Medical Board of California (2024)

E-Prescription Requirements

Except under certain circ*mstances, the law requires all prescriptions to be issued electronically, pursuant to Business and Professions Code section 688. Prescribers who fail to follow these requirements may be referred to the appropriate state professional licensing board for administrative sanctions, as deemed appropriate by that board.

The following exemptions were added effective January 1, 2023:

• The prescriber's practice is located in the area of an emergency or disaster declared by a federal, state, or local government;
• The prescriber issues 100 or fewer prescriptions per calendar year; or
• The prescriber is unable to issue electronic data transmission prescriptions due to circ*mstances beyond their control.

To use one of the above exemptions, the prescriber must register online annually with the Board of Pharmacy and state their method of qualification for the exemption.

The additional electronic prescribing exemptions are:

• The prescription is issued to a terminally ill patient pursuant to Health and Safety Code 11159.2.
• An electronic data transmission prescription is not available due to a temporary technological or electrical failure.
• The prescriber issues a prescription to be dispensed by a pharmacy located outside California.
• If issued in a hospital emergency department or urgent care clinic, the prescription is not required to be transmitted electronically, but shall be electronically issued and may be given to the patient directly, when one or more of the following conditions are present:
  • The patient resides outside California.
  • The patient resides outside the geographic area of the hospital.
  • The patient is homeless or indigent and does not have a preferred pharmacy.
  • The prescription is issued at a time when a patient's regular or preferred pharmacy is likely to be closed.
• The prescriber and the dispenser are the same entity.
• The prescription is issued by a prescriber under circ*mstances whereby the prescriber reasonably determines that it would be impractical for the patient to obtain substances prescribed by an electronic data transmission prescription in a timely manner, and the delay would adversely impact the patient's medical condition.
• The prescription includes elements not covered by the latest version of the National Council for Prescription Drug Programs' SCRIPT standard, as amended from time to time.

Requirements Related to Controlled Substances Prescriptions

If, due to a technological or electrical failure, a prescriber does not issue electronically a prescription for a controlled substance, the prescriber shall document the reason in the patient's medical record as soon as possible, and within 72 hours of the end of the technological or electrical failure.

Under this law, prescriptions for controlled substances, as defined by Business and Professions Code section 4021, must comply with Parts 1300, 1304, 1306, and 1311 of Title 21 of the Code of Federal Regulations. In June 2010, the U.S. Drug Enforcement Administration (DEA) established the Electronic Prescriptions for Controlled Substances (EPCS) procedures. Title 21 of the Code of Federal Regulations provides EPCS guidance including, third-party certification that prescription software applications meet DEA requirements, identify-proofing of prescribers, two-factor authentication when signing prescriptions, and access controls established by software users. Part 1311 of Title 21 specifies the requirements in detail. For assistance, or more information on EPCS, contact [email protected].

The Board recommends that all licensed prescribers have paper prescription forms available that meet the requirements of Health and Safety Code section 11162.1, should a technological or electrical failure prevent a prescription from being issued electronically.

For additional information about these requirements, please visit the California Legislation Information website.

AB 2789 Toolkit for Prescribers

• Podcast Episode 8 - Mandatory E-Prescribing Begins Jan. 1, 2022 (September15,2021)

  Download | Text

• Board of Pharmacy FAQs
• Board of Pharmacy E-Prescribing Exemption Request Form