By Patrick O'Brien, JD, Legal Coordinator, American Med Spa Association

A California law has gone into effect as of the first of the year that requires prescriptions in most circumstances to be submitted electronically. This law includes prescriptions both for controlled substances and legend drugs. The electronic prescription standards remain the same as are currently in California. In addition to the rules in this section, practitioners must also comply with federal Medicare rules on electronic prescribing for controlled substances. Previously, prescriptions could be made via phone, electronically, or using specially printed prescription pads. However, now all prescriptions must be made through an electronic system unless they meet one of several exemptions.

The exemptions include: 1) prescriptions of schedule II controlled substances that comply with the rules made to terminally ill patients, 2) when electronic prescribing is not possible due to a temporary electric or technological failure, 3) prescriptions intended to be filled outside of California, 4) prescriptions made by hospitals or urgent care clinics to patients who live outside of the area or are homeless or whose pharmacy is likely closed, 5) prescriptions by veterinarians, 6) prescriptions for glasses or contacts, 7) when the prescription and dispensing are within the same entity, 8) when the prescriber reasonably determines that an electronic prescription makes it impractical for the patient to obtain the prescribed substances, and 9) the prescription includes elements not covered in the latest SCRIPT standard from the National Council for Prescription Drug Program.

The burden of showing that the prescription meets one of these exemptions falls on the prescribing practitioner. Pharmacists are still able to fill written, faxed, and oral prescriptions and do not have to verify that an exemption was met. Practitioners and pharmacists who fail to comply with these rules can receive discipline and sanctions from their licensing boards. Many electronic health record systems include the ability to transmit electronic prescriptions. You will want to check with your system provider to determine the best way to implement this or if you need to purchase a standalone prescription system.