State-by-State Doctor Shopping Prevention Silos

By Doug Brockway

February 23, 2015

PMPs as currently designed and governed cannot look beyond state lines and thus cannot stop doctor shopping across state lines.

Because PMPs do not operate across state lines, multiple prescriptions can be written in one state and filled a very short time later in another state with no-one the wiser.

In the North East this is a big problem.  In Eastern Massachusetts, where I am at this moment, I can be in New Hampshire in 20 minutes, in Rhode Island in less than an hour, and in Connecticut, Vermont or Maine in less than two hours.  New York State is less than three hours away.

But even in the middle of the US the lack of inter-state controls over doctor shopping endanger us all.  Take St. Louis, for example.  According to the firm Inbound Logistics, Items shipped by truck from the bi-state region reach 70 percent of the U.S. population within 48 hours. A doctor shopper can do the same.  A doctor shopper with an airline ticket is faster.

Of all the reasons that PMPs cannot fully respond to Doctor Shopping this one requires inter-state cooperation.  It requires that an easy-to-use, fast method be developed for a doctor or pharmacist to see all the PMP records of an individual. 

This means a cross-state method of identifying patients (for personal security reasons it cannot be the social security number) and a way to use that identifier to collect from and deliver doctor shopping relevant information to doctors and pharmacists. 

The credit card networks do this today.  A similar capability exists as an overlay for existing PMPs.  Solutions like these are needed in order to provide sufficient integration across PMPs that interstate doctor shopping is slowed if not prevented.