Resolve, Regarding Legislative Review of Portions of Chapter 11: Rules Governing the Controlled Substances Prescription Monitoring Program and Prescription of Opioid Medications, a Late-filed Major Substantive Rule of the Department of Health and Human Services
Maine Legislature, Session 128, LD 1363
Committee Amendment CA_A_H477 (House)

COMMITTEE AMENDMENT "fl' to H.P. 940, L.D. 1363, "Resolve, Regarding 
Legislative Review of Portions of Chapter 11: 
Rules Governing the Controlled 
Substances Prescription Monitoring Program and Prescription of Opioid Medications, a 
Late-filed Major Substantive Rule of the Department of Health and Human Services" 
Amend the resolve by striking out all of section 1 and inserting the following: 
'Sec. 1. Adoption. Resolved: That final adoption of portions of Chapter 11: 
Rules Governing the Controlled Substances Prescription Monitoring Program and 
Prescription of Opioid Medications, a provisionally adopted major substantive rule of the 
Department of Health and Human Services that has been submitted to the Legislature for 
review pursuant to the Maine Revised Statutes, Title 5, chapter 3 75, subchapter 2-A 
outside the legislative rule acceptance period, is authorized only if: 
1. Cancer aftercare. In Section 4, subsection A, paragraph 4, ~ubparagraph b, 
division (i) in the portion of the rule that is a routine technical rule, Exemption Code A 
for active and aftercare cancer treatment must be amended to remove the 6-month limit 
for aftercare cancer treatment post remission; 
2. Second prescriptions for opioid~. 
In Section 4) subsection A, paragraph 4, 
subparagraph b, division (i} in the portion of the rule that is a routine ·technical rule, 
Exemption Code H is amended to provide that if an individual is prescribed a 2nd opioid 
after proving unable to tolerate a first opioid, the individual is not required to return the 
initial prescription to a pharmacy for collection prior to dispensation of the 2nd 
prescription .. The department shall recommend to dispensers that a patient be provid~d 
with guidance on proper disposal of the first opioid prescription; 
3. Early refills. In Section 4, subsection B of the rule, a new paragraph 3. is added to 
allow for dispensers to provide an early refill of a prescription to an individual before the 
refill date if,. in the judgment of the dispenser, the early refill does not represent a pattern 
of early refill requests by the individual; 
· 
COMMITTEE AMENDMENT 
COMMl'ITEE AMPNDMENT ·ff' to 11.P. 940, L.D. 1363 
4. 
Verification by dispensers. 
In Section 4, subsection B of the rule, a new 
paragraph 4 is added to allow for dispensers to contact prescribers by telephone to verify 
and document information about prescriptions; 
5. 
Out-of-state prescriptions. 
In Section 4, subsection B of the rule, a new 
paragraph 5 is added to establish a process for a dispenser who receives a prescription for 
an opioid medication from an out-of-state prescriber that does not comply wi.th 
department rules. The dispenser may fill the prescription .if the dispenser records an ora,1 
confirmation with the validity of the prescription from the out-of-state prescriber and 
documents any missing information such as diagnosis code, exemption code and acute or 
chronic pain notation and the dispenser makes a reasonable effort to detennine that the 
oral confirmation came from the prescriber or prescriber's agent, which may include a 
telephone call to the prescriber's telephone number listed in a telephone directory or other 
direct01y; and 
6. 
Delayed implementation of ICD-10 codes. 
In Section 5, subsection C, 
paragraph 1, subparagraph n of the rule, the requirement for dispensers to provide 
information to the Prescription Monitoring Program on the exemption code and ICD-10 
code is delayed until July 1, 2018 and a provision is added to authorize a waiver after that 
date from the department for dispensers who are unable with good cause to comply with 
the requirement.' 
SUMMARY 
This amendment provides that the Department of Health and Human Services may 
finally adopt p01iions of Chapter 11: 
Rules Governing the Controlled Substances 
Prescription Monitoring Program and Prescription of Opioid Medications, a provisionally 
adopted major substantive rule that was filed outside the legislative rule acceptance 
period, only if the rule is modified. 
The first required modification is to the routine technical portions of the rule. 
establishing Exemption Code A for active and aftercare cancer treatment. The exemption 
code in the rule must be amended to remove the 6-month limit for aftercare cancer 
treatment post remission. 
The 2nd required modification is to the routine technical portions of the rule 
establishing Exemption Code H for circumstances when an individual is prescribed a 2nd 
opioid after proving unable to tolerate a first opioid. The exemption code in the rule must 
be amended so that the individual is not required to return the initial prescription to a 
phannacy for collection prior to dispensation of the 2nd prescription. The depatiment 
must recommend to dispensers that patients are provided with guidance on proper 
disposal of the first opioid prescription. 
The 3rd required modification is to allow for dispensers to provide an early refill of a 
prescription before the refill date if, in the judgment of the dispenser, the early refill does 
not represent a pattern of early refill requests by the individual. 
The 4th required modification is to allow for dispensers to contact prescribers by 
telephone to verify and document information about prescriptions. 
COMMITTEE AMENDMENT 
COMMITl'EE AMFNDMENT ff 
to H.P. 940, L.D. 1363 
The 5th required modification is to establish a process for a dispenser who receives a 
prescription for an opioid medication from an out-of-state prescriber that does not comply 
with department rules. The dispenser may fill the prescription if the dispenser records an 
oral confirmation with the validity of the prescription from the out-of-state prescriber and 
documents any missing information such as diagnosis code, exemption code and acute or 
chronic pain notation and the dispenser makes a reasonable effort to determine that the 
oral confirmation came from the prescriber or prescriber's agent, which may include a 
telephone call to the prescriber's telephone number listed in a telephone directory or other 
direct01y. 
The 6th required modification is to delay the requirement for dispensers to provide 
information to the Prescription Monitoring Program on the exemption code and ICD-10 
code until July 1, 2018 and allow the Department of Health and Human Services to 
approve waivers after July 1, 2018 for dispensers who are unable with good cause to 
comply with the requirement. 
COMMITTEE AMENDMENT