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Abbott Signs Bill Requiring e-Prescribing of Controlled Substances

Monday, June 17, 2019   (0 Comments)
Posted by: Brian Sparks
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Mandatory electronic prescribing of controlled substances in Texas

Late last week, Texas Governor Greg Abbott signed House Bill 2174, which requires the electronic prescribing of all controlled substances (CII–CV) beginning January 1, 2021.

The law provides for prescriber waivers, which may be renewed annually, if there is economic hardship, technological limitations not reasonably within the control of the prescriber, or other exceptional circumstances demonstrated by the prescriber. The law also provides for exceptions when a controlled substance is not required to be prescribed electronically, including issuance by a veterinarian; when electronic prescribing is not available due to temporary technological or electronic failure, as prescribed by board rule; and when necessary elements are not supported by the most recently implemented national data standard that facilitates electronic prescribing (which may be the case with compounded prescriptions today).

A pharmacist who receives a controlled substance prescription in a manner other than electronically is not required to verify that the prescription is exempt from the requirement of electronic submission. The pharmacist may dispense a controlled substance pursuant to an otherwise valid written, oral, or telephonically communicated prescription. The Texas State Board of Pharmacy and regulatory entities for prescribers will jointly develop rules to implement the law, and each regulatory entity will enforce the law and issue waivers for the agency’s licensees.

This bill also requires that, beginning September 1, 2019, for the treatment of acute (not chronic) pain, a practitioner may not issue a prescription for an opioid in an amount that exceeds a 10-day supply, nor provide for a refill of an opioid for acute pain. Exceptions are provided for cancer care, hospice or other end-of-life care, palliative care, and opioids prescribed for the treatment of substance addiction.

In addition, this bill requires two hours of continuing education for pharmacists regarding the monitoring of controlled substances.

What does this mean for pharmacists?

Community pharmacists will especially benefit from the documentation, accuracy and accountability of electronic prescribing of controlled substances, which will improve patient care. It also increases safety and security in the prescribing process. Not only does it eliminate handwriting errors, the Drug Enforcement Administration’s (DEA) e-prescribing requirements call for two-factor authentication, reducing the likelihood of fraudulent prescribing. Additional benefits include workflow improvement through decreased phone calls and adherence improvement by allowing providers to monitor and improve first-fill adherence, as patients are more likely to fill prescriptions that are sent electronically to their pharmacy.

Effective Date: January 1, 2021 for e-prescribing of controlled substances; September 1, 2019 for acute pain opioid prescription quantity limits; September 1, 2021 for continuing education requirement.

Thanks to Rep. John Zerwas and Sen. Lois Kolkhorst for supporting this legislation!

TPA's online legislative wrapup offers a full list of which bills passed, which bills failed, and which bills TPA helped to defeat. It also provides effective dates and a detailed explanation of what the legislation means for pharmacy.


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