‘‘(2) 
EXCEPTION
FOR
CERTAIN
CIR-
CUMSTANCES.—The Secretary, the Secretary of 
Health and Human Services, and the Secretary of 
the Treasury shall jointly, through rulemaking, 
specify circumstances and processes by which the re-
quirement under paragraph (1) may be waived, with 
respect to a schedule II, III, IV, or V controlled sub-
stance that is a prescription drug covered by a group 
health plan or group health insurance coverage of-
fered by a health insurance issuer, including in the 
case of— 
‘‘(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-
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retary of Health and Human Services, and the 
Secretary of the Treasury, not to exceed one 
year, from the requirement to use electronic 
prescribing 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 
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-
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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 
electrical failure, as specified jointly by the Sec-
retary, the Secretary of Health and Human 
Services, and the Secretary of the Treasury 
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. 
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‘‘(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 health insurance coverage offered by a 
health insurance issuer to cover, or the author-
ity of a dispenser to continue to dispense, a pre-
scription drug if the prescription for such drug 
is an otherwise valid written, oral, or fax pre-
scription 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 or 
beneficiary of a group health plan or group or 
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individual health insurance coverage 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 Health 
and Human Services, and the Secretary of the 
Treasury shall promulgate regulations specifying re-
quirements for the policies established by group 
health plans and health insurance issuers under 
paragraph (1). Such regulations shall include re-
quirements for— 
‘‘(A) a uniform process by which plans and 
issuers are required to set the e-prescribing re-
quirements; 
‘‘(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-
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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 health insur-
ance 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; 
‘‘(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. 
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