Michigan prescribers have until at least January 1, 2023, before they will be required to electronically transmit all prescriptions for controlled and non-controlled substances.  This delay is due to the Centers for Medicare & Medicaid’s (CMS) decision to postpone enforcement of Medicare’s e-prescribing mandate.

Earlier this fall, the Michigan Department of Licensing and Regulatory Affairs (LARA) sent a formal statement to prescribers and stakeholders confirming that the Bureau of Professional Licensing’s (BPL) enforcement of the electronic prescribing standard will coincide with the CMS’s enforcement schedule for Part D prescription drug programs.  The 2022 Medicare Physician Fee Schedule Final Rule extended the date of compliance actions to no earlier than January 1, 2023.

Michigan’s statute allows for a waiver to be issued if a prescriber cannot meet the electronic prescribing requirements.  Rules promulgated by LARA address the process for obtaining a waiver and related eligibility criteria.  They are expected to be finalized by the end of 2021.  Once the rules are in place, BPL will have a process for applying for a waiver. The form and instructions for applying for the waiver will be posted on their website, www.michigan.gov/bpl. MSMS actively participated in the public comment process, submitting several suggested changes that were incorporated by LARA.

In addition to the waiver, Michigan’s statute provides the following exceptions to the e-prescribing mandate:

• If the prescription is issued by a prescriber who is a veterinarian licensed under this article.
• If the prescription is issued under a circumstance in which electronic transmission is not available due to a temporary technological or electrical failure.
• If the prescription is issued by a prescriber who has received a waiver from the department under subsection (7).
• If the prescription is issued by a prescriber who reasonably believes that electronically transmitting the prescription would make it impractical for the patient who is the subject of the prescription to obtain the prescription drug in a timely manner and that the delay would adversely affect the patient's medical condition. A prescriber who does not electronically transmit a prescription under this subdivision shall document the specific reason for his or her belief that the delay would adversely affect the patient's medical condition.
• If the prescription is orally prescribed under section 7333(3) or (4).
• If the prescription is issued by a prescriber to be dispensed outside of this state.
• If the prescription is issued by a prescriber who is located outside of this state to be dispensed by a pharmacy located inside of this state.
• If the prescription is issued and dispensed in the same health care facility and the individual for whom the prescription is issued uses the drug exclusively in the health care facility. As used in this subdivision, "health care facility" includes, but is not limited to, any of the following:
  • A hospital.
  • A hospice.
  • A dialysis treatment clinic.
  • A freestanding surgical outpatient facility.
  • A skilled nursing facility.
  • A long-term care facility that provides rehabilitative, restorative, or ongoing skilled nursing care to an individual who is in need of assistance with activities of daily living.

• If the prescription contains content that is not supported by the National Council for Prescription Drug Programs Prescriber/Pharmacist Interface SCRIPT Standard.
• If the prescription is for a drug for which the FDA requires the prescription to contain content that cannot be transmitted electronically.
• If the prescription is issued under circumstances in which the prescriber is not required to include on the prescription a name of a patient for whom the prescription is issued including, but not limited to, a prescription issued under section 5110.
• If the prescription is issued by a prescriber who is prescribing the drug under a research protocol.
• If the prescription is dispensed by a dispensing prescriber.
• If the prescription is for a dialysis-related drug that is administered as part of or incident to a home-based dialysis treatment.