Thank you for providing services to a participant of Health Professionals Services Program (HPSP). We appreciate the work you do and your willingness to collaborate with us. Reports from treatment providers enable HPSP to monitor participant symptoms and illness management, and ability to work. HPSP provides treatment providers with a signed authorization, a copy of the participant's Monitoring Plan, and report forms (if required).
Treatment Provider (TP) Report Forms
Link to FSMB Prescribing Standards of Opioid Use in Treatment of Chronic Pain
Treatment Provider Information
As a treatment provider, we ask that you:
- immediately communicate with HPSP if the participant is not complying with treatment recommendations, experiences an exacerbation of symptoms, relapses or is unable to practice safely;
- communicate with HPSP when there are changes in treatment recommendations; and
- submit brief quarterly progress reports as identified in the participant's Monitoring Plan.
We ask HPSP participants to:
- ensure that treatment providers are mutually agreed upon with HPSP (a treatment provider may not be a participant’s co-worker, colleague or professional partner);
- meet with treatment providers at a frequency recommended by the providers, but at least quarterly, throughout the duration of monitoring (unless otherwise specified in the Monitoring Plan);
- notify their HPSP case manager if the treatment provider changes and promptly execute new Authorizations;
- ensure treatment providers submit quarterly reports (it is helpful for them to remind you to submit reports); and
- maintain current Authorizations for treatment providers.