By Ryan Ekvall | Wisconsin Reporter
MADISON – Your dog is sick. Quick, what do you do?
Get her to the veterinarian, of course.
But when you arrive, be prepared to provide your pooch’s birth date, middle name and Medicare identification numbers.
Yep, under the state’s Prescription Drug Monitoring Program, or PDMP, veterinarians this year will be required to report such information electronically.
Chalk it up to yet another unintended consequence of state law.
In 2009, then-Gov. Jim Doyle signed Act 362, requiring pharmacists to record an array of information when dispensing drugs. The idea is to crack down on “doctor shopping,” where a junkie, unable to renew a prescription from his current provider, shops around for a doctor who will write a prescription, usually unaware of the patient’s drug history.
The law includes veterinarians.
“The way the bill was written it included ‘pharmacist or practitioners’ who dispense prescription drugs. So when it got to the pharmacy board, the way it was defined, veterinarians were going to be part of the law,” said Rep. Dean Knudson, R-Hudson, a practicing veterinarian. “That wasn’t the original intent of the law.”
The word “practitioner” opened the door to the inclusion of veterinarians in the law.
“The pharmacy board recognized this was an issue, but without statutory change they couldn’t make an exemption,” Knudson said.
The Wisconsin Pharmacy Examining Board delayed veterinarians from reporting for 90 days after the program launched on Jan.1.
Knudson since has introduced a bill that has gained rare bipartisan support to exempt veterinarians from the Prescription Drug Monitoring Program. It passed the Assembly Committee on Agriculture earlier this week. The Assembly is expected to take up the bill Tuesday.
If the Legislature doesn’t act, it could cost the roughly 3,000 licensed veterinarians in Wisconsin a combined$7 million or more per year to comply with the letter of the law, according to the Wisconsin Veterinarian’s Medical Association.
Kim Brown Pokorny, executive director of the WVMA, said veterinarians don’t have a uniform health care record system for veterinary medicine. Because vets don’t typically deal with insurance companies, Medicare or Medicaid, most don’t keep electronic records.
For the vets that do, Pokorny said the computer software doesn’t collect the fields required by the law.
“They have to run like three or four different reports and manually enter it in the Excel sheets. It’s a massive obstacle,” she said.
The WMVA asked some of its members to test how long it would take to comply with the law and found it took at least an hour a day to record the information and more time to upload it to software. At $24 an hour for staff, the costs pile up quickly, taking time away from money-making activities, like, say treating patients, dwindles.
The National Alliance for Model State Drug Laws, a nonprofit, bipartisan organization funded by congressional appropriations each year, takes a different stance. Veterinarians should report dispensing information to the PDMP in order to close a potential loophole for diversion, a representative of the organization told Wisconsin Reporter.
The WMVA, however, contends those instances are rarer than a three-legged cat.
“Indeed, in all the years of my practicing in a very large veterinary hospital, I can count on one hand, with fingers to spare, the number of situations where a client attempted to obtain controlled substances inappropriately,” said Dr. K.C. Brooks, testifying at the committee hearing.
Drugs with street names such as Special K — ketamine — are administered by vets, but as an anesthetic, not prescription. Other drugs, the WMVA contends, may let a 10-pound cat catch a buzz if administered improperly, but have no effect on a 200-pound man.
Another vet testified he identified two abusers during his 30 year career in the field – one a person, one a cat.
An animal’s owner looking to abuse the system must go through the trouble of presenting an injured or ailing pet before getting painkillers. Knudson said it raises eyebrows if a pet owner comes in asking for specific medication for an animal’s ailment.
Veterinarians also are required to keep logs of the drug prescriptions they write for potentially unannounced Drug Enforcement Agency audits.
‘Reform poster child’
Eighteen other states require veterinarians to report at least some of the data requirements under the PDMP as of July 2012. South Carolina, Kentucky and Arizona have indicated they may move to exempt vets in the future, according to a study by the Minnesota Board of Pharmacy. The study also found most states were unable to point to a case of diversion of controlled substances the National Alliance for Model State Drug Laws is worried about.
At the beginning of Wisconsin’s legislative session, Republicans introduced an ambitious initiative they called “Right the Rules,” aimed at reviewing all the state’s regulations and altering or eliminating the onerous ones.
Veterinarians responded overwhelmingly to Gov. Scott Walker’s separate Small Business Regulatory Review Board about what they say are undue burdens the drug monitoring program law creates. The review board agreed and suggested that portion of the law be repealed.
“This could be the poster child for regulatory reform,” Knudson said. “A well-meaning Legislature wrote a law and well-meaning regulators make sure it’s being followed, but it just doesn’t do what it was intended to do.”
Contact Ryan Ekvall at firstname.lastname@example.org