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 
or group or individual health insurance cov-
erage offered by a health insurance issuer, has 
a waiver (or is otherwise exempt) under para-
graph (2) from the requirement under para-
graph (1). 
‘‘(B) AUTHORITY TO DISPENSE.—Nothing 
in this subsection shall be construed as affect-
ing the authority of a group health plan or 
group or individual health insurance coverage 
offered by a health insurance issuer to cover, or 
the authority of a dispenser to continue to dis-
pense, a prescription drug if the prescription 
for such drug is an otherwise valid written, 
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oral, or fax prescription that is consistent with 
applicable law. 
‘‘(C) PATIENT CHOICE.—Nothing in this 
subsection shall be construed as affecting the 
ability of an individual who is a participant, 
beneficiary, or enrollee of a group health plan 
or group or individual health insurance cov-
erage offered by a health insurance issuer and 
who is prescribed a schedule II, III, IV, or V 
controlled substance that is a prescription drug 
covered by the plan or coverage to designate a 
particular dispenser to dispense a prescribed 
controlled substance to the extent consistent 
with the requirements under this subsection. 
‘‘(4) 
REGULATIONS
ON
POLICY
REQUIRE-
MENTS.—The Secretary, the Secretary of Labor, 
and the Secretary of the Treasury shall promulgate 
regulations specifying requirements for the policies 
established by group health plans and health insur-
ance issuers under paragraph (1). Such regulations 
shall include requirements for— 
‘‘(A) a uniform process by which plans and 
issuers are required to set the e-prescribing re-
quirements; 
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‘‘(B) a process by which plans and issuers 
are required to grant waivers and exceptions to 
participating providers pursuant to paragraph 
(2); and 
‘‘(C) a mechanism for plans and issuers to 
recognize waivers issued to participating pro-
viders under part D of title XVIII of the Social 
Security Act, pursuant to paragraph (2)(C). 
‘‘(5) PROHIBITIONS.—The policies established 
pursuant to paragraph (1) by a group health plan or 
health insurance issuer offering group or individual 
health insurance coverage may not— 
‘‘(A) require dispensers of a schedule II, 
III, IV, or V controlled substance to confirm 
that the prescription for the controlled sub-
stance was electronically issued by a partici-
pating provider in accordance with such poli-
cies, as described in paragraph (1); 
‘‘(B) require dispensers of such controlled 
substances to submit information or data be-
yond what is otherwise required to process a 
prescription drug claim in order to confirm a 
participating provider’s compliance with such 
policies; 
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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 
and health insurance issuer offering group or indi-
vidual health insurance coverage shall annually sub-
mit to the Secretary, the Secretary of Labor, and 
the Secretary of the Treasury an attestation of com-
pliance 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 the 
Labor, and the Secretary of the Treasury shall joint-
ly consult with dispensers of controlled substances, 
State insurance regulators, health insurance issuers 
offering group or individual health insurance cov-
erage, and health care practitioners.’’. 
(b) EMPLOYEE RETIREMENT INCOME SECURITY ACT 
OF 1974 AMENDMENT.—Section 722 of the Employee Re-
tirement Income Security Act of 1974 (29 U.S.C. 1185k) 
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is amended by adding at the end the following new sub-
section: 
‘‘(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 and a 
health insurance issuer offering group health insur-
ance coverage, with respect to a participating pro-
vider, as defined in section 716(a)(3), shall have in 
place policies, subject to paragraphs (4) and (5), 
that require any prescription for a schedule II, III, 
IV, or V controlled substance (as defined by section 
202 of the Controlled Substances Act) covered by 
the plan or coverage that is transmitted by such a 
participating provider for such a participant or bene-
ficiary be electronically transmitted 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 re-
quirements that are substantially similar (as jointly 
determined by the Secretary, the Secretary of 
Health and Human Services, and the Secretary of 
the Treasury) to the requirements of paragraph (2) 
of such section 1860D–4(e). 
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