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Dear Licensee,
Beginning January 1, 2020, House File 2377 (2018 Iowa Acts) mandates the electronic transmission of all prescriptions, including all controlled substances, unless specifically exempted. For the purposes of this mandate, orders written in an in-patient setting are not considered prescriptions. Electronic prescribing, or "e-Prescribing," allows health care providers to enter prescription information into a computer device-such as a tablet, laptop, or desktop computer-and securely transmit the prescription to pharmacies using a special software program and connectivity to a transmission network.
The law establishes exemptions to this mandate which include:
- Prescriptions for a patient residing in a nursing home, long-term care facility, correctional facility, or jail
- Prescriptions authorized by a licensed veterinarian
- Prescriptions for a device
- Prescriptions dispensed by a department of veterans affairs pharmacy
- Prescriptions requiring information that makes electronic transmission impractical, such as complicated or lengthy directions for use or attachments
- Prescriptions for compounded preparations containing two or more components
- Prescriptions issued in response to a public health emergency in a situation where a non-patient specific prescription would be permitted
- Prescriptions issued for an opioid antagonist pursuant to Iowa Code section 135.190 or a prescription issued for epinephrine pursuant to Iowa Code section 135.185
- Prescriptions issued during a temporary technical or electronic failure at the location of the prescriber or pharmacy-documentation on the prescription is required
- Prescriptions issued pursuant to an established and valid collaborative practice agreement, standing order, or drug research protocol
- Prescriptions issued in an emergency situation which may include, but is not limited to, the issuance of a prescription to meet the immediate care need of a patient after hours when a prescriber is unable to access electronic prescribing capabilities. Such prescriptions shall be limited to a quantity sufficient to meet the acute need of the patient with no authorized refills
In addition to these exemptions, prescribers, medical groups, institutions and pharmacies may petition the Board of Pharmacy for a blanket exemption to the e-Prescribing mandate. Blanket exemptions will only be considered for economic hardships, technical limitations that the prescriber, medical group, institution, or pharmacy cannot control, or other exceptional circumstances. Those who wish to seek a blanket exemption must submit a completed petition request by October 1, 2019. The petition request form may be found on the Pharmacy Board's website. Only completed petition requests will be considered. Attached to the petition request form is information from vendors of electronic prescribing systems who may be able to meet your e-Prescribing needs. The Board does not endorse any particular vendor and providers are not limited to the vendors whose information is provided. Note that the Board does not require electronic health record (EHR) systems, nor does it require an electronic prescribing system be integrated into an EHR system.
Administrative penalties for noncompliance. Violations of the e-Prescribing mandate may result in an administrative penalty of $250 per violation, up to a maximum of $5,000 per calendar year. Administrative penalties do not constitute disciplinary action. Administrative penalties will be assessed by the provider's professional licensing board. All monies collected from the imposition of administrative penalties will be utilized to fund the continued efforts of the Iowa Prescription Monitoring Program.
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