POCP: States' e-prescribing rules for controlled substances vary
A little more than a year after the U.S. Drug Enforcement Administration (DEA) issued its interim final rule on e-prescribing controlled substances, 32 states have rules in place that allow electronic transmission of controlled substances, according to the ePrescribing Law Survey, a compendium of state and federal pharmacy statutes and regulations, updated by Point-of-Care Partners (POCP).

The interim rule has given prescribers the option of electronically prescribing controlled substances and permits pharmacies to receive, dispense and archive e-prescriptions. In addition, the rule enables pharmacies and hospitals to integrate prescription records into other medical records.

"The DEA's new requirements have major implications for states, vendors and pharmacies," stated the Coral Springs, Fla.-based healthcare IT strategy and management consulting firm. "Many state boards of pharmacy will require rules changes for one or more class of controlled substance prescriptions and many have additional requirements that exceed those imposed by the DEA. This results in nuances among the various state board regulations that need to be accounted for when programming prescribing software."

For example, Alabama and Montana require a hard-copy prescription before dispensing an electronically transmitted CII prescription, and e-prescriptions for CIII-V controlled substances currently are not allowed, POCP noted. In Nebraska, CII prescriptions may not be transmitted electronically, but CIII-V e-prescriptions are allowed if the federal regulations are met and dispense-as-written wording specific to Nebraska is included on the prescription.

Each state has different regulations pertaining to printing and faxing prescriptions from computer-based clinical solutions, and there can be substantial consequences if if stakeholders such as EHR vendors get it wrong. For example, a state board of pharmacy could shut down e-prescribing or penalize customers, according to the company.

The compendium contains information current as of March 31, gleaned from board of pharmacy websites and other published materials, such as pharmacy association and board of pharmacy newsletters, state health and safety codes, as well as other statutes and Medicaid rules and regulations (where applicable). It also includes details about prescribing from EHRs.