Home Pharmacy practice Have paper prescriptions followed the horse and buggy trail? Almost. | Akerman LLP – Rx Health Law

Have paper prescriptions followed the horse and buggy trail? Almost. | Akerman LLP – Rx Health Law

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For most Florida prescribers whose licenses haven’t been renewed since 2019, it’s time to start e-prescribing. In 2019, the legislature enacted a law that required e-prescribing. However, this requirement came into effect on the earliest of the prescriber’s license renewal date or July 1, 2021. Florida Statutes Section 456.42 (3) requires healthcare professionals to “electronically submit prescriptions”. This term is not defined and, while it was probably intended to mean “electronic prescription”, it does not say so.

The requirement that practitioners electronically transmit prescriptions only applies to health care practitioners authorized by law to prescribe (MD, DO, APRN, AM, podiatrists, dentists and optometrists) who:

  • Maintain an electronic health records (“EHR”) system; or
  • Prescribing medication as an owner, employee or contractor of an approved healthcare facility or practice that maintains the EHR

This requirement would apply to practitioners in a “registered health facility” (such as hospitals, health care clinics, outpatient surgery centers, and other approved facilities) who have an EHR. It is less clear what qualifies as “practical” or whether this applies to practitioners in locations not authorized with EHRs (such as exempt health care clinics). Nonetheless, physicians in private practice who use the EHR would be well advised to begin electronic prescribing. Obviously, practitioners who do not use the EHR and only use paper medical records will not have to comply.

There are a multitude of exemptions from the electronic filing requirement. It does not apply to:

  • Practitioners
  • Orders that cannot be transmitted electronically according to NCPDP SCRIPT standards
  • Practitioners have been granted a one-year waiver by the Ministry of Health
  • Practitioners who reasonably determine that it would be impractical for the patient to obtain the medication in a timely manner and that this would have a negative impact on the patient’s health
  • Practitioners prescribing drugs as part of a research protocol
  • Prescriptions for drugs for which the FDA requires the prescription to contain items that cannot be included in the electronic prescription
  • Prescriptions for palliative care patients or residents of nursing homes, or
  • Prescriptions when the prescriber or patient determines that it is in the patient’s best interest to compare prices between pharmacies in the area and the prescriber documents this decision in the medical record

The Ministry of Health, in consultation with the advice of relevant health professionals, may adopt rules for the application of the law. The Medical Council has a web page with Faq which, although informative, does not have the force and effect of law. The Board of Medicine indicated on its website FAQs that faxing prescriptions would not be considered an electronic prescription. The website also states that prescriptions given during a phone call to a pharmacy (oral prescriptions) can only be used if one of the exceptions above applies. Pharmacists are likely to need additional information when a prescriber requests a prescription. Prescribers will need to tell the pharmacist either that they are not maintaining the EHR or that they will need to identify which of the eight exemptions applies. Prescribers and pharmacists will have to adapt to these new requirements.


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