Missouri Mandates Electronic Prescribing

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 Missouri Governor Mike Parson recently signed SB275 into law. This Act mandates Missouri healthcare providers to electronically prescribe all controlled substance medications contained in Schedules II-IV with an effective date of January 1st, 2021.  Missouri was very determined to pass an EPCS mandate, as they had at least 6 pieces of legislation pending that contained a mandate.  SB275 contains many elements of the additional pieces of legislation that were being debated.


Other subsections of the Act include:

  • The Act states that electronic prescriptions of controlled substances can be substituted for a written prescription at the direct request from the patient.
  • There are provisions in the Act for a waiver system with similar circumstances for approval as other states have enacted.  Some of these include economic hardship, technological limitations, and other circumstances determined by the board.
  • The Act establishes penalties for practitioners who do now follow regulations established in this Act.
  • The Act establishes the “Joint Committee on Substance Abuse Prevention and Treatment”, a new commission consisting of Senate, House, and governor-elected members to explore solutions and modify legislation for the state of Missouri pertaining to substance abuse.
  • Regulations for the cost of Medication-Assisted Treatment (MAT) are established within the Act.
  • Dentists are no longer allowed to prescribe extended-release opioids and any doses greater than 50 Morphine Milligram Equivalents per day.
  • Several other state regulations are changed including: Drug trafficking offenses, practitioner credentialing procedures, nicotine replacement therapy, and collaborative practice arrangements between physicians and physician assistants.


Missouri is currently above the national average for opioid-related overdose deaths, with 16.5 deaths per 100,000 people while the national average is 14.6 deaths.  Prescription opioid overdose deaths continued to gradually rise until 2010, then have remained stable.  Heroin deaths have gradually risen since 2007 and synthetic opioid deaths have all risen drastically since 2014, up from ~100 to 618 in 2017.[1]  Missouri is the only state in the US to have not established a Prescription Drug Monitoring Program (PDMP).  However, St. Louis County, MO created their own PDMP for use within their county.  Jackson County, MO has partnered with St. Louis County to use their PDMP.  Prescribers across the state have joined the PDMP on a voluntary basis, tired of waiting for Missouri State Legislators to establish an official state-wide PMP.  There is currently no state legislation for establishing a PDMP.

Missouri currently has a 25% prescriber enablement for electronic prescribing of controlled substances, which is below the national average of 35.4%.  Pharmacy enablement for EPCS is 97.9% which is above the national average for pharmacy enablement is 95.4%.[2]  There will likely be a big push leading up to 2021 to secure electronic prescribing, MDToolbox encourages providers not to wait!

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 Missouri 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!




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