The California Medical Association (CMA) has received numerous calls from physicians whose prescriptions are being turned away by pharmacies for being non-compliant with state law. Specifically, the forms in question do not have checkboxes to indicate refills.

California law requires 14 elements that must appear on California security prescription forms, including "check boxes that shall be printed on the form so that the prescriber may indicate the number of refills ordered." Security forms that lack the check boxes, even if they indicate refills in a different way, are deemed non-compliant. This requirement took effect in 2007.

In recent weeks, some pharmacies have begun to refuse to fill prescriptions written on non-compliant forms. The California Board of Pharmacy also recently reminded licensees that will it cite and fine pharmacists/pharmacies who dispense controlled drugs with non-compliant forms.

According to the Board of Pharmacy, physicians who are using non-compliant forms should educate themselves on the required elements of the security prescription forms, order compliant forms from a Department of Justice-licensed security printer and consider using e-prescribing for controlled substances.

In the meantime, if you do not have compliant forms, remember that Schedule III-V controlled substances may be filled as an oral prescription if the pharmacist verifies verbally with the prescriber the number of any refills ordered and notes it on the security form. For Schedule II medications—where there are no alternatives, such as the availability of compliant forms or e-prescribing—the Board of Pharmacy allows use of a non-compliant form on a temporary basis to allow patients to receive any Schedule II medications in a timely manner. There are further exemptions to the security form requirements for a prescription for controlled substances for use by a patient who has a terminal illness.

For more information on the California security prescription form requirements and exceptions, see CMA On-Call document #3201, “Controlled Substances: Prescribing.” CMA On-Call documents are available free to members in CMA's online health law library at www.cmanet.org/cma-on-call. Nonmembers can purchase documents for $2 per page.

CMA members also receive 15 percent off all orders of compliant California security prescription pads and electronic health record printer paper from RxSecurity.

Contact: CMA legal information line, (800) 786-4262 or legalinfo@cmadocs.org