Electronic Prescribing Waiver Request

Effective January 1, 2022, Senate Bill 0166 (CH0299)/House Bill 0512 (CH0230) (2020) Drugs and Devices – Electronic Prescriptions – Controlled Dangerous Substances​ requires licensed health care providers to electronically prescribe prescriptions for controlled dangerous substances​. The Health General Article, 21-220(C) provides exceptions to this requirement, and the requirement to request a waiver. A health care practitioner who is unable to electronically transmit prescriptions for controlled dangerous substance drugs may request a waiver from the electronic prescribing requirement under certain circumstances. A waiver, if granted, may not exceed one year.

The effective date of the state law aligned with the comparable federal law (Section 2003 of the SUPPORT Act). In December 2020, Centers for Medicare and Medicaid Services (CMS) implemented the first phase of this mandate by naming the standard that prescribers must use for e-prescribing transmissions and delaying compliance actions until January 1, 2022.

On November 2, 2021, CMS an​n​ounced they are delaying the start date for compliance actions to January 1, 2023, in response to stakeholder feedback. In order to maintain alignment with the federal government, MDH is also delaying compliance actions to January 1, 2023

 
To view existing electronic prescribing waiver recipients, visit the Online Waiver Verification page​.


Electronic Prescribing Instructions & Application


STEP 1: VERIFY YOU NEED A WAIVER
 A. You can apply for a waiver under the following circumstances:

  • Economic Hardship.
  • Technological limitations that are not reasonably within the control of the health practitioner; or
  • Any other exceptional circumstances as demonstrated by the health practitioner.

B. You are not required to obtain a waiver or prescribe electronically under the following exceptions:

A Health Practitioner may issue a written, or if authorized by state and federal law, oral prescription for a controlled dangerous substance if:

  • Electronic prescribing is not available due to a temporary technological or electrical failure
  • The prescription is to be dispensed by a pharmacy located outside of the state
  • The prescribing entity and dispensing entity of the drug or device are the same
  • The prescription is issued by a health practitioner outside of the state
  • The health practitioner is prescribing and dispensing the controlled dangerous substance directly to the patient.
  • The prescription is being dispensed directly to the patient in accordance with §12-102(2)(IV) of the Health Occupations Article.
  • The prescription is for an individual who:
    • Resides in a nursing or assisted living facility; or
    • is receiving care through a hospice or palliative care program and the prescription is related to the care provided,
    • is receiving care at an outpatient renal dialysis facility and the prescription is related to the care provided
    • is incarcerated in a state detained or confined in a correctional facility as defined in§ 1-101 of the   Correction Services Article
  • The prescription is issued by a licensed veterinarian
  • The prescription includes elements that are not supported by the most recent version of the National Council for Prescription Drug Programs Prescriber/Pharmacist interface Script Standard
  • The prescription is issued for a drug for which the federal Food and Drug Administration requires the prescription to contain certain elements that cannot be transmitted electronically.
  • The prescription is not specific to one patient, including prescriptions that are:
    • in accordance with a standing order
    • for an approved protocol for drug therapy
    • for collaborative drug management
    • the comprehensive medication management, or
    • in response to a public health emergency
  • The prescription prescribes a drug under a research protocol.
  • The prescription is issued by a health practitioner who has received a waiver by the Maryland Department of Health.
  • The prescription is issued by a health practitioner who requested a waiver, and the Department has not issued the waiver to the practitioner or has not rejected the practitioners request for a waiver.
  • The health practitioner issuing the prescription or the drug for which the prescription is issued falls under a waiver issued by the Secretary.
  • The prescription is issued by a health practitioner who writes a low volume of prescriptions for controlled substances, as determined by the Maryland Health care Commission.
  • The health practitioner reasonably determines that it would be impactable for the practitioner to prescribe the drug or device by electronic means:
    • in a timely manner; and
    • the delay would adversely impact the patient's medical condition.

 

STEP 2: COMPLETE THE WAIVER APPLICATION

All approved waivers will be public information and posted on the Office of Controlled Substance Administration website.

Click here to complete and submit an Electronic Prescribing Waiver Request.