Law requires Texas physicians to query PMP before prescribing opioids

Texas physicians are required to check the Texas Prescription Monitoring database before prescribing opioids (hydrocodone, oxycodone, etc.); benzodiazepines (alprazolam or diazepam); barbiturates; or carisoprodol. Physicians must check each patient’s prescription history within the database for evidence of doctor-shopping or drug diversion. (1)

This means that surgeons must query the database before prescribing for their postoperative patients and a primary care physician must query the database before prescribing for their sprained ankle patients. The law does not apply to physicians prescribing for patients diagnosed with cancer or patients receiving hospice care.

PMP checks are also not required for inpatient care or during an outpatient encounter setting, such as an emergency department or ambulatory surgical center visit.

“The mandatory PMP check is required only when a physician prescribes opioids, benzodiazepines, barbiturates, or carisoprodol to the ultimate user for take-home use upon leaving an outpatient setting, such as a doctor's office or ambulatory surgical center, or upon discharge from an inpatient setting, such as a hospital admission, or discharge from an emergency department visit.” (2)
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Guidelines for querying the PMP.

1. Register with the Texas Prescription Monitoring Program (PMP)
The Texas State Board of Pharmacy manages the PMP and automatically creates PMP accounts based on information it receives from the Texas Medical Board. However, prescribers must manually finalize their accounts.

With your finalized account, you can find out if a patient is receiving Schedule II, III, IV, and V controlled substances. You can also receive email notifications when the system finds evidence of suspicious activity.

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2. At your discretion, delegate the task of checking the database to trusted staff.
Once you are registered, you can assign medical staff to assist in querying the PMP. It is important that your delegate register for his or her own account in the system. Physicians should never share PMP log-in information with their staff or delegate.

In addition, physicians and staff should only query their own prescribing history or patients with whom they have an established relationship. Querying individuals who are not your patients is a violation of HIPAA.

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3. Document when you query the PMP
Current risk management recommendations call for physicians (or delegates) to check the PMP regarding any new patient who is currently taking controlled substances; any existing patient who requests an early refill of a controlled substance; or any patient who triggers concern about abuse of controlled substances.

To show that you are in compliance with these recommendations, document in the patient’s chart that you have checked the PMP before prescribing opioids, benzodiazepines, barbiturates, carisoprodol.  

 
For more information

• The PMP database is available at http://www.pharmacy.texas.gov/PMP/.
• Finalize your account at http://www.pharmacy.texas.gov/PMP/.
• View the registration manual at http://www.pharmacy.texas.gov/files_pdf/Registration_Manual.pdf.
• PMP FAQs are available at https://texas.pmpaware.net/support; email the PMP at texaspmp@pharmacy.texas.gov, or call 512-305-8050. 
   

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Sources

1. Texas House Bill 2561. Texas State Legislature. LegiScan. Available at https://legiscan.com/TX/text/HB2561/id/1625193. Accessed February 3, 2025.


2. Texas Medical Board. Updated guidance regarding requirements to check the Prescription Monitoring Program. February 21, 2020. Available at https://tmb.state.tx.us/idl/83AD8D09-A358-C993-197F-CE2849A9A490 . February 3, 2025.

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