Last Updated: Aug 29, 2019
The Pennsylvania Department of Health (DOH) has issued new guidance on the state’s e-prescribing law, which is set to take 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.
DOH Clarifies an Exception in the Law for Practitioners without Internet, EHR
In its guidance, available online here, DOH provides its interpretation of an exception in the law (one of the law’s several exceptions) addressing practitioners and facilities without internet access or an electronic health record (EHR) system.
It is important for physicians to be aware that DOH interprets this statutory exception as requiring both elements be met, i.e. a practitioner must lack both Internet access and an EHR system. If a practitioner only lacks one of the two items listed in that statutory exception, then the practitioner would not qualify for the exception.
Practitioners or facilities that may lack an EHR but not internet access, or do not qualify for any other exception contained in the law, should apply for a hardship exemption if they will be unable to comply with the law by the Oct. 24 effective date.
How to Apply for a Hardship Exemption Under Act 96
Any practitioner, pharmacy, or health care facility that does not meet one of the exceptions in Act 96 but is unable to timely comply with the electronic prescribing requirements may petition the Department of Health (DOH) for an exemption from the requirements based upon economic hardship, technical limitations, or exceptional circumstances.
DOH says it may take a minimum of ten business days to render a decision on a hardship exemption, though it cautions that this timeframe could take longer depending on the volume of requests it receives. It is important for any practitioner to file for a hardship exemption as soon as possible to ensure that the Department issues a decision prior to the law taking effect.
DOH offers online hardship exemption form that can be used when applying for a temporary exemption. View Hardship Exemption Form
Practitioners who may be seeking a hardship exemption are encouraged to continue to plan for the e-prescribing requirement, as that requirement must be implemented unless an exception applies, or DOH grants a hardship exemption.
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.