Article - Health - General
§21–2A–04.2. NOT IN EFFECT
** CONTINGENCY – NOT IN EFFECT –
CHAPTER 147 OF 2016 **
(a) (1) Beginning
July 1, 2018, a prescriber:
(i) Shall request
at least the prior 4 months of prescription monitoring data for a
patient before initiating a course of treatment for the patient that
includes prescribing or dispensing an opioid or a benzodiazepine;
(ii) Shall, if
a patient’s course of treatment continues to include prescribing
or dispensing an opioid or a benzodiazepine for more than 90 days
after the initial request for prescription monitoring data, request
prescription monitoring data for the patient at least every 90 days
until the course of treatment has ended; and
(iii) Shall assess
prescription monitoring data requested from the Program before deciding
whether to prescribe or dispense or continue prescribing or dispensing
an opioid or a benzodiazepine.
(2) If a prescriber
decides to prescribe or continue to prescribe an opioid or a benzodiazepine
after requesting prescription monitoring data from the Program and
assessing the prescription monitoring data, the prescriber shall document
in the patient’s medical record that the prescription monitoring
data was requested and assessed.
(b) A prescriber
is not required to request prescription monitoring data from the Program
if the opioid or benzodiazepine is prescribed or dispensed to an individual:
(1) In an amount
indicated for a period not to exceed 3 days;
(2) For the treatment
of cancer or cancer–related pain;
(3) Who is:
(i) A patient receiving
treatment in an inpatient unit of a hospital;
(ii) 1. A
patient in a general hospice care program as defined in § 19–901
of this article; or
2. Any other patient
diagnosed with a terminal illness;
(iii) A patient
who resides in:
1. An assisted
living facility;
2. A long–term
care facility;
3. A comprehensive
care facility; or
4. A developmental
disabilities facility; or
(4) To treat or
prevent acute pain for a period of not more than 14 days following:
(i) A surgical
procedure in which general anesthesia was used;
(ii) A fracture;
(iii) Significant
trauma; or
(iv) Childbirth.
(c) A prescriber
may not be required to comply with the provisions of this section
when:
(1) Prescribing
or dispensing an opioid or a benzodiazepine drug that has been listed
by the Secretary under § 21–2A–03(b)(3) of this subtitle
as having a low potential for abuse;
(2) Accessing prescription
monitoring data would result in a delay in the treatment of a patient
that would negatively impact the medical condition of the patient;
(3) Electronic
access to prescription monitoring data is not operational as determined
by the Department; or
(4) Prescription
monitoring data cannot be accessed by the prescriber due to a temporary
technological or electrical failure.
(d) If a prescriber
does not access prescription monitoring data for any of the reasons
provided under subsection (c)(2), (3), or (4) of this section:
(1) The prescriber
shall use reasonable medical judgment in determining whether to prescribe
or dispense an opioid or a benzodiazepine; and
(2) The prescriber
shall enter an appropriate record in the patient’s medical chart,
including the reason why prescription monitoring data was not accessed.
(e) If a pharmacist
or pharmacist delegate has a reasonable belief that a patient may
be seeking a monitored prescription drug for any purpose other than
the treatment of an existing medical condition:
(1) Before dispensing
a monitored prescription drug to the patient, the pharmacist or pharmacist
delegate shall request prescription monitoring data to determine if
the patient has received other prescriptions that indicate misuse,
abuse, or diversion of a monitored prescription drug; and
(2) The pharmacist
shall have the responsibility described in 21 C.F.R. § 1306.04.
(f) The Secretary
may adopt regulations to provide additional clinical, technical, or
administrative exemptions based on new standards of practice.