By Anna Schwartz
On January 1, 2021, two laws imposing security prescription requirements on pharmacists and other licenses went into effect after nearly three years in the making. In September 2018, California first enacted AB 1753 (Low) (Chapter 479, Statutes of 2018), which introduced new formatting and printing requirements for written prescriptions of controlled substances. According to the author, the purpose of AB 1753 is to curb the “criminal enterprises [that] derive tremendous profit through prescription pad theft and fraud” as “addiction to pharmaceutical opioids grows.”
In March 2019, California enacted AB 149 (Cooper) (Chapter 4, Statutes of 2019), which details the specific security formatting requirements and includes a transition period from the date of passage to December 31, 2020, to support an orderly shift by prescribers to compliant prescription forms. Pursuant to AB 149, Health and Safety Code sections 11162.1 and 11162.2 set forth that all paper prescriptions for controlled substances must be written on California Security Prescription Forms, forms that can only be printed by approved printers in the California Department of Justice’s Security Prescription Printer Program. The security prescription forms contain fifteen security elements, including a barcode, unique serial number, and watermark to curtail counterfeit prescriptions.
On January 1, 2021, the transition period for AB 149 ended. As a result, except for limited emergency situations, pharmacists are unable to fill controlled substances’ written prescriptions that are not on a compliant form. To assist prescribers and furnishers with the change, the Board of Pharmacy, the Medical Board of California, and the California Department of Justice released a joint statement on November 19, 2020, to answer frequently asked questions about the new requirements. The Boards recommended to those who prescribe controlled substances and who have not acquired forms compliant with AB 149 to order them as soon as possible, or in lieu of using the new prescription forms, prescribers also have the option to utilize electronic prescribing, which becomes mandatory in 2022 pursuant to AB 2789 (Wood) (Chapter 438, Statutes of 2018). By 2022, all healthcare practitioners authorized to issue prescriptions must be able to electronically transmit prescriptions for both controlled and non-controlled substances unless specified exceptions are met.
Additionally, AB 149 revised data reporting requirements for controlled substances. Beginning January 1, 2021, the dispensing of a controlled substance must be reported to the Controlled Substance Utilization Review and Evaluation System (CURES) within one working day after the medication is released to the patient. Previously, the deadline to report was seven days after dispensing. According to the bill’s author, by mandating a tighter timeline, the law ensures that prescriptions filled using illegal forms can be linked to prescription data collected through the CURES database.