Opioid Electronic Prescribing Law Passes in Arkansas
Arkansas State ePrescribing Law Pases

Opioid Electronic Prescribing Law Passes in Arkansas

Prescriptions for controlled substances such as opioids and narcotics will be moved to a paperless, e-prescription system by 2021 under a bill which just passed in the Arkansas Legislature.

According to data from the U.S. Centers for Disease Prevention and Control (CDC), Arkansas ranks second among all U.S. states in opioid prescription rates and opioid abuse by youths. Both the Attorney General’s office, and a coalition of counties and cities across Arkansas filed lawsuits against drug makers alleging that the companies’ actions contributed to the crisis.

Electronic prescribing provides many benefits including the ability to conduct forensic reviews of historical data to identify drug seeking behavior and out of compliance prescribers and pharmacies. There are challenges in rural areas where legitimate chronic pain patient needs may not be met. Rural areas without the electronic prescribing and internet access may not be able to receive and fill presriptions.

These concerns were raised by several committee members about the effectiveness of an electronic system in rural areas and in the event of a natural disaster. Their concerns hinged on another set of statistics provided by Lane: That while almost all pharmacists can receive electronic prescriptions, only 66 percent of health care providers are set up to use the system.

“I have a problem at this day and time with the technology,” said Sen. Terry Rice, R-Waldron. “It’s far from being complete for rural Arkansas.”

The National Association of Chain Drug Stores (NACDS) endorsed the enactment of an electronic prescribing bill (SB 174), for controlled substance prescriptions for Schedule II through Schedule VI, which will help prevent opioid abuse. Arkansas Gov. Asa Hutchinson (R) signed the bill into law March 13, which will become effective January 1, 2021. 

According to NACDS, State Sen. Kim Hammer (R), sponsor of the Senate bill; State Rep. Justin Boyd (R), a pharmacist and sponsor of the bill in the House; Kirk Lane, Arkansas drug director; and the Arkansas Pharmacists Association, were instrumental in getting the legislation passed.

The legislation enjoys popular and nonpartisan support in the state for mandatory e-prescribing. A January 2019 survey, conducted by Morning Consult and commissioned by NACDS, found that 64 percent of Arkansas registered voters support rules that all prescriptions must be handled electronically, rather than by paper or fax, to reduce the likelihood of fraud and abuse. Only 20 percent indicated opposition.

NACDS President and CEO Steven C. Anderson, IOM, CAE, said: “Fifteen states have enacted e-prescribing legislation as part of the opioid-abuse solution, and we congratulate Arkansas for helping to lead the way on this critical issue.” 

President Trump signed into law federal legislation in 2018—the SUPPORT for Patients and Communities Act (H.R. 6)—which includes provisions of the NACDS-backed Every Prescription Conveyed Securely Act. The new federal law requires electronic prescribing for Schedule II through V controlled substances prescriptions covered under Medicare Part D to help prevent fraud, abuse and waste – with limited exceptions to ensure patient access.

Reflective of the path toward greater use of electronic prescribing as a safeguard, NACDS was on the leading edge of working with the Drug Enforcement Administration to allow electronic prescribing of controlled substances. Until 2010, it was not allowed.

NACDS’ policy recommendations to help address the opioid-abuse epidemic reflect pharmacists’ firsthand experiences on the frontlines of care, as well as extensive collaboration with law enforcement. In addition to e-prescribing, NACDS’ recommendations involve drug disposal, prescription drug monitoring plans, and limits on initial fills of opioid prescriptions for acute pain.

The policy recommendations issued by NACDS are part of a strategy to improve adherence to provisions of the Controlled Substances Act which include drug disposal; patient education; security initiatives; fostering naloxone access; stopping illegal online drug-sellers and providers who dispense improperly without cross-checking State prescribing databases.

Michael F. Arrigo

Michael is Managing Partner & CEO of No World Borders, a leading healthcare management and IT consulting firm. He serves as an expert witness in Federal and State Court and was recently ruled as an expert by a 9th Circuit Federal Judge. He serves as a patent expert witness on intellectual property disputes, both as a Technical Expert and a Damages expert. He leads a team that provides Cybersecurity best practices for healthcare clients, ICD-10 Consulting, Meaningful Use of Electronic Health Records. He advises legal teams as an expert witness in HIPAA Privacy and Security, medical coding and billing and usual and customary cost of care, the Affordable Care Act and benefits enrollment, white collar crime, False Claims Act, Anti-Kickback, Stark Law, Insurance Fraud, payor-provider disputes, and consults to venture capital and private equity firms on mHealth, Cloud Computing in Healthcare, and Software as a Service. He advises self-insured employers on cost of care and regulations. Arrigo was recently retained by the U.S. Department of Justice (DOJ) regarding a significant false claims act investigation. He has provided opinions on over $1 billion in health care claims and due diligence on over $8 billion in healthcare mergers and acquisitions. Education: UC Irvine - Economics and Computer Science, University of Southern California - Business, studies at Stanford Medical School - Biomedical Informatics, studies at Harvard Medical School - Bioethics. Trained in over 10 medical specialties in medical billing and coding. Trained by U.S. Patent and Trademark Office (USPTO) and PTAB Judges on patent statutes, rules and case law (as a non-attorney to better advise clients on Technical and Damages aspects of patent construction and claims). Mr. Arrigo has been quoted in the Wall Street Journal, New York Times, and National Public Radio.

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