The PDMP Use Mandate applies to both CDS Prescribers and Pharmacists. See below for information specific to each profession.
Effective July 1, 2018, a Prescription Drug Monitoring Program (PDMP) use mandate for providers prescribing controlled dangerous substances (CDS) medications and pharmacists goes into effect. The full text of the use mandate can be found in Health General-Article § 21-2A-04.2.
The requirements and exemptions of this mandate are summarized below.
Mandatory Use for CDS Prescribers: Prescribers include the following practitioners with CDS prescriptive authority: physicians, physician assistants, dentists, podiatrists, nurse practitioners, and advanced practice nurse midwives. Prescribers must query and assess PDMP data (through the CRISP portal or integration within the Electronic Health Record (EHR), where available):
- Before beginning a new course of treatment with opioids or benzodiazepines
- When a course of treatment extends beyond 90 days. In this case, prescribers must query again at least every 90 days thereafter before prescribing or dispensing opioids or benzodiazepines
- Must view at least the last 4 months of data ( This will always be available within a PDMP data view.)
- A prescriber delegate may pull the PDMP data, but the prescriber remains responsible for assessing the data prior to making a prescribing decision.
Exceptions to this mandate: A prescriber is NOT REQUIRED to request PDMP data if the opioid or benzodiazepine is prescribed or dispensed to an individual:
- For a period of 3 days or less (
- For cancer treatment or cancer-related pain
- For a patient who is:
- Receiving treatment in an inpatient unit of a hospital
- Part of a general hospice program*
- Diagnosed with a terminal illness *
- Residing in a nursing home, long-term care, developmental disability, or assisted living facility
- To treat or prevent acute pain for a period of 14 days or less (
- Surgical procedure*
- Bone Fracture
- Significant trauma*
* See specific FAQs for definitions of these terms
Mailing to Prescribers May/June 2018
Mandatory Use for Pharmacists: Pharmacists must query and assess the PDMP data when they suspect any CDS prescription is being filled for something other than treatment of an existing medical diagnosis, essentially a restatement of the corresponding responsibility under federal regulations.
Effective adoption of PDMP as a clinical decision support tool both under the use mandate, and as recommended by the Centers for Disease Control and Prevention (CDC), the President’s Opioid Commission on Combating Drug Addiction and the Opioid Crisis, and the Maryland Heroin and Opioid Emergency Task Force relies on integrating PDMP data access into the realities of a put in place to assist providers are:
- Use of Delegates, who can access the PDMP on behalf of a prescriber or pharmacist and provide that PDMP data report to the provider for a prescribing or dispensing decision
- Integrating PDMP access into an EHR, which is available in many hospital system settings across the state
Mailing to Pharmacists May/June 2018