Code of Maine Rules › 14 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 118 - OFFICE OF SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES (SAMHS) › Chapter 11 - RULES GOVERNING THE CONTROLLED SUBSTANCES PRESCRIPTION MONITORING PROGRAM AND PRESCRIPTION OF OPIOID MEDICATIONS › Section 118-11-4 - General Requirements for Prescribing and Dispensing

Current through 2024-29, July 17, 2024
A. Prescriber Requirements
1. This subsection applies to all prescribers
				as defined in the Definition section of this policy.
2. Prescriber Numbers
a. Each prescriber must acquire a DEA number.
				This number may be obtained from the U.S. Department of Justice, Drug
				Enforcement Administration, Office of Diversion Control.
b. Prescribers must clearly indicate their
				DEA number on every prescription for a controlled substance written by the
				prescriber.
c. If U.S. Military
				affiliated prescribers with a service identification number do not have a valid
				DEA number, the prescriber's service identification number may be used. These
				providers must clearly indicate their service identification number on every
				prescription for a controlled substance written by the prescriber.
3. Prescription Code Requirement
				when the Prescription is Written for a Patient Under Treatment for Either
				Chronic or Acute Pain The prescriber must designate whether a prescription is
				for the treatment of acute pain or chronic pain. The following designations
				should be used.
i. For Acute pain, the word
				"Acute" should be written on the prescription
ii. For Chronic pain, the word "Chronic"
				should be written on the prescription
iii. For prescriptions using exemption code F
				(Acute pain for an individual with an existing opioid prescription for chronic
				pain), the word Acute should be used, as the seven (7) day limit
				applies.
4. Requirement
				to Include Diagnosis Code and Exemption Code
a. Diagnosis Code
i. All prescribers must include the diagnosis
				(ICD-10) code on the prescription for any opioid involving the Palliative Care
				Exemption.
ii. Diagnosis codes are
				not required on veterinary prescriptions
b.
Exemption Code
i.
All prescribers must include the
				exemption code, if the member is claiming an exemption from the 100 Morphine
				Milligram Equivalent aggregate daily limit. The codes are as follows:
Exemption Code A: Pain associated with active and
				  aftercare cancer treatment. Providers must document in the medical record that
				  the pain experienced by the individual is directly related to the individual's
				  cancer or cancer treatment;
Exemption Code B: Palliative care in conjunction with a
				  serious illness;
Exemption Code C: End-of-life and hospice
				  care;
Exemption Code D: Medication-Assisted Treatment for
				  substance use disorder;
Exemption Code E: A pregnant individual with a
				  pre-existing prescription for opioids in excess of the 100 Morphine Milligram
				  Equivalent aggregate daily limit. This exemption applies only during the
				  duration of the pregnancy;
Exemption Code F: Acute pain for an individual with an
				  existing opioid prescription for chronic pain. The seven day prescription limit
				  applies;
Exemption Code G: Individuals pursuing an active taper
				  of opioid medications, with a maximum taper period of six months, after which
				  time the opioid limitations will apply, unless one of the additional exceptions
				  in this subsection apply; or
Exemption Code H: Individuals who are prescribed a
				  second opioid after proving unable to tolerate a first opioid, thereby causing
				  the individual to exceed the 100MME limit for active prescriptions. For this
				  exemption to apply, each individual prescription must not exceed 100 MME.
				  Dispensers shall provide patients with guidance on proper disposal of the first
				  prescription.
ii.
Exemption codes are not required on veterinary
				prescriptions.
5. Requirement to Include Notation of
				Veterinary Prescription
All prescriptions intended for use by an animal must
				  indicate such use on the prescription.