Chapter Legislative Updates
Danna L. Kauffman
Schwartz, Metz and Wise, P.A.
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Chapter Legislative Letter(s) & Other Information
2020 General Assembly Updates
Maryland Insurance Administration – New Web Page
The Maryland Insurance Administration had developed a new web page for health care providers with information and complaint processes related to the following:
prompt pay/clean claims
retroactive denial of claims
when you are not on a carriers HMO or provider panel
Click here to see the new web page.
New requirement for physicians and other healthcare providers regarding mandatory reporting of suspected vaping illnesses to local health departments. To read the order by the Secretary of Health, click here.
Quality-Based Reimbursement Program
Click here to see the final QBR measurements.
PDMP Use Mandate – Effective July 1, 2018
Prescribers must query PDMP data (through the CRISP portal or integration within the Electronic Health Record (EHR), where available), assess the PDMP data before prescribing, and document these actions in the patient’s medical record:
1. Before beginning new course of treatment with opioid or benzodiazepine
2. If course of treatment extends beyond 90 days, then at least every 90 days before prescribing or dispensing opioid or benzodiazepine
Exceptions to this mandate, as explicitly listed in statute, include prescribers who are exempted from the above requirements if a prescription is written:
- For no more than 3 days supply
- For cancer treatment or cancer-related pain
- To a patient in an inpatient hospital
- To a patient in hospice
- To a patient residing in nursing or other assisted living facility
To treat or prevent acute pain for a period of not more than 14 days following:
- Surgery with general anesthesia
- Significant trauma
- For a specific medicine included in a list compiled by the Secretary of drugs with low potential for abuse
- In the event of electrical or technological issues
Mandatory Use for Pharmacists: Pharmacists must query and assess the PDMP data when they suspect any CDS prescription is being filled for something other than treatment of an existing medical diagnosis, essentially a restatement of their corresponding responsibility under federal regulations.
Effective adoption of PDMP as a clinical decision support tool both under the use mandate, and as recommended by the Centers for Disease Control and Prevention (CDC), the President’s Commission on Combating Drug Addiction and the Opioid Crisis, and the Maryland Heroin and Opioid Emergency Task Force relies on integrating PDMP data access into the realities of a provider’s practice. Two main avenues to assist providers are:
- Use of Delegates, who can access the PDMP on behalf of a prescriber or pharmacist and provide that PDMP data report to the provider for a prescribing or dispensing decision
- Integrating PDMP access into an EHR, which is available in many hospital system settings across the state.