Legal Status of EPT in Maryland

I. Statutes/regs on health care providers’ authority to prescribe for STDs to a patient’s partner(s) w/out prior evaluation (Explanation)

[+] Certain health care providers are authorized to dispense or otherwise provide certain antibiotic therapy to partners of patients diagnosed with chlamydia, gonorrhea, or trichomoniasis without making a personal physical assessment of the partner. Md. Code Ann., Health-Gen. §18-214.1.

[+] Notwithstanding any other provision of law, a pharmacist licensed under Title 12 of the Health Occupations Article may dispense antibiotic therapy prescribed in accordance with [Md. Code Ann., Health-Gen. §18-214.1(b)]. Md. Code Ann., Health-Gen. §18-214.1 (effective 10/1/2017)

[+] Maryland released rules in support of its statutory authorization of EPT, which includes eligibility criteria for EPT, requirements for patient counseling and educational materials to be provided to patients who are provided with EPT treatment, prescribing procedures and dispensing format requirements, and reporting procedures for cases of EPT. Md. Code Regs. 10.06.07.01-.08

II. Specific judicial decisions concerning EPT (or like practices) (Explanation)

III. Specific administrative opinions by the Attorney General or medical or pharmacy boards concerning EPT (or like practices) (Explanation)

[-] A physician who prescribes naloxone—a non-controlled substance—to a patient to give to another heroin user in the event of an overdose would be subject to criminal prosecution and disciplinary action for aiding unauthorized practice of medicine and for violating applicable laws without statutory authority to do so. 88 Op. Att’y Gen. Md. 03-009 (2003).*

[-] No single State law specifies the contents of a valid prescription. However, the necessary elements of a prescription may be inferred from statutes that govern the dispensing and labeling of prescription drugs. Generally, a prescription will include the identity of the patient…. See Md. Code Ann., Health Occ. § 12-504 (circumstances under which pharmacist may substitute generically equivalent drug of “same dosage form and strength” for specified brand name drug); Md. Code Ann., Health-Gen. § 21-221(a) (“if stated in the prescription,” a dispensed drug must be labeled with the name of the patient, any directions for use, and any cautionary statements); 01 Op. Att’y Gen. Md. 01-026 (2001).*

[-] The Maryland Board of Physician Quality Assurance expressed concern about internet prescribing. It questioned the existence of a bona fide doctor/patient relationship when a person, previously unknown to the physician, provides subjective answers to questions via an online questionnaire and the physician provides prescriptions medications.*

[-] The Maryland Board of Physicians suspended the license of a physician pursuant to a Consent Order of the North Carolina Board sanctioning the physician for authorizing prescriptions without a physical examination and without any prior physician-patient relationship.*

IV. Laws that incorporate via reference guidelines as acceptable practices (including EPT) (Explanation)

[+] The secretary or health officer shall take any action necessary to prevent the spread of a communicable disease and shall issue special instructions, when necessary, for the control of a disease or condition. Md. Code Regs. § 10.06.01.06.

[+] Regulations incorporate by reference: APHA CCD Manual, 20th Edition, 2015, except where such recommendations conflict with health regulations. Md. Code Regs. §§ 10.06.01.01-1.

V. Prescription requirements (Explanation)

[+] (Explanation) Prescription label need not bear patient’s name. However if name is provided on prescription, label must bear the name of the patient. Md. Code Ann., Health-Gen. § 21-220 and § 21-221.

VI. Assessment of EPT’s legal status with brief comments (Explanation)

Statutory authority expressly authorizes certain providers to provide EPT for chlamydia, gonorrhea, and trichomoniasis. The Secretary of the Maryland Department of Health and Mental Hygiene adopted regulations to implement EPT.