APPENDIX A: VERMONT PRESCRIPTION MONITORING SYSTEM (VPMS)
The Vermont Prescription Monitoring System (VPMS) is a statewide, electronic database of controlled substance prescriptions dispensed by Vermont- licensed pharmacies. VPMS is a clinical tool to promote appropriate prescribing, while deterring the misuse, abuse, and diversion of controlled substances. VPMS is also a surveillance tool that is used to monitor statewide trends in the dispensing of controlled substances. Information on account Log In, User Support, Regulations, Forms, and Manuals can be found at https://www.healthvermont.gov/alcohol-drugs/ professionals/vermont-prescription-monitoring- system-vpms . The Vermont Prescription Monitoring System Rule is provided below. Vermont Prescription Monitoring System Rule https://www.healthvermont.gov/sites/default/files/ documents/pdf/REG_vpms-20170701.pdf Last Accessed November 2021
3.6 “Delegates” are individuals employed by prescribers, pharmacists, or the Vermont Chief Medical Examiner who are authorized by these entities to access the VPMS database related to the clinical care of bona fide current patients of the authorizing health care prescriber or dispenser or related to a bona fide investigation or inquiry into an individual’s death by the Chief Medical Examiner. 3.7 “Department” means the Vermont Department of Health. 3.8 “Dispensed” means a Schedule II, III, or IV controlled substance given to a patient by a pharmacy or prescriber pursuant to an order by a prescriber. 3.9 “Dispenser” means a pharmacy or prescriber that prepares and delivers a Schedule II, III, or IV controlled substance for a patient pursuant to an order by a prescriber. 3.10.“Drug Diversion Investigator” means an employee of the Department of Public Safety whose primary duties include investigations involving violations of laws regarding prescription drugs or the diversion of prescribed controlled substances, and who has completed a training program offered or designated by the Department of Health designed to ensure that officers have the training necessary to use responsibly and properly any information that he or she receives from the VPMS. 3.11 “OBOT” means Office Based Opioid Treatment physician practice for prescribing buprenorphine as established by the Drug Abuse and Treatment Act of 2000. In Vermont, OBOTs are often referred to as “Spokes”. An OBOT may be a preferred provider, an individual physician practice or several physicians practicing as a group. 3.12 “OTP” means an Opioid Treatment Program as defined and regulated by federal regulation 42 CFR, Part 8 and DEA regulations related to safe storage and dispensing at OTPs (§1301.72). OTPs are specialty addiction treatment programs for dispensing opioid-replacement medication including methadone and buprenorphine under carefully controlled and observed conditions. OTPs offer onsite ancillary services. In Vermont, OTPs are sometimes referred to as “Hubs”. 3.13 “Palliative care” as defined in 18 V.S.A. section 2(6) means interdisciplinary care given to improve the quality of life of patients and their families facing the problems associated with a serious medical condition. 3.14 “Pharmacist” means a health care professional licensed to dispense Schedule II, III or IV controlled substances as defined by the Vermont Administrative Rules of the Board of Pharmacy.3.15 3.15 “Pharmacy” means an entity that dispenses Controlled Substances, or provides pharmaceutical care, as defined by the Vermont Administrative Rules of the Board of Pharmacy. 3.16.“Prescriber” means a health care professional licensed to prescribe Schedule II, III or IV controlled substances.
3.17 “Query” means the action of accessing a Prescription Drug Monitoring Program and retrieving information from it regarding controlled substance(s) prescribed or dispensed to a patient. 3.18 “Reciprocal Agreements” means a written agreement that provides for the exchange of information requests and responses of Prescription Drug Monitoring Program data between state data-sharing partners if access under such agreement is consistent with the privacy, security, and disclosure protections under the statute and these regulations. 3.19 “Replacement prescription” means an unscheduled prescription request in the event that the document on which a patient’s prescription was written has been lost or stolen, or the patient’s prescribed medication is reported to the prescriber as having been lost or stolen. 3.20 “Report of Controlled Substances Dispensed” means the report format used by pharmacies for submitting required data to the VPMS pursuant to this rule. 3.21 “Reportable prescription” means each controlled substance dispensed from any Vermont-licensed pharmacy. 3.22 Unsolicited Report” is a notification sent to a patient’s provider when clinical thresholds established by the Department have been met or exceeded. 3.23 “Vermont Prescription Monitoring System” (VPMS) means the statewide database that collects data on Schedule II, III, or IV controlled substances dispensed by a Vermont-licensed pharmacy. 4.0 Required Reporting for Pharmacies and Prescribers who Dispense Controlled Substances 4.1 Filing of Report of Controlled Substances Dispensed 4.1.1 Pharmacies and other dispensers shall report each dispensed prescription for a Schedule II, III, or IV controlled substance to the VPMS within either 24 hours or one business day of dispensing the prescription. This applies to all licensees, irrespective of location or number of prescriptions of controlled substances dispensed. 4.1.2 Pharmacies and other dispensers must submit a “zero controlled substances report” on any day that no controlled substances are dispensed. 4.2 Required Information from Reporting Pharmacy 4.2.1 The Report of Controlled Substances Dispensed from each pharmacy shall include the data elements detailed in the VPMS Data Collection Manual. These data elements include information related to the patient, prescription, dispenser, and prescriber.
1.0 Authority
This rule is adopted pursuant to 18 V.S.A. §§ 4287 and 289 and Section 2a of Act 173 (2016).
2.0 Purpose
This rule implements the Vermont Prescription Monitoring System (VPMS) created by 18 V.S.A. chapter 84A, that requires the Department of Health to establish an electronic database and reporting system for monitoring dispensed prescriptions of controlled substances. The intent is to promote public health through enhanced opportunities to prevent, detect and treat misuse of controlled substances, without interfering with the legitimate medical use of those substances. The use of VPMS in treating patients in hospice care, and other end-of- life care is not required. In the event of electronic or technological failure, the requirements for registering with, uploading to and querying the VPMS are waived.
3.0 Definitions
3.1 “Administered” means direct application of a drug to the body of a patient by means of injection, inhalation, ingestion or any other means. 3.2 “Chronic Pain” means pain caused by various diseases or abnormal conditions and that continues longer than 90 days. 3.3 “Commissioner” means the Commissioner of Health. 3.4 “Controlled substance” means a substance listed on the Federal Drug Enforcement Administration’s Schedules II, III or IV as defined in 21 C.F.R. Part 1308. 3.5 “DEA” means the Federal Drug Enforcement Administration.
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