Kansas Mandates Electronic Prescribing

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Kansas Governor Laura Kelly recently signed HB2119 into law. This Act mandates Kansas healthcare providers to electronically prescribe all controlled substance medications that contain an opiate with an effective date of July 1st, 2021.  The Kansas mandate details several circumstances where electronic prescribing is not required.  However, there are a couple of circumstances that are not typical or seen in mandates that other states have enacted:

  • If the prescription is for a compounded controlled substance containing two or more components (one of which being an opiate) that make “electronic submission impractical”, electronic prescribing is not required. This provision is likely to help accommodate prescribers who are using software that does not support prescription orders for custom compounds.  At the time of writing this blog, many software systems only allow selecting orders from a list of drugs (MDToolbox e-Rx software however DOES accommodate custom compounds and would allow for this type of order to be electronically sent).
  • If a prescriber issues 50 or fewer controlled substance prescriptions that contain an opiate per year, electronic prescribing is not required.

 

Other subsections of the Act include:

  • 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 details penalties for practices that violate or misrepresent themselves when applying for waivers.
  • The Act establishes penalties for any prescriber who violates “any lawful rules or regulations” set in place by the state which would include the EPCS mandate established by this Act.
  • More than half of the Act amends previous legislation with new medical definitions for existing and future laws.

 

Kansas is currently well below the national average for opioid-related overdose deaths, with 5.1 deaths per 100,000 people in 2017 while the national average was 14.6 deaths.  Prescription opioid overdoses rose steadily from 2000 to 2007, then have consistently decreased from 2014 to 2017.  Heroin and synthetic opioid deaths have remained consistent despite the national average rising sharply in the last few years.[1]  Despite being one of the lowest states for opioid overdose deaths, Kansas prescribes more opioids than the national average.  Opioid prescriptions are 69.8 per 100 people while the national average is 58.7 per 100 people.[2]  Kansas was one of the first states to enact legislation for a prescription drug monitoring program (K-TRACS).  It went operational in 2010 but the state does not mandate it’s use for non-dispensing prescribers.  Funding issues threatened the K-TRACS program but support was reapproved by the Governor for 2018 and 2019.[3]

Kansas currently has an 18.6% prescriber enablement for electronic prescribing of controlled substances, which is significantly below the national average of 35.4%.  Pharmacy enablement for EPCS is 98.8% which is above the national average for pharmacy enablement of 95.4%.[4]  There will likely be a big push leading up to 2021 to secure electronic prescribing, MDToolbox encourages providers not to wait!

Kansas now aligns with several other states mandating electronic prescribing.  MDToolbox looks forward to working with providers throughout Kansas 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/florida-opioid-summary

[2]https://opioid.amfar.org/KS

[3]http://www.kslegresearch.org/KLRD-web/Publications/BudgetBookFY19/2019BudgetAnalysisRpts/Biennial-Pharmacy.pdf

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

Washington State Mandates Electronic Prescribing

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Photo Credit: Tyler Bird

Washington Governor Jay Inslee recently signed SB5380 into law. This Act mandates Washington healthcare providers to electronically prescribe all controlled substances with an effective date of January 1st, 2021.  This bill was created by request of the Governor and was one of several bills pushed through the House and Senate the day before Washington’s legislative session ended.

Other subsections of the Act include:

  • Several sections of the bill state that prescribers of varying practice must inform patients of their right to refuse an opioid prescription.
  • 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.
  • Pharmacies are not required to verify if a controlled substance prescription received via written, oral, or fax falls within the state and federal laws.
  • Effective January 1st, 2021 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 as well.
  • A large portion of the Act establishes regulations and oversight that governs opioid addiction treatment.  The Act establishes that substance use disorders are medical conditions and discusses various aspects of how law enforcement, the Department of Corrections, and school districts should act when dealing with substance abuse.

Washington has remained well above the national average for opioid-related overdose deaths since tracking began in 1999 but in 2015 was overtaken by the national average as US rates began to rise.  Prescription opioid overdose deaths have continued to gradually decrease since 2011, however heroin deaths have begun to rise.[1]  Washington State established and has been utilizing their PMP since 2012.  In 2017, Washington passed HB1427 which created 5 commissions and boards tasked with creating requirements and recommendations for WA prescribers to follow for curbing opioid misuse.  One requirement established is that prescribers must complete additional training for the prescribing of opioids.  The Agency Medical Director’s Group suggests using opioid misuse risk assessment tools with every new patient that is being considered for an opioid prescription.  These guides determine whether the patient should be prescribed opioids by assigning a score based on several history, illness, and risk questions.

Washington currently has an 18.2% provider enablement for electronic prescribing of controlled substances, which is significantly below the national average of 34.4%.  Pharmacy enablement for EPCS is 96.0% which is above the current national average for pharmacies of 95.3%.[2]  There will likely be a big push leading up to 2021 to secure electronic prescribing, MDToolbox encourages providers not to wait!

Washington now aligns with several other states mandating electronic prescribing.  MDToolbox looks forward to working with providers throughout Washington 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/washington-opioid-summary

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

 

TELEMEDICINE & EPCS: New Regulations Coming in Fall 2019!

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While the United States government has been writing legislation to control addictive drugs since the early 1900’s, The Controlled Substances Act (CSA) of 1970 laid the groundwork for how controlled substances are regulated.  The CSA established the schedule system that is still used today for drug classification.  The act also established policy for regulations on the manufacture, importation, possession, use, and distribution of scheduled substances.  The CSA has been amended 9 times since its enactment, the eighth amendment in 2008 was titled The Ryan Haight Online Pharmacy Consumer Protection Act which brought portions of the CSA into the digital age.

The Ryan Haight Act amends the CSA to prohibit the delivery, distribution, and dispensing of controlled substances over the internet without a valid prescription.  The Ryan Haight Act forces online pharmacies to report their controlled substance prescriptions to the Attorney General and requires that online pharmacies to display compliance information on their website.  There are several definitions established in the Act, one of the most important being that a “valid prescription” must come from a practitioner that has conducted at least one in-person medical visit with the patient.  As technology has advanced and telehealth has risen in popularity, this section of the Act has created issues for digital practitioners that may never see their patient in face to face.

The Ryan Haight Act also contains a “Special Registration for Telemedicine” section that tasked the Attorney General to issue certain regulations to allow the prescribing of controlled substances without an in-person consult.  The Attorney General has not issued an update on this provision since the Ryan Haight Act was written and enacted in 2008.  Some States have taken that responsibility upon themselves to rule on controlled substances being issued by telemedicine such as Indiana, Michigan, Ohio, Florida, Delaware, New Hampshire, West Virginia, and Connecticut[1].  These states passed legislation allowing for controlled substances to be prescribed via telehealth without seeing the patient in-person so long as certain requirements are met.  The state laws contradict the federal law that the Ryan Haight Act established and there is uncertainty what the legal ramifications might be in court.

In 2018, President Trump signed the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, also known as the SUPPORT Act.  The Support Act contains legislative changes for many aspects of healthcare including Medicaid and Medicare, funding the CURES Act, an EPCS mandate, State PMP requirements, and many more.  The Support Act also finally sets a date for the telehealth controlled-substance exemptions to be written that were established in the Ryan Haight Act of 2008.  The Support Act requires the Attorney General write the final regulations that specify “the limited circumstances in which a special registration under this subsection may be issued” and “the procedure for obtaining a special registration”[2].  The deadline for the Attorney General to establish these regulations is October 24th, 2019.

We don’t exactly know what the regulations and restrictions will look like or how stringent the requirements for a telehealth provider to prescribe a controlled substance without an in-person visit will be until fall of this year.  The federal regulations could follow some of the State-level legislation or could be in contrast and create a necessary change for telehealth prescribers in those states who have attempted to setup their practice following their State’s laws.

We at MDToolbox are watching for any 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 the opioid epidemic. Contact us for more information or to start your free 30 day free trial.

[1]https://www.healthcarelawtoday.com/2018/06/27/new-connecticut-law-allows-telemedicine-prescribing-of-controlled-substances/

[2]https://www.congress.gov/bill/115th-congress/house-bill/6/text#toc-HA8EADE1EA6CF4E62B8D435826C060821

Indiana Mandates Electronic Prescribing

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Indiana Governor Eric Holcomb recently signed SB176 into law. This Act mandates Indiana healthcare providers to electronically prescribe all controlled substances with an effective date of January 1st, 2021.  This bill began as an 8-line document allowing patients to transfer their prescription to another pharmacy.  Several amendments were made in the two weeks it took the Indiana House and Senate to pass the bill bringing it to 15 pages in length.

Other subsections include:

  • The Act amends several sections of state code by adding the phrase “or electronically transmit” to add electronic prescribing as a valid means of prescribing.
  • 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.
  • 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 Act allows for advanced practice registered nurses to send prescriptions under their own credentials once they have met the requirements established by the board, previously nurse practitioners were required to send prescriptions under a supervising physicians’ credentials.
  • Telemedicine is also addressed in this Act.  Indiana has allowed for the prescribing of controlled and non-controlled (excluding opioids) prescriptions for telemedicine providers so long as certain criteria is met.  One regulation is that an Indiana licensed practitioner has seen the patient in person and developed a medical plan that the telemedicine prescriber is following. (Note: Stay tuned for our next blog concerning U.S. Wide Telemedicine Prescribing that goes into more details about the uncertainty of telemedicine and the current laws governing it.)

Indiana has remained below the national average for opioid-related overdose deaths since 1999, following the national trend and increasing in number of deaths.  However, the rate has increased sharply in recent years catching up with the national average.  If the rate continues as forecasted, it will pass the national average for the first time since the National Institute on Drug Abuse has been collecting data.  Prescription opioid overdose deaths decreased in 2011 but have begun to rise again in recent years along with heroin and synthetic opioid deaths.  Indiana enacted SB226 on April 26th, 2017, the Act limits the first fill prescription of opioids to seven days for adults.  The law also limits opioid prescriptions for minors to seven days.  Prescriptions can exceed seven days under certain circumstances, such as the doctor determines that the patient requires it and if the patient is in palliative care.[1]

Indiana currently has a 30.5% provider enablement for electronic prescribing of controlled substances, which is just below the national average of 33.4%.  Pharmacy enablement for EPCS is 97.8% which is above the current nation average for pharmacies, which is 95.2%.[2]  There will likely be a big push leading up to 2021 to secure electronic prescribing, MDToolbox encourages providers not to wait!

Indiana now aligns with several other states mandating electronic prescribing.  MDToolbox looks forward to working with providers throughout Indiana 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]http://www.hallrender.com/2017/06/21/new-indiana-law-imposes-a-seven-day-limit-on-opioid-prescriptions/

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

Tennessee Amends and Delays E-Prescribing Mandate

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Tennessee Governor Bill Haslam recently signed SB0810 into law.  This Act mandates Tennessee healthcare providers to electronically prescribe all controlled substances with an effective date of January 1st, 2021.  Tennessee had previously passed HB1993 which mandated EPCS for Schedule II drugs by January 1st, 2020.  This latest Act makes several changes to the prior legislation:

  • The new Act replaces Schedule II drugs with Schedule II-V.  Now, all controlled substances are required to be electronically prescribed. 
  • The required date for prescribers to follow the mandate has been postponed to January 1st, 2021 from January 1st, 2020. 
  • Tennessee pharmacies are now required to be able to issue partial prescriptions in their electronic system of Schedule II drugs by January 1st, 2020 or face action by The Board of Pharmacy.  Tennessee previously passed 63-1-163 which regulated pharmacies when filling partial prescription orders.  The new amendment requires the pharmacy’s electronic system to be able to split the medication orders should a patient only want a partial order, or if the pharmacy is low on stock of the Schedule II drug.

Tennessee has remained above the national average for opioid-related overdose deaths since 2003, rising even faster than the national trend in number of deaths.  While some states have had a flattening or reduction in prescription opioid overdose deaths in recent years, Tennessee has continued to trend upward.  The number of deaths from synthetic opioids and heroin had remained stable until 2014, when the numbers began to rise.

Last year, Tennessee passed HB1831: “TN Together Opioid Reform” which made several major strides toward the fight against opioid addiction.  The Act budgeted $30 million for prevention, treatment, and law enforcement tasks in relation to the opioid epidemic.  The Act also mandated that pharmacies check the State PMP registry.  The biggest change has to do with how much of a drug you can get and when. Under the new law, pharmacists can only partially fill a prescription for no more than half of the number of days it’s written for. And there are limits on prescriptions, too: General prescriptions are limited to a 10-day supply (and no more than 500 cumulative morphine milligram equivalents).[1]

Tennessee currently has a 23.5% provider enablement for electronic prescribing of controlled substances, which is well below the national average of 33.4%.  Pharmacy enablement for EPCS is 96.7% which is above the current nation average for pharmacies is 95.2%.[2]  HB1993, which was passed a year ago would have required EPCS of Schedule II drugs only 8 month from the writing of this blog.  There will likely be a big push leading up to 2021 to secure electronic prescribing, MDToolbox encourages providers not to wait!

Tennessee now aligns with several other states mandating electronic prescribing.  MDToolbox looks forward to working with providers throughout Tennessee 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.knoxnews.com/story/news/health/2018/06/29/tennessee-opioid-prescription-law-pharmacy/746208002/

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

Colorado Mandates Electronic Prescribing

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Colorado Governor Jared Polis recently signed SB079 into law. This Act mandates Colorado healthcare providers to electronically prescribe controlled substances that are scheduled as II-IV with an effective date of either July 1st, 2021, or July 1st 2023.  The Act breaks down the medical field to several categories of healthcare providers: podiatrists, dentists, optometrists, advanced practice nurses, physicians, and physician assistants.  For each practitioner category there is a provision for those who are practicing in a rural area of the state or are a sole-practitioner to postpone the mandate from July 1st 2021 to July 1st 2023.  Dentists are mandated for EPCS by July 1, 2023 regardless of if they serve a rural or urban community.

Other subsections of this Act include:

  • The act contains provisions for a waiver to using EPCS as many State Mandate laws do, however Colorado allows for practitioners who write less than 25 prescriptions for controlled substances per year to not have to adopt electronic prescribing.
  • Prescribers are required to indicate on their license renewal whether they have complied with the EPCS mandate.
  • Pharmacies are not required to verify if a controlled substance prescription received via written, oral, or fax falls within the state and federal laws.

Colorado has remained slightly above the national average for opioid-related overdose deaths since 1999, following the national trend and increasing in number of deaths.  The rate then flattened in 2015 and 2016, falling below the national trend.  Heroin related deaths have been climbing; however, prescription opioid deaths have been slightly declining in recent years.

Several legislative initiatives have been enacted as Colorado continues the fight against the opioid epidemic.  In 2017, the general assembly enacted Senate Bill 17-074, which created a 2-year medication-assisted treatment (MAT) expansion pilot program, administered by the university of Colorado college of nursing, to expand access to medication-assisted treatment to opioid-dependent patients in Pueblo and Routt counties. The 2017 Act directs the general assembly to appropriate $500,000 per year for the 2017-18 and 2018-19 fiscal years from the marijuana tax cash fund to the university of Colorado board of regents, for allocation to the college of nursing to implement the pilot program. The pilot program repeals on June 30, 2020.[1]  Currently, Senate Bill 19-001 is under consideration to expand and continue the MAT in future years.  Colorado also passed Senate Bill 18-022 in 2018, which limits the quantity of opioids that a patient can receive.

Colorado currently has a 31.7% provider enablement for electronic prescribing of controlled substances, which is just below the national average of 33.4%.  Pharmacy enablement for EPCS is 97.4% which is above the current nation average for pharmacies, which is 95.2%.[2]  There will likely be a big push leading up to 2021 to secure electronic prescribing, MDToolbox encourages providers not to wait!

Colorado now aligns with several other states mandating electronic prescribing.  MDToolbox looks forward to working with providers throughout Colorado 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://leg.colorado.gov/bills/sb19-001

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

Kentucky Mandates Electronic Prescribing

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Kentucky Governor Matt Bevin recently signed HB342 into law. This Act mandates Kentucky healthcare providers to electronically prescribe all controlled substances with an effective date of January 1st, 2021

Other subsections of this Act include:

  • 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, these are to be determined.
  • Pharmacies are not required to verify if a controlled substance prescription received via written, oral, or fax falls within the state and federal laws.

Kentucky has remained above the national average for opioid-related overdose deaths since 2001, several years were double the national rate.  In 2000, only nine counties in the U.S. had overdose death rates of more than 20 per 100,000 people, and four of these were located in Kentucky.  By 2014, more than half of Kentucky counties had overdose rates that high.  This represents a quadrupling of deaths due to drug overdose, from less than 250 in 2000 to more than 1,000 each year since 2010.  According to the Kentucky Justice and Public Safety Cabinet, drug overdose deaths reached 1,248 in 2015. [1]

Over the past two decades, the Commonwealth has taken efforts to curb problems related to substance use. In 1998, Kentucky became one of the first states to launch a prescription drug monitoring program—the Kentucky All Schedule Prescription Electronic Reporting (KASPER) system to monitor medical use of controlled substances, such as prescription opioid painkillers. KASPER has since been enhanced and now offers health care providers and pharmacies real-time 24-hour access to prescription information that can be used to monitor and prevent overuse of prescription medications.  Policymakers have also adopted policies aimed at reducing the impact of illegal drugs, such as passing the 2015 Senate Bill 192, which authorized expanded use of naloxone, a drug that treats opioid overdoses, and funded substance use treatment programs.[2]

Kentucky currently has only 18.9% provider enablement for electronic prescribing of controlled substances, which is below the national average of 33.4%.  Pharmacy enablement for EPCS is 98.1% which makes Kentucky one of the states with highest percentage of pharmacies ready to receive electronic prescriptions.  The current nation average for pharmacies is 95.2%.[2]  There will likely be a big push leading up to 2021 to secure electronic prescribing, MDToolbox encourages providers not to wait!

Kentucky now aligns with several other states mandating electronic prescribing.  MDToolbox looks forward to working with providers throughout Kentucky 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.healthy-ky.org/res/images/resources/Full-Substance-Use-Brief-Final_12_16-002-.pdf

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

Arkansas Mandates Electronic Prescribing

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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 1st, 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/

 

Wyoming Mandates Electronic Prescribing

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Wyoming Governor Mark Gordon recently signed Enrolled Act No 66/SF0047 into law. This Act mandates Wyoming providers to electronically prescribe all controlled substances with an effective date of January 1st, 2021.  The Act has provisions for the state board to provide some exemptions to the requirement for emergencies and has the power to grant an extension to a dispenser or practitioner; however, being granted an extension is not guaranteed.

Other subsections of this Act include:

  • Prior to writing a prescription for a controlled substance, providers are required to search the state PMP database, as well as every 3 months thereafter for as long as the patient remains on a controlled substance.
  • Pharmacies must submit their dispense data on controlled substances to the state daily.
  • All prescribing providers are required to take 3 hours of continuing education every two years related to the responsible prescribing of controlled substances when they renew their license.
  • All Schedule II prescriptions require either written or electronic prescription until the 1/1/21 mandate, oral orders will not be accepted.
  • All Schedule III and IV prescriptions shall not be refilled more than six months after the prescribed date, and not refilled more than five times unless renewed. 

In recent years, Wyoming has fallen below the national average for opioid-related overdose deaths.  However, prior to 2015 Wyoming was above the national average for 5 consecutive years[1].  The state trends continue to rise along with the national average of opiate-related deaths.  Wyoming currently has only 17.5% provider enablement for electronic prescribing of controlled substances[2], well below the national average.  There will likely be a big push leading up to 2021 to secure electronic prescribing, MDToolbox encourages providers not to wait!

Wyoming now aligns with several other states mandating electronic prescribing. MDToolbox looks forward to working with providers throughout Wyoming 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/wyoming-opioid-summary

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

Arizona Delays E-Prescribing Mandate

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Photo Credit: Gage Skidmore

Arizona Governor Doug Ducey signed House Bill 2075 into law on February 14th, 2019.  This bill amends and addresses issues with the Arizona Opioid Epidemic Act (HB 1001) that was signed into law on January 26th of 2018.  In an effort to combat opioid abuse, the law mandates that prescribers electronically prescribe schedule II controlled substances. The original deadlines were 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. However, there were several concerns that the original law was passed rather quickly and significant changes have been made to the policy in the latest bill.

The Arizona State Board of Pharmacy1 lists the major provisions to HB 1001 as:

  • Moves the 2019 implementation dates for urban and rural counties to January 1, 2020 for all counties.
  • Allows for written prescriptions if the e-prescribing system is not operational or available in a timely manner, the occurrence must be noted in records maintained by the pharmacy for a period of time set by the Arizona Board of Pharmacy.
  • Exempts requirements for Indian Health Services and federal facilities.
  • Eliminates the waiver process through the Arizona Board of Pharmacy but provides rulemaking authority in consultation with a Task Force to add additional exceptions.
  • Delays e-prescribing requirements for veterinarians until e-prescribing software is widely available.
  • Allow for prescriptions to be faxed if the prescription is compounded for direct administration to a patient, residents of a long-term care facility and hospice patients.
  • Resolves a statutory conflict that inadvertently imposed a prohibition on physician assistants prescribing more than a 72-hour dosage of opioids or benzodiazepines.
  • Contains a retroactive clause to December 31, 2018 so the legislation takes effect immediately once it becomes law.

Over 40,000 healthcare providers2 in Arizona applied for a waiver to exempt themselves from the requirement to e-prescribe.  The waivers were granted to those who lacked adequate internet access or faced other hardships restricting their access to use e-prescribing software.  With the passing of HB 2075, on January 1st 2020 almost all providers in the state of Arizona will need a method of e-prescribing controlled substances per the law as there will not be a waiver process. 

While the deadline has been extended for providers to adopt e-prescribing in Arizona, MDToolbox encourages prescribers not to wait. The advantages of e-prescribing are countless and it’s been proven to be an important tool for preventing opioid abuse. Contact us today for a demo or free trial to see just how easy it is!

 

1. https://pharmacy.az.gov/important-law-changes

2.https://www.kgun9.com/news/local-news/legislation-fixes-problems-with-arizona-opioid-measure