PA Pharmacists: Stop Refusing to Fill Handwritten Controlled Substance Scripts

I am not the first person to write about this. Pharmacists receive information from different sources though and I figured I could help spread the word. In this post, I will cover: (1) the e-prescribing act that recently took effect; (2) permitted exceptions; and (3) proper actions for pharmacists in PA.

Reading this on your bathroom break?

For those community pharmacists that may only get one break during a 13 hour shift, here’s the quick and dirty: Don’t refuse to fill valid handwritten scripts for controlled substances! You should not be calling a provider for exception verification or to question why the provider did not e-prescribe. You can read the rest after your shift…

1 The New Electronic Prescribing Act

Act 96 of 2018 (“the act”) was approved on Oct. 24, 2018, and took effect on Oct. 24, 2019. The act established a new requirement for practitioners: electronic prescribing for controlled substances. Practitioners are no longer able to transmit Schedule II-V controlled substance prescriptions orally, in writing, by fax, etc. There are a two key points to address before discussing how this affects pharmacists.

  1. The act required the PA Department of Health to promulgate regulations in accordance with the act. In other words, DOH needs to draft regulations that will be used to inform practitioners and enforce the new requirement. These regulations were supposed to be drafted by April 22, 2019. As of this writing, they still have not been approved.
  2. There are several exceptions to the e-prescribing requirement (discussed in section 2). However, these are not highly relevant to pharmacists at this point. Pharmacists are NOT responsible for policing or verifying exceptions.

2 Exceptions to Electronic Prescribing

The act listed several exceptions that would enable a practitioner to avoid e-prescribing a controlled substance. I will list examples below. However, it is critical that I reiterate the most important point for pharmacists. You are not required to police prescriptions or verify exceptions. Here is the direct language from the act:

A pharmacist who receives a written, oral or faxed prescription shall not be required to verify that the prescription properly falls under one of the exceptions provided in subsections (a) and (b) from the requirement to electronically prescribe. A pharmacist may continue to dispense medications from the otherwise valid written, oral or faxed prescriptions that are consistent with current laws and regulations.

Act 96 of 2018, Section 3 (b.3) (1)

In other words… you can assume that a written, oral, or faxed script was issued under one of the exceptions.

Here are some exceptions that practitioners may rely on:

  • practitioner is a veterinarian
  • practitioner lacks internet access or an electronic health record system
  • patient resides in a nursing home or is enrolled in a hospice program
  • pharmacy is not set up to receive electronic prescriptions
  • script is for a controlled substance that is not required to be reported to the PDMP
  • and several others…

3 Proper Actions for PA Pharmacists

Going forward, I believe there are two key points for pharmacists:

  1. Do NOT refuse to fill handwritten scripts for controlled substances that are valid. I think this one should be clear by now…
  2. Monitor for updates. As mentioned, we are still waiting for approved regulations from PA DOH. Luckily, you have great resources at your fingertips:
    1. I would suggest monitoring the bulletins issued by the Pennsylvania Pharmacists Association. PPA does an excellent job keeping pharmacists up to date and it’s well-worth the membership.
    2. You can monitor PA DOH’s page: Electronic Prescribing of Controlled Substances. They answer FAQ’s and post notifications.

As always, thank you for your support. If you have questions or comments, please respond to this post or reach out via email or social media. -Anthony

*I am not an attorney. I am a law student. Nothing on this website or page should be taken as legal advice or legal services.

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