Your controlled prescriptions are in a registry: who sees it

This is what is known in English as a PDMP: a database recording the dispensing of controlled drugs. It exists so a physician can see the full picture before prescribing and so agencies can detect patterns, but the law surrounds it with confidentiality rules and heavy criminal penalties, precisely because it contains sensitive medical information. What almost nobody knows is that the information about you is also yours to look at.

To review information about yourself: any person, as to their own receipt of controlled substances or drugs, or their authorized representative. For a minor’s: their parents or guardians, subject to state or federal confidentiality provisions. The law places these figures among those excepted from the education requirement it imposes on the system’s professional users, meaning you do not have to take training to look at your own record. The other accesses are for professionals and officials, each with its condition: the prescriber must maintain a bona fide relationship with the patient or be examining their own history or prescribing activity; the pharmacy or dispenser must be providing pharmaceutical care to a bona fide patient or examining their own dispensing activity.

• To review your own information: being the person to whom the controlled substances were dispensed, or their authorized representative.Verified against the official source
• For a minor’s: being their parent or guardian, subject to state or federal confidentiality provisions.Verified against the official source

• The law does not list documents by name for this request: access is governed by the procedures ASSMCA adopts by regulation. Ask ASSMCA which ones it requires before going.

1. 1

   Step 1: Know the registry exists and what it collects

   ASSMCA, in coordination and consultation with an Advisory Commission, created and established the Controlled Substance Prescription Monitoring Program, to implement and maintain an electronic surveillance system for monitoring prescriptions of controlled substances and drugs dispensed in or to an address in Puerto Rico. ASSMCA may contract or enter collaborative agreements with other agencies or with private entities to operate the system, and those entities are subject to the same confidentiality provisions and the same penalties.

2. 2

   Step 2: You may request the information about you

   Article 7 lists who may review prescription monitoring information, and among the figures excepted from the education requirement appears, first on the list, a person or their authorized representative as to that person’s own receipt of controlled substances or drugs. You need not be a professional nor have taken the training the law requires of the system’s professional users.

3. 3

   Step 3: If it is a minor’s, their parents or guardians request it

   The same list includes the parents or guardians of a minor, subject to state or federal confidentiality provisions. That last phrase matters: the law defers to the applicable confidentiality rules, which may vary with the minor’s age and the type of service, and we do not reproduce them here because we did not read them.

4. 4

   Step 4: Know who else may see it

   The list is closed and worth knowing: a prescriber or their authorized representative, to provide necessary health care to a patient with whom they maintain a bona fide relationship, or to examine their own history or prescribing activity; a pharmacy, dispenser or their authorized representative, to provide necessary pharmaceutical care to a bona fide patient or to examine their own dispensing activity; an officer or agent of a security or law enforcement agency or a prosecutor, in connection with investigating, administering, overseeing or enforcing the laws or regulations governing the use and handling of controlled substances or drugs; an authorized representative of a licensing and regulatory agency conducting a bona fide investigation of a prescriber or dispenser; authorized staff or contractors of the Administration itself; a forensic physician, pathologist or official investigating causes of death; a physician authorized by an addiction treatment program, for a bona fide patient within that program; and the pertinent judicial authorities, in judicial proceedings for violations of the controlled substance provisions.

5. 5

   Step 5: Four years, then it is destroyed

   The Administration shall keep prescription monitoring information for a period of no less than four (4) years from the date of collection. After that period, the information must be responsibly destroyed in a safe and adequate manner. There is an exception: when a security or law enforcement agency, a licensing and regulatory agency for prescribers or dispensers, or a judicial authority asks the Administration in writing to preserve specific information, the Administration shall preserve it.

6. 6

   Step 6: If someone disclosed it improperly, that is a felony

   The criminal penalties are among the heaviest we have read in this library, and they are asymmetric. Every person authorized to receive prescription information who knowingly and willfully discloses, reproduces or misuses it, in violation of this law, commits a felony punishable per violation by a fixed term of two (2) years’ imprisonment or a ten thousand ($10,000) dollar fine, or both, at the court’s discretion. And every unauthorized person who knowingly and willfully obtains or attempts to obtain that information commits a felony punishable per violation by a fixed term of five (5) years’ imprisonment or a twenty thousand ($20,000) dollar fine, or both.

ASSMCA runs the Program and is the one that establishes, by regulation, the procedures and standards for access, use and disclosure of the information. ASSMCA publishes on its own site a page titled PDMP, linked from its main menu; we verified it exists but its content is generated with JavaScript and we could not read it, so ask there about the current procedure to request your own information. If what happened is that a pharmacy or dispenser failed to submit information, or that an authorized person disclosed it improperly, the law directs referring the case to the appropriate professional licensing and regulatory agency for administrative sanctions; the criminal penalties are pursued by prosecutors.

• Not knowing you can review the monitoring information about yourself.
• Believing you need training to see it: the law expressly excepts you from that requirement.
• Assuming any of your physicians may consult it: a bona fide relationship with the patient is required.
• Thinking the information is kept forever: the minimum is four years and then it is destroyed, absent a written preservation request.
• Believing improper disclosure is only an administrative violation: the law makes it a felony.
• Going to ASSMCA without first asking what procedure and documents its regulation requires.
• Confusing this registry with your physician’s medical record or with your plan’s drug list.

These are the government pages this guide is based on.

• Administración de Servicios de Salud Mental y Contra la Adicción (ASSMCA)

  ASSMCA

  bvirtualogp.pr.gov

• ASSMCA

  ASSMCA

  www.assmca.pr.gov

• PDMP — ASSMCA page

  ASSMCA

  www.assmca.pr.gov