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ARIZONA STATE SENATE
Fifty-Fourth Legislature, First Regular Session
AMENDED
electronic prescribing; exceptions; deadlines.
Purpose
An emergency measure that extends the deadline for compliance with electronic prescription requirements for schedule II controlled substances that are opioids (schedule II opioids) to January 1, 2020. Provides exceptions to electronic prescription requirements under specified circumstances. Directs the Regulatory Board of Physician Assistants (BPA) to certify a physician assistant (PA) for controlled substance prescription privileges if the PA meets certain requirements.
Background
Laws 2018, First Special Session, Chapter 1, also known as the Arizona Opioid Epidemic Act (Act), establishes various requirements and prohibitions for prescribing, administering and dispensing schedule II opioids. Specifically, the Act requires electronic prescribing for schedule II opioids in counties with populations of more than 150,000 beginning January 1, 2019, and requires electronic prescribing for schedule II opioids in counties with populations of less than 150,000 beginning July 1, 2019. Prescription orders provided for medically-assisted treatment are exempt from electronic prescription requirements.
The
Act requires the Board of Pharmacy (Board) to adopt rules and establish a
waiver process for electronic prescription requirements for medical
practitioners who lack adequate access to broadband internet or face other
hardships that prevent compliance. Additionally, the Act directs the Director
of the Board to provide a report to the Governor and the presiding officer in
each legislative chamber, by September 1, 2018, regarding the ability of healthcare
providers to access and use electronic prescribing tools and comply with
electronic prescribing requirements
(A.R.S.
§ 36-2525).
The BPA is currently required to certify PAs for 90-day prescription privileges for schedule II or III controlled substances that are not opioids or benzodiazepine if the PA meets the following criteria: 1) has completed 45 hours in pharmacology or clinical management of drug therapy within three years of their application for certification; 2) is certified by a national commission on the certification of PAs at the time of application; or 3) satisfies any other requirement established by BPA rule (A.R.S. § 32-2504).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Requires electronic prescription orders for schedule II opioids in all counties beginning January 1, 2020.
2. Authorizes a pharmacist to dispense a written prescription order for a schedule II opioid during any time-period in which an established electronic prescribing system or a pharmacy management system is not operational or available in a timely manner.
3. Authorizes a medical practitioner to write a prescription order for a schedule II opioid during any time-period in which an established electronic prescribing system or a pharmacy management system is not operational or available in a timely manner.
4. Requires that a medical practitioner indicate on the written prescription order that the electronic prescribing system or pharmacy management system is not operational or available.
5. Permits a medical practitioner to write a prescription order for a schedule II opioid if it will be dispensed for the patient from a Veterans Administration (VA) facility, a health facility on a military base, an Indian health services hospital or facility, or a tribal-owned clinic.
6. Permits a pharmacist to dispense a written prescription order for a schedule II opioid if the order indicates that the medical practitioner provided care for the patient in a VA facility, a health facility on a military base, an Indian health services hospital or facility, or a tribal-owned clinic.
7. Permits a medical practitioner or their agent to transmit a prescription order for a schedule II opioid to a pharmacy by fax if the prescription order is for a patient being discharged from a hospital to another licensed healthcare institution.
8. Requires medical practitioners and pharmacists to maintain a record of when the electronic prescribing system or pharmacy management system is not operational or available.
9. Removes the requirement that the Board adopt rules and establish a waiver process for medical practitioners who lack adequate access to broadband internet or face other hardships that prevent compliance with electronic prescription requirements.
10. Permits the Board, in consultation with the Computerized Central Database Tracking System Task Force, to prescribe rules that provide exceptions to electronic prescribing requirements for pharmacists and medical practitioners.
11. Requires the BPA to certify a PA for 30-day prescription privileges for schedule II, III, IV and V opioids or benzodiazepine if the PA meets specified criteria.
12. Requires the BPA to certify a PA for 90-day prescription privileges for schedule IV and V controlled substances that are not opioids if the PA meets specified criteria.
13. Stipulates that initial prescriptions issued by a PA who is certified for schedule II opioid prescription privileges, and who has been delegated to issue the prescription by the PA's supervising physician, are subject to prescribed dosage, supply and morphine milligram equivalency limitations.
14. Makes technical and conforming changes.
15. Becomes effective on signature of the Governor, if the emergency clause is enacted, retroactive to January 1, 2019.
Amendments Adopted by Committee
1. Adds references to pharmacy management systems.
2. Requires the BPA to certify PAs for controlled substance prescription privileges if the PA meets prescribed criteria.
3. Makes conforming changes.
Senate Action
HHS 1/30/19 DPA 8-0-0
Prepared by Senate Research
February 1, 2019
CRS/kja