Most state legislative sessions have come to a close for 2019.  There are a handful of states that have year-round legislative sessions (MA, MI, NJ, NY, OH, PA, WI), but the majority of 2019 state legislation being drafted has either passed or died.  We saw a record number of States this year that have passed electronic prescribing mandates.  As of the writing of this blog, 27 of the 50 states have an active or pending mandate! 

States that have passed a mandate in 2019 are listed below:

States requiring e-prescribing of all prescriptions:

• Delaware (1/1/21)

• Florida (7/1/21 or upon license renewal)

States requiring e-prescribing of controlled substances:

• Arkansas (1/1/21)

• Colorado (7/1/21 or 7/1/23 for solo practitioners)

• Indiana (1/1/21)

• Kansas (7/1/21)

• Kentucky (1/1/21)

• Missouri (1/1/21)

• Nevada (1/1/21)

• South Carolina (1/1/21)

• Texas (1/1/21)

• Washington (1/1/21)

• Wyoming (1/1/21)

Two states have enacted amendments to their previously passed mandates.  Tennessee has made several major changes to their mandate.  The amended Act expands the mandate to cover not only Schedule II drugs, but all controlled substances.  The effective date has also been postponed to January 1^st, 2020.  Arizona has also amended their mandate passed in 2018.  Arizona had initially set effective dates of January 1, 2019 for prescribers in counties with populations more than 150,000 and July 1, 2019 for prescribers in rural counties with less than 150,000 residents.  The amended mandate has an updated effective date of January 1^st, 2020 for all counties in the State.

The majority of states share language in their bills, however there are a few state mandates that contained unique provisions in the wording of their legislation.

• Missouri’s mandate states that electronic prescriptions of controlled substances can be substituted with a written prescription at the direct request of the patient, maintaining an avenue for written prescriptions.

• Florida’s mandate has a provision that allows for practices that exclusively use paper charts to not follow the state mandate requiring electronic prescribing.  In speaking with a prescriber in Florida, they were waiting for clarification on this provision before making any prescribing arrangements as the provision’s wording is not entirely clear as to what constitutes an electronic health record as is written in the Act.

• Washington’s mandate requires that medical entities with ten or more prescribers must use an EHR that is integrated with the state Prescription Monitoring Program (PMP) database.  The EHR must demonstrate both sending and receiving of PMP data.  A waiver process will be made available for this requirement.

• Colorado allows for practitioners who write less than 25 prescriptions for controlled substances per year to not have to adopt electronic prescribing.

Michigan currently has pending legislation for their mandate and is currently being deliberated in committee.  There is also an anticipated update to the Ryan Haight act as required per 2018’s SUPPORT Act regarding telemedicine.  The deadline established in the SUPPORT Act is October 24^th, 2019.  Watch our blog or check our social media accounts for any updates regarding either of these legislation changes.

If you reside in any of the states that have enacted mandates this year, MDToolbox encourages prescribers to do their research and adopt a solution early to ensure that they comply with state regulations.

Please see our website for other states that have either passed or have pending legislation that mandates electronic prescribing.  MDToolbox looks forward to providing tools and resources to assist providers throughout the United States to ease the transition and help our customers combat the opioid epidemic.  With MDToolbox, providers have access to tools such as Electronic Prescribing of Controlled Substances (EPCS) and convenient on the go e-prescribing with our mobile app!  We offer a free 30 day free trial, so Contact us for more information!

Arkansas Governor Asa Hutchinson recently signed Act No 447/SB174 into law. This Act mandates Arkansas healthcare providers to electronically prescribe all controlled substances with an effective date of January 1^st, 2021.  Arkansas does not recognize Marijuana as a Schedule I drug.  The state has added a Schedule to their classification; Schedule VI, and classified marijuana as such.  The act refers to all controlled substances as Schedule II-VI.

Other subsections of this Act include:

• Schedule III and Schedule IV drugs shall not be filled or refilled more than six months after the date of prescribing or be refilled more than five times unless renewed.
• The act contains provisions for a waiver to delay the mandate for a specified time period for e-prescribing in the event of economic hardship, technological limitations, or exceptional circumstances.
• Pharmacies are not required to verify if a controlled substance prescription received via written, oral, or fax falls within the state and federal laws.
• The practitioner licensing board can issue a $250 fine for each violation of failure to e-prescribe a controlled substance.

Arkansas has remained below the national average for opioid-related overdose deaths since 2009.  However, in 2016 Arkansas was one of just eight states to fail the “National Safety Council: Prescription Nation” report that analyzed prescription drug usage state-by-state.   Arkansas was found to be ranked second in the list of highest rate of opioid prescribing states in the US[2].  The state government has worked hard since this ranking to get opioid prescriptions under control by requiring opioid education for practitioners, psychological therapy for patients while they are taking controlled substances, and additional support for inmates.

Arkansas currently has only 24.6% provider enablement for electronic prescribing of controlled substances, which is below the national average of 33.4%[3].  There will likely be a big push leading up to 2021 to secure electronic prescribing, MDToolbox encourages providers not to wait!

Arkansas now aligns with several other states mandating electronic prescribing. MDToolbox looks forward to working with providers throughout Arkansas to ease the transition and help provide tools and resources in combating the opioid epidemic. With MDToolbox providers have access to tools such as Electronic Prescribing of Controlled Substances (EPCS) and convenient on the go mobile e-prescribing.  Contact us for more information or to start your free 30 day free trial.

[1]https://www.drugabuse.gov/drugs-abuse/opioids/opioid-summaries-by-state/arkansas-opioid-summary

[2]https://www.nwaonline.com/news/2018/nov/11/arkansas-and-the-opioid-epidemic-201811/?opinion

[3]https://surescripts.com/enhance-prescribing/e-prescribing/e-prescribing-for-controlled-substances/