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PDMP name: Agency Responsible: Agency Type: PDMP Website: PDMP Email: Mielo, James - Administrator 124 Halsey St Newark NJ 07102 Office: (973) 273-8010 Fax: Email: NJPMRS mieloj@dca.lps.state.nj.us ASAP Versions Accepted ASAP 1995 ASAP 1997 ASAP 3/2005 New Jersey Department of Law and Public Safety, Division of Consumer Affairs Law Enforcement Agency http://www.njconsumeraffairs.gov/pmp njpmp@dca.lps.state.nj.us ASAP 4/2007 ASAP 4-1/2010 ASAP 4-2/2011 Pharmacy in-state Pharmacy out-state/mail order Pharmacy out-state other Dispensing doctor Contact Information Rosen, Eric - 124 Halsey St Newark NJ 07102 Office: (973) 504-6584 Fax: Email: Technological Capabilities Electronic data transmissio Fax data transmission Mail data transmission Media data transmission Required Data Transmitters Veterinarian Veterans Administration Indian Health Services rosene@dca.lps.state.nj.us Data Transmission Methods Allowed Other data transmission Other: Data Collection Entity: Vendor Vendor name: Optimum Technology Data Storage Entity: Vendor Vendor name: Optimum Technology Report Generation Entity: Vendor Vendor name: Optimum Technology Data Access Method: Web Portal/On-Line Statistics Data Collection, Storage, Generation and Access Data Access Entity: Vendor Vendor name: Optimum Technology PDMP region: Statistics Year: 2014 DEA Registered Prescribers: 45,359 State population: 8,938,175 DEA Registered Dispensers: 2,093 East

Interstate data sharing PMPi Hub RxCheck Hub RxSentry Hub HIE method Other Hub Data Access via Health Information Exchang via Electronic Health Recor via Pharmacy Dispensing Syste Controlled Schedules Monitored Schedule II monitored Schedule III monitored Schedule IV monitored Schedule V monitored Data Collection and Dates Collection frequency: 1 Legislation enacted: 01-04-2008 PDMP operational 09-01-2011 Data Sharing List of states involved in sharing: CT, DE, MN, RI, VA Impediments to data sharing: MOU Signed with CT. Currently awaiting vendor configuration of PMPi Hub interface. Anticipate sharing to begin in April 2014. Patient Matching Exact Match Probablistic/Manual Matc Probablistic Match Other Match for queries If probalistic match does not provide certainty of a match, request is forwarded to system administrator for final selection Policies and Procedures Monitor other authority Human Growth hormones Remove from Monitoring Web 24/7 Fax 24/7 Web Business Hours Fax Business Hours Other Other Substances Monitored Data Request Methods and Hours of Operation Phone Business Hours Email Business Hours Mail Business Hours In-Person Business Hours Other Relevant Statutes and Rules Law/Rule Website: http://www.state.nj.us/lps/ca2/pmp/statreg.htm Law/Statute citation: NJ Statute 45: 1-45 to 1-52; 24:21-54 Regulation/Rule citation: Dr Shopper law/statute: Pill Mill law/statute: Pain Clinic law/statute: Disclosure law/statute: NJ Statute 45: 1-49(b) Data Retention Policy All Information Purged Data Retention Time: Record Retention Details: De-Identified Data Retention Details: Prescriber Information Purged Dispenser Information Purged Data Retention Patient Information Purged Drug Information Purged Retain De-Identified Data

Required Enrollment - Prescriber Required Enrollment - Dispenser PDMP Required Enrollment and Patient Query Required Patient Query - Prescriber Required Patient Query - Dispenser Required PDMP Enrollment and/or PDMP Query Detai requires physicians and pharmacists to check PDMP before prescribing/dispensing controlled substance and every 3 months thereafter. Select Data Fields Available Payment method captured Patient Identification captured Person dropping off captured Person picking up captured Ability to id prescriber specialty Prescriber: Dispenser: Miscellaneous Capabilities and Policies Authority to release de-identified data Ability to de-identified data Authority to release for epidemiological or educational purposes Engaged in release for epidemiological or educational purposes Required Notification to consumers Mandated Use of Advisory Group Patient Access to Query List Requirements to Query PDMP To register, DEA Registration number (required for certain user types), state license number (required) and NPI (If available). Regulatory Board: Regulatory Board can query by certification of investigation Law Enforcement: Law Enforcement/ Attorney General can query via grand jury subpoena and officer's certification. Attorney General: Law Enforcement/ Attorney General can query via grand jury subpoena and officer's certification. Researcher: Patient: Other: Prescriber Access to Patient History Prescriber Access to Own History Dispenser Access to Patient History Dispenser Access to Own History PDMP Available Reports Available Reports to Selected Requestors Licensing Board Access to Patient History Licensing Board Access to Licensee History Law Enforcement Access to Patient History Law Enforcement Access to Prescriber History Law Enforcement Access to Dispenser History

Requestors and Reports Authorized to Generate Requestor Type Prescriber Dispenser/Business (i.e., pharmacy) Dispenser/Person (i.e., pharmacist) Midlevel - Physician Assistant Midlevel - Nurse Practitioner Prescriber Delegate Dispenser Delegate Patient Law Enforcement - Federal Law Enforcement - State Law Enforcement - Local Prosecutorial Authority Correctional Supervision Medical Examiner/Coroner Drug Court Licensing/Regulatory Board State Health Department Medicaid Fraud and Abuse Medicaid Drug Utilization and Review Medicare Workers Compensation - State Workers Compensation - Insurance Peer Review Committee Drug Treatment Provider Third-party Payer Researchers Other PDMP Solicited Reports Unsolicited Reports In-State Out-of-State In-State Out-of-State

Requestors and Reports Being Generated Requestor Type Prescriber Dispenser/Business (i.e., pharmacy) Dispenser/Person (i.e., pharmacist) Midlevel - Physician Assistant Midlevel - Nurse Practitioner Prescriber Delegate Dispenser Delegate Patient Law Enforcement - Federal Law Enforcement - State Law Enforcement - Local Prosecutorial Authority Correctional Supervision Medical Examiner/Coroner Drug Court Licensing/Regulatory Board State Health Department Medicaid Fraud and Abuse Medicaid Drug Utilization and Review Medicare Workers Compensation - State Workers Compensation - Insurance Peer Review Committee Drug Treatment Provider Third-party Payer Researchers Other PDMP Solicited Reports Unsolicited Reports In-State Out-of-State In-State Out-of-State