In 2018, the legislature of the state of California passed Assembly Bill 2789, mandating electronic prescribing for California prescribers beginning on January 1, 2022.
The bill requires healthcare practitioners authorized to issue prescriptions to have the capability to transmit electronic data transmission prescriptions, and requires pharmacies to have the capability to receive those transmissions. The bill also requires those healthcare practitioners to issue prescriptions as an electronic data transmission prescription, unless specified exceptions are met.
The bill does not require the pharmacy to verify that a written, oral, or faxed prescription satisfy the specified exemptions. Pharmacies receiving the electronic data transmission prescription are required to immediately notify the prescriber if the electronic data transmission prescription fails, is incomplete, or is otherwise not appropriately received. The pharmacy is also required to transfer or forward the prescription to another pharmacy at the request of the patient, as specified.
The bill exempts from these provisions a healthcare practitioner, pharmacist, or pharmacy when providing healthcare services to specified individuals under the jurisdiction of the Department of Corrections and Rehabilitation. Healthcare practitioners, pharmacists, or pharmacies that fail to meet the applicable requirements imposed by this bill will be referred to the appropriate state professional licensing board solely for administrative sanctions, as provided.
There are a few exceptions to the requirements. Though not exhaustive, below are those relevant to Physicians, Nurse Practitioners, and Physician Assistants – i.e. “prescribers."
- 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.
- The Rx will be dispensed by a pharmacy outside the state (California).
The Rx is issued in a hospital ER or urgent care and one or more of the following conditions exists:
- The patient resides out of California.
- The patient resides outside the geographic area of the hospital.
- The Rx is issued at a time when the patient’s regular pharmacy is likely closed.
Note – this exception appears to apply to ER/Urgent care settings only.
- The prescriber is also the dispenser, i.e., you dispense medications in your office setting consistent with the dispensing pharmacy rules.
- 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.
- 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.
The rule does not apply to prescribers providing healthcare services to:
- An inmate
- 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 statute here: https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB2789
Providers must use approved vendors to order tamper-resistant forms from secure prescription printer companies. For more information on obtaining the correct electronic prescriptions for controlled substances, please visithttps://oag.ca.gov/cures
Access CMA’s FAQ on California’s Electronic Prescribing Mandate: Download Now
Contact Andie Tena, CAP’s Director of Practice Management Services at 213-473-8630 or via email at MyPractice@CAPphysicians.com for assistance.
Andie Tena is CAP’s Director of Practice Management Services. Questions or comments related to this column should be directed to atena@CAPphysicians.com.