Implementation of Public Law Chapter 488
Re: Opioid Prescribing
This law makes five major changes to opioid prescribing:
1. It mandates use of the State’s Prescription Monitoring Program and expands those who use it;
2. Enacts strict limits on opioid prescribing for acute and chronic pain (ALL opioids, not just Schedule II, including buprenorphine products);
3. Mandates education for opioid prescribers;
4. Mandates electronic prescribing of opioids;
5. Provides for a "Partial Fill" at a pharmacy, at the direction of the patient
Prescription Monitoring Program (PMP)
Requires prescribers to check the PMP upon initial prescription of a benzodiazepine or an opioid, and every 90 days thereafter for as long as the prescription is renewed.
This provision does not apply when a benzodiazepine or an opioid is ordered or administered in an emergency room, an inpatient hospital, a long term care facility or a residential care facility
Requires dispensers to check the PMP prior to dispensing a benzodiazepine or opioid under the following circumstances:
A. The person is not a resident of the State;
B. The prescription is from a prescriber with an address outside of this State;
C. The person is paying cash when the person has a prescription insurance on file;
D. According to the pharmacy record, the person has not had a prescription for a benzodiazepine or an opioid medication in the previous 12 months.
Limits on Prescribing
7/29/16 – Limits new opioid prescriptions, or an aggregate of multiple opioid prescriptions, to no more than 100 MMEs per day.
7/29/16 until 7/1/17 – For patients with active prescriptions that exceed 100 MMEs per day, opioid prescriptions must be limited to 300 MMEs per day, in aggregate.
1/1/17 – Opioid prescriptions for acute pain limited to 7 day supply within a 7 day period (renewable) Opioid prescriptions for chronic pain limited to a 30 day supply within a 30 day period (renewable).
7/1/17 – New and existing prescriptions for opioid medications are limited to 100 MMEs per patient.
Exemptions by Statute (must include Exemption Code on prescription):
Effective 1/1/17 - Opioid prescriptions for acute pain limited to 7-supply within a 7-day period (renewable). Opioid prescriptions for chronic pain limited to a 30-day supply within a 30-day period (renewable). Prescription must say "Acute pain" or Chronic pain".
12/31/17 – As a condition of prescribing opioid medications, all prescribers must complete 3 hours of Continuing Medical Education (CME) on the prescription of opioid medication every 2 years.
7/1/17 – all prescribers "with the capability" must prescribe opioids electronically. A waiver from DHHS must be requested if compliance cannot be met. Applications for waivers are available April 1, 2017.
Individuals who violate this law may be subject to civil penalties of $250 per violation, not to exceed $5,000 per calendar year. Violations may be reported to licensing boards.
For more information, please contact:
More resources available at http://www.maine.med.com/advocacy/opioid-crisis or https://www.mainequalitycounts.org/page/2-1488/caring-for-me