House Bill 831 (2019), Electronic Prescribing, was signed into law by Governor DeSantis. The effective date is January 1, 2020. The bill provides important new requirements for prescribers to generate and transmit all prescriptions electronically upon licensure renewal or by July 1, 2021, whichever is earlier.
The law requires prescribers to generate and transmit all prescription electronically, unless:
- The practitioner and the dispenser are the same entity;
- The prescription cannot be transmitted electronically under the most recently implemented version of the National Council for Prescription Drug Programs SCRIPT Standard;
- The practitioner has been issued a waiver by the department, not to exceed 1 year, due to demonstrated economic hardship, technology limitations that are not reasonably within the control of the practitioner, or another exceptional circumstance demonstrated by the practitioners;
- The practitioner reasonably determines that it would be impractical for the patient in question to obtain a medicinal drug prescribed by electronic prescription in a timely manner and such delay would adversely impact the patient’s medical condition;
- The practitioner is prescribing a drug under a research protocol;
- The prescription is for a drug for which the federal Food and Drug Administration requires the prescription to contain elements that may not be included in electronic prescribing;
- The prescription is issued to an individual receiving hospice care or who is a resident of a nursing home facility; or
- The practitioner determines that it is in the best interest of the patient, or the patient determines that it is in his or her own best interest to compare prescription drug prices among area pharmacies. The practitioner must document such determination in the patient’s medical record.
Frequently Asked Questions
Is there a waiver process?
The prescribing practitioner should log into their MQA Online Services account and follow the steps in the user guide to submit a waiver. The Executive Director of each board will approve or deny the waiver and then notify the practitioner.
How do I apply for a waiver?
Please log into your MQA Online Services account and follow the steps in this user guide.
Is there a list of companies that offer electronic prescribing?
Yes. Our sister Agency, the Agency for Health Care Administration (AHCA) has a website with more information on how to electronically prescribe: https://ahca.myflorida.com/SCHS/ePrescribing/index.shtml
You may also find electronic prescribing vendors here: https://surescripts.com/network-alliance/eprescribing-prescriber-software/
Is electronic prescribing mandatory for Florida health care practitioners?
Section 456.42(3), Florida Statutes, requires prescribing health care practitioners to electronically transmit prescriptions for medicinal drugs upon renewal of license or by July 1, 2021, whichever is earlier, unless a specific exception applies.
When do I have to start electronically prescribing?
After January 1, 2020, you must start electronically prescribing upon licensure renewal or by July 1, 2021, whichever is earlier.
What about weekends and holidays—can I not phone in a call-in prescription anymore?
Weekends are not different than in business days.
Does federal law require electronic prescribing?
Federal law requires that on or after January 1, 2021, every prescription for a covered Part D Schedule II, III, IV or V controlled substance must be transmitted electronically unless a specific exemption applies.
Can a written prescription be used when there is a temporary electronical or technological failure?
What exceptions are there to the electronic prescribing requirement?
Practitioners do not have to electronically prescribe if:
- The practitioner and the dispenser are the same entity.
- The prescription cannot be transmitted electronically under the most recent version of the National Council for Prescription Drugs Programs SCRIPT Standard,
- The practitioner has been issued a waiver due to economic hardship, technological limitations not within the practitioner’s control or other demonstrated exceptional circumstance.
- The practitioner reasonably determines that it is impractical for the patient to obtain an electronically prescribed medicinal drug in a timely manner and the delay will adversely impact the patient’s medical condition.
- The drug is prescribed under a research protocol.
- The prescription is for a drug that the Food and Drug Administration (FDA) requires elements that may not be included in an electronic prescription.
- The prescription is issued to an individual in a nursing home or hospice care.
- The practitioner determines it is in the best interest of the patient, or the patient determines it is in his or her own best interest, to compare prescription drug prices among area pharmacies and the practitioner documents this determination in the medical record.
What is the definition of an electronic health record? How do I know if I’m using an electronic health records system? Surely every practice management ‘chart’ is not an electronic health record.
An electronic health record (EHR) is a digital version of a patient’s paper chart. Typically an EHR system consists of computer hardware and software that is purchased or leased.
Can a prescription be issued electronically using any electronic healthcare recordkeeping system?
No, most electronic healthcare recordkeeping systems will require some modifications in order to electronically prescribe, including additional security features and registration of the certified software.
What if I don’t maintain electronic health records?
Then this law does not pertain to your current practices.
Can a controlled substance be electronically prescribed?
Do we have to electronically prescribe controlled substances, or do we continue to use our counterfeit proof pads?
Practitioners who do not have access at their practice or place of employment to an EHR system may still provide written prescriptions to patients. There are other circumstances under which a practitioner with an EHR does not have to prescribe electronically: if the practitioner and the dispenser are the same entity; if the prescription cannot be transmitted under the most recently implemented version fo the NCPDP SCRIPT program; if a DOH waiver has been issued; if it is impractical for a patient to obtain in a timely manner a drug electronically prescribed; the drug is under a research protocol; the prescription is for a drug for which the FDA requires the prescription to contain elements that may not be included in electronic prescribing; the prescription is for a patient receiving hospice care or who is a resident of a nursing facility; or the practitioner or patient determines that it is in the best interest of the patient to be able to compare drug prices among area pharmacies.
Should I get rid of the tamper-proof controlled substance prescription pads?
Not necessarily. Under limited circumstances the use of these pads will still be allowed.
What does interoperable and accessible digital format mean?
Interoperability refers to the architecture or standards that make it possible for a different EHR systems to exchange information between providers. Digital accessibility is the ability of an electronic document to be easily navigated and understood by a wide range of users, including those with disabilities
Is an electronic facsimile of a prescription considered to be an electronic prescription?
No. A prescription generated on an electronic health recordkeeping system must be transmitted electronically. One that has been generated but then printed out and transmitted via fax is not considered an electronic prescription.
Does a practitioner still have to consult the PDMP prior to e-prescribing a controlled substance?
Yes. The practitioner must consult the PDMP prior to prescribing a controlled substance in Schedules II through V regardless of how the prescription is issued.
Are oral, phone in verbal prescriptions still permissible after the mandate becomes effective?
Yes, if one or more of the exceptions are applicable.
What is an eRx?
This is the abbreviation for electronically transmitting a drug prescription directly to a pharmacy using electronic health record technology.
Is it at the responsibility of a pharmacist to confirm if a prescribing practitioner is electronically prescribing?
What if a Pharmacy is not able to accept electronic prescriptions?
A pharmacy would need to ensure they have the appropriate software to accept electronic prescriptions.