Massachusetts General Laws
Chapter 94c - Controlled Substances Act
Section 18b - Voluntary Non-Opiate Directive Form

Section 18B. (a) The department shall establish a voluntary non-opiate directive form. The form shall indicate to all practitioners that an individual shall not be administered or offered a prescription or medication order for an opiate. The form shall be posted on the department's searchable website. An individual may execute and file a voluntary non-opiate directive form with a practitioner registered under section 7 or other authority authorized by the secretary to accept the voluntary non-opiate directive form for filing. An individual may revoke the voluntary non-opiate directive form for any reason and may do so by written or oral means.
(b) The department shall promulgate regulations for the implementation of the voluntary non-opiate directive form which shall include, but not be limited to:
(i) procedures to record the voluntary non-opiate directive form in the individual's interoperable electronic health record and in the prescription drug monitoring program established in section 24A;
(ii) a standard form for the recording and transmission of the voluntary non-opiate directive form, which shall include verification by a practitioner registered under section 7 and which shall comply with the written consent requirements of the Public Health Service Act, 42 U.S.C. § 290dd–2(b), and 42 CFR Part 2; provided, however, that the voluntary non-opiate directive form shall also provide the basic procedures necessary to revoke the voluntary non-opiate directive form;
(iii) requirements for an individual to appoint a duly authorized guardian or health care proxy to override a previously recorded voluntary non-opiate directive form;
(iv) procedures to ensure that any recording, sharing or distribution of data relative to the voluntary non-opiate directive form complies with all state and federal confidentiality laws; and
(v) appropriate exemptions for emergency medical personnel.
(c) A written prescription that is presented at an outpatient pharmacy or a prescription that is electronically transmitted to an outpatient pharmacy shall be presumed to be valid for the purposes of this section and a pharmacist in an outpatient setting shall not be held in violation of this section for dispensing a controlled substance in contradiction to a voluntary non-opiate directive form, except upon evidence that the pharmacist acted knowingly against the voluntary non-opiate directive form.
(d) No health care provider or employee of a health care provider acting in good faith shall be subject to criminal or civil liability or be considered to have engaged in unprofessional conduct for failing to offer or administer a prescription or medication order for an opiate under the voluntary non-opiate directive form.
No person acting as an agent pursuant to a health care proxy shall be subject to criminal or civil liability for making a decision under clause (iii) of subsection (b) in good faith.
(e) Any board of professional licensure may limit, condition or suspend the license of or assess fines against a licensed health care provider who recklessly or negligently fails to comply with a person's voluntary non-opiate directive form.

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