As part of our ongoing review of the ever-growing liability of healthcare providers in relation to the opioid crisis, below is an overview of the most recent opioid related legislation in Maryland .
Effective October 1, 2018, amendments to Md. Code Ann. Health Occupations §1-223, mandates additional requirements for healthcare providers pertaining to the prescription of opioids and co-prescribed benzodiazepine. Specifically, the amended statute requires health care providers, in addition to the already required guidelines, to advise patients of the benefits and risks associated with the opioid being prescribed and, in the event opioids and benzodiazepines are prescribed together, advise of the benefits and risks associated with the benzodiazepine and the benzodiazepine with the opioid. The amended language makes clear that violation of section (b) of the statute, which relates to limitations on prescribing opioids, or the new advising requirements, is grounds for disciplinary action by the health occupation boards.
The amendments do not give practitioners guidance on what precise information needs to be communicated. However, guidance may be found in the draft bill. Reasons why the prescription is necessary, addiction and overdose even when taken as prescribed, developing physical or psychological dependence on the opioid, the risks of taking opioids with alcohol, and alternative treatments that may be available, were listed as required points of discussion in the draft. While not included in the final amendments, they may nonetheless provide some insight into the required discussion. In addition, the Maryland Board of Physicians contains a link for the Center for Disease Control (CDC)’s guidelines for prescribing opioids for chronic pain. They contain guidelines on when to initiate or continue opioids for chronic pain; opioid selection, dosage, duration, follow up and discontinuation; and assessing risk and addressing harm of opioid use. The guidance does not provide steadfast rules, but may be helpful. As is crucial in any situation where the failure to act in a certain manner may result in liability or board licensing proceedings, documentation is key. It is imperative for prescribing healthcare providers to incorporate the careful and detailed description of the required discussion with their patients in their medical records.
As focus on the opioid crisis continues to brighten, so too will the scrutiny on healthcare providers and others who are the gatekeepers to access. We will continue to provide updates on the latest statutes, case law and trends related to the crisis.
Megan Anderson is an Associate in PK Law’s Medical Malpractice Defense Group. Megan Anderson is an Associate in the Firm’s Medical Malpractice Defense Group where she focuses her practice on the defense of individual health care providers and the defense of health care institutions. Prior to joining PK Law Megan practiced for several years at a regional civil litigation firm where she focused her practice on the defense of professionals, including medical professionals. Megan has extensive civil litigation experience in the areas of insurance defense, malpractice defense and general liability defense. She has managed cases that were pending throughout the State of Maryland as well as in the United States District Court for the District of Maryland. She can be reached at 410-938-0645 or firstname.lastname@example.org.
Joan Cerniglia-Lowensen is a Member with Pessin Katz Law, P.A. (PK Law). She has close to twenty five years of civil litigation experience throughout the State of Maryland in both state and federal courts. Prior to becoming an attorney, Ms. Cerniglia-Lowensen was a registered nurse achieving both a BSN and a MS with a major in nursing. As an attorney, she primarily practices in the health care defense field. She defends nurses, doctors, veterinarians, dentists, healthcare providers, healthcare facilities, mental healthcare workers, urgent care facilities and nursing homes in medical malpractice matters; professional liability and tort claims; and disciplinary actions before various regulatory boards. She provides risk management advice to a variety of healthcare entities, insurers and individuals and continuing education to healthcare workers and entities; and has been published in both journals and texts on issues of risk management and liability of healthcare professionals. She also defends individuals and entities in a variety of civil litigation matters. She can be reached at 410-339-6753 or email@example.com.
Kathryn Jackson is an associate in the firm’s Medical Malpractice Defense Group. She recently passed the Maryland bar and was sworn in as an attorney in Maryland.