Preparing for California's Electronic Prescribing Mandate

In 2018, the Governor signed into law Assembly Bill 2789 amending section 688 to the Business and Professions Code related to the healing arts. Current pharmacy law allows for prescriptions to be oral, written or electronically transmitted (to a pharmacist). On and after January 1, 2022, healthcare practitioners authorized to issue prescriptions must do so by electronic data transmission means, and pharmacies must be able to accept and process a Rx electronically transmitted.  The failure to comply with these provisions requires referral to the licensing board for administrative sanctions.

There are a few exceptions to this rule, including the below non-exhaustive list, relevant to Physicians, Nurse Practitioners and Physician Assistants – i.e. “prescribers”:

  1. The system used for the electronic transmission is temporarily “down” due to technical or other failure(s), i.e., computer crash, internet service loss, power failure.
  2. The Rx will be dispensed by a pharmacy outside the state (California).
  3. The Rx is issued in a hospital ER or urgent care and one or more of the following conditions exists:
    1. The patient resides out of California.
    2. The patient resided outside the geographic area of the hospital.
    3. The Rx is issued at a time when the patient’s regular pharmacy ins likely closed.

Note – this exception appears to apply to ER/Urgent care settings only.

  1. The prescriber is also the dispenser, i.e., you dispense medications in your office setting consistent with the dispensing pharmacy rules.
  2. The prescriber determines the (clinical) conditions are such that electronic transmission is “impractical” for the patient to obtain the medication in a timely manner and delay would impact the patient’s medical condition.
  3. A prescriber who does not issue an electronic Rx (per 2 above) must document the reasons in the medical record ASAP or within 72 hours of the end of the technical issues that prevented electronic transmission of the Rx.  
  4. The rule does not apply to prescribers providing healthcare services to:
    1. An inmate
    2. Parolee
    3. A minor (youth) under jurisdiction of the Dept of Corrections and Rehabilitation.

Pharmacies are required to notify prescribers if the transmission failed or otherwise is incomplete (note: this provision presumes their systems are operational).

This article is a brief overview of AB 2789. We encourage you to do a deeper dive by reviewing the body of the stature here: https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB2789

The CMA Newswire is offering a free webinar to CMA members on the topic June 17th. For more info go here: https://www.cmadocs.org/newsroom/news/view/ArticleId/49374/Are-you-ready-for-California-s-electronic-prescribing-mandate