01.31.20

U.S. Senator Tammy Baldwin Calls on VA Secretary Wilkie to Release State Reports on Prescription Drug Monitoring Compliance

Wisconsin’s Prescription Drug Monitoring Program Compliance Report is Available Here

WASHINGTON, D.C. – Today, U.S. Senator Tammy Baldwin today sent a letter to U.S. Department of Veterans Affairs (VA) Secretary Robert Wilkie requesting that the VA publicly release their reports showing compliance rates for the State Prescription Drug Monitoring Program (PDMP). These databases help ensure safe opioid prescribing practices and reduce the risk of opioid overdose at the VA, and ultimately provide safer care for our nation’s veterans.

“I believe increasing awareness of opioid prescription rates as well as how often providers are querying PDMP databases will help continue to improve the way we treat veterans’ pain and decrease reliance on powerful opioids,” wrote Senator Baldwin in her letter. “Accordingly, I am requesting that the VA publicly release state-by-state PDMP query compliance reports annually.”

Baldwin received the Wisconsin report on PDMP compliance, publicly available here, and is urging Secretary Wilkie to make the information for every state publicly available in order to increase oversight and awareness about opioid prescribing at VA facilities nationwide.

“The VA should replicate this reporting process at a national scale, and provide additional information on the extent to which facilities are taking specific steps to achieve compliance rates of over 90%. The VA and VISN 12 in particular have made great strides in changing the way we treat veteran’s pain and decreasing reliance on powerful opioids,” Senator Baldwin continued. “After passage of the Jason Simcakoski Memorial and Promise Act, which strengthened the VA’s Opioid Safety Initiative, the Tomah VAMC alone saw a 47 percent decrease in the number of veterans on chronic opioids. For veterans on opioids and benzodiazepines, there was a 76 percent reduction. This is tremendous progress, but oversight is needed to ensure that the VA keeps its promise to our veterans and delivers the care that they have earned.”

The full letter is available here and below.

 

January 31, 2020

 

The Honorable Robert Wilkie

Secretary of Veterans Affairs

810 Vermont Ave, NW

Washington, DC 20420

 

Dear Mr. Secretary:

I am writing today regarding compliance rates for querying State Prescription Drug Monitoring Program (PDMP) databases.  State PDMP databases are an important tool to ensure safe opioid prescribing practices and reduce the risk of opioid overdose. I believe increasing awareness of opioid prescription rates as well as how often providers are querying PDMP databases will help continue to improve the way we treat veterans’ pain and decrease reliance on powerful opioids.  Accordingly, I am requesting that the VA publicly release state-by-state PDMP query compliance reports annually.

In a September 23, 2019 Department of Veterans Affairs Office of Inspector General (VA OIG) report entitled, “State Prescription Drug Monitoring Programs Need Increased Use and Oversight,” the OIG found that from April 2017 to March 2018, clinicians failed to check the state PDMP databases for 73% of veterans prescribed opioids in the care of the VA. VA requires its clinicians to complete a PDMP query when they prescribe patients opioids or other controlled substances if a query has not been completed within the past year.

Although no Wisconsin facilities were included in this report, I wrote to the Acting Network Director for VISN 12 on October 16, 2019, requesting compliance rates for all Wisconsin facilities.  On November 15, VISN 12 reported that there has been significant progress at each facility in Wisconsin since 2017, with all facilities exceeding 70% compliance with annual PDMP evaluations for eligible patients. However, VISN 12 still falls short of the goal of exceeding 90%.  I have attached for your review the Wisconsin rates provided to my office, which show quarterly compliance information. 

The VA should replicate this reporting process at a national scale, and provide additional information on the extent to which facilities are taking specific steps to achieve compliance rates of over 90%. The VA and VISN 12 in particular have made great strides in changing the way we treat veteran’s pain and decreasing reliance on powerful opioids. After passage of the Jason Simcakoski Memorial and Promise Act, which strengthened the VA’s Opioid Safety Initiative, the Tomah VAMC alone saw a 47 percent decrease in the number of veterans on chronic opioids. For veterans on opioids and benzodiazepines, there was a 76 percent reduction. This is tremendous progress, but oversight is needed to ensure that the VA keeps its promise to our veterans and delivers the care that they have earned.

Section 913(c) of the Comprehensive Addiction and Recovery Act of 2016 (CARA) (P.L. 114-198) requires the VA to submit an annual report on opioid therapy and prescription rates to the House of Representatives and the United States Senate Committees on Veterans' Affairs. A number of recommendations for achieving greater compliance with PDMP requirements are outlined in the VA OIG’s September 2019 report.  I appreciate your consideration of my request for additional reporting and offer my support to help the VA increase its public awareness of the VA’s usage and processes when prescribing opioids.