29 Pain management clinic Are there penalties for noncompliance: Criminal penalties
eTable 11. Provisions excluded from LASSO high-dose dispensing models in the fentanyl phase, 2013-2016
Provision category Provision
PDMP Access What professionals have access to the PDMP data: None
PDMP Access Whose PDMP data does the law allow dispensers to access: None PDMP Access What professionals have access to the PDMP data: None
PDMP Access Whose PDMP data does the law allow prescribers to access: None PDMP Access What professionals have access to the PDMP data: None
Initial prescription
opioid limits Are exceptions to the initial prescription limit allowed: Surgical pain
33
eTable 12. LASSO coefficients, high dispensing, prescription opioid phase (2006-2009), primary analysisProvision category Provision Coefficient
PDMP Access Whose PDMP data does the law allow dispensers to access: Former patients 2.32
PDMP Access What professionals have access to the PDMP data: None 1.95
PDMP Admin Which state agency or department is responsible for operating the PDMP: Attorney General 1.42 Pain management clinic Does the PMC law require PMC sites to keep patient records: 10 years 1.39 PDMP Report What drug schedules are required to be reported to the PDMP: Federal Schedule I 0.82 PDMP Admin Is the PDMP required to report suspicious or statistically outlying prescribing, dispensing or purchasing:
Prescriber/dispenser report
0.61 PDMP Admin Is the PDMP permitted to report statistically outlying prescribing, dispensing or purchasing activity: Law
enforcement report
0.52 PDMP Access Does the law allow out-of-state law enforcement to access PDMP data: No restrictions 0.47 PDMP Access What professionals have access to the PDMP data: Medical examiner or coroner 0.46
PDMP Report How often must dispensers report data to the PDMP: Every 7 days 0.43
PDMP Report What drug schedules are required to be reported to the PDMP: State Schedule V 0.43
PDMP Admin How does the law provide funding for the PDMP: Gifts 0.4
PDMP Report Is the PDMP allowed to share data with Medicaid/Medicare: Yes 0.37
PDMP Admin How does the law provide funding for the PDMP: Grants 0.24
PDMP Admin Is the PDMP required to report suspicious or statistically outlying prescribing, dispensing or purchasing activity: Professional licensing report
0.21 PDMP Admin Is the PDMP permitted to report suspicious or statistically outlying prescribing, dispensing or purchasing:
Law enforcement report
0.19 PDMP Admin How long does the law allow PDMP data to be stored by the administrating agency: 5 years or more 0.18 PDMP Admin How long does the law allow PDMP data to be stored by the administrating agency: No timeframe specified 0.18 PDMP Access Whose PDMP data does the law allow prescribers to access: Prospective patients 0.17
PDMP Admin How does the law provide funding for the PDMP: Appropriations 0.14
PDMP Admin How long does the law allow PDMP data to be stored by the administrating agency: Between 1 to 2 years year or less
0.11 PDMP Report How often must dispensers report data to the PDMP: Between 8 and 27 days 0.1 PDMP Admin Which state agency or department is responsible for operating the PDMP: Professional licensing authority
(e.g., Pharmacy or Medical Board)
0.08
PDMP Admin Does the law require evaluation of the PDMP: Yes 0.07
PDMP Report Does the law impose restrictions on interstate sharing: Receiving state must allow reciprocity with this state 0.03
PDMP Admin Which state agency or department is responsible for operating the PDMP: Law enforcement 0.02 PDMP Admin Which state agency or department is responsible for operating the PDMP: Department of Health/HHS 0.01 PDMP Access Whose PDMP data does the law allow dispensers to access: Prospective patients 0.01
PDMP Admin How does the law provide funding for the PDMP: Charging fees -0.08
PDMP Report How often must dispensers report data to the PDMP: Real-time -0.1
PDMP Access Whose PDMP data does the law allow prescribers to access: None -0.15
PDMP Report Does the law impose restrictions on interstate sharing: Must have bilateral memorandum of understanding or data sharing
-0.23
PDMP Access What professionals have access to the PDMP data: Drug courts -0.33
PDMP Report How often must dispensers report data to the PDMP: Every 28 days or more -0.4 PDMP Report What drug schedules are required to be reported to the PDMP: State Schedule I -0.45 PDMP Admin How long does the law allow PDMP data to be stored by the administrating agency: 1 year or less -0.47 PDMP Admin Is the PDMP permitted to report suspicious or statistically outlying prescribing, dispensing or purchasing
activity: Professional licensing report
-0.57
PDMP Admin Does the law require the PDMP to have an advisory/oversight board: Yes -0.61
PDMP Access Does the law allow patients to access their own PDMP data: Yes -0.8
PDMP Access Does the law allow in-state law enforcement to access PDMP data: No restrictions -1.06 PDMP Admin How long does the law allow PDMP data to be stored by the administrating agency: Between 2 to 5 years -1.22 PDMP Access Does the law allow in-state law enforcement to access PDMP data: Subpoena -1.38 No PO limits were enacted between 2006 and 2009 so these provisions were excluded. Only provisions with non-zero coefficients identified by the LASSO model are shown and were subsequently included in the random forest models however after rounding coefficients could be displayed as zero.
35
eTable 13. LASSO coefficients, high dispensing, heroin phase (2010-2012), primary analysisProvision Category Provision Coefficient
PDMP Report
Does the law impose restrictions on interstate sharing: Receiving state must allow reciprocity with this
state 0.84
PDMP Access Whose PDMP data does the law allow dispensers to access: Prospective patients 0.73
PDMP Access Whose PDMP data does the law allow prescribers to access: Former patients 0.63
PDMP Access What professionals have access to the PDMP data: Medical examiner or coroner 0.59 Pain Management Clinic What is the maximum supply of medication that PMC physicians can prescribe: 30-day supply 0.59
PDMP Admin How does the law provide funding for the PDMP: Gifts 0.58
PDMP Report Is the PDMP allowed to share data with private insurers: Yes 0.49
PDMP Admin Is the PDMP permitted to report suspicious or statistically outlying prescribing, dispensing or purchasing
activity: Professional licensing report 0.33
Pain Management Clinic
What criteria is used to determine if a practice is subject to the PMC law: Specific percentage of patients
being treated for pain 0.3
PDMP Admin Is the PDMP required to report suspicious or statistically outlying prescribing, dispensing or purchasing:
Prescriber/dispenser report 0.27
PDMP Report What drug schedules are required to be reported to the PDMP: Federal Schedule I 0.22 PDMP Access Does the law allow out-of-state law enforcement to access PDMP data: No restrictions 0.19 PDMP Admin How long does the law allow PDMP data to be stored by the administrating agency: No timeframe
specified 0.19
PDMP Admin How does the law provide funding for the PDMP: Appropriation provisions 0.16
PDMP Report What drug schedules are required to be reported to the PDMP: State Schedule II 0.12 PDMP Report What drug schedules are required to be reported to the PDMP: State Schedule V 0.12
PDMP Admin Does the law exempt PDMP data from open records or FOIA laws: Yes 0.09
PDMP Access
Does the law allow out-of-state law enforcement to access PDMP data: Warrant, judicial finding of
probable cause 0.08
Admin Does the law require or permit PDMP to release de-identified data for research or education: Yes 0.05 PDMP Admin Which state agency or department is responsible for operating the PDMP: Department of Health/HHS 0.04 PDMP Admin Is the PDMP permitted to report statistically outlying prescribing, dispensing or purchasing activity: Law
enforcement report 0.04
PDMP Admin Which state agency or department is responsible for operating the PDMP: Consumer protection 0.02 PDMP Report Does the state require prescribers to check the PDMP before prescribing: Every patient, every time 0.02 PDMP Admin Which state agency or department is responsible for operating the PDMP: Attorney General 0.01
PDMP Access Whose PDMP data does the law allow dispensers to access: None 0
PDMP Access What professionals have access to the PDMP data: Drug courts -0.05
PDMP Report How often must dispensers report data to the PDMP: Real-time -0.05
PDMP Admin Is the PDMP required to report suspicious or statistically outlying prescribing, dispensing or purchasing:
Other -0.06
Pain Management Clinic Are PMC professionals required to have any specific controlled substance training: Yes -0.07 PDMP Report What drug schedules are required to be reported to the PDMP: State Schedule I -0.07 Pain Management Clinic
What criteria is used to determine if a practice is subject to the PMC law: Practice delivers pain
management services -0.1
PDMP Admin Does the law require evaluation of the PDMP: Yes -0.17
PDMP Admin How long does the law allow PDMP data to be stored by the administrating agency: Between 1 to 2 years -0.23
PDMP Report Does the law permit the PDMP to share data with other state PDMPs: Yes -0.23
PDMP Access Does the PDMP allow delegates to access data: Yes -0.28
PDMP Admin How does the law provide funding for the PDMP: Charging fees -0.28
PDMP Report Does the state require dispensers to check the PDMP before dispensing: New patients only -0.31
PDMP Report How often must dispensers report data to the PDMP: Every 28 days or more -0.32
PDMP Report Does the law impose restrictions on interstate sharing: Receiving state must allow reciprocity with this
state -0.37
PDMP Admin Is the PDMP permitted to report suspicious or statistically outlying prescribing, dispensing or purchasing
activity: Professional licensing report -0.56
PDMP Report What drug schedules are required to be reported to the PDMP: Not specified -0.58
PDMP Access Whose PDMP data does the law allow prescribers to access: None -0.65
PDMP Access Does the law allow patients to access their own PDMP data: Yes -0.81
PDMP Access Does the law allow in-state law enforcement to access PDMP data: No restrictions -0.9
PDMP Access Does the law allow in-state law enforcement to access PDMP data: Subpoena -1.49
PDMP Access What professionals have access to the PDMP data: None -2.29
Only provisions with non-zero coefficients identified by the LASSO model are shown and were subsequently included in the random forest models however after rounding coefficients could be displayed as zero.
37
eTable 14. LASSO coefficients, high dispensing, fentanyl phase (2013-2016), primary analysisProvision category Provision Coefficient
PDMP Report Does the law impose restrictions on interstate sharing: Physically bordering states only or higher priority 1.74
PDMP Access Whose PDMP data does the law allow dispensers to access: Former patients 1.24
Pain Management Clinic What criteria is used to determine if a practice is subject to the PMC law: Practice directly dispenses opioids 1.07 Pain Management Clinic What are the owner requirements: Certification in pain management 0.97 PDMP Admin Is the PDMP required to report suspicious or statistically outlying prescribing, dispensing or purchasing: Law
enforcement report
0.89
PDMP Admin Does the law require the PDMP to have an advisory/oversight board: Yes 0.79
PDMP Access Does the law allow in-state law enforcement to access PDMP data: Active investigations 0.77
PDMP Report Does the law impose restrictions on interstate sharing: No restrictions 0.62
Pain Management Clinic What is the maximum supply of medication that physicians can prescribe: 30-day supply 0.57 Initial Prescription
Opioid Limits
What substances are specified in the initial prescription limit: Schedule II 0.55
PDMP Admin How does the law provide funding for the PDMP: Grants 0.49
Pain Management Clinic Does the law require that a medical director be physically present at the pain clinic: Yes 0.39
Pain Management Clinic Does the law require pain management certification: Annual 0.37
PDMP Admin How long does the law allow PDMP data to be stored by the administrating agency: No timeframe specified 0.36
PDMP Admin How does the law provide funding for the PDMP: No funding specified 0.32
PDMP Report What drug schedules are required to be reported to the PDMP: Federal Schedule I 0.32
PDMP Report How often must dispensers report data to the PDMP: Every 7 days 0.3
PDMP Access Whose PDMP data does the law allow dispensers to access: Prospective patients 0.27 Pain Management Clinic What criteria is used to determine if a practice is subject to the PMC law: Practice advertises as a pain clinic 0.22 PDMP Report What drug schedules are required to be reported to the PDMP: Federal Schedule V 0.19 PDMP Access Whose PDMP data does the law allow prescribers to access: Prospective patients 0.15
PDMP Report How often must dispensers report data to the PDMP: Between 8 and 27 days 0.15
Initial Prescription
Opioid Limits Is there an initial prescription limit law: 30 days 0.13
PDMP Report What drug schedules are required to be reported to the PDMP: State Schedule V 0.13
PDMP Access What professionals have access to the PDMP data: Law enforcement 0.11
PDMP Access Does the law allow in-state law enforcement to access PDMP data: Active investigations 0.1
PDMP Access What professionals have access to the PDMP data: Drug courts 0.05
PDMP Access What professionals have access to the PDMP data: Medical examiner, coroner 0.05 PDMP Admin How long does the law allow PDMP data to be stored by the administrating agency: 1 year or less -0.02 Pain Management Clinic Are pain clinic physicians required to check the PDMP prior to prescribing opioids: Yes -0.04
PDMP Admin How does the law provide funding for the PDMP: Appropriation provisions -0.04
PDMP Admin Is the PDMP required to report suspicious or statistically outlying prescribing, dispensing or purchasing:
Prescriber or dispenser
-0.07
Pain Management Clinic Are there penalties for noncompliance: Disciplinary Action -0.09
PDMP Access Does the law require or permit PDMP to release de-identified data for research or education: Yes -0.1 PDMP Admin Is the PDMP permitted to report suspicious or statistically outlying prescribing, dispensing or purchasing activity:
Professional licensing report -0.1
PDMP Access Does the law allow in-state law enforcement to access PDMP data: Subpoena -0.15
PDMP Admin How does the law provide funding for the PDMP: Charging fees -0.15
PDMP Report How often must dispensers report data to the PDMP: Every 28 days or more -0.15
Pain Management Clinic What are the owner requirements: Physically present at clinic -0.16
PDMP Access Does the law allow in-state law enforcement to access PDMP data: No restrictions -0.23 PDMP Report Does the state require prescribers to check the PDMP before prescribing: Chronic pain patients -0.24 PDMP Report Does the state require prescribers to check the PDMP before prescribing: Chronic pain patients -0.27
PDMP Access Does the law exempt PDMP data from open records or FOIA laws: Yes -0.27
Pain Management Clinic Are there penalties for noncompliance: Criminal -0.35
PDMP Access Whose PDMP data does the law allow dispensers to access: Current -0.38
Pain Management Clinic Does the law require clinic sites to keep patient records: 5 years -0.43
PDMP Access Does the law allow patients to access their own PDMP data: Yes -0.45
PDMP Report Does the state require dispensers to check the PDMP before dispensing: New patients only -0.5 PDMP Admin How long does the law allow PDMP data to be stored by the administrating agency: Between 2 to 5 years -0.5
PDMP Access Does the PDMP allow delegates to access data: Yes -0.56
Initial Prescription Opioid Limits
Are exceptions to the initial prescription limit allowed: Hospice -0.6
PDMP Report Does the state require dispensers to check the PDMP before dispensing: Every patient, every time -0.6 PDMP Report What drug schedules are required to be reported to the PDMP: Not specified -0.62 PDMP Report What drug schedules are required to be reported to the PDMP: State Schedule I -0.9 PDMP Admin Which state agency or department is responsible for operating the PDMP: Professional licensing authority (e.g.,
Pharmacy or Medical Board)
-0.94