Maine E-Prescribing Mandate Origin

Governor Paul R. LePage signed into law LD 1646, “An Act To Prevent Opiate Abuse by Strengthening the Controlled Substances Prescription Monitoring Program” earlier this spring. He was motivated to introduce the law after meeting with the widow of a working man who was over-prescribed opiates following a workplace injury. Unfortunately, the husband’s addiction lead to his death caused by an overdose.

Approximately 75% of heroin addicts begin with prescription opioid medications.

Governor LePage aims to combat the addiction that devastates the Maine community by mandating electronic prescribing.

Maine's e-Prescribing Mandate

   Required PMP Check

  • Prescribers must check the PMP upon initial prescription of benzodiazepine or opioid medication and every 90 days following
  • The mandate PMP check for initial opioid and benzodiazepine scripts is January 1, 2017
  • Exception: No PMP check is required for benzodiazepine or opioid medication directly administered in an emergency room setting, an inpatient hospital setting, a long-term care facility, or a residential care facility. 

   CME Requirements

  • A prescriber must complete 3 hours of CME on the prescription of opioid medication every 2 years as a condition of prescribing opioid medication
Maine's e-Prescribing Mandate

    Prescription Dosage Limits, Morphine Milligram             Equivalents (MMEs)

  • New opioid patients after effective date of law
    • May not prescribe any combination of opioid medication in an aggregate amount of more than 100 MMEs per day
  • Existing opioid patients with active prescription in excess of 100 MMEs per day as of effective date of law ("Legacy Patients")
    • Form effective date of law, July 29th, until July 1st, 2017, may not prescriptive any combination of opioid medication in an aggregate amount of more than 200 MMEs per day
  • Exception: What is deemed "medically necessary" until January 1, 2017. More exceptions forthcoming

   Prescription Duration Limits 

  • Acute Pain, a prescription may not be written for more than a 7-day supply within a 7-day period
  • Chronic Pain, a prescription may not be written for more than a 30-day supply within a 30-day period
  • Scripts may be renewed without limit based on medical necessity
  • Limits only apply to opioid medications
  • Exceptions: When prescribing for...
    • Active of aftercare cancer treatment
    • Palliative care
    • End of life and hospice care
    • Medication-assisted treatment for substance use disorder
  • Exceptions: When directly ordered or administrated in...
    • An emergency room
    • An inpatient hospital
    • A long-term care or residential care facility
Maine's e-Prescribing Mandate

January 1, 2017

  • Mandatory check of the PMP
  • Limits on prescriptions for acute and chronic pain

July 1, 2017

  • Mandatory electronic prescribing
  • Patients with active prescriptions in excess of 100 MMEs must be tapered to an aggregate amount of 100 MMEs or less per day

December 31, 2017

  • CME requirement 
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