During the 2019 legislative session, in response to the opioid crisis, the Legislature passed Substitute Senate Bill 5380 into law, establishing rules for opioid prescribing, Electronic Health Record (EHR) integration with the Prescription Monitoring Program (PMP), outlining a state opioid response plan, and, among other things, amending RCW 69.50.312 (Electronic communication of prescription information) to require that all prescriptions for controlled substances Schedules II-IV and refills for controlled substances Schedules III-V be transmitted electronically. Currently, the e-prescribing mandate will become effective Jan. 1, 2022. The bill also directs the Department of Health (DOH) to develop a waiver process for this electronic prescribing mandate.

The DOH filed to notify the public of the proposed new rules that will establish the electronic prescribing waiver criteria. The waiver will be available for those that can demonstrate an inability to comply with the e-prescribing mandate due to economic hardship, technological limitations, or other exceptional circumstances.

Under the proposed waiver rule:

• A practitioner may submit an attestation to the department for a waiver from the electronic prescribing mandate if the practitioner is experiencing an economic hardship, technological limitations not reasonably in the control of the practitioner, or other exceptional circumstance.
  • An attestation for a waiver under economic hardship may be submitted if the practitioner experienced bankruptcy in the previous year or submitted an attestation for a waiver due to a bankruptcy in the previous year, opened a new practice after Jan. 1, 2020, intends to discontinue operating in Washington prior to Dec. 31, 2021, or operates a low-income clinic (that serves a minimum of 30% Medicaid patients).
  • An attestation for a waiver under technological limitations may be submitted if there are technological limitations outside of the control of the practitioner and the practitioner is in the process of transitioning to an electronic prescription system.
  • An attestation waiver under other exceptional circumstance may be filed if the practitioner is providing services at a free clinic, generates fewer than one hundred prescriptions of Schedules II – V drugs in a one year period (including both new and refill prescriptions), is located in an area without sufficient internet access to comply with the mandate, or unforeseen circumstances like natural disasters, widespread health care emergencies, or other unforeseeable barriers inhibit the practitioner from compliance.
• A practitioner does not need to submit a waiver if exempted from the mandate under RCW 69.50.312 (2).
• A practitioner must submit an attestation for the waiver using forms provided by the department. The department shall deem the waiver granted upon submission of an attestation and the practitioner will be deemed exempt for the calendar year in which the attestation is signed.
• A practitioner is limited to three waivers under the economic hardship and technical limitations category. There is no limit to the number of waivers a practitioner can file for under the exceptional circumstances category.

The DOH will hold a virtual public hearing on June 4, 2021 at 9:30 AM to discuss the proposed rule. Those interested in participating in the hearing can register to attend here.

Virtual Hearing Registration