E-Prescribing of Controlled Substances to be Required Jan. 1
By David Doolittle

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Although state law and Medicare policy will require electronic prescriptions for all controlled substances beginning Jan. 1, Texas prescribers have several options for delaying implementation for at least another year.

State lawmakers in 2019 passed House Bill 2174, which, among other provisions, made electronic prescribing of controlled substances (EPCS) mandatory at the start of 2021.

However, prescribers who demonstrate financial or technical hardships, or other exceptional circumstances, can apply for a waiver that, if approved, will grant a one-year delay. Waivers can be renewed annually for up to five years if the hardship persists.

There also are several exceptions to the e-prescribing mandate that do not require a waiver, including a temporary technological or electronic failure, certain emergencies, or when a physician or physician’s delegate issues a prescription to be dispensed by an out-of-state pharmacy.

The Texas Medical Board is set to publish final EPCS rules and waiver forms in the coming weeks.

In a letter last week, TMA called on the Texas Medical Board to exercise greater transparency in decisions on exceptions and waivers to the rule. TMA is watching closely and will alert you as soon as the waiver applications are available.

Texas’ EPCS requirement was set to coincide with Medicare’s e-prescription mandate for controlled substances.

In its final 2021 physician fee schedule, released last week, Medicare said the requirement will still go into effect Jan. 1, but that enforcement will be delayed until Jan. 1, 2022. The enforcement delay is intended “to encourage prescribers to implement [e-prescribing] as soon as possible, while helping ensure that our compliance process is conducted thoughtfully,” CMS said.

Note that all schedules have prescriptions that fall into the controlled-substance category and that can be reviewed on the Drug Enforcement Administration’s list of controlled substances

In the meantime, if you are not already using EPCS, now may be a good time to start.

Your electronic health records (EHR) vendor likely has the option available and can help you get set up.

If you do not use an EHR, or if your vendor does not have EPCS available, stand-alone options are available. You can expect to pay about $75 per month per physician for the stand-alone option.

To search stand-alone certified EPCS software, go to the Surescripts page for prescriber software and “focus your search” by choosing standalone eRx.  

If you have questions about EPCS, contact TMA’s Health Information Technology Department at (800) 880-5720 or via email.

Last Updated On

December 09, 2020

Originally Published On

December 09, 2020

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David Doolittle

Editor

(512) 370-1385

Dave Doolittle is editor of Texas Medicine and Texas Medicine Today. Dave grew up in Austin, where he attended culinary school as well as the University of Texas. He spent years covering Central Texas for the Austin American-Statesman newspaper. He is the father of two girls, a proud Longhorn, and an avid motorsports fan.

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