​​Background

The Maryland Prescription Drug Monitoring Program (PDMP) collects information on all Schedule II–V controlled dangerous substance (CDS) prescriptions dispensed in Maryland and makes these data available to authorized end users. In addition to disclosing data solicited by authorized users, the PDMP may also proactively notify certain individuals or entities when outlier patient or prescriber behavior is identified. Unsolicited Reporting refers to the activity of analyzing PDMP data for indicators of concern and then proactively reporting relevant PDMP data to a specific individual or entity based on those findings.

Unsolicited Reporting is considered a national best practice and has been adopted by most states. Under HB025 (Chapter 531, Prescription Drug Monitoring Program – Revisions, 2019), the Office of the PDMP is required to review prescription monitoring data for indications of possible misuse or abuse of prescription drugs by patients and possible violations of law or breaches of professional standards by prescribers or dispensers. The Office of the PDMP is then required to provide education to providers who are identified through this review.

The letters, also referred to as Unsolicited Reporting Notifications (URNs), are provided for educational and practice improvement purposes with the goal of supporting clinical decision-making and reducing the risk of adverse outcomes for patients receiving CDS prescriptions. URNs are not public record. Providers should apply their clinical judgement when interpreting these notifications, taking into account each patient's history, diagnosis, care plan, hospice involvement, ​or complex pain management needs. Each URN also includes educational resources.

Since 2016, the Office of the PDMP has sent URNs by mail using the address prescribers provide to the DEA. In 2022 the PDMP began transitioning to sending URNs electronically.​