EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb1111*
HOUSE BILL 1111
J1 2lr2500
HB 1125/21 – HGO
By: Delegates Beitzel and McComas
Introduced and read first time: February 11, 2022
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Prescription Drug Monitoring Program – Prescribers of Opioids – Notification 2
Requirement 3
FOR the purpose of requiring a prescriber to notify the Prescription Drug Monitoring 4
Program of certain information relating to opioids and opioid reversal drugs if the 5
prescriber prescribes or dispenses an opioid in a certain dosage; prohibiting a 6
prescriber from being required to make a certain notification more than once for each 7
patient; and generally relating to the Prescription Drug Monitoring Program and 8
prescribers of opioids. 9
BY repealing and reenacting, without amendments, 10
Article – Health – General 11
Section 21–2A–02(a) 12
Annotated Code of Maryland 13
(2019 Replacement Volume and 2021 Supplement) 14
BY repealing and reenacting, with amendments, 15
Article – Health – General 16
Section 21–2A–04.2 17
Annotated Code of Maryland 18
(2019 Replacement Volume and 2021 Supplement) 19
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 20
That the Laws of Maryland read as follows: 21
Article – Health – General 22
21–2A–02. 23
(a) There is a Prescription Drug Monitoring Program in the Department. 24
2 HOUSE BILL 1111
21–2A–04.2. 1
(a) (1) Beginning July 1, 2018, a prescriber: 2
(i) Shall request at least the prior 4 months of prescription 3
monitoring data for a patient before initiating a course of treatment for the patient that 4
includes prescribing or dispensing an opioid or a benzodiazepine; 5
(ii) Shall, if a patient’s course of treatment continues to include 6
prescribing or dispensing an opioid or a benzodiazepine for more than 90 days after the 7
initial request for prescription monitoring data, request prescription monitoring data for 8
the patient at least every 90 days until the course of treatment has ended; and 9
(iii) Shall assess prescription monitoring data requested from the 10
Program before deciding whether to prescribe or dispense or continue prescribing or 11
dispensing an opioid or a benzodiazepine. 12
(2) If a prescriber decides to prescribe or continue to prescribe an opioid or 13
a benzodiazepine after requesting prescription monitoring data from the Program and 14
assessing the prescription monitoring data, the prescriber shall document in the patient’s 15
medical record that the prescription monitoring data was requested and assessed. 16
(3) (I) SUBJECT TO SUBPARAGRA PH (II) OF THIS PARAGRAPH , IF A 17
PRESCRIBER PRESCRIBE S OR DISPENSES AN OP IOID IN A DOSAGE OF 50 MORPHINE 18
MILLIGRAM EQUIVALENT S OR MORE , THE PRESCRIBER SHALL NOTIFY THE 19
PROGRAM WHETHER THE PATIENT: 20
1. HAS RECEIVED EDUCATION R EGARDING THE RISKS 21
ASSOCIATED WITH OPIO ID USE; 22
2. IS AWARE THAT AN OPIO ID OVERDOSE REVERSAL 23
DRUG IS AVAILABLE ; AND 24
3. WAS PRESCRIBED OR DISPEN SED AN OPIOID 25
OVERDOSE REVERSAL DR UG. 26
(II) A PRESCRIBER MAY NOT B E REQUIRED TO M AKE THE 27
NOTIFICATION REQUIRE D UNDER SUBPARAGRAPH (I) OF THIS PARAGRAPH MO RE 28
THAN ONCE FOR EACH PATIENT . 29
(b) A prescriber is not required to request prescription monitoring data from the 30
Program if the opioid or benzodiazepine is prescribed or dispensed to an individual: 31
(1) In an amount indicated for a period not to exceed 3 days; 32
HOUSE BILL 1111 3
(2) For the treatment of cancer or cancer–related pain; 1
(3) Who is: 2
(i) A patient receiving treatment in an inpatient unit of a hospital; 3
(ii) 1. A patient in a general hospice care program as defined in 4
§ 19–901 of this article; or 5
2. Any other patient diagnosed with a terminal illness; 6
(iii) A patient who resides in: 7
1. An assisted living facility; 8
2. A long–term care facility; 9
3. A comprehensive care facility; or 10
4. A developmental disabilities facility; or 11
(4) To treat or prevent acute pain for a period of not more than 14 days 12
following: 13
(i) A surgical procedure; 14
(ii) A fracture; 15
(iii) Significant trauma; or 16
(iv) Childbirth. 17
(c) A prescriber may not be required to comply with the provisions of this section 18
when: 19
(1) Prescribing or dispensing an opioid or a benzodiazepine drug that has 20
been listed by the Secretary under § 21–2A–03(b)(3) of this subtitle as having a low 21
potential for abuse; 22
(2) Accessing prescription monitoring data would result in a delay in the 23
treatment of a patient that would negatively impact the medical condition of the patient; 24
(3) Electronic access to prescription monitoring data is not operational as 25
determined by the Department; or 26
(4) Prescription monitoring data cannot be accessed by the prescriber due 27
to a temporary technological or electrical failure. 28 4 HOUSE BILL 1111
(d) If a prescriber does not access prescription monitoring data for any of the 1
reasons provided under subsection (c)(2), (3), or (4) of this section: 2
(1) The prescriber shall use reasonable medical judgment in determining 3
whether to prescribe or dispense an opioid or a benzodiazepine; and 4
(2) The prescriber shall enter an appropriate record in the patient’s 5
medical chart, including the reason why prescription monitoring data was not accessed. 6
(e) If a pharmacist or pharmacist delegate has a reasonable belief that a patient 7
may be seeking a monitored prescription drug for any purpose other than the treatment of 8
an existing medical condition: 9
(1) Before dispensing a monitored prescription drug to the patient, the 10
pharmacist or pharmacist delegate shall request prescription monitoring data to determine 11
if the patient has received other prescriptions that indicate misuse, abuse, or diversion of 12
a monitored prescription drug; and 13
(2) The pharmacist shall have the responsibility described in 21 C.F.R. § 14
1306.04. 15
(f) The Secretary may adopt regulations to provide additional clinical, technical, 16
or administrative exemptions based on new standards of practice. 17
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 18
October 1, 2022. 19