Michigan Governor Gretchen Whitmerrecently signed her State’s electronic prescribing mandate into law. Michigan House Bill 4217mandates healthcare providers to electronically prescribe all prescriptions with an effective date of October 1^st, 2021. This bill was initially introduced in 2019 with an effective date of January 1^st, 2021. The bill took until summer of 2020 to pass after being amended several times in both the House and Senate.

The Michigan mandate contains several exceptions in which electronic prescribing is not required, but all are standard to what other states have enacted. The mandate also makes mention of a waiver system but has no details on specifics other than the waiver is not to last for more than 2 years.

One unique section to the electronic prescribing legislation is that the mandate only takes effect if both SB248 and SB254 are also enacted into law. Both additional bills have also been enacted.

• SB248 is a bill related to regulation changes for pharmacists including the dispensing of medications. The bill covers new requirements and penalties for non-compliance. The bill also discusses licensing for acupuncturists.

• SB254 is a bill related to legal responsibilities of health care employees and their interactions with patients. The bill establishes that the Michigan Department of Health may investigate allegations of misconduct and pass along their findings to the appropriate disciplinary subcommittee.

Michigan is currently well above the national average for opioid-related overdose deaths, with 20.8 deaths per 100,000 people while the national average is 14.6 deaths. Prescription opioid overdose deaths continued to gradually rise until 2016, then have been on a slight downward trend since then. Heroin and synthetic opioid deaths have continued to rise since the early 2000’s with a sharp rise in synthetic opioid use beginning in 2014.[1]

The gradual decline in prescription opioid overdose deaths in Michigan might be in part due to the State legislature enacting a 10-bill package to attempt combatting the opioid epidemic in their state in Demember 2017. The bills covered a wide range of changes for Michigan residents and healthcare professionals. Among the requirements are:

• Mandatory patient education when being prescribed opioids
• Patient-provider relationship requirements
• PMP check requirements
• Drug dispensing restrictions
• Opioid education in the public school system

Michigan currently has a 44.9% prescriber enablement for electronic prescribing of controlled substances, below the national average of 51.1%. Pharmacy enablement in Michigan for EPCS is 95.3%, which is also below the national average of 97.1%.[2] MDToolbox encourages providers not to wait until the last minute to setup electronic prescribing!

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 Michigan 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!

[1]https://www.drugabuse.gov/drug-topics/opioids/opioid-summaries-by-state/michigan-opioid-involved-deaths-related-harms
[2]https://surescripts.com/enhance-prescribing/e-prescribing/e-prescribing-for-controlled-substances/

Utah Governor Gary Herbert and Maryland Governor Larry Hogan have both recently signed their State’s electronic prescribing mandates into law. Utah House Bill 177 mandates healthcare providers to electronically prescribe all controlled substance medications with an effective date of January 1^st, 2022. Both Maryland Senate Bill 166 and House Bill 512 also mandate providers to electronically prescribe all controlled substances with an effective date of January 1^st, 2022.

The Utah and Maryland mandates require their State’s various medical boards to establish rules and regulations for a system to temporarily waive the requirement of electronic prescribing. Maryland’s waiver will not exceed one year, and Utah’s waiver will grant up to a two-year extension for the electronic prescribing requirement. Maryland’s mandate states that the Health Occupations Board may take disciplinary action for violating the mandate, while Utah’s bill goes into specific detail about criminal charges and monetary fines for prescribers who violate the electronic prescribing mandate. The Utah mandate also goes into additional detail about licensing to manufacture, produce, and conduct research with medications.

Utah is currently above the national average for opioid-related overdose deaths, with 15.5 deaths per 100,000 people while the national average is 14.6 deaths. Prescription opioid overdose deaths continued to gradually rise until 2015, then have been on a downward trend since then.[1] Heroin and synthetic opioid deaths have continued to rise since the early 2000’s. Utah began attempting to tackle their Opioid dependence problems heavily in 2017. SB258 established guidelines for prescribing both opiates and opiate antagonists. HB146 setup guidelines for partial filling of schedule II controlled substance prescriptions.

Maryland is second only to West Virginia for having the highest opioid-related overdose deaths with 33.7 deaths per 100,000 people, more than double the national rate. Prescription opioid overdose deaths continued to gradually rise until taking a sharp turn in 2016, but have since been on a downward trend. Synthetic opioid deaths have sharply risen since 2015. [2] In 2017 Larry Hogan signed the Heroin and Opioid Prevention Effort (HOPE) and Treatment Act into law. The HOPE Act improved patient education, increased treatment services, and eventually expanded Naloxone access. The Controlled Dangerous Substances – Volume Dealers Act passed in 2018 allowed for more effective prosecution of drug traffickers in the state.

Utah is ahead of Maryland in their EPCS enablement statistics. Utah currently has a 50.6% prescriber enablement for electronic prescribing of controlled substances, slightly below the national average of 51.1% while Maryland has only 34.9% prescriber enablement. Pharmacy enablement in Utah for EPCS is 99.0%, well above the national average of 97.1% while Maryland is slightly below the national average at 96.9%.[3] MDToolbox encourages providers not to wait until the last minute to setup electronic prescribing!

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 Maryland and Utah 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!

[1]https://www.drugabuse.gov/opioid-summaries-by-state/utah-opioid-summary
[2]https://www.drugabuse.gov/opioid-summaries-by-state/maryland-opioid-involved-deaths-related-harms
[3]https://surescripts.com/enhance-prescribing/e-prescribing/e-prescribing-for-controlled-substances/

Electronic prescribing has many advantages for dentists and dental offices. Sending prescriptions electronically can drastically improve a dentist’s workflow by being able to transmit prescriptions to the pharmacy quickly and efficiently, avoiding the traditional stresses of writing out paper prescriptions, making phone calls, or dealing with pages of faxes.

Here are five ways MDToolbox offers one of the best e-Prescribing software services to save dental practices time & money:

1. Dental e-prescribing allows dentists to improve the safety and quality of care they provide. 

Patients may remember to bring their medication list with them to see their cardiologist but might not remember their list when seeing the dentist. Some electronic prescribing systems (such as MDToolbox) allow for pulling medication fill history for patients automatically, so even if the patient cannot recall their medications, the dentist will have a record of it. MDToolbox can improve patient safety by alerting for any drug to drug interactions, drug allergy interactions, drug to condition interactions, and duplicate therapy conditions. These alerts could save a patient’s life.

2. MDToolbox allows for checking State PMPs in one click.

The opioid epidemic plaguing our country has resulted in many states mandating checking the state specific Prescription Drug Monitoring Programs (PMPs) prior to prescribing certain controlled substance medications. MDToolbox allows dentists in most states to be able to check this data directly within the prescription writer, saving dentists time when they could be seeing patients.

3. Dental practices require different software than traditional medical offices.

MDToolbox offers a stream-lined stand-alone solution to electronic prescribing without the extensive, steep learning curve of a full EMR. Quickly accessing a patient file and sending a prescription to the pharmacy can be invaluable to an efficient workflow in a modern dental practice. Prescribers will also find dental-specific medication monograph data when looking up drug information in the program.

4. Electronic prescribing saves patient’s money, which may help when the Nitrous Oxide wears off.

 MDToolbox offers real-time pricing benefit from directly within our system. This allows for viewing the price of the specific medication the dentist is prescribing at their patient’s specific pharmacy as they are writing the prescription. The system will present potential alternatives that may save the patient money by making a brand or pharmacy change.

5. Meet State and National mandates to electronically prescribe.

States are continuing to pass legislation requiring all prescribers, including dentists, to send electronic prescriptions. See our State Map for information on current and pending legislation. Some States detail extensive penalties for not complying with their electronic prescribing legislation. In addition, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act will require EPCS at the national level starting in January 2021.

MDToolbox looks forward to providing tools and resources to assist dentists throughout the United States to ease the transition, helping our customers increase the efficiency of their office and combat the opioid epidemic. With MDToolbox, dentists have access to tools such as Electronic Prescribing of Controlled Substances (EPCS), the ability to check most State’s PMPs without having to separately login to their State portal, 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!

MDToolbox is proud to announce that we have recently won three awards for our electronic prescribing platform!

Capterra, a free online service that helps organizations find the right software, has awarded MDToolbox both their “Best Value” and “Best Ease of Use” awards for 2020.  These were independently assessed based on user reviews and online search activity amongst the electronic prescribing software market. The awards are only given to software companies whose products reach an average review rating score greater than 4.5 across all of the products’ published reviews within the submission period.

In our Capterra reviews, Valori C. stated “…there are not enough superlatives to describe this product and its affordability.”  MDToolbox is extremely proud to be recognized for Best Value for electronic prescribing, as we concentrate on providing the most affordable option on the market without sacrificing features or generating secondary income off our users by including ads or selling their patient data. With MDToolbox, our focus is solely on providing software that healthcare providers can rely on, so they can focus on what really matters – patient care.

Ease of Use is something difficult to achieve considering the myriad of regulations that come with electronic prescribing. MDToolbox engineers are constantly striving to lessen the learning curve for electronic prescribing. Noreene R. said “I was able to figure out how to use it on my own when my secretary was out for a week. The ease of operation is really impressive and there are so few steps to complete the transaction. We are very happy that we chose this system.” 

However, if that learning curve is still too steep for some users, MDToolbox prides itself on having some of the best customer support in the market with average hold-times of under 30 seconds.  Our support staff are happy to assist our users better utilize the system to make their medical practice as efficient as possible.            

GetApp, a sister site of Capterra that also focuses on helping professionals find the right software, has awarded MDToolbox their “Best Functionality and Features” award for 2020.  GetApp calculated scores for their award based on user reviews and product features evaluated by a research analyst.

Julie B. wrote “The ease of use is the most important thing that I liked about the software. Also the feature of notifying the pharmacy of discontinuing the medication. That is a feature I did not have on the other software I used. I can also track the medication from escribing through to the pharmacy's acceptance which is great.”

MDToolbox has remained a frontrunner for adopting new features and certifying to industry standards.  MDToolbox staff are driven to provide as many useful features as possible while our engineers are ensuring the stable functionality that is imperative to the modern medical practice. State Prescription drug Monitoring Program (PMP) integration, real-time prescription benefit information, compounded-drug prescribing, and drug interaction alerts are just some of the included advanced features that make MDToolbox stand out as a superior electronic prescribing system.

We’re thankful to all of our users who’ve left us such great reviews and aim to continue providing the best e-prescribing software we can. Please see Capterra for our full reviews and if you’re ready to check out our award-winning software yourself, make sure to sign up for our free 30 day trial!

The Best badge recipients are determined by the subjective opinions of individual end-user customers based on their own experiences, the number and timing of published reviews on Gartner’s digital sites (Capterra.com, SoftwareAdvice.com, and GetApp.com) and review ratings for a given product in the category, and are not intended in any way to represent the views of Gartner or its affiliates.

The Department of Health and Human Services (HHS) and the Drug Enforcement Administration (DEA) have released clarification of United States Code contained in the Controlled Substances Act affecting Telehealth visits. 

President Trump in a Tuesday briefing said his administration would "encourage everyone to maximize use of telehealth to limit exposure to the virus."

The DEA has clarified that during a Public Health Emergency, which was issued by Secretary Azar of HHS on January 31^st, 2020 due to the COVID-19 virus, that controlled substances may be prescribed via telemedicine without first conducting an in-person visit with the patient.  The Ryan Haight Act of 2008 established regulations and prohibited heathcare providers from prescribing controlled substances to patients that they haven’t first examined in-person.  Section 802(54)(D) of the Controlled Substances Act allows for the Ryan Haight Act to be circumvented during a public health emergency which would allow MDToolbox customers to electronically prescribe controlled substances (EPCS) for patients via telemedicine.

The DEA has stated three conditions for prescribing controlled substances via telemedicine:

• The prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of his/her professional practice
• The telemedicine communication is conducted using an audio-visual, real-time, two-way interactive communication system.
• The practitioner is acting in accordance with applicable Federal and State law.

Not all States allow for EPCS via telemedicine, prescribers will need to ensure that they are following both their State law as well as the State law where the patient resides prior to prescribing via telemedicine.  Some states that allow for EPCS via telemedicine include Indiana, Michigan, Ohio, Florida, Delaware, New Hampshire, West Virginia, and Connecticut.  Prescribers should contact their State Medical and Pharmacy Boards as well as the State Boards where their patient resides to ensure their compliance.

HHS has also issued further clarification on the systems that can be used for a telemedicine visit, they have ensured penalties will not be enforced for using apps such as:

• Apple FaceTime
• Facebook Messenger video chat
• Google Hangouts video
• Skype

This is not an inclusive list and are examples of apps that can be used.  The app must be a private communication means that support both audio and video.  The DEA provided further clarification that public communication apps or streaming services are not to be used such as:

• Facebook Live
• Twitch
• TikTok

The DEA has missed several deadlines to establish rules and a waiver system to allow electronic prescribing of controlled substances via telemedicine during a time in which we are not in a Public Health Emergency.  Reducing these road-blocks, as we are seeing with the emergency measures in place due to COVID-19 can help bring healthcare into the 21^st century and help reduce stress on our medical system as well as help prevent infections.

We at MDToolbox applaud HHS and the DEA for removing the telemedicine restrictions and our team are watching for more regulation changes on a federal level that would allow electronic prescription of controlled substances via a telehealth practitioner.  You will find any policy and regulation updates here in our blog.  MDToolbox looks forward to working with telehealth providers and help provide tools and resources in combating healthcare system strain.  Contact us for more information or to start your free 30 day free trial.

Emergency legislation has just been enacted that will allow for Medicare reimbursement for practices utilizing telemedicine to treat patients at home regardless of where they live.  The Coronavirus Preparedness and Response Supplemental Appropriations Act was introduced on Wednesday March 6^th, 2020.  The bill was enacted and became law on the following Friday with near unanimous support in both the House and Senate.  The Act provides $8.3 billion in emergency funding to agencies responding to the Coronavirus outbreak.

The emergency funding is to be distributed by the Department of Health and Human Services (HHS) as follows:

• $3.4 billion for the Office of the Secretary – Public Health and Social Services Emergency Fund (PHSSEF)
• $1.9 billion for the Centers for Disease Control and Prevention (CDC)
• $1.6 billion for international response efforts
• $836 million for the National Institute of Allergy and Infectious Diseases (NIAID),
• $61 million for the Food and Drug Administration (FDA)
• $20 million is for the Small Business Administration (SBA)

The Act includes a provision entitled the “Telehealth Services During Certain Emergency Periods Act of 2020” which details a waiver removing restrictions on Medicare providers allowing them to offer telehealth services to beneficiaries regardless of whether the beneficiary is in a rural community.  The waiver becomes effective when either the President of the United States or Secretary of HHS declare a public health emergency.  Secretary Azar of HHS declared a public health emergency on January 31^st, 2020 which was retroactive to January 27^th, 2020.

 “To protect public health, the bill will allow Medicare providers to extend telemedicine services to seniors regardless of where they live, at an estimated cost of $500 million,” House Speaker Nancy Pelosi said in a statement released on March 4th.

From the demographics of those infected and killed by COVID-19 internationally, the current data available shows that the elderly age group are most affected by the virus.  While the virus has only begun spreading rapidly in the US in the past two weeks, the Act will hopefully be pro-active enough to save lives by giving patients the option to stay home, away from hospitals and doctor offices to be triaged and seen remotely by care providers.

China needed to emergently construct temporary hospitals in a matter of days to handle the influx of patients seeking medical attention, the US could likely see a similar rise in hospital visits and admittances.  Further adoption of telehealth could help alleviate some of that strain on the healthcare system, reducing infection by keeping patients at home, allowing providers to see more patients, and by reducing the sheer numbers of people entering healthcare facilities.

MDToolbox has positioned itself to cater to both traditional and telehealth providers needing a simple feature-rich electronic prescribing solution that can be implemented in a minimal timeframe.  Our stand-alone electronic prescribing system is streamlined and easy to use with a much more gentle learning curve than larger EMRs.  Most prescribers can be electronically prescribing within 24 hours, minimal downtime before being able to send prescriptions electronically to more than 98% of the pharmacies in the U.S. including mail order pharmacies that can deliver directly to home-quarantined patients.

Although the Coronavirus Preparedness Act removes some of the restrictions hindering telemedicine, the DEA has missed several deadlines to establish rules and a waiver system to allow electronic prescribing of controlled substances (EPCS) via telemedicine.  The Ryan Haight Act of 2008 requires an in-person consultation at regular intervals prior to EPCS via telemedicine.  Reducing these road-blocks can help bring healthcare into the 21^st century and help reduce stress on our medical system as well as help prevent infections.

We at MDToolbox applaud Congress and HHS for removing some of the telemedicine restrictions and our team are watching for more regulation changes on a federal level that would allow electronic prescription of controlled substances via a telehealth practitioner.  You will find any policy updates here in our blog.  MDToolbox looks forward to working with telehealth providers and help provide tools and resources in combating healthcare system strain.  Contact us for more information or to start your free 30 day free trial.

The U.S. Department of Health and Human Services (HHS) has released their Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs report. This report was required by the 21st Century Cures Act and is intended to reduce the effort and time required by clinicians to meet reporting requirements, record health information, and improve the functionality and intuitiveness of EHRs.

“Usable, interoperable health IT is essential to a healthcare system that puts the patient at the center” said HHS Secretary Alex Azar. “We received feedback from hundreds of organizations and healthcare providers on this new burden-reduction strategy, and the input made clear that there are plenty of steps still necessary to make IT more usable for providers and maximize the promise of electronic health records.”

Clinician burden is linked to EHR usability, the report was written considering input from more than 200 comments submitted in response to the draft report (released in November 2018) and recommendations. The report details three primary goals:

• Reduce the effort and time required to record information in EHRs for health care providers when they are seeing patients

• Reduce the effort and time required to meet regulatory reporting requirements for clinicians, hospitals, and health care organizations

• Improve the functionality and intuitiveness (ease of use) of EHRs.

“The taxpayers made a massive investment in EHRs with the expectation that it would solve the many issues that plagued paper-bound health records,” said CMS Administrator Seema Verma. “Unfortunately – as this report shows – in all too many cases, the cure has been worse than the disease. Twenty years into the 21st century, it’s unacceptable that the application of Health IT still struggles to provide ready access to medical records – access that might mean the difference between life and death. The report’s recommendations provide valuable guidance on how to minimize EHR burden as we seek to fulfill the promise of an interoperable health system.”

Specifically, ONC and CMS looked at four key areas and offered strategies to address each area:

•  Increasing public health reporting by working to increase provider PDMP queries, increasing adoption of EPCS, and developing a process to address the issue of inconsistent data collected by federal, state, and local programs.

• Reducing clinical documentation requirements by leveraging health IT to standardize data and processes around ordering services and by reducing required documentation for patient visits.

• Increasing health IT usability and standardization by promoting user interface optimization, promoting harmonization surrounding clinical content such as medication information, and simplifying order entry in EMRs to reduce burden.

• Standardizing federal health IT and EHR reporting by simplifying program requirements such as the Merit-based Incentive Payment System (MIPS) and the Medicare Promoting Interoperability Program.

MDToolbox is optimistic that the medical industry will soon see improvements that stem from the research and public commentary addressed in this report as it is used to affect coming regulations and standards.  We are proud to have already addressed some of the key strategic areas for improvement detailed in the report.  With MDToolbox, providers have access to tools such as Electronic Prescribing of Controlled Substances (EPCS), convenient on the go e-prescribing with our mobile app, and prescribers can register for our PMP-gateway access option in most states.  Our engineers are continually developing methods and workflows to save providers and medical staff time and energy.  We offer a free 30 day free trial, so Contact us for more information!

OptumRx, the pharmacy benefit provider for United Healthcare, will require electronic prescriptions for all controlled substances for its home delivery pharmacy service effective March 1, 2020.  OptumRx has stated that they are “…part of a nationwide effort to require e-prescriptions for opioids and other controlled substances for its home delivery pharmacy. We’re joining with care providers and communities to help prevent opioid misuse and addiction.” MDToolbox commends OptumRx for being among the first home delivery pharmacy services to require EPCS (electronic prescribing of controlled substances).

At this time, the requirement does not apply to members residing in Alaska, Guam, Puerto Rico, or the U.S. Virgin Islands.  OptumRx is also not requiring prescribers who are exempt from either their State EPCS requirements or the SUPPORT Act EPCS requirements.  As states have created legislation for their own electronic prescribing mandates, some have allowed for prescribers to apply for temporary exemptions that will be honored by OptumRx.

2020 sees several more states requiring electronic prescribing such as Arizona, Florida, Iowa, North Carolina, Oklahoma, Rhode Island, and Virginia.  As of this week, 33 of 50 states have current or pending electronic prescribing mandate legislation.  Federal law will also require physicians to electronically prescribe controlled substances for Medicare patients effective January 1, 2021.  There will likely be more major mail-order and retail pharmacies requiring electronic prescribing in the near future, continue watching our blog for the latest news on electronic prescribing.

Please see our website for 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!

Massachusetts passed House Bill 4742 “An Act for Prevention and Access to Appropriate Care and Treatment of Addiction” in 2018 which mandated prescribers to electronically prescribe all controlled substances by January 1^st, 2020.  The bill also required prescribers to utilize the state Prescription Monitoring Program (PMP) when writing a prescription for a Schedule II, III, or benzodiazepine.

After taking public comment in the summer of 2019, the Massachusetts Department of Public Health presented proposed amendments to the Public Health Council.  These amendments were approved at the end of September 2019.  The new amendments go into effect on 12/27/19, just ahead of the mandate deadline of 1/1/20. 

The approved amendments that were adopted include:

• Delay full implementation of the ePrescribing mandate until January 1, 2021;

• Clarify pharmacists’ role related to filling prescriptions submitted under an ePrescribing exception or waiver;

• Expand the Schedule VI exception from individuals with a MCSR for Schedule VI only to all Schedule VI medications;

• Clarify prescriptions that cannot be issued electronically under federal or state law or regulations, including those prescriptions the FDA requires contain elements, such as an attachment, that are not supported through current ePrescribing systems; and

• Add two additional ePrescribing exceptions as follows:

o   Prescriptions for residents of nursing homes through January 1, 2023, or such later date as determined by the Department; and

o   Prescriptions issued in response to a declared public health emergency, diseases dangerous to public health, or other urgent public health matter. 

The Massachusetts Department of Public Health stated that education and guidance will be forthcoming throughout the remainder of 2019 and through 2020.  This will also include additional guidance to prescribers and facilities regarding the waiver process if more time (past 1/1/21 deadline) is necessary.

MDToolbox recommends adopting electronic prescribing and integrating it into your practice as early as possible to be prepared to meet any approaching deadlines.  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 nation 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!

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!