2018 MARYLAND GENERAL ASSEMBLY HEALTH LAW UPDATE
The 438th Session of the Maryland General Assembly concluded April 9, 2018. Of the approximate 3,127 bills and resolutions considered by the General Assembly, 889 bills and 3 resolutions passed both chambers. Among them and highlighted below are the more notable pieces of legislation affecting the health care industry, as discussed in “The 90 Day Report, A Review of the 2018 Legislative Session,” published by the Maryland General Assembly, Department of Legislative Services.
Laws Enacted by the Legislature and Approved by the Governor
Opioids and Other Controlled Dangerous Substances
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House Bill 359 authorizes an emergency medical services provider, who treats and releases, or transports to a medical facility, an individual experiencing a suspected or actual overdose, to report the incident using an appropriate information technology platform, including the Washington/Baltimore High Intensity Drug Trafficking Area overdose detection mapping application program. In addition, HB 359 provides that an emergency medical services provider who makes a good faith report is immune from criminal liability. Effective: July 1, 2018.
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Senate Bill 522 and House Bill 653 require a health care provider to advise a patient of the benefits and risks associated with a prescribed opioid or co-prescribed benzodiazepine. House Bill 922 requires the Maryland Department of Health (“MDH”) to identify a method for establishing a tip line for a person to report a licensed prescriber whom the person suspects is prescribing or overprescribing certain medication. Effective: October 1, 2018.
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Senate Bill 87 updates the lists of Schedule I through V of the Controlled Dangerous Substances Act (“CDS”) to reflect federal lists and State exceptions; authorizes MDH to impose a civil penalty for violations of the CDS; and alters publication requirements for drug and prescription records impoundment notices. Effective: October 1, 2018.
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Senate Bill 232 and House Bill 407 require a general hospice care program to establish a written policy for the collection and disposal of unused prescription medications and require a program employee to collect and dispose of a patient’s unused medication on the death of the patient or the termination of a prescription by a patient’s prescriber. Effective: October 1, 2018.
Medical Cannabis
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Notwithstanding Maryland’s legalization of medical cannabis, Maryland health care providers certified by the Center for Medicare and Medicaid Services (“CMS”) are required to operate and provide medical services in accordance with applicable Federal laws. Such laws still prohibit the dispensing of medical cannabis.
Medical Records
Generally
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Senate Bill 230 requires a health care provider to disclose a medical record in accordance with compulsory process no later than 30 days after receiving the required documentation and any fees relating to the provision of the medical record that are owed to the health care provider by the party or the attorney representing the party seeking the medical record. A health care provider may request up to 30 additional days to disclose a medical record on a showing of good cause. Effective: October 1, 2018.
Prescription Records
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Senate Bill 13 and House Bill 115 require the Maryland Health Care Commission (“MHCC”) to convene interested stakeholders to assess the benefits and feasibility of developing an electronic system to allow health care providers to access a patient’s complete prescription medication history. Effective: July 1, 2018. Note: This law is in effect for a 2 year period. If no further action taken by the General Assembly, it will end on June 30, 2020.
Health Occupations
Physicians
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Senate Bill 234 enters Maryland into the Interstate Medical Licensure Compact (the “Compact”) for physicians. Under the Compact, participating state medical boards retain their licensing and disciplinary authority but agree to share information and processes that are essential to the licensing and regulation of physicians who practice across state borders. Participation in the Compact is voluntary for both states and physicians. The Compact is intended to provide a streamlined process that allows physicians to be licensed in multiple states, enhancing the portability of a medical license. The bill establishes procedures and requirements for physicians to obtain and maintain an expedited license to practice medicine in a member state and the composition, powers, and responsibilities of the Interstate Medical Licensure Compact Commission. Effective: July 1, 2019. Note: This law is in effect for a period of 3 years and 3 months and is scheduled to expire on September 30, 2022.
Physician Assistants
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Senate Bill 549 and House Bill 591 authorize a physician assistant to personally prepare and dispense a drug that the physician assistant is authorized to prescribe under a delegation agreement if the supervising physician possesses a dispensing permit and the physician assistant only dispenses drugs within the supervising physician’s scope of practice and within the scope of the delegation agreement. The bills (1) repeal authorization for a physician assistant to dispense personally a starter dosage or samples of a drug; (2) establish that a delegation agreement must include specified provisions relating to dispensing authorization; and (3) make a series of conforming changes. Effective: October 1, 2018.
Health Care Facilities
Health Maintenance Organizations (“HMO”) and Certificates of Need (“CON”)
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Senate Bill 619 and House Bill 1282 provide that an HMO or a health care facility that controls or is controlled by an HMO must have a CON before the HMO or health care facility builds, develops, operates, purchases, or participates in building, developing, operating, or establishing any other health care project for which a CON is required unless at least 90% of the patients who will receive health care services from the project will be individuals enrolled in that HMO. Effective: October 1, 2018.
Residential Treatment Centers – Inappropriate Sexual Behavior
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House Bill 1130 requires that a privately owned and operated residential treatment center be subject to reporting requirements established by the Maryland Department of Health (“MDH”). The reporting requirements apply when a staff member observes, receives a complaint regarding, or otherwise has reason to believe that an individual has been subjected to inappropriate sexual behavior. Effective: July 1, 2018.
Nursing Homes
Maryland Nursing Home Resident Protection Act
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Senate Bill 386 requires MDH to initiate an investigation of a nursing home complaint alleging actual harm within 10 business days. For any complaint alleging immediate jeopardy to a resident, MDH must make every effort to investigate within 24 hours and must investigate within 48 hours. Uncodified language in the bill requires OHCQ to receive annually 10 new, full-time merit positions each fiscal year beginning in fiscal 2020 and ending in fiscal 2024. Effective: July 1, 2018.
Pending Legislation to Watch
Unlike the bills described above, which were signed into law by the Governor, the following bills may or may not become law. The Governor has until May 28 to sign, veto, or allow them to pass without his signature, in which case they will become law. We will update this at that time.
Opioids and Other Controlled Dangerous Substances
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House Bill 517 expands an exemption from the requirement to query the Prescription Drug Monitoring Program (“PDMP”). For up to 14 days following a surgical procedure, a prescriber is not required to request data from PDMP when prescribing or dispensing an opioid or benzodiazepine (rather than only surgical procedures in which general anesthesia was used).
Medical Records
Mental Health
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Senate Bill 864 and House Bill 1392 require a health care provider to disclose legal and medical records (including mental health records) without the authorization of an individual to a public defender who states in writing that the Office of the Public Defender (“OPD”) represents the individual in an involuntary admission or release proceeding under the Health-General Article or a commitment or release proceeding under the Criminal Procedure Article. The bills also require facilities to notify OPD about the admission of an emergency evaluee or a change in admission status. Senate Bill 947 and House Bill 1635 prohibit a hearing officer from ordering the release of an individual who meets the requirements for involuntary admission because the individual was kept at an emergency facility for more than 30 hours in violation of law. House Bill 33 authorizes a disabled person to apply for voluntary admission to a facility for the treatment of a mental disorder and sets standards and criteria for a facility to accept a disabled person for voluntary admission, and the statute provides that a facility may not admit a disabled person for a voluntary admission unless specified criteria are satisfied and the disabled person is able to ask for release.
Health Care Facilities
Renewal Applications and Fees
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Senate Bill 108 repeals specified application and renewal fees and requirements for the renewal of a license or permit (once an initial license or permit has been approved) for specified providers regulated by the Office of Health Care Quality (“OHCQ”). The bill effectively authorizes OHCQ to issue nonexpiring licenses to specified provider types and eliminates all related licensing fees. Mandated periodic survey and reporting requirements are unchanged.
For more information about the 2018 legislative changes or other health law matters, please contact Greg Garrett via email or 410.752.9767, Ferrier Stillman via email or 410.752.9731, or a member of the Tydings health care practice group.
This alert has been prepared by Tydings for informational purposes only and does not constitute legal advice.