Last Updated: Mar 25, 2020
Important Note for COVID-19 Emergency: In a March 24, 2020 email to PA PDMP registrants, the Pa. Department of Health confirmed that "Act 96 of 2018 contains exceptions for prescribers who are unable to meet electronic prescribing requirements due to the COVID-19 response. A prescriber who reasonably determines that electronically prescribing a controlled substance would be impractical or cause an untimely delay resulting in an adverse impact on the patient's medical condition meets a statutory exception from the electronic prescribing requirements of Act 96."
Pennsylvania's e-prescribing law took effect on Oct. 24, 2019.
The law – Act 96 of 2018 – mandates that all Schedule II through V controlled substances, except when dispensed or administered directly to a patient by a practitioner or authorized agent, other than a pharmacist, to an ultimate user, shall be prescribed electronically. This law replaces the traditional method of prescribing controlled substances to a patient, i.e. paper prescription pads.
Guidance on Exceptions for Practitioners Who Lack EHR or Internet
In the Pennsylvania Department of Health's original guidance on Act 96, it said that practitioners would be required to apply for a hardship exemption if they lacked either an EHR system or internet access but not both and were unable to comply with the law.
The Pennsylvania Medical Society (PAMED) was concerned that this requirement could potentially force some practices to stop prescribing controlled substances or even close altogether. In September 2019, we sent this letter to DOH and asked them to reconsider their interpretation.
On Oct. 21, 2019, PAMED received a response from Secretary of Health Rachel Levine, MD. She said that, based on our feedback, DOH has updated their guidance concerning Act 96.
The revised guidance clarifies the requirements for practices that do not have an EHR system but do have internet access (or vice versa):
- The Department of Health will not take action against a practitioner if the practitioner has an EHR system but does not have internet access. Likewise, the Department of Health will not take action against a practitioner if the practitioner has internet access but does not have an EHR.
- Under these circumstances (either lack of an EHR or lack of internet access), a practitioner is not required to apply for a hardship exemption and is therefore not required to e-prescribe.
Get DOH’s revised Act 96 guidance here.
We thank DOH and the Governor’s Administration for working with PAMED on this issue.
How to Apply for a Hardship Exemption Under Act 96
For practitioners, pharmacies, or health care facilities that do not meet one of the exceptions in Act 96 (such as the exception for those without EHR or internet noted above) but is unable to comply with the law may petition DOH for a temporary exemption based upon economic hardship, technical limitations, or exceptional circumstances.
DOH offers online hardship exemption form that can be used when applying for a temporary exemption. View Hardship Exemption Form
Pharmacy Verification of Paper Prescriptions
Act 96 does not require a pharmacist who receives a written, oral or faxed prescription to verify that the prescription falls under one of the statutory exceptions or a hardship exemption. Therefore, a pharmacist may continue to dispense medications from an otherwise valid written, oral or faxed prescription that is consistent with current laws and regulations.
Note, however, that separate from Act 96, pharmacy regulations do not require a pharmacist to fill a prescription if the pharmacist knows or has reason to know that it is false, fraudulent or unlawful, or that it is tendered by a patient served by a public or private third-party payor who will not reimburse the pharmacist for that prescription. In addition, a pharmacist may decline to fill or refill a prescription if, in the pharmacist’s professional judgment exercised in the interest of the safety of the patient, the pharmacist believes the prescription should not be filled or refilled.
The pharmacist is required to explain the decision to the patient, and if deemed necessary, the pharmacist shall attempt to discuss the decision with the prescriber. Therefore, nothing in Act 96 or the pharmacy regulations require a pharmacist to unequivocally honor a prescription, regardless of whether it is filed electronically or via a prescription pad.
Get Answers to FAQs on the E-Prescribing Law
In this Quick Consult fact sheet, PAMED answers physicians’ frequently asked questions about the law. It clarifies all the exceptions under the law and the penalties for violating the requirements.
Get the Quick Consult
You can also visit DOH’s Act 96 resource page here.
PAMED members with questions on Act 96 can contact our Knowledge Center at 855-PAMED4U (855-726-3348) or KnowledgeCenter@pamedsoc.org.