MAPS - do physicians know how to use it, really?

By Monica P. Navarro,* Vezina Law Group

Increasingly, the State of Michigan is including negligence and incompetence charges in licensing actions against physicians and other health care professionals arising out of the prescription of controlled substances. And I'm not talking about the obvious cases in which the physician should know he/she is dealing with a drug seeker. I'm talking about cases in which the physician did not suspect a drug-habit. To that defense, the State's common reply, acting through a Licensing Board, is that the physician could have known about the drug-habit had he/she checked MAPS.

So what is MAPS? It is the Michigan Automated Prescription System. It is a prescription monitoring program that is used to identify and prevent drug diversion at the prescriber, pharmacy, and patient levels by collecting Schedule 2-5 controlled substances prescriptions dispensed by pharmacies and practitioners. Collection of this prescription information allows physicians, dentists, pharmacists, nurse practitioners, physician's assistants, podiatrists and veterinarians to query this data for patient-specific reports which allow a review of the patient's Schedules 2-5 controlled substance prescription records. This enables the practitioner to determine if patients are receiving controlled substances from other providers and to assist in the prevention of prescription drug abuse. To receive information from MAPS, licensees must register

However, use of MAPS is not mandatory in Michigan. Indeed, many physicians do not even know how to use MAPS. And even if a physician knows how to use MAPS, how is that physician supposed to know when he/she MUST check MAPS in the absence of obvious drug seeking behavior by the patient. Should the physician check MAPS every single time before prescribing? Keep in mind that the MAPS report takes a good fifteen-minutes to generate, thus adding significant wait time for the patient. Should MAPS be checked only for new patients? At regular intervals? It's hard to say for sure given that the State has not issued any guidance on the expected use of MAPS, but will nevertheless charge a licensee who, in hindsight, could have used MAPS to alert himself/herself of a drug-abuse problem.

Therefore, one thing is for sure. Physicians must gain an understanding of and register with MAPS. Physicians must strongly consider using MAPS automatic monthly reporting feature, should a physician request it, which identifies and notifies physicians when their patients cross certain thresholds. And, certainly, physicians must pro-actively develop meaningful MAPS policies for their practices, ideally in consultation with their legal counsel.

*Monica P. Navarro specializes in healthcare law and related litigation, including full representation of physicians and allied-healthcare professionals. Having served as a member of the State of Michigan Board of Psychology for eight years, she has extensive experience in licensing actions. She can be reached at mnavarro@vezinalaw.com