Starting January 1, 2022, nearly all prescriptions written in the state of California must be transmitted electronically, under a bill passed by the California State Legislature in 2018. Under the legislation, physicians and other prescribers must electronically transmit most prescriptions.
The legislation is partially based on the Medicare “electronic prescribing for controlled substances” (EPCS) requirement and much of the language in the California law was pulled from federal regulations. One of the biggest differences between the EPCS requirement and the California requirement is in California, almost all prescriptions must be electronically transmitted, not just prescriptions for controlled substances.
Exceptions to the Rule
As is often the case, there are select exceptions to the rule, including:
· Controlled substance prescriptions for use by a patient with a terminal illness
· Situations where e-prescribing is not available due to a temporary technological or electrical failure
· If the prescribing physician is issuing a prescription to be dispensed by a pharmacy located outside the state of California
· If the prescription is issued in a hospital emergency department or urgent care clinic and one of the following is met: (1) the patient is not a California resident (2) the patient resides outside the geographic area of the hospital or (3) the patient is homeless or indigent and does not have a preferred pharmacy
· If the prescription is issued at a time when a patient’s preferred pharmacy is closed
· If the prescribing physician and the dispenser are the same entity
· If the prescription is issued by a prescribing physician under circumstances where the physician reasonably finds that it would be impractical for the patient to obtain controlled substances from an e-prescription in a timely manner and such delay would adversely impact the patient’s medical condition
· If the prescription includes elements not covered by the latest version of the National Council for Prescription Drug Programs’ SCRIPT standard
Additionally, prescriptions issued by veterinarians and prescriptions issued for eyeglasses and contact lenses are excluded from this rule. If a physician believes a certain prescription is covered by one of these exceptions, he or she must document it in the patient record within 72 hours of filing the prescription.
Physicians who fail to comply with the law will be referred to the Medical Board of California. While the Medical Board has published several communications outlining the law requirements, it has not proposed any specific enforcement actions they may take upon receiving a referred case.
The only way an enforcement action is triggered is via a complaint (most likely by a patient or pharmacist). There is no private right of action created by the law, meaning physicians cannot be sued for failing to comply with the law.