Amendment #930 to H4200

Electronic Prescribing of Controlled Substances

Representatives Dykema of Holliston, Ashe of Longmeadow, Benson of Lunenburg, Cutler of Duxbury, Dwyer of Woburn, Rogers of Norwood, Stanley of Waltham, Walsh of Framingham, Fiola of Fall River, Hunt of Sandwich, Keefe of Worcester and Khan of Newton move to amend the bill by adding the following sections:

SECTION XX. Section 1 of chapter 94C of the General Laws, as so appearing, is hereby amended by striking the definition for “written prescription” in its entirety and replacing it with the following definition:-

“Written prescription”, a lawful order from a practitioner for a drug or device for a specific patient that is transmitted electronically, consistent with federal requirements for electronic prescriptions for controlled substances, with the electronic signature and electronic instructions of the prescriber, and transmitted directly to a pharmacy designated by the patient without alteration of the prescription information, except that third-party intermediaries may act as conduits to route the prescription from the prescriber to the pharmacist; provided, however, that “written prescription” shall not include an order for medication which is dispensed for immediate administration to the ultimate user by a practitioner, registered nurse or licensed practical nurse. A prescription generated on an electronic system that is printed out or transmitted via facsimile is not considered an electronic prescription.

SECTION XX. Section 8 of chapter 94C, as so appearing, is hereby amended, in subsection (f), by striking, in line 57, the words “oral or”.

SECTION XX. Section 17 of chapter 94C, as so appearing, is hereby amended, in subsection (c), by striking in line 9, the words “or oral”.

SECTION XX. Section 18 of chapter 94C, as so appearing, is hereby amended in subsection (c), by striking, in lines 28-29, the words “deliver or mail” and inserting in place thereof the words “transmit electronically”

SECTION XX. Section 20 of chapter 94C, as so appearing, is hereby amended in subsection (c) by striking the second and third sentences and inserting in place thereof the following:-

The written prescription shall be transmitted electronically to the pharmacy. Upon receipt, the dispensing pharmacy shall attach said written prescription to the oral prescription, which the pharmacy has reduced to writing.

SECTION XX. Section 23 of chapter 94C, as so appearing, is hereby amended by striking subsections (g) and (h) in their entirety and inserting in place thereof the following:-

(g) Unless otherwise prohibited by law, a written prescription for a controlled substance or a medical device with a controlled substance component, provided that the medical device is regulated by the department, shall be: (1) transmitted electronically; and (2) signed by the prescriber using authentication and auditing systems compliant with DEA regulations and (3) prescribed and dispensed using software applications compliant with DEA regulations. The department of public health shall promulgate regulations setting forth standards for electronic prescriptions.

(h) No practitioner shall issue any written prescription for a controlled substance or a medical device with a controlled substance component, unless it is transmitted electronically, except for prescriptions that are:

(1) issued by veterinarians;

(2) issued or dispensed in circumstances where electronic prescribing is not available due to temporary technological or electrical failure, as set forth in regulation;

(3) issued by practitioners who have received a waiver or a renewal thereof for a specified period determined by the department, not to exceed two years, from the requirement to use electronic prescribing, due to economic hardship, technological limitations that are not reasonably within the control of the practitioner, or other exceptional circumstance demonstrated by the practitioner; provided that the department shall establish in regulation appropriate due process for approvals and denials, including due process on appeal;

(4) issued by a practitioner under circumstances outlined in department regulations where, notwithstanding the practitioner's present ability to make an electronic prescription as required by this subdivision, such practitioner reasonably determines that it would be impractical for the patient to obtain substances prescribed by electronic prescription in a timely manner, and such delay would adversely impact the patient's medical condition, provided that if such prescription is for a Schedule II through V controlled substance, the quantity does not exceed a three day supply if it was used in accordance with the directions for use.

(i) In the case of a written prescription for schedule II through V controlled substances, issued by a practitioner under paragraphs (2), (4) and (5) of subdivision (h) of this section, the practitioner shall be required to note the manner of the issuance of such prescription in the patient record as soon as practicable, as set forth in regulation.

(j) Clinic pharmacies operated by a health maintenance organization licensed under chapter 176G and licensed pursuant to section 51 of chapter 111 may refill prescriptions which have been previously dispensed by another health maintenance organization clinic pharmacy, provided that prior to dispensing a refill, the pharmacy refilling the prescription verifies the appropriateness of the refill through a centralized database.

SECTION XX. Sections XX through XX of this act shall take effect 2 years after the enactment date.

SECTION XX. Section 24A of chapter 94C of the General Laws, as appearing in the 2012 Official Edition, is hereby amended, in lines 27 and 28, by striking the words “7 days” and inserting in place thereof the following words:- “24 hours at the end of each business day.”

SECTION XX. Sections XX of this act shall take effect within 1 year of the enactment date.

Additional co-sponsor(s) added to Amendment #930 to H4200

Electronic Prescribing of Controlled Substances