DCP: Electronic Prescribing of Controlled Substances

Electronic Prescribing of Controlled Substances

Public Act 17-131, Section 3, requires Electronic Prescribing of Controlled Substances (EPCS) starting on January 1, 2018 for all controlled substances. In addition to improving efficiency, this will help stop prescription fraud with fewer opportunities to duplicate or modify paper prescriptions.

 

 

Drug Enforcement Administration

 

Exemption Instructions

 

Verify EPCS Exemption Status

 

Electronic Prescribing of Controlled Substances

Frequently Asked Questions

General

 

What is Electronic Prescribing of Controlled Substances (EPCS)?

  • EPCS allows prescribers to use a software system to electronically transmit Schedule II-V controlled substance prescriptions to a pharmacy.

What is required for a prescriber to transmit an electronic Schedule II-V controlled substance prescription?

  • Software used by prescribers to transmit an electronic Schedule II-V controlled substance prescription must meet the requirements set forth by the Drug Enforcement Administration (DEA). 
  • More information may be found on the DEA’s website.
Which medications must be electronically prescribed?
  • All Schedule II, III, IV, and V controlled substance medications
  • For more information regarding controlled substances, see the Frequently Asked Questions.
Prescribers
 

How should a transmitted electronic Schedule II-V prescription be stored?

  • Dispensed electronic Schedule II-V controlled substance prescriptions may be stored electronically or on paper using the software that created the prescription. 
  • All records must be maintained for a minimum of three (3) years and shall be made available for inspection at reasonable times.

 

What exceptions exist for Electronic Prescribing of Controlled Substance (EPCS)?

  • Technological and/or electrical failure
  • Adverse impact on the patient’s medical condition or patient care (compounded prescriptions, complicated directions for use)
  • The intended pharmacy is not located in the State of Connecticut
  • Lack of technological capacity

What constitutes “technological failure” or “electrical failure”?

  • A failure of computer system, application, or device or the loss of electrical power to such system, application, or device or any other reasonable service interruption to such system, application, or device that reasonably prevents the prescriber from utilizing their EPSC system. 
  • Failure for a pharmacy to accept an electronic prescription would also be an appropriate use of this.  In this case, you may want to let the pharmacy know that they are having an issue so that they may attempt to correct it.

What procedure must prescribers follow during a “technological failure” or “electrical failure”?

  • Prescribers should attempt to correct any and all causes within one’s control. 
  • Prescribers must document in the patient’s medical record the reason why a paper prescription was authorized during a “technological failure” or “electrical failure”.
  • This must be done as soon as practicable, but no later than seventy-two hours following the end of the temporary “technological failure” or “electrical failure” that prevented the electronic transmission of prescriptions. 
  • Prescribers are encouraged to document the reason for a paper prescription on the paper prescription provided to the patient.

What procedure must a prescriber follow when issuing an electronic prescription that adversely impacts the patient’s medical condition?

  • A paper prescription may be issued to the patient for up to a five (5) day supply of a Schedule II-V controlled substance. 
  • Prescribers issuing the paper prescription must document the reason why the prescription was not electronically transmitted.
  • Prescribers are encouraged to document the reason for a paper prescription on the paper prescription provided to the patient.

What procedure must a prescriber follow when the patient’s pharmacy is located outside of Connecticut?

  • A paper prescription may be issued to the patient.  The prescriber issuing the paper prescription must document the reason why the prescription was not electronically transmitted. 
  • The prescriber is encouraged to document the reason for a paper prescription on the paper prescription provided to the patient.

What procedure must a prescriber follow when the issuance of an electronic Schedule II-V controlled substance prescription negatively impacts patient care?

  • In these instances, a paper prescription may be issued to the patient.
  • Some examples of this may be: a prescription requiring a pharmacist to compound two or more products; a prescription for direct administration to a patient by parenteral, intravenous, intramuscular, subcutaneous, or intraspinal infusion; a prescription bearing long or complicated directions; a prescription in which the federal Food and Drug Administration requires the inclusion of certain elements; a prescription transmitted orally to a pharmacist by a health care practitioner for a patient in a chronic and convalescent nursing home.
  • The prescriber is encouraged to document the reason for a paper prescription on the paper prescription provided to the patient.

What does “technological capacity” mean?

  • Possession of a computer system, hardware or device that can be used to electronically transmit controlled substance prescriptions consistent with the requirements of the Drug Enforcement Administration.
  • More information may be found on the DEA’s website.

What procedure must a prescriber follow when lacking the ability or “technological capacity” to comply with the requirements set forth for Electronic Prescribing of Controlled Substances (ECPS)?

  • The prescriber must file an exemption with the Department of Consumer Protection’s Drug Control Division.

What is the procedure for filing an Electronic Prescribing of Controlled Substances (ECPS) exemption with the Department of Consumer Protection’s Drug Control Division?

  • The Department of Consumer Protection will send a brief questionnaire to each prescriber with an Active Controlled Substance Registration.  This questionnaire will serve as the exemption.  The questionnaire only needs to be completed by the prescriber if they are seeking the exemption.
  • At this time, any prescriber that completes the exemption questionnaire and answers "Yes" to questions 4 that asks about the waiver has successfully completed exemption. 
  • The prescriber is encouraged to document that they have completed the exemption with the Department of Consumer Protection on the written prescriptions.

What procedure must a prescriber follow when one’s ability to comply with the requirements set forth for Electronic Prescribing of Controlled Substances (ECPS) exists in some, but not all, practice settings?

  • Prescribers must comply with the requirements set forth for Electronic Prescribing of Controlled Substances (ECPS) in practice settings with “technological capacity”.
  • Prescribers may issue a paper or facsimile prescription in practice settings without “technological capacity”.

Can prescribers change/update my questionnaires for Electronic Prescribing of Controlled Substances?

  • Yes.  If you log in to your account for your Controlled Substance Registration for Practitioner you can update your account at any time.

Can prescribers electronically prescribe controlled substances prior to January 1, 2018?

  • If your software is compliant with the Drug Enforcement Administration requirement then you can electronically prescribe controlled substances prior to the January 1, 2018 mandate. 

Is an electronic facsimile of a prescription considered an electronic prescription?

  • No.  A facsimile is a copy of an original prescription.

What should I do if my Electronic Health Record has temporary periods of “downtime” or temporary periods of time where Electronic Prescribing of Controlled Substances is unavailable?

  • This is considered "technological failure or electrical failure".  If your "downtime" is scheduled, it is recommended that you share that information with pharmacies within your area if possible.  Please see above.

Does an electronic prescription require a written follow-up prescription to be sent to the pharmacy?

  • No.

Is it mandatory for pharmacies to receive electronic prescriptions for controlled substances?

  • Yes.
What should a prescriber do if the pharmacy a patient wants to use is closed?
  • If the prescription is of an urgent nature, they can either locate another pharmacy or utilize a different exemption such as the exemption where Electronic Prescribing of Controlled Substances may negatively impact patient care. 

How do prescribers know if their software is compliant with the requirements for Electronic Prescribing of Controlled Substances?

  • You should contact your software vendor as they should be able to provide you with information.

Are oral prescriptions for controlled substances still permitted?

  • Schedule II prescription can be communicated by a prescribing practitioner known to or confirmed by a pharmacist orally in an emergency. 
  • The filling pharmacist shall promptly reduce such oral order to writing on a prescription blank.  Such oral order shall be confirmed by the proper completion and mailing or delivery of the prescription prepared by the prescribing registrant to the pharmacist filling such oral order within seventy-two hours. 
  • The pharmacist shall affix the temporary prescription to the properly completed prescription. 
  • The properly completed prescription can either be hand written or electronically transmitted but should indicated that it is part of the telephoned in prescription.

What if I am a prescriber and I work at multiple locations that don't all have the ability to comply with Electronic Prescribing of Controlled Substances?

  • Please complete the questionnaire for an exemption.  In the locations where you can comply with Electronic Prescribing of Controlled Substance you will be required to do so.
 
What should I do if I don't prescribe controlled substances?
  • If your computer system can comply with Electronic Prescribing of Controlled Substances then you do not need to do anything.  If your software cannot comply with Electronic Prescribing of Controlled Substances then you should complete the questionnaire for a waiver.
 
Do I have to purchase software to comply with Electronic Prescribing of Controlled Substances?
  • Your software vendor may charge you for the ability to comply with Electronic Prescribing of Controlled Substances.  At this time, you are not required to purchase any software because you can apply for the exemption.
What should I do if I have an active Controlled Substance Registration but don't actively practice in Connecticut or I have retired from practice?
  • If you practice with a software system that can comply with Electronic Prescribing of Controlled Substances then you do not need to do anything.  If your software cannot comply with Electronic Prescribing of Controlled Substances then you should complete the questionnaire for a waiver. 
What should I do if I practice in another state but see patients from Connecticut?
  • A paper prescription would still be permitted.
 

Pharmacist/Pharmacy

 

What is the pharmacist responsibility when receiving a written prescription for a controlled substance after January 1, 2018?

  • A pharmacist has a duty to determine if a prescription is valid whether it was transmitted electronically or otherwise permitted by law. 
  • Prescribers are encouraged to place the reason for the written prescription on the prescription.
  • Any prescriptions issued prior to January 1, 2018 with refills are still valid without an electronic prescription.
Do all pharmacies in Connecticut have to accept electronic prescriptions?
  • Yes
What are the record keeping requirements for pharmacists/pharmacies for Electronic Prescribing of Controlled Substances?
  • All records are required to be maintained on file for three (3) years at the premises of the pharmacy and maintained current and separate from other business records.
  • All records must be stored in a manner that is readily available for inspection by the Department of Consumer Protection, or authorized agents at reasonable times.
  • Prescription records that have been received electronically may be stored electronically, provided the files are maintained in the pharmacy computer system for not less than three (3) years.  If an electronically transmitted prescription is printed, it shall be filed separately from other prescriptions.  All schedule II prescriptions shall be filed in a separate file and all schedule III, IV, and V prescriptions shall be stored in a separate file.  All controlled substance prescriptions shall, immediately upon filling, be filed chronologically and consecutively.

What exceptions exist for Electronic Prescribing of Controlled Substance (EPCS)?

  • Technological and/or electrical failure (see prescriber area above for more information)
  • Adverse impact on the patient’s medical condition or patient care (compounded prescriptions, complicated directions for use)
  • The intended pharmacy is not located in the State of Connecticut
  • Lack of technological capacity

 

As a pharmacist, how do I know if a prescriber has applied for the exemption from the EPCS requirement?

  • All exemption information will be available on our website at www.elicense.ct.gov by prescriber. 
What should a Connecticut pharmacist do if they receive a written prescription for a patient that was originally intended to be filled outside of Connecticut?
  • If the pharmacist, in their professional judgment believes that the prescription is appropriate they should fill the prescription.  If the pharmacist decides to fill the prescription, they should document their rationale in a manner that would be readily retrievable.

Are oral prescriptions for controlled substances still permitted?

  • Schedule II prescription can be communicated by a prescribing practitioner known to or confirmed by a pharmacist orally in an emergency. 
  • The filling pharmacist shall promptly reduce such oral order to writing on a prescription blank.  Such oral order shall be confirmed by the proper completion and mailing or delivery of the prescription prepared by the prescribing registrant to the pharmacist filling such oral order within seventy-two hours. 
  • The pharmacist shall affix the temporary prescription to the properly completed prescription. 
  • The properly completed prescription can either be hand written or electronically transmitted but should indicated that it is part of the telephoned in prescription.
 If you have additional questions please email DCP.DrugControl@ct.gov


Content Last Modified on 11/15/2017 1:57:27 PM