An Act To Allow Pharmacists To Dispense an Emergency Supply of Chronic Maintenance Drugs
Maine Legislature, Session 130, LD 1776
Committee Amendment CA_A_H842 (House)
Amends: 24-A MRSA §4317-E, 32 MRSA §13786-F

COMMITTEE AMENDMENT" A" to H.P. 1327, L.D. 1776, "An Act To Allow 
Pharmacists To Dispense an Emergency Supply of Chronic Maintenance Drugs" 
Amend the bill by striking out all of the emergency preamble. 
Amend the bill by striking out everything after the enacting clause and inserting the 
following: 
'Sec. 1. 24-A MRSA §4317-E is enacted to read: 
§4317-E. Coverage for emergency supply of chronic maintenance drugs 
1. Definition. As used in this section, unless the context otherwise indicates. "chronic 
maintenance drug" has the same meaning as in Title 32. section 13786-F, subsection 1. 
2. Coverage required. A carrier offering a health plan in this State must make 
available coverage for an emergency supply of a chronic maintenance drug dispensed 
pursuant to Title 32, section 13786-F in the same manner as coverage for other chugs under 
the health plan. A carrier may impose any deductible, copayment, coinsurance or other 
cost-sharing reguirement for the chronic maintenance drug as long as the amount of the 
deductible. copayment, coinsurance or other cost-sharing requirement is applied in the 
same manner as if the chronic maintenance drug were dispensed as prescribed by a 
provider. 
3. Application. This section does not apply to a health plan offered for use with a 
health savings account unless the federal Internal Revenue Service determines that the 
benefits reguired by this section are permissible benefits in a high deductible health plan as 
defined in the federal Internal Revenue Code. Section 223(c)(2). 
Sec. 2. 32 MRSA §13786-F is enacted to read: 
§13786-F. Dispensing of emergency supplies of chronic maintenance drug 
1. Definition. For the purposes of this section, "chronic maintenance drug" means a 
medication prescribed to treat a chronic, long-term condition and that is taken on a regular. 
recurring basis. 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT "A" to H.P. 1327, L.D. 1776 
2. Emergency supply. A pharmacist may dispense an emergency supply of a chronic 
maintenance drug without a current, valid prescription from a practitioner, subject to the 
following requirements: 
A. The pharmacy at which the pharmacist is practicing has a record of a prescription 
for the chronic maintenance drug in the name of the patient who is requesting the 
emergency supply, including the amount of the chronic maintenance drug dispensed as 
provided in the most recent prescription or the standard unit of dispensing for the 
chronic maintenance drug, and the record of that prescription for the chronic 
maintenance drug does not include a notation from a practitioner that no emergency 
supply is permitted; 
B. 
The pharmacist attempts but is unable to obtain authorization to refill the 
prescription described in paragraph A from the practitioner who issued the prescription 
or another practitioner responsible for the patient's care; 
C. In the pharmacist's professional judgment, the chronic maintenance drug is essential 
to sustain the life of the patient or to continue therapy for a chronic condition of the 
patient and failure to dispense the chronic maintenance drug could reasonably produce 
undesirable health consequences or cause physical or mental discomfort; 
D. Except as provided in this subsection, the amount of the chronic maintenance drug 
dispensed does not exceed a 30-day supply as provided in the prescription or, if the 
standard unit of dispensing for the chronic maintenance drug exceeds a 3 0-day supply, 
the amount of the chronic maintenance drug dispensed does not exceed the smallest 
standard unit of dispensing; 
E. With respect to a chronic maintenance drug that is a controlled substance included 
in Schedule III or IV of 21 United States Code, Section 812 or 21 Code of Federal 
Regulations, Section 1308, the amount of the chronic maintenance drug dispensed does 
not exceed a 7-day supply; 
F. The chronic maintenance drug is not a controlled substance included in Schedule I 
or II of21 United States Code, Section 812 or 21 Code of Federal Regulations, Section 
1308; and 
G. The pharmacist has not dispensed the chronic maintenance drug in an emergency 
supply under this subsection to the same patient more than twice in the preceding 12-
month period. 
• 
The pharmacist shall exercise professional judgment in determining the amount of the 
chronic maintenance drug to be dispensed, up to the maximum amount specified in this 
subsection. The pharmacist shall notify the practitioner who issued the prescription or 
another practitioner responsible for the patient's care no later than 72 hours after the chronic 
maintenance drug is dispensed. The pharmacist shall fulfill all documentation and other 
requirements established by the board when dispensing an emergency supply of a chronic 
maintenance drug. 
3. Rules. The board may adopt rules for dete1mining what constitutes a chronic 
maintenance drug and what reporting procedures are necessary in dispensing an emergency 
supply of a chronic maintenance drug. Rules adopted by the board pursuant to this 
subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.' 
Amend the bill by striking out all of the emergency clause. 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT 'A-" to H.P. 1327, L.D. 1776 
Amend the bill by relettering or renumbering any nonconsecutive Part letter or section 
number to read consecutively. 
SUMMARY 
This amendment replaces the bill. The amendment allows a pharmacist to dispense an 
emergency supply of a chronic maintenance drug to a patient without a prescription if the 
pharmacist is unable to obtain authorization to refill the prescription from a health care 
provider and the pharmacist has a record of the prescription in the name of the patient, 
including the amount of the drug dispensed in the most recent prescription or the standard 
unit of dispensing the drug, and that record does not indicate that no emergency supply is 
permitted. The amendment prohibits the dispensing of controlled substances included in 
Schedules I and II under the federal Controlled Substances Act. 
The amendment limits the amount dispensed to up to a 30-day supply or, if the standard 
unit of dispensing exceeds a 30-day supply, to the smallest standard unit of dispensing and 
further prohibits a pharmacist from dispensing the chronic maintenance drug in an 
emergency supply to the same patient more than twice in a 12-month period except that, if 
the drug is included on Schedule Ill or IV of the federal Controlled Substances Act, the 
amount dispensed may not exceed a 7-day supply. The amendment requires the pharmacist 
to make a professional judgment that the prescription is essential to sustain the life of the 
patient or to continue therapy for a chronic condition of the patient and that failure to 
dispense the drug could reasonably produce undesirable health consequences or cause 
physical or mental discomfort. 
The amendment adds a requirement that the pharmacist notify the practitioner who 
issued the prescription or another practitioner responsible for the patient's care no later than 
hours after the emergency supply is dispensed. 
The amendment requires health insurance plans to make available coverage for an 
emergency supply of a chronic maintenance drug dispensed in this manner. Any cost-
sharing requirement applicable to that chronic maintenance drug may be imposed by a 
health insurer on an emergency supply. 
The amendment removes the emergency preamble and emergency clause from the bill. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 03/23/22 .:b.Jrae 
LD 1776 
LR2273(02) 
An Act To Allow Pharmacists To Dispense an Emergency Supply of Chronic Maintenance Drugs 
Fiscal Note for Bill as Amended by Committee Amendment '~' C 
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Committee: Health Coverage, Insurance and Financial Services 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - Other Special Revenue Funds 
Fiscal Detail and Notes 
Additional costs to the Maine Board of Phannacy within the Office of Professional and Occupational Regulation, 
Department of Professional and Financial Regulation, and the Bureau of Insurance in the Department of Profession, 
and Financial Regulation to implement the requirements of this legislation can be absorbed within existing budgeted 
resources. 
LR2273(02) - Fiscal Note - 'P:H>e 1 of 1