licensed in ND they will provide the data whether it is shipped to the patient or the patient is on location. Other states may be contacted directly to see if they allow law enforcement to access their database and how to obtain that information. The National Association of State Controlled Substance Authorities is a great resource to find more information on other state PDMPs.

What is an example of how law enforcement officers may use the PDMP?
A law enforcement officer may be investigating a person suspected of selling controlled substances and wishes to determine how the prescription medications are being obtained. Requesting a PDMP report may allow the investigator to determine if the person is receiving the medication from multiple prescribers/ pharmacies via theft, or from another source.

Public

Will having this program in our state limit the ability of patient to receive necessary medications?
No, the PDMP will not interfere with the legitimate use of any medication. The purpose of the program is to promote optimal patient and community health by ensuring the correct use of scheduled medications, and to prevent potential diversion and abuse.

Why is it important?
Medicine misuse and abuse is one of the fastest growing health concerns in the county. The PDMP helps protect you and your loved ones, increases the quality of your care, decreases health care costs, decreases crime, and protects your future.

"HOW CAN YOU HELP"

TELL THE DR. TO PRESCRIBE ONLY WHAT YOU NEED.
DISPOSE OF UNUSED MEDICATIONS PROMPTLY.
KEEP MEDICATIONS OUT OF THE REACH OF SMALL CHILDREN.
LOCK MEDICATION UP IF YOU HAVE CONCERNS FAMILY MEMBERS OR OTHERS MIGHT ACCESS THEM WITHOUT YOUR KNOWLEDGE.

Can a citizen request their own report?
Yes. You can contact the PDMP by calling 701-877-2410 or sending an email to pdmp@ndboard.pharmacy. A form will be sent which will need to be completed and notarized prior to a report being completed.

How is patient privacy protected?
The PDMP is HIPAA compliant. It has built in security features designed to protect patient information. The HIPAA privacy regulations permit disclosure of protected health information, without authorization or opportunity to agree or object, in certain specified instances. These include disclosures for a covered person's own treatment, payment of claims, and health care operations of the covered entity. In addition, state laws may also address privacy concerns with regard to confidentiality of patient information. In some instances, state law may provide for more stringent restrictions on release of patient information than the HIPAA privacy regulations; in those cases, the state law takes precedence.

Further, HIPAA privacy rules permit disclosure of protected health information to law enforcement, without authorization or opportunity to agree or object, provided such disclosure is limited to investigation or conduct of an official inquiry into a potential violation of law, or prosecutions arising from these violations. Even in those circumstances when disclosure to law enforcement is permitted by the rule, the privacy rule does not require covered entities to disclose any information. However, some other federal or state law may require a disclosure, and the privacy rule does not interfere with the operation of these other laws. The PDMP is an example of one of these state laws.

A current list of "drugs of concern" can be inquired by calling the PDMP office at 701-877-2410. Some examples of previous "drugs of concern" were gabapentin, tramadol, and carisoprodol, all of which are now reportable as a controlled substance.

North Dakota Board of Pharmacy