In 2018, AB 2789, the mandatory provider e-prescribing law for California, was designed to coincide with the new Medicare EPCS (Electronic Prescribing of Controlled Substances) requirement that was to go live nationally at the start of 2022. AB 2789 goes live January 1, 2022 and extends the EPCS expectations from controlled substance to all prescriber and dispenser prescriptions with very few exemptions possible. The CMA posted a helpful article on this subject on October 5 (link provided below).
As a semi-retired physician still doing locum tenens coverage for a CCRC, I had hoped for an exemption, but this bill is very clear about which providers are exempt. In our settings of care, you won’t find any provider exemptions, except in the state prison system. Fortunately, we still have time to comply with this law. For me, the physicians I cover use an EHR platform certified by the Office of the National Coordinator for Health IT (ONC) that will electronically transmit prescriptions, including controlled substances. In December, prior to providing locum tenens services, I’ve set aside time for acquiring this skill. For those who have not yet adopted an EHR, the CMA article advises a standalone electronic prescribing platform that must have the ability to do EPCS and query the CURES database. They also urge considering systems that are connected to the largest pharmacy prescribing platform, SureScripts network.
Most of the larger nursing facility EHR systems (e.g., Point Click Care, Matrix) have the capability to incorporate electronic prescribing, including EPCS, although there may be an additional cost to the facility. Prescribers who lack access to other avenues of e-prescribing and practice solely in these settings should ask their facilities to explore this option.
Pharmacists filling non-electronic prescriptions are not obligated to determine why these prescriptions are not being transmitted in a compliant fashion. The responsibility for electronic transmission rests squarely on the prescribers themselves. It remains to be seen whether facilities might face any scrutiny or sanctions for not ensuring that their attending prescribers have the ability to e-prescribe.
I know we live in a time when some mandates have been met with protests and informed refusals. For those who choose that route, AB 2789, has designated the MBC (Medical Board of CA), to implement appropriate disciplinary actions, which haven’t yet been published. However, physicians can’t be sued for failing to comply with the law.
I know this has been another challenging year for providers and facilities. However, this change may improve the efficiency, cost, legibility, and accuracy of prescribing as well as the use big data and analytics, which may favorably impact future prescribing practices.
Who says, “You can’t teach an old dog new tricks?”
References
CMA Article: Are you ready for California’s electronic prescribing mandate?
Bill Text - AB-2789 Health care practitioners: prescriptions: electronic data transmission.