SCRIPTS Expansion

SCRIPTS Expansion

5/5/2016

Earlier this year, BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina partnered with the South Carolina Department of Health & Environmental Control (DHEC) to enhance our standard of care requirements for prescription monitoring. This new program helps decrease inappropriate use of prescription drugs by allowing you to document and verify dispensing activities for your patients in a centralized system. This prescription monitoring program (PMP) is known as the South Carolina Reporting & Identification Prescription Tracking System (SCRIPTS). The South Carolina Boards of Medical Examiners, Dentistry and Nursing assert that SCRIPTS should be part of every patient’s initial evaluation and subsequent monitoring, and is considered the standard of care.

This program was introduced as a requirement for practitioners to use for all State Health Plan members being prescribed opioids beginning March 15, 2016. We are now extending this program to all South Carolina BlueCross and BlueChoice® members being prescribed opioids effective June 1, 2016.

What is SCRIPTS?

  • SCRIPTS requires dispensing practitioners and pharmacies to collect and report dispensing activity of all CII-CIV controlled substances. As of September 1, 2014, SCRIPTS had more than 63 million records. 

  • It is intended to improve the state's ability to identify and stop diversion of prescription drugs in an efficient and cost-effective manner that will not impeded the appropriate medical use of licit controlled substances where there is a valid prescriber-patient or pharmacist-patient relationship. 

Why is this important to providers?

  • When using SCRIPTS, you will be able to view information for controlled substance (CII-CIV) prescriptions your patient has had filled for the specified time period, as well as the prescriber who prescribed them and the dispenser who dispensed them. 

  • If you receive a letter from us that indicates your patient has been identified as overusing/abusing a prescription drug you can review SCRIPTS to gauge prescribing patterns for that patient. 

What should you do?

  • SCRIPTS is a free service designed to help physicians monitor patient behavior. Create an account to use SCRIPTS at https://southcarolina.pmpaware.net

  • Talk with your patients about any adverse findings found on their SCRIPTS report. Let them know that you can lawfully monitor his or her prescriptions in accordance with SC Code Ann. Section 44-53-1610 et. seq. (Prescription Monitoring Act) 

  • Regularly review your BlueCross provider report card with your provider advocate to determine the impact you are having on improving patient prescribing patterns. 

Are there any exceptions to the SCRIPTS requirement?

Yes.  There are circumstances in which you are exempt from using SCRIPTS for patients. These exceptions are based upon the recommendations from the Governor’s Prescription Drug Abuse Prevention Council in letter to Governor Haley dated September 29, 2015.

  1. Established chronic pain patients - When a relationship between a physician and chronic pain patient has been established. Use SCRIPTS for all new patients with chronic pain prior to supplying the initial prescription. SCRIPTS should be used thereafter, at least monthly. Once a relationship has been established between the physician and patient, it is recommended that SCRIPTS be utilized at least every three months. Use SCRIPTS more frequently if you suspect abuse. 

  2. Hospice - Certified hospice patients.

  3. Patients in skilled nursing, nursing home or assisted living facilities - Patients in facilities where medications are provided by staff and are carefully monitored. 

  4. Administration - When a controlled substance is directly administered by the physician, physician’s assistant, nurse, dentist or other licensed healthcare practitioner. 

  5. Exigent circumstances - If the prescribing physician or practitioner is temporarily unable to access SCRIPTS. Examples of such circumstances may include loss of power, temporary computer problems or if SCRIPTS is inoperable. If such circumstances occur, the prescriber should document these circumstances preventing timely access to SCRIPTS in the patient’s medical record. Include the adverse impact, if any, on the patient if the prescription was not made available in a timely manner. 

  6. Issuance of less than a five day supply - If the prescription supply is for five days or less.

Frequently Asked Questions

  1. How can physicians sign up? A link is available on DHEC's website, http://www.dhec.sc.gov/scripts/, as well as a User Support Guide that details how to register. 

  2. Is a reference or query number issued after the application is submitted? There is no reference or query number with this PMP system. We recommend that physicians document in the medical chart when they queried the system. Include the date and time you accessed the system. Audits will be done post pay throughout the year to ensure providers are using the program appropriately. You may receive requests to submit medical records if the account is selected for one of these audits. 

  3. Is this program free for providers? Yes, there is no cost for practitioners, pharmacists or delegates. 

  4. Where is the data stored? The data is stored and maintained in a highly secure database. Confidentiality is of utmost importance to the PMP. 

  5. What is the turnaround time for a report? The website is available 24/7. In most cases, the patient report is available for viewing within seconds. There may be up to a 24-48 hour delay from the actual dispensing date until the data is available online. 

  6. What are the uses for SCRIPTS reports? A SCRIPTS report provides information for scheduled II-IV controlled substance prescriptions a patient has had filled for the specified time period, as well as the prescriber who prescribed them and the dispenser who dispensed them. The report should be used to supplement a patient evaluation, to confirm a patient's drug history or document compliance with a therapeutic regimen.

  7. Is it safe to say that a SCRIPTS report is complete and accurate? SCRIPTS does not warrant any report to be accurate or complete. The report is based on the search criteria entered and the data entered by the dispensing pharmacy or practitioner. It also depends on the timely submission of data from the dispensing pharmacy or practitioner. For more information about any prescription in a SCRIPTS report or to verify a prescription, please contact the pharmacy or dispensing practitioner that dispensed it. 

Additional information about SCRIPTS use and access is available at http://www.scdhec.gov/Health/FHPF/DrugControlRegisterVerify/PrescriptionMonitoring/

 

For questions about this bulletin, please contact Provider Education at 803-264-4730 or by email at provider.education@bcbssc.com