L.D. 273 Testimony





Joint Standing Committee on Health & Human Services

Room 209, Cross State Office Building

Thursday, April 20, 2017, 1:00 p.m.

Good afternoon Senator Brakey, Representative Hymanson, and Members of the Health and Human Services Committee.  I am Gordon Smith, a resident of East Winthrop and Executive Vice President of the Maine Medical Association.  I am here today to speak in favor of L.D. 273.

The MMA is a professional organization representing more than 4000 physicians, residents, and medical students in Maine whose mission is to support Maine physicians, advance the quality of medicine in Maine, and promote the health of all Maine citizens.

We are pleased to support LD 273 which corrects an oversight in the original law, P.L. 2015, Chapter 488.  The intention was to exempt from the mandated check of the Prescription Monitoring Program (PMP) and from the e-prescribing mandate prescribers treating patients exempt from the MME limits and the durational limit.  To substantiate this intent, I have attached to my testimony a copy of a memo from me, dated March 18, 2016 to the Chairs of this Committee.  The purpose of that memo was to provide the details of an agreement reached between the Maine Medical Association and the LePage Administration following a meeting between myself, Commissioner Mayhew, and David Sorenson of the Governor’s Office.   I believe that David will confirm the accuracy and authenticity of this memo which should be in the Committee files as well. 

Section 5 of the memo clearly states that none of the provisions of the law would apply to the four exempt categories.  These categories include cancer patients, individuals receiving hospice care, end of life care and palliative care.  Note that the memo also states that the prescribing of buprenorphine (Suboxone) is exempt.  That exemption will be important to encourage an increase in the number of prescribers taking the courses and receiving the waiver necessary to prescribe buprenorphine for treatment of substance use disorders.  There are a number of existing Suboxone providers who do not have the capacity to e-prescribe and it would be another barrier to treatment to stop them from prescribing on July 1, 2017.

Others testifying will substantiate the need for these exemptions, particularly with respect to hospice care, end of life care, and for patients receiving treatment for active cancers.

As Representative Hymanson has stated in her testimony, the reason these patients were intended to be exempt from all the requirements of P.L. 2015, Chapter 488 was that there is little risk of diversion or addiction in these situations.

Thank you for the opportunity to testify in support of this legislation and I would be happy to answer any questions you may have.