‘‘(6) ATTESTATION
OF
COMPLIANCE.—Begin-
ning on January 1, 2026, each group health plan 
and health insurance issuer offering group health in-
surance coverage shall annually submit to the Sec-
retary, the Secretary of Health and Human Services, 
and the Secretary of the Treasury an attestation of 
compliance with the requirements of this subsection. 
‘‘(7) CONSULTATION REQUIREMENT FOR RULE-
MAKING.—In promulgating regulations to carry out 
this subsection, the Secretary, the Secretary of 
Health and Human Services, and the Secretary of 
the Treasury shall jointly consult with dispensers of 
controlled substances, State insurance regulators, 
health insurance issuers offering group or individual 
health insurance coverage, and health care practi-
tioners.’’. 
(c) INTERNAL REVENUE CODE OF 1986 AMEND-
MENT.—Section 9822 of the Internal Revenue Code of 
1986 is amended by adding at the end the following new 
subsection: 
‘‘(d) 
REQUIREMENTS
FOR
ELECTRONIC-PRE-
SCRIBING FOR CONTROLLED SUBSTANCES.— 
‘‘(1) IN GENERAL.—Except as provided pursu-
ant to paragraph (2), for plan years beginning on or 
after January 1, 2026, a group health plan, with re-
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spect to a participating provider, as defined in sec-
tion 9816(a)(3), shall have in place policies, subject 
to paragraphs (4) and (5), that require any prescrip-
tion for a schedule II, III, IV, or V controlled sub-
stance (as defined by section 202 of the Controlled 
Substances Act) covered by the plan that is trans-
mitted by such a participating provider for such a 
participant or beneficiary be electronically trans-
mitted consistent with standards established under 
paragraph (3) of section 1860D–4(e) of the Social 
Security Act, under an electronic prescription drug 
program that meets requirements that are substan-
tially similar (as jointly determined by the Secretary, 
the Secretary of Health and Human Services, and 
the Secretary of Labor) to the requirements of para-
graph (2) of such section 1860D–4(e). 
‘‘(2) 
EXCEPTION
FOR
CERTAIN
CIR-
CUMSTANCES.—The Secretary, the Secretary of 
Health and Human Services, and the Secretary of 
Labor shall jointly, through rulemaking, specify cir-
cumstances and processes by which the requirement 
under paragraph (1) may be waived, with respect to 
a schedule II, III, IV, or V controlled substance that 
is a prescription drug covered by a group health, in-
cluding in the case of— 
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‘‘(A) a prescription issued when the par-
ticipating provider and dispensing pharmacy are 
the same entity; 
‘‘(B) a prescription issued that cannot be 
transmitted electronically under the most re-
cently implemented version of the National 
Council 
for 
Prescription 
Drug 
Programs 
SCRIPT Standard; 
‘‘(C) a prescription issued by a partici-
pating provider who received a waiver (which 
may include a waiver obtained pursuant to sec-
tion 1860D–4(e)(7)(B)(iii) of the Social Secu-
rity Act) or a renewal thereof for a period of 
time as determined by the Secretary, the Sec-
retary of Health and Human Services, and the 
Secretary of Labor, not to exceed one year, 
from the requirement to use electronic pre-
scribing due to demonstrated economic hard-
ship, technological limitations that are not rea-
sonably within the control of the participating 
provider, or other exceptional circumstance 
demonstrated by the participating provider; 
‘‘(D) a prescription issued by a partici-
pating provider under circumstances in which, 
notwithstanding the participating provider’s 
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ability to submit a prescription electronically as 
required by this subsection, such participating 
provider reasonably determines that it would be 
impractical for the individual involved to obtain 
substances prescribed by electronic prescription 
in a timely manner, and such delay would ad-
versely impact the individual’s medical condition 
involved; 
‘‘(E) a prescription issued by a partici-
pating provider prescribing a drug under a re-
search protocol; 
‘‘(F) a prescription issued by a partici-
pating provider for a drug for which the Food 
and Drug Administration requires a prescrip-
tion to contain elements that are not able to be 
included in electronic prescribing, such as a 
drug with risk evaluation and mitigation strate-
gies that include elements to assure safe use; 
‘‘(G) a prescription issued for an individual 
who receives hospice care or for a resident of a 
nursing facility (as defined in section 1919(a) 
of the Social Security Act); 
‘‘(H) a prescription issued under cir-
cumstances in which electronic prescribing is 
not available due to temporary technological or 
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electrical failure, as specified jointly by the Sec-
retary, the Secretary of Health and Human 
Services, and the Secretary of Labor through 
rulemaking; and 
‘‘(I) a prescription issued by a partici-
pating provider allowing for the dispensing of a 
non-patient specific prescription pursuant to a 
standing order, approved protocol for drug ther-
apy, collaborative drug management, or com-
prehensive medication management, in response 
to a public health emergency or other cir-
cumstances under which the participating pro-
vider may issue a non-patient specific prescrip-
tion. 
‘‘(3) RULES OF CONSTRUCTION.— 
‘‘(A) VERIFICATION.—Nothing in this sub-
section shall be construed as requiring a dis-
penser to verify that a participating provider, 
with respect to a prescription for a schedule II, 
III, IV, or V controlled substance that is a pre-
scription drug covered by a group health plan, 
has a waiver (or is otherwise exempt) under 
paragraph (2) from the requirement under 
paragraph (1). 
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‘‘(B) AUTHORITY TO DISPENSE.—Nothing 
in this subsection shall be construed as affect-
ing the ability of a group health plan to cover, 
or the ability of a dispenser to continue to dis-
pense, a prescription drug if the prescription 
for such drug is an otherwise valid written, 
oral, or fax prescription that is consistence with 
applicable laws and regulations. 
‘‘(C) PATIENT CHOICE.—Nothing in this 
subsection shall be construed as affecting the 
ability of an individual who is a participant or 
beneficiary of a group health plan and who is 
prescribed a schedule II, III, IV, or V con-
trolled substance that is a prescription drug 
covered by the plan to designate a particular 
dispenser to dispense a prescribed controlled 
substance to the extent consistent with the re-
quirements under this subsection. 
‘‘(4) 
REGULATIONS
ON
POLICY
REQUIRE-
MENTS.—The Secretary, the Secretary of Health 
and Human Services, and the Secretary of Labor 
shall promulgate regulations specifying requirements 
for the policies established by group health plans 
under paragraph (1). Such regulations shall include 
requirements for— 
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‘‘(C) reject, deny, or recoup reimbursement 
for a prescription drug claim based on the for-
mat in which the prescription was issued; or 
‘‘(D) require a participating provider to 
use a specific vendor for electronic prescribing 
or a specific electronic prescribing product or 
system. 
‘‘(6) ATTESTATION
OF
COMPLIANCE.—Begin-
ning on January 1, 2026, each group health plan 
shall annually submit to the Secretary, the Secretary 
of Health and Human Services, and the Secretary of 
Labor an attestation of compliance with the require-
ments of this subsection. 
‘‘(7) CONSULTATION REQUIREMENT FOR RULE-
MAKING.—In promulgating regulations to carry out 
this subsection, the Secretary, the Secretary of 
Health and Human Services, and the Secretary of 
Labor shall jointly consult with dispensers of con-
trolled substances, State insurance regulators, health 
insurance issuers offering group or individual health 
insurance coverage, and health care practitioners.’’. 
(d) UPDATE OF BIOMETRIC COMPONENT OF MULTI-
FACTOR AUTHENTICATION.—Not later than 1 year after 
the date of enactment of this Act, the Attorney General 
shall finalize a regulation updating the requirements for 
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the biometric component of multifactor authentication 
with respect to electronic prescriptions of controlled sub-
stances, as required under section 2003(c) of the SUP-
PORT for Patients and Community Act (Public Law 115– 
271). 
Æ 
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