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Arizona: e-Prescribing of Controlled Substances

The Practice Fusion EHR provides advanced electronic prescribing capabilities, including electronic prescribing of controlled substances (EPCS).*

Practice Fusion: Using an EHR system to meet Arizona state mandates for certified EPCS. EPCS allows you to:

  • e-Prescribe scheduled drugs right from the Practice Fusion EHR
  • Use one workflow for all prescriptions
  • Minimize patient wait times at pharmacies
  • Reduce unnecessary office visits
  • Improve safety and reduce fraud and abuse
  • Integrate with your state’s Prescription Drug Monitoring Program (PDMP) to check for patients with duplicate prescriptions or other signs of “doctor shopping”
  • Fully integrate with the Practice Fusion EHR and e-prescribing workflow
  • Use a streamlined process for fast identity verification
  • Automatically check patient-specific formularies and perform drug and allergy checks
  • Automatically receive Electronic Prior Authorizations (ePA) for prescriptions

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Arizona State Mandates

Electronic Prescribing of Controlled Substances (EPCS)

Federal Mandate: Medicare Advantage & Medicare Part D Practitioners In 2018, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act was passed by the federal government.1,2 This Act includes legislation that requires Medicare Advantage and Medicare Part D practitioners to begin electronically prescribing controlled substances January 1, 2021. Medicare Advantage and Medicare Part D prescribers in every state are subject to the above mandate and must comply. Due to the COVID-19 health emergency, the Centers for Medicare & Medicaid Services (CMS) has postponed penalties for noncompliance; however, enforcement of those penalties will begin January 1, 2022.2,3

Arizona State Mandate: All Prescribers In June, 2017, the 2016 Arizona Opioid Report was released, prompting Governor Ducey to declare an Opioid Emergency in the state of Arizona.4 Over the next year, numerous regulations were put into place to help control opioid use:5

  • June 2017: Beginning of enhanced surveillance of the use of controlled substances
  • June 2017: Implementation of emergency opioid prescribing and treatment rules for healthcare institutions
  • October 2017: Requirement for prescribing physicians and dispensing pharmacists to check patients’ prescription histories in the state’s PDMP before prescribing opioids
  • December 2017: Launch of the 2018 Opioid Prescribing Guidelines

These measures culminated with passage of the Arizona Opioid Epidemic Act in January, 2018. This act established numerous new laws and regulations for prescribers concerning the electronic prescribing of controlled substances (EPCS).4,5 These rules implemented tighter prescribing restrictions for schedule II controlled substances, such as a 5-day limit for initial prescriptions (14-day limit for surgical procedures.)5 The act also encouraged prescribers to assess patients’ health and medical histories prior to initiating opioid therapy, checking for warning signs such as:5

  • Present or past substance use or family history of substance use
  • Sleep disordered breathing issues
  • Psychiatric co-morbidities and suicide risk
  • Pregnancy and the likelihood of future pregnancy
  • Potential drug interactions

In addition, providers were required to check their state’s PDMP database for patients’ prescription medication histories.

Beginning January 1, 2020, all prescriptions for schedule II controlled substances were to be transmitted electronically. This mandate was waived July, 2020, in response to the COVID-19 public health emergency. However, July 9, 2021, this requirement was once more put in place: All schedule II controlled substances that are opioids must again be dispensed with an electronic prescription.5,6

Prescription Drug Monitoring Program (PDMP) or Prescription Monitoring Program (PMP)

Prescriber review of the Prescription Monitoring Program (PMP) became mandatory in 2017. The prescriber is required to check the PMP for all new patients and continue checking quarterly for patients being prescribed a schedule II, III, or IV opioid analgesic or benzodiazepine.7-9

Why choose Practice Fusion in Arizona for EPCS

Whether you just need a simple solution to address Arizona state mandates or are interested in more robust features such as text message appointment reminders or charting, Practice Fusion has the right features to meet your needs. We offer advanced e-prescribing capabilities including EPCS, prior authorization management, and allergy alerts. Your subscription will also include features such as:

  • Charting
  • Electronic lab and imaging test ordering and results
  • Compliance tracking
  • Appointment scheduling
  • Text message appointment reminders
  • Support for quality payment programs

In addition, Practice Fusion is able to integrate directly with Arizona’s PDMP database. This means prescribes can consult the PDMP from within their existing workflow.

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References:

  1. Centers for Medicare & Medicaid Services (CMS). Medicare Program: Electronic Prescribing of Controlled Substances; Request for Information (RFI). Federal Register: The Daily Journal of the United States Government. Updated August 4, 2020. Accessed September 16, 2021, https://www.federalregister.gov/documents/2020/08/04/2020-16897/medicare-program-electronic-prescribing-of-controlled-substances-request-for-information-rfi.
  2. CMS delays enforcement of e-prescribing requirement for controlled substances. California Medical Association. Updated December 15, 2020. Accessed September 16, 2021, https://www.cmadocs.org/newsroom/news/view/ArticleId/49150/CMS-delays-enforcement-of-e-prescribing-requirement-for-controlled-substances.
  3. CMS formally delays EPCS enforcement. National Community Pharmacists Association. Updated December 4, 2020. Accessed August 22, 2021, https://ncpa.org/newsroom/qam/2020/12/04/qam-ad-cms-formally-delays-epcs-enforcement.
  4. News Release: Arizona Making Progress In Fight Against The Opioid Epidemic. Office of the Arizona Governor Doug Ducey. Updated August 2, 2019. Accessed September 18, 2021, https://azgovernor.gov/governor/news/2019/08/arizona-making-progress-fight-against-opioid-epidemic.
  5. Brady B. Arizona Opioid Epidemic Act - An Update. Center for Rural Health; October 17, 2019. Accessed September 18, 2021. [https://www.acponline.org/system/files/documents/about_acp/chapters/az/2az_opioid_epidemic_act_-an_update-brady-derksen.pdf](https://www.acponline.org/system/files/documents/about_acp/chapters/az/2az_opioid_epidemic_act-an_update-_brady-derksen.pdf).
  6. Arizona State Board of Pharmacy. FAQ: Arizona Controlled Substances Prescription Monitoring Program. July 7, 2021. Accessed September 18, 2021. https://docs.google.com/document/d/161ySFbkbqx8JMUK0B7EuMO8XhAvm12MiJhNtJ22mN5A/edit.
  7. State PDMP Profiles and Contacts. Prescription Drug Monitoring Program Training and Technical Assistance Center. Updated July 7, 2021. Accessed August 19, 2021, https://www.pdmpassist.org/State.
  8. Prevent Opioid Misuse and Abuse in Arizona: Prescriber Requirements for Compliance with Arizona’s Controlled Substance Prescription Monitoring Program (PMP) (Arizona Medical Association (ARMA)) (2017).
  9. Frequently Asked Questions (FAQs). Arizona State Board of Pharmacy Controlled Substances Prescription Monitoring Program. Updated July 9, 2021. Accessed August 6, 2021, https://pharmacypmp.az.gov/faqs.

*Electronic Prescriptions for Controlled Substances (EPCS) is only available in the 50 US states and the District of Columbia