Controlled Substance Monitoring Database Program

Copies of all minutes are maintained in the official record section of the administrative office. Please contact the board administrator to make arrangements to review minutes of meetings held prior to 2004.

• February 11, 2025
• February 13, 2024
• August 29, 2023
• February 21, 2023
• October 18, 2022
• June 21, 2022
• February 15, 2022 
  
• October 12, 2021
• June 22, 2021
• February 2, 2021
• October 6, 2020
• June 23, 2020
• February 3, 2020
• October 8, 2019
• July 9, 2019
• April 9, 2019 (Cancelled)
• February 4, 2019
• October 2, 2018
• July 10, 2018
• April 10, 2018
• February 6, 2018
• October 17, 2017
• July 25, 2017
• May 16, 2017 (Meeting Canceled)
• March 21, 2017
• January 31, 2017
• October 4, 2016
• August 16, 2016 (Meeting Canceled)
• June 7, 2016
• March 22, 2016
• January 25, 2016
• October 13, 2015
• August 25, 2015
• March 31, 2015
• January 26, 2015 
• October 21, 2014
• July 15, 2014
• May 13, 2014
• January 27, 2014
• October 8, 2013
• August 20, 2013
• April 16, 2013
• January 8, 2013

If required to register as set out above, a Healthcare Practitioner, both prescribers and dispensers, or their agents must register within 30 days of receiving a DEA number or becoming an agent of a Healthcare Practitioner with a DEA number.

Go to www.tncsmd.com and click on the word “register” to begin the registration process. Completion of the registration process will require specific identifying elements. Once registration is complete and approved, you will receive an email with your username and instructions to create a password.  Medical Examiner role is only for State Medical Examiners.

Yes, if you are authorized to practice in TN and otherwise qualified to register in TN you can register. Otherwise, you should register with home state PDMP and TN has agreements to share with the majority of states.

Initially, the system will send you an email with a link to create a password. The password requirements are:

·        Passwords must contain a minimum of eight (8) characters

·        One uppercase alphabet letter

·        One lowercase alphabet letter

·        One number character

·        One special character (EXAMPLE: +, $, %)

·        Must not be the same as your previous password

If you are unable to log in, you may select Forgot/Reset Password and provide answers to the security questions you selected at registration or choose to have the system send a link to the email contained in your “My Account”/user profile in the CSMD. You will be able to create a new password using one of the two options provided. If you are unable to create a new password from those two options, then you will need to send an email to CSMD.ADMIN@tn.gov:  or call 615-253-1305 for assistance.

Attached are the instructions on how to fix this error message in the CSMD for Google Chrome and Microsoft Edge. 

You can still register at www.tncsmd.com, but you will need to obtain a Tennessee State ID. You will input the Tennessee State ID number into the Driver’s License field when registering. If you hold a Driver’s License from another state, you can register with the CSMD, but it may require manual validation by the CSMD Team.

In order to assure you maintain access to the system, you must always keep a unique active email address. Please be sure to update your account as needed by navigating to the “My Account“ link after successfully logging in at www.tncsmd.com.

The delegate will start the process by registering for the CSMD at www.tncsmd.com by choosing the appropriate role (licensed or unlicensed Health Care Extender Practitioner if you work for a prescriber and Health Care Extender Pharmacist for pharmacy technician). After picking the appropriate role, the delegate must provide all of the required information. To connect to the supervising practitioner or supervising pharmacist, the registrant will need their supervisor’s driver's license number. When this number is added, the name of the supervisor will appear for selection to add to the registration. Once the registration is complete by either auto-approved or manually approved, the supervisor selected will receive an email communicating there is a Health Care Extender/Delegate waiting for supervisory approval. The supervisor and or Health Care Extender/Delegate can revoke/inactivate a relationship at any time by logging into the CSMD and navigating to the “My Account” to discontinue the relationship.

The Supervisor will receive an email every time a Health Care Extender/Delegate or an APRN/PA adds that user as a supervisor to make the supervisor aware of the action. It is the responsibility of the supervisor to log in the CSMD and either approve or revoke the supervisory relationship. At any point in time, you no longer supervise a CSMD user in your account, log into the CSMD and

“ inactive/revoke” that relationship by logging in to the CSMD and navigating to “My Account”.

All healthcare practitioners are required to check the CSMD before prescribing an opioid, benzodiazepine, or Schedule II amphetamine to a human patient:

(1)   at the beginning of a new episode of treatment;

(2)   prior to each new prescription for the first 90 days of that treatment; and

(3)   every six (6) months thereafter if that treatment is continued.

A new episode of treatment means a prescription for a controlled substance that has not been prescribed by that healthcare practitioner within the previous six (6) months. A new episode of treatment includes not only changes to specific drugs but also all changes to dosage and frequency of the drugs prescribed.

Healthcare practitioners are required to check the CSMD before dispensing an opioid, benzodiazepine or Schedule II amphetamines as a new episode of treatment to a human patient: (1) for the first time at that practice site and (2) every six (6) months thereafter if that treatment is continued.

However, healthcare practitioners are not required to check, pursuant to statute, if: (a) the controlled substance is prescribed or dispensed for a patient who is currently receiving hospice care; ; (b) the quantity of the controlled substance which is prescribed or dispensed does not exceed an amount which is adequate for a single, three-day treatment period and does not allow a refill; or (c) the controlled substance is prescribed for administration directly to a patient during the course of inpatient or residential treatment in a hospital or nursing home licensed under title 68. 

Before prescribing or dispensing, a healthcare practitioner is also required to check the database if the healthcare practitioner is aware or reasonably certain that a person is attempting to obtain a Schedule II-V controlled substance, identified by the committee or commissioner as demonstrating a potential for abuse, for fraudulent, illegal, or medically inappropriate purposes, in violation of § 53-11-402.

An authorized healthcare practitioner’s delegate may check the database on behalf of the healthcare practitioner.

Note: It may be a good practice for healthcare practitioners to regularly check the database to arm themselves with sufficient information to guide their decisions concerning treatment plans, to keep abreast of their patients’ morphine milligram equivalents (MME) dosages, multiple provider episodes, and to decrease the risk of adverse effects from prescribing.

Licensed veterinarians are not required to check the database before prescribing a controlled substance to a non-human patient. However, changes to the scheduling of certain drugs, most pertinently gabapentin, may affect the requirements related to the treatment of non-human patients.

A person licensed, registered, or otherwise permitted to prescribe, distribute, or dispense a controlled substance in the course of professional practice.

A certified registered nurse anesthetist (CRNA) as described in Section 63-7-103 of the Tennessee Code Annotated. Tennessee is one of the first states to allow direct access for CRNAs without a DEA Registration.

Healthcare practitioner delegates may register with the permission and supervision of a healthcare practitioner.

Additionally, the law allows a number of other state and federal officials to register with the database including, certain law enforcement officers, medical examiners, drug court judges, and others. For more information regarding such registration please refer to Tenn. Code Ann. § 53-10-306.

The law requires that each person or entity operating a practice site where a controlled substance is prescribed or dispensed to a human patient shall provide for electronic access to the database at all times when a healthcare practitioner provides healthcare services to a human patient potentially receiving a controlled substance. A violation of this requirement is punishable by a civil penalty not to exceed one hundred dollars per day assessed against the person or entity operating the practice site; the penalty shall only be imposed when there is a continued pattern or practice of not providing electronic access to the database.

Please send an email to CSMD.admin@tn.gov with as much detail as possible including screenshots with any messages or errors about the issue and your direct contact information or call 615-253-1305.

The committee members shall be:

One of the governor-appointed licensed members of each of the following healthcare professional licensure boards or committees: (A) The board of medical examiners; (B) The board of osteopathic examination; (C) The board of dentistry; (D) The board of podiatric medical examiners; (E) the board of optometry;  (F) The board of veterinary medical examiners; (G) the board of nursing; The board of medical examiners’ committee for physician assistants; and The board of pharmacy; and one (1) of the members of the board of pharmacy and one (1) of the members of the board of medical examiners who were appointed to those boards to represent the general public. The boards shall choose those representatives.

Yes. First, hover over the REQUEST tab on the upper navigation bar, and then choose “Practitioner Self-Lookup” from the list. A page will display defaulted to your DEA. Choose the timeframe that you want to view and then click “View Report”. This will produce a report of all prescriptions dispensed and attributed to your DEA. You have the ability to export this report as a PDF to perform a further review of the information. This report also allows you to generate a report for a specific patient for a specified time and see only the prescription you have written for that patient. Populate the patient information and choose “View Report” and you are able to save this report as a PDF for further review.

If there are any prescriptions on your report that do not belong to you, please check with the pharmacy that dispensed the prescription so they can assess a potential forgery or correct any errors. Please allow thirty (30) days after requesting the pharmacy or other dispenser correct an error to allow time to get the correction in the database. After thirty (30) days, you should notify the CSMD program if the error has not been corrected.

If after a conversation with the pharmacy fraudulent activity is identified, please report any fraudulent patient activity to local law enforcement as necessary.

Yes. Under the “Request” tab, click on “Practitioner v. Peer”. The system will default to the prior month, but you may change the time frame with the dropdown boxes. The system will show your rank out of those in the same specialty which you reported to the CSMD upon registration. This ranking is based on the total number of prescriptions dispensed during the chosen time period.

From the “Practitioner Self-Lookup” page, there is a dropdown box which lists the prescribing supervisees associated with your account. From here, you may run a report on a selected supervisee or select to run on all supervisees.

Once you are logged into the CSMD there is a step by step instruction available within the application by clicking the  question mark in the dark blue bar on the right side. This will display text instructions to walk you through a patient request. Hover over the REQUEST tab on the top navigation bar. Then choose “New Request” and a page will appear that defaults to a PATIENT report. Fill in the patient’s LAST NAME, FIRST NAME, and DOB (date of birth). Scroll down the page and locate the Date Range. It defaults to the past year, but you can change that by clicking on the check mark in the box and entering the dates correctly (mm/dd/yyyy). You must choose the type of report output you want, either ”PDF” or ”XLS”. If you would like to query other states to determine if your patient has data, mark the appropriate checkbox by the states, and then click SUBMIT at the very bottom of the page.

The system will show you an indicator (a green spinning wheel or task bar depending on your browser) while it is searching the database. Multiple state data will be return if the user is authorized to view another state’s data. Once the taskbar disappears, a screen will come up with the “Patient Rx History Report” link in the middle of the page. Click on that link and the file can be Opened or Saved. This link is only used if running data on the CSMD. If you run a multi-state report, please click the “Display all Results” button instead of the “Patient Rx History Report” hyperlink.

Potentially you may share that information. As long as the information shared is contained in the patient’s medical record and the sharing is otherwise allowed under the law, it may be shared with a third-party payer. The Prescription Safety Act of 2016 explicitly provides that CSMD reports may be placed in a medical record and that “[o]nce placed in a patient’s medical records, [a CSMD report] shall be subject to disclosure on the same terms and conditions as medical records.” Tenn. Code Ann. § 53-10-306(h)(4).

As such, under the Prescription Safety Act, it is legally permissible to share CSMD reports contained within a medical record as long as that sharing is in compliance with all other legal requirements.

Yes, any healthcare practitioner who prescribes or dispenses controlled substances who has actual knowledge that a person has knowingly, willfully, and with intent to deceive, obtain or attempted to obtain a controlled substance must report that information within five (5) business days to the local law enforcement agency. A reporting form (Practitioner Report of Potential Doctor Shopper to Law Enforcement) is available at:  http://tn.gov/assets/entities/health/attachments/PH-4152.pdf

Please call your nearest law enforcement agency and/or the Tennessee Dangerous Drug Task Force at 423-752-1479 or fax the completed form to 423-267-8983.

Exception: Any healthcare practitioner who has actual knowledge that a person has knowingly, willfully, and with the intent to deceive, obtain or attempted to obtain a controlled substance and who is providing treatment to a person with a mental health illness, may, but is not required to, report the information to law enforcement personnel.

Yes. To review queries performed by delegates, click on "Request" and then “View Request” and you will find a dropdown box listing all delegates/ extenders associated with your registration. Choose a delegate/extender and the time period you wish to review, and you may review all queries performed by that individual during the chosen time period. Information regarding those delegate/extenders will remain viewable for the supervised time period in cases where you no longer supervise that delegate/extender.

While the requirements of the Prescription Safety Act are generally applicable to veterinarians, the Act provides that licensed veterinarians who never prescribe a controlled substance in an amount intended to treat a non-human patient for more than five (5) days are not required to register in the database. Licensed veterinarians are not required to check the database prior to prescribing an opioid or a benzodiazepine to a non-human patient. Moreover, licensed veterinarians are not required to report to the database drugs dispensed which are limited to an amount adequate to treat a non-human patient for a maximum of five (5) days.

The monitoring is conducted by the Tennessee Department of Health staff and overseen by the CSMD Committee. The committee seeks to identify unusual patterns of prescribing and dispensing controlled substances that appear to be higher than normal, taking into account the particular specialty, circumstances, patient-type or location of the healthcare practitioners.

The application provides visual help on many pages by clicking on the blue question mark () located on the right side of the page. Many pages will have a “Show Me” where a video will demonstrate how to perform the task, but some will only contain a text walk through of how to perform the task. The CSMD Administrators are available via email CSMD.ADMIN@TN.GOV or by phone at 615-253-1305.

Failure to comply with the requirements of the CSMD laws may subject a licensee to discipline by the licensing board. Additionally, the Prescription Safety Act of 2016 allows for criminal penalties under certain circumstances.

A complaint form is available by navigating to the complaints website. The form for health care providers can be submitted electronically or if you choose to print and fill out the form it should then be sent to the Office of Investigations, The complaint form for a pharmacist or pharmacy may be printed and filled out and sent to the Board of Pharmacy.

In many cases, yes. The Tennessee Department of Health is authorized to enter into agreements with other states or other entities acting on behalf of a state for the purposes of sharing and dissemination of data and information in the database as of January 1, 2013. As agreements are finalized users will have the option to view other states' data by checking the appropriate boxes at the bottom of the patient request screen. At this time the Tennessee Department of Health has data-sharing agreements with Alabama, Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Nevada, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Virginia, West Virginia, Wisconsin and one-way data sharing (allowing Tennessee to receive data) with Military Health System prescription monitoring program

Please note incorporating additional states into the reports you generate may increase response time or in some cases, a timeout as TN has no control of the response time from other states. Additionally, please be aware that each linked state has different laws regarding what roles have access to and the use of their prescription monitoring information.

Tennessee law requires all prescribers who prescribe controlled substances and provides direct care to patients in Tennessee for more than 15 calendar days per year to register with the database. Additionally, Tennessee law requires essentially all prescribers who prescribe opioids or benzodiazepines to register with the database. However, federal law is allowed to override any such requirements. As such to the extent state law and federal law are in conflict, the applicable federal law will control.

To register go to http://www.tncsmd.com and choose the Practitioner from the job type and enter all the required information.

An individual user may choose to change their Internet Browser settings to allow their assigned login ID to be saved in the Browser Cookie. By choosing to save their assigned login ID in the Cookie, the "Username" field will automatically be populated with their assigned login ID. For assistance, you should contact your Information Technology Department. Each user is responsible for maintaining the confidentiality of their username and password.

Beginning June 15th, 2022, Microsoft will stop supporting Internet Explorer. For healthcare providers to experience the best performance, the following browsers are recommended: Microsoft Edge, Safari, Google Chrome, or Firefox.

APRN and PA users must identify all supervisors (related to prescribing controlled substances) in the CSMD by entering the supervisors’ driver’s license number. For current registrants, please click on “My Account” to update this information.

From the “My Account” screen, scroll down to the “Supervisor Relationships” section. Existing supervisors already reported to the CSMD will appear and to add additional supervisors, users may simply enter the driver’s license number and issuing state and click the “Add” button. Click “Save” at the bottom of the page to save the edits and the user will receive a message that the edit has been successfully entered.

For new supervisory relationships that involve a practice location not already in their “My Account” information, users will need to add in the details of the practice location and then may add the supervisor’s driver’s license number and issuing state. A popup box will appear with the practice locations associated with that supervisory registrant and the supervisee should select the appropriate location or locations and click “Add the Selected Provider”. This should return the user to the “My Account” screen. Click “Save” at the bottom of the page to save the edits and the user will receive a message that the edit has been successfully entered.

The supervising physician associated with that driver’s license number will be notified by email and also upon next logging into the CSMD that delegates are awaiting approval. The supervising physician may then navigate to the “My Account” screen which will list all previously approved as well as pending delegate relationships. Click “Approve” to accept the supervisory relationship and the supervisory/ delegate relationship status will appear as “Active” for both the supervisor and the APRN or PA.

If the supervisory relationship agreement is terminated, the supervisor or the APRN/ PA may click “Inactive/Revoke” on the “My Account” screen. At that time, the supervisor or delegate being “inactivated /revoked” will be notified of the action to end the Supervisory Relationship.

Notification of changes to the supervisory relationship via the CSMD does not eliminate the requirement on the part of the APRN or PA to file appropriate forms with your licensing board.

Yes. APRN’s and PA’s must report all supervisors (related to prescribing controlled substances) who have supervision, control, and responsibility for the prescriptive services of that APRN/ PA or for whom that APRN/ PA may be performing CSMD queries. The “My Account” screen allows you to add as many supervisors as necessary.

As referenced in Question #6 above, registration for users who do not have a driver’s license should obtain a Tennessee State ID and input that number into the Driver’s License field when registering. The supervisor can provide the Tennessee State ID number to the supervisee to allow the supervisee to make the supervisory relationship connection in the CSMD

There is a button on the right side of the menu bar that allows you to move easily from the CSMD to the data collection site for dispensers. Information regarding Data Collection is below.

Gabapentin is a Schedule V Controlled Substance in Tennessee and therefore should be treated just like any other Schedule V Controlled Substance.

You may report TennCare fraud, waste, or abuse here.

DISPENSER DATA COLLECTION: In order to comply with statutory requirements, dispensers of controlled substance prescriptions will need to ensure that their pharmacy dispensing system is compliant with the ASAP 4.2A (June 2017 version). The new fields in ASAP 4.2A (June 2017 version) will allow the dispensing site to be compliant with statutory requirements.

Medical Necessity

The CSMD Committee has determined in ASAP 4.2A (June 2017 version) that DSP24 Treatment Type, which is a situational field, will be utilized to report “Medical Necessity”. When a prescriber is required to write “Medical Necessity” on the prescription, then the dispenser must submit a code to the TN data collection. The DSP24 Treatment Type field, with an entry of 99, will be used to indicate “Medical Necessity” was indicated on the prescription. In the healthcare practitioner's view, the software companies may choose to provide the option to indicate “Medical Necessity” in their software without visually displaying the ASAP field name.

ICD-10 code

When a prescriber places an ICD-10 code on the prescription, the dispenser must submit the ICD-10 code to the TN data collection. DSP25 Diagnosis Code, which is a situational field available in the ASAP 4.2A (June 2017 version) will be utilized. This field will only be populated when the ICD-10 code is listed on the prescription and is submitted with no hyphens, dashes, or periods.

Partial Fills

The new ASAP 4.2A (June 2017 Version) format will allow the dispensing site to be report partial fills dispensed to a patient using DSP13 (Partial Fill Indicator) and in addition to reporting quantity dispensed use DSP22 (Quantity Prescribed) to provide clarity.

The CSMD team has updated the Data Collection Manual, and it has been posted on the CSMD website: http://www.tn.gov/health/csmd. There is a TN Data Collection Manual section that contains the manual as well as other useful information.