Health Maintenance Organizations - Payments to Nonparticipating Providers - Reimbursement Rate
House Bill 737 authorizes a competent individual to create a “nonopioid advance directive,” a written instruction stating that the person refuses the offer or administration of opioid medication, including in an emergency when the person cannot communicate a preference. The bill places this directive within Maryland’s existing advance directive framework, so a person would use the same general procedures for making and revoking an advance directive that already apply under state law.
The bill also directs the Maryland Department of Health to create a model nonopioid advance directive form and post it on the Department’s website, and it requires the Department to adopt regulations to implement the new section. The act is scheduled to take effect October 1, 2025.
HB0737 would add a new section to the Health-General Article establishing a legally recognized nonopioid advance directive in Maryland. It would expand the state’s advance directive laws by allowing individuals to document a refusal of opioid medication in advance, including in emergency settings, and would make that refusal part of the medical decision-making process when the patient cannot speak for themselves. The bill also imposes administrative duties on the Maryland Department of Health to publish a model form and promulgate implementing regulations, affecting healthcare providers, emergency responders, patients, and anyone using advance care planning documents.
Based on the bill text and the limited available context, the measure appears to be framed as a patient-autonomy and public health bill rather than a controversial enforcement measure. No committee transcript or vote record is available here, so there is no documented floor or committee debate to indicate strong support or opposition. The overall tone of the legislation is procedural and permissive, focusing on giving competent adults another advance-planning option.
The main potential point of contention is the practical effect of allowing a patient to refuse opioids even during an emergency, which could raise concerns among clinicians and emergency responders about pain management, treatment flexibility, and how to interpret the directive in urgent care situations. Another possible issue is how the directive would interact with standard medical judgment, informed consent, and existing emergency protocols. However, no specific objections or supporters are identified in the provided discussion materials.