EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*hb0241*
HOUSE BILL 241
J2 3lr1831
SB 305/22 – EHE CF SB 161
By: Delegate Bagnall Delegates Bagnall, Alston, Bhandari, Chisholm, Cullison,
Guzzone, Hill, Hutchinson, S. Johnson, Kaiser, Kerr, Kipke, R. Lewis,
Lopez, Martinez, M. Morgan, Pena–Melnyk, Reilly, Rosenberg, Szeliga,
Taveras, White, and Woods
Introduced and read first time: January 23, 2023
Assigned to: Health and Government Operations
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 1, 2023
CHAPTER ______
AN ACT concerning 1
State Board of Physicians – Dispensing Permits 2
FOR the purpose of transferring oversight of the inspection of the offices of dispensing 3
physicians from the Office of Controlled Substances Administration to the State 4
Board of Physicians; altering the circumstances under which a physician may 5
dispense drugs or devices; requiring that certain appropriations be transferred to the 6
Board on a certain date; providing for the transfer of certain functions, powers, 7
duties, property, records, fixtures, credits, assets, liability, obligations, rights, and 8
privileges; requiring that certain employees of the Office be transferred to the Board 9
without diminution of their rights, benefits, employment, or retirement status; 10
requiring that certain positions at the Office be transferred to the Board; providing 11
for the continuity of certain transactions affected by or flowing from this Act; 12
providing for the continuity of certain laws, regulations, standards and guidelines, 13
policies, orders and other directives, forms, plans, membership, contracts, property, 14
investigations, administrative and judicial responsibilities, rights, and other duties 15
and responsibilities; and generally relating to the dispensing of drugs or devices by 16
licensed physicians. 17
BY repealing and reenacting, with amendments, 18
Article – Health Occupations 19
Section 12–102(a) and (c), 12–102.1, 12–102.2, and 14–509 20
Annotated Code of Maryland 21 2 HOUSE BILL 241
(2021 Replacement Volume and 2022 Supplement) 1
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 2
That the Laws of Maryland read as follows: 3
Article – Health Occupations 4
12–102. 5
(a) (1) In this section the following [terms] WORDS have the meanings 6
indicated. 7
(2) “In the public interest” means the dispensing of drugs or devices by a 8
licensed dentist[, physician,] or podiatrist to a patient when a pharmacy is not conveniently 9
available to the patient. 10
(3) “Personally preparing and dispensing” means that the licensed 11
dentist[, physician,] or podiatrist: 12
(i) Is physically present on the premises where the prescription is 13
filled; and 14
(ii) Performs a final check of the prescription before it is provided to 15
the patient. 16
(c) (1) This subsection does not apply to a licensed dentist who obtains a 17
permit from the State Board of Dental Examiners under subsection (h) of this section. 18
(2) This title does not prohibit: 19
(i) A licensed veterinarian from: 20
1. Personally preparing and dispensing the veterinarian’s 21
prescriptions; or 22
2. Dispensing, in accordance with § 2–313(c) of the 23
Agriculture Article, compounded nonsterile preparations or compounded sterile 24
preparations provided by a pharmacy; 25
(II) A LICENSED PHYSICIAN F ROM PERSONALLY PREPA RING 26
AND DISPENSING PRESC RIPTIONS IF THE PHYS ICIAN HAS OBT AINED A PERMIT 27
UNDER § 14–509 OF THIS ARTICLE; 28
[(ii)] (III) A licensed dentist[, physician,] or podiatrist from 29
personally preparing and dispensing the dentist’s[, physician’s,] or podiatrist’s 30
prescriptions when: 31 HOUSE BILL 241 3
1. The dentist[, physician,] or podiatrist: 1
A. Has applied to the board of licensure in this State which 2
licensed the dentist[, physician,] or podiatrist; 3
B. Has demonstrated to the satisfaction of that board that the 4
dispensing of prescription drugs or devices by the dentist[, physician,] or podiatrist is in 5
the public interest; 6
C. Has received a written permit from that board to dispense 7
prescription drugs or devices except that a written permit is not required in order to 8
dispense starter dosages or samples without charge; and 9
D. Posts a sign conspicuously positioned and readable 10
regarding the process for resolving incorrectly filled prescriptions or includes written 11
information regarding the process with each prescription dispensed; 12
2. The person for whom the drugs or devices are prescribed 13
is a patient of the prescribing dentist[, physician,] or podiatrist; 14
3. The dentist[, physician,] or podiatrist does not have a 15
substantial financial interest in a pharmacy; and 16
4. The dentist[, physician,] or podiatrist: 17
A. Complies with the dispensing and labeling requirements 18
of this title; 19
B. Records the dispensing of the prescription drug or device 20
on the patient’s chart; 21
C. Allows the Office of Controlled Substances Administration 22
to enter and inspect the dentist’s[, physician’s,] or podiatrist’s office at all reasonable hours 23
and in accordance with § 12–102.1 of this subtitle; 24
D. On inspection by the Office of Controlled Substances 25
Administration, signs and dates an acknowledgment form provided by the Office of 26
Controlled Substances Administration relating to the requirements of this section; 27
E. Except for starter dosages or samples without charge, 28
provides the patient with a written prescription, maintains prescription files in accordance 29
with § 12–403(c)(13) of this title, and maintains a separate file for Schedule II prescriptions; 30
F. Does not direct patients to a single pharmacist or 31
pharmacy in accordance with § 12–403(c)(8) of this title; 32 4 HOUSE BILL 241
G. Does not receive remuneration for referring patients to a 1
pharmacist or pharmacy; 2
H. Complies with the child resistant packaging requirements 3
regarding prescription drugs under Title 22, Subtitle 3 of the Health – General Article; 4
I. Complies with drug recalls; 5
J. Maintains biennial inventories and complies with any 6
other federal and State record–keeping requirements relating to controlled dangerous 7
substances; 8
K. Purchases prescription drugs from a pharmacy or 9
wholesale distributor who holds a permit issued by the Board of Pharmacy, as verified by 10
the Board of Pharmacy; 11
L. Annually reports to the respective board of licensure 12
whether the dentist[, physician,] or podiatrist has personally prepared and dispensed 13
prescription drugs within the previous year; and 14
M. Completes ten continuing education credits over a 5–year 15
period relating to the preparing and dispensing of prescription drugs, offered by the 16
Accreditation Council for Pharmacy Education (ACPE) or as approved by the Secretary, in 17
consultation with each respective board of licensure, as a condition of permit renewal; OR 18
[(iii) A licensed physician from dispensing a topical medication 19
without obtaining the permit required under item (ii)1C of this paragraph or completing 20
the continuing education required under item (ii)4M of this paragraph when the physician: 21
1. Otherwise complies with item (ii) of this paragraph; and 22
2. Has obtained a special written permit under § 14–509 of 23
this article; 24
(iv) A licensed physician who complies with the requirements of item 25
(ii) of this paragraph from personally preparing and dispensing a prescription written by: 26
1. A physician assistant in accordance with a delegation 27
agreement that complies with Title 15, Subtitle 3 of this article; or 28
2. A nurse practitioner who is authorized to practice under 29
Title 8, Subtitle 3 of this article and is working with the physician in the same office setting; 30
or] 31
[(v)] (IV) A hospital–based clinic from dispensing prescriptions to 32
its patients. 33 HOUSE BILL 241 5
12–102.1. 1
(a) This section does not apply to [a]: 2
(1) A licensed dentist who obtains a permit from the State Board of Dental 3
Examiners under § 12–102(h) of this subtitle; OR 4
(2) A LICENSED PHYSICIAN W HO OBTAINS A PERMIT FROM THE 5
STATE BOARD OF PHYSICIANS UNDER § 14–509 OF THIS ARTICLE . 6
(b) The Office of Controlled Substances Administration shall enter and inspect 7
the office of a dentist[, physician,] or podiatrist who holds: 8
(1) An initial dispensing permit: 9
(i) Within 6 months after receiving the report required under § 10
12–102(l)(1) of this subtitle; and 11
(ii) At least one more time during the duration of the permit; and 12
(2) A renewed dispensing permit at least two times during the duration of 13
the permit. 14
(c) The Office of Controlled Substances Administration promptly shall report the 15
results of the inspections required under subsection (b) of this section to the respective 16
board of licensure. 17
12–102.2. 18
(a) This section does not apply to [a]: 19
(1) A licensed dentist who obtains a permit from the State Board of Dental 20
Examiners under § 12–102(h) of this subtitle; OR 21
(2) A LICENSED PHYSICIAN W HO OBTAINS A PERMIT FROM THE 22
STATE BOARD OF PHYSICIANS UNDER § 14–509 OF THIS ARTICLE . 23
(b) The Board of Dental Examiners[, the Board of Physicians,] and the Board of 24
Podiatric Medical Examiners shall charge a fee to a dentist[, physician,] or podiatrist who 25
holds a dispensing permit in an amount that will produce funds to approximate but not 26
exceed the documented costs to the Office of Controlled Substances Administration for 27
inspection of dispensing permit holders. 28
6 HOUSE BILL 241
(c) Revenues collected by the Board of Dental Examiners [, the Board of 1
Physicians,] and the Board of Podiatric Medical Examiners under this section shall be paid 2
into the General Fund of the State. 3
14–509. 4
(a) (1) In this section[,] THE FOLLOWING WORDS HAVE THE MEANINGS 5
INDICATED. 6
(2) “ACCME” means the Accrediting Council for Continuing Medical 7
Education. 8
(3) “ADMINISTERING ” MEANS THE DIRECT INT RODUCTION OF A 9
SINGLE DOSAGE OF A D RUG OR DEVICE AT A G IVEN TIME, WHETHER BY INJECTION 10
OR OTHER MEANS , AND WHETHER IN LIQUI D, TABLET, CAPSULE, OR OTHER FORM . 11
(4) “DISPENSING PERMIT ” MEANS A WRITTEN PERM IT ISSUED BY THE 12
BOARD TO A LICENSED P HYSICIAN TO PERSONAL LY PREPARE AND DISPE NSE DRUGS 13
OR DEVICES TO A PATI ENT. 14
(5) “IN THE PUBLIC INTERES T” MEANS THE DISPENSING OF DRUGS 15
OR DEVICES BY A LICE NSED PHYSICIAN TO A PATIENT WHEN A PHARM ACY IS NOT 16
CONVENIENTLY AVAILAB LE TO THE PATIENT. 17
(6) “PERSONALLY PREPARING AND DISPENSING ” MEANS THAT THE 18
LICENSED PHYSICIAN : 19
(I) IS PHYSICALLY PRESENT ON THE PREMISES WHER E THE 20
PRESCRIPTION IS FILL ED; AND 21
(II) PERFORMS A FINAL CHEC K OF THE PRESCRIPTIO N BEFORE 22
IT IS PROVIDED TO TH E PATIENT. 23
(7) “SAMPLE UNIT ” HAS THE MEANING STAT ED IN 21 C.F.R. § 24
203.3(AA). 25
(8) “STARTER DOSAGE ” MEANS AN AMOUNT OF A DRUG OR A DEVICE 26
SUFFICIENT TO BEGIN THERAPY: 27
(I) FOR A DURATION OF 72 HOURS OR LESS ; OR 28
(II) PRIOR TO OBTAINING A LARGER QUANTITY OF T HE DRUG 29
OR DEVICE TO COMPLET E THE THERAPY . 30
HOUSE BILL 241 7
(9) “TOPICAL MEDICATION PE RMIT” MEANS A WRITTEN PERM IT 1
ISSUED BY THE BOARD TO A LICENSED P HYSICIAN TO DISPENSE TOPICAL 2
MEDICATIONS THAT ARE AP PROVED BY THE FEDERA L FOOD AND DRUG 3
ADMINISTRATION FOR TH E TREATMENT OF HYPOT RICHOSIS. 4
(b) [A physician may dispense a topical medication that is approved by the federal 5
Food and Drug Administration for the treatment of hypotrichosis without obtaining a 6
dispensing permit or completing the continuing education required under § 12–102(c)(2)(ii) 7
of this article if the physician: 8
(1) Otherwise complies with the requirements of § 12–102(c)(2)(ii) of this 9
article; and 10
(2)] THIS SECTION DOES NOT APPLY TO A PHYSICIAN WHO: 11
(1) (I) Has received a [special class of written] TOPICAL MEDICATION 12
permit from the Board[.]; 13
[(c) The Board may issue a special class of written permit to a physician under 14
subsection (b) of this section if the physician: 15
(1)] (II) DISPENSES ONLY A TOPI CAL MEDICATION THAT IS 16
APPROVED BY THE FEDE RAL FOOD AND DRUG ADMINISTRATION FOR TH E 17
TREATMENT OF HYPOTRI CHOSIS; 18
(III) Completes 1 hour of continuing medical education per year on 19
the dispensing of topical medications developed by an ACCME–accredited Maryland 20
nonprofit or governmental entity; and 21
[(2)] (IV) Pays to the Board a $100 permit fee; 22
(2) PERSONALLY DISPENSES A DRUG OR DEVICE SAM PLE TO A 23
PATIENT IF: 24
(I) THE SAMPLE COMPLIES W ITH THE LABELING 25
REQUIREMENTS OF § 12–505 OF THIS ARTICLE; 26
(II) NO CHARGE IS MADE FOR THE SAMPLE; AND 27
(III) THE AUTHORIZED PRESCRIBE R ENTERS AN APPROPRI ATE 28
RECORD IN THE PATIEN T’S CHART; 29
(3) ADMINISTERS A PRESCRI PTION DRUG OR DEVICE IN THE COURSE 30
OF TREATING A PATIEN T; 31
8 HOUSE BILL 241
(4) PERSONALLY DISPENSES A STARTER DOSAGE OF A PRESCRIPTION 1
DRUG OR DEVICE TO A PATIENT IF: 2
(I) THE STARTER DOSAGE CO MPLIES WITH THE LABE LING 3
REQUIREMENTS OF § 12–505 OF THIS ARTICLE; 4
(II) NO CHARGE IS MADE FOR THE STARTER DOSAGE ; AND 5
(III) THE LICENSED PHYSICIA N ENTERS AN APPROPRI ATE 6
RECORD ON THE PATIEN T’S CHART; OR 7
(5) DISPENSES A PRESCRIPTION DRUG OR DEVICE IN THE COU RSE OF 8
TREATING A PATIENT A T: 9
(I) A MEDICAL FACILITY OR CLINIC THAT IS OPERA TED ON A 10
NONPROFIT BASIS ; 11
(II) A HEALTH CENTER THAT O PERATES ON A CAMPUS OF AN 12
INSTITUTION OF HIGHE R EDUCATION; OR 13
(III) A PUBLIC HEALTH FACILITY , A MEDICAL FACILITY U NDER 14
CONTRACT WITH A STATE OR LOCAL HEALTH DEPARTMENT , OR A FACILITY FUNDED 15
WITH PUBLIC FUNDS . 16
(C) A LICENSED PHYSICIAN M AY PERSONALLY PREPAR E AND DISPENSE 17
PRESCRIPTIONS ONLY I F: 18
(1) THE PHYSICIAN: 19
(I) HAS AN ACTIVE LICENSE IN GOOD STANDING ; 20
(II) HAS APPLIED TO THE BOARD FOR A DISPENSIN G PERMIT; 21
(III) HAS PAID A FEE DETERM INED BY THE BOARD TO PRODUCE 22
FUNDS TO APPROXIMATE BUT NOT EXCEED THE D OCUMENTED COSTS TO T HE 23
BOARD FOR CONDUCTING INSPECTION S OF DISPENSING PERM IT HOLDERS; 24
(IV) HAS DEMONSTRATED TO T HE SATISFACTION OF T HE BOARD 25
THAT THE DISPENSING OF PRESCRIPTION DRUG S OR DEVICES BY THE PHYSICIAN IS 26
IN THE PUBLIC INTERE ST; 27
(V) HAS RECEIVED A DISPEN SING PERMIT FROM THE BOARD; 28
AND 29
HOUSE BILL 241 9
(VI) HAS A SIGN CONSPICUOU SLY POSITIONED AND R EADABLE 1
REGARDING THE PROCES S FOR RESOLVING INCO RRECTLY FILLED PRESC RIPTIONS 2
OR INCLUDES WRITTEN INFORMATION REGARDIN G THE PROCESS WITH E ACH 3
PRESCRIPTION DISPENS ED; 4
(2) THE INDIVIDUAL FOR WH OM THE DRUG OR DEVIC E IS 5
PRESCRIBED IS A PATI ENT OF: 6
(I) THE PRESCRIBING PHYSI CIAN; 7
(II) A PHYSICIAN ASSISTANT IN ACCORDANCE WITH A 8
DELEGATION AGREEMENT THAT COMPLIES WITH TITLE 15, SUBTITLE 3 OF THIS 9
ARTICLE; OR 10
(III) A NURSE PRACTITIONER W HO IS AUTHORIZED TO PRACTICE 11
UNDER TITLE 8, SUBTITLE 3 OF THIS ARTICLE AND IS WORKING WITH THE 12
PHYSICIAN IN THE SAM E OFFICE SETTING ; 13
(3) THE PHYSICIAN DOES NO T HAVE A SUBSTANTIAL FINANCIAL 14
INTEREST IN A PHARMA CY; AND 15
(4) THE PHYSICIAN: 16
(I) COMPLIES WITH THE DIS PENSING AND LABELING 17
REQUIREMENTS OF THIS TITLE, TITLE 12 OF THIS ARTICLE , AND THE BOARD’S 18
REGULATIONS ; 19
(II) RECORDS THE DISPENSIN G OF THE PRESCRIPTIO N DRUG 20
OR DEVICE ON THE PAT IENT’S CHART; 21
(III) PROVIDES THE PATIENT WIT H A WRITTEN PRESCRIP TION, 22
MAINTAINS PRESCRIPTI ON FILES IN ACCORDAN CE WITH § 12–403(C)(13) OF THIS 23
ARTICLE, AND MAINTAINS A SEPA RATE FILE FOR SCHEDULE II PRESCRIPTIONS ; 24
(IV) DOES NOT DIRECT PATIE NTS TO A SINGLE PHAR MACIST OR 25
PHARMAC Y IN ACCORDANCE WITH § 12–403(C)(8) OF THIS ARTICLE; 26
(V) DOES NOT RECEIVE REMU NERATION FOR REFERRI NG 27
PATIENTS TO A PHARMA CIST OR PHARMACY ; 28
(VI) COMPLIES WITH THE CHI LD RESISTANT PACKAGI NG 29
REQUIREMENTS REGARDI NG PRESCRIPTION DRUG S UNDER TITLE 22, SUBTITLE 3 30
OF THE HEALTH – GENERAL ARTICLE; 31
10 HOUSE BILL 241
(VII) COMPLIES WITH DRUG RE CALLS; 1
(VIII) MAINTAINS BIENNIAL IN VENTORIES AND COMPLI ES WITH 2
ANY OTHER FEDERAL AN D STATE RECORD –KEEPING REQUIREMENTS RELATING TO 3
CONTROLLED DANGEROUS SUBSTANCES; 4
(IX) PURCHASES PRESCRIPTIO N DRUGS FROM A PHARM ACY OR 5
WHOLESALE DISTRIBUTO R THAT HOLDS A PERMI T ISSUED BY THE STATE BOARD OF 6
PHARMACY, AS VERIFIED BY THE STATE BOARD OF PHARMACY; AND 7
(X) COMPLIES WITH CONTINU ING EDUCATION REQUIR EMENTS 8
RELATING TO THE PREP ARING AND DISPENSING O F PRESCRIPTION DRUGS AS 9
PROVIDED FOR IN REGU LATIONS ADOPTED BY T HE BOARD. 10
(D) A PHYSICIAN WHO FAILS TO COMPLY WITH THE P ROVISIONS OF THIS 11
SECTION GOVERNING TH E DISPENSING OF PRES CRIPTION DRUGS OR DE VICES 12
SHALL: 13
(1) HAVE THE DISPEN SING PERMIT REVOKED ; AND 14
(2) BE SUBJECT TO DISCIPL INARY ACTION BY THE BOARD. 15
(E) (1) (I) WITHIN 6 MONTHS AFTER THE BOARD ISSUES AN INITI AL 16
DISPENSING PERMIT TO A LICENSED PHYSICIAN , THE BOARD SHALL ENTER AND 17
INSPECT THE OFFICE O F THE PHYSICIAN. 18
(II) IF THE BOARD RENEWS A DISPEN SING PERMIT TO A 19
LICENSED PHYSICIAN , THE BOARD SHALL ENTER AND INSPECT THE OFFICE O F THE 20
PHYSICIAN AT LEAST O NE TIME DURING THE D URATION OF THE RENEW ED PERMIT. 21
(2) THE BOARD SHALL REPORT TO THE OFFICE OF CONTROLLED 22
SUBSTANCES ADMINISTRATION AND THE OFFICE OF THE ATTORNEY GENERAL ANY 23
VIOLATION RELATED TO CONTROLLED DANGEROUS SUBSTANCES FOUND DUR ING 24
AN INSPECTION REQUIR ED UNDER PARAGRAPH (1) OF THIS SUBSECTION . 25
SECTION 2. AND BE IT FURTHER ENACTED, That , on: 26
(a) On the effective date of this Act, the following shall be transferred to the State 27
Board of Physicians: 28
(1) all appropriations, including State and federal funds, held by the Office 29
of Controlled Substances Administration for the purposes of conducting inspections of 30
offices of physicians who hold dispensing permits under § 14–509 of the Health Occupations 31
Article on the effective date of this Act; and 32
HOUSE BILL 241 11
(2) subject to subsection (b) of this section, all books and records including 1
electronic records, real and personal property, equipment, fixtures, assets, liabilities, 2
obligations, credits, rights, and privileges held by the Office of Controlled Substances 3
Administration for the purposes of conducting inspections of offices of physicians who hold 4
dispensing permits under § 14–509 of the Health Occupations Article on the effective date 5
of this Act. 6
(b) If the record relates to a pending or ongoing investigation that was initiated 7
by the Office of Controlled Substances Administration before the effective date of this Act, 8
the Office may provide the State Board of Physicians with a copy of the record in lieu of the 9
original record. 10
SECTION 3. AND BE IT FURTHER ENACTED, That all employees of the Office of 11
Controlled Substances Administration who are assigned more than 50% of the time to a 12
function related to conducting inspections of offices of physicians who hold dispensing 13
permits under § 14–509 of the Health Occupations Article on the effective date of this Act 14
shall be transferred to the State Board of Physicians without diminution of their rights, 15
benefits, employment, or retirement status. 16
SECTION 4. AND BE IT FURTHER ENACTED, That all positions of the Office of 17
Controlled Substances Administration who are assigned more than 50% of the time to a 18
function related to conducting inspections of offices of physicians who hold dispensing 19
permits under § 14–509 of the Health Occupations Article on the effective date of this Act 20
shall be transferred to the State Board of Physicians. 21
SECTION 5. AND BE IT FURTHER ENACTED, That any transaction affected by 22
the transfer of oversight of the conducting of inspections of offices of physicians who hold 23
dispensing permits under § 14–509 of the Health Occupations Article and validly entered 24
into before the effective date of this Act, and every right, duty, or interest flowing from it 25
remains valid after the effective date of this Act and may be terminated, completed, 26
consummated, or enforced under the law. 27
SECTION 6. AND BE IT FURTHER ENACTED, That all existing laws , regulations, 28
proposed regulations, standards and guidelines, policies, orders and other directives, forms, 29
plans, memberships, contracts, property, investigations, administrative and judicial 30
responsibilities, rights to sue and be sued, and all other duties and responsibilities 31
associated with the oversight of the conducting of inspections of offices of physicians who 32
hold dispensing permits under § 14–509 of the Health Occupations Article prior to the 33
effective date of this Act shall continue and, as appropriate, are legal and binding on the 34
State Board of Physicians until completed, withdrawn, canceled, modified, or otherwise 35
changed under the law. 36
SECTION 7. AND BE IT FURTHER ENACTED, That this Act shall take effect 37
October 1, 2023. 38