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PDMP name: Agency Responsible: Agency Type: PDMP Website: PDMP Email: Higgins, Ronnie - Special Agent 40 Pryor St SW, Ste 2000 Atlanta GA 30303 Office: (404) 656-5100 Fax: (404) 651-8210 Email: rhiggins@gdna.ga.gov ASAP Versions Accepted ASAP 1995 ASAP 1997 ASAP 3/2005 Georgia Drugs and Narcotics Agency Law Enforcement Agency www.hidinc.com/gapdmp 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 Georgia Contact Information Office: 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 Data Transmission Methods Allowed Other data transmission PDMP region: Other: Out of State Pharmacies are Voluntary Data Collection Entity: Vendor Vendor name: Health Information Designs, Inc. (HID) Data Storage Entity: Vendor Vendor name: Health Information Designs, Inc. (HID) Report Generation Entity: Vendor Vendor name: Health Information Designs, Inc. (HID) Data Access Method: Web Portal/On-Line Statistics Statistics Year: 2014 DEA Registered Prescribers: 36,381 State population: 10,097,343 Data Collection, Storage, Generation and Access DEA Registered Dispensers: 2,463 Data Access Entity: Vendor Vendor name: Health Information Designs, Inc. (HID) South

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: 7 Legislation enacted: 05-13-2011 PDMP operational July 2013 Data Sharing List of states involved in sharing: Impediments to data sharing: Exact Match Probablistic Match Policies and Procedures Monitor other authority Remove from Monitoring Web 24/7 Fax 24/7 Web Business Hours Fax Business Hours Other Patient Matching Other Substances Monitored Probablistic/Manual Matc Other Match for queries 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://sos.ga.gov/cgi-bin/plblaws.asp?board=03 Law/Statute citation: GA Code 16-13-57 to -65 Regulation/Rule citation: Dr Shopper law/statute: GA Code 16-13-43 (a) (6) Pill Mill law/statute: Pain Clinic law/statute: Disclosure law/statute: GA Code 16-13-64 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 Patient Query Details: Requires each physician owning or practicing in a pain management clinic to register with the PMP and must regularly check the PMP on all new and existing patients 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: Regulatory Board: Law Enforcement: Attorney General: Researcher: Patient: Other: Prescriber Access to Patient History Prescriber Access to Own History Dispenser Access to Patient History Dispenser Access to Own History 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 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 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 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