§ 23 — Written or electronic prescriptions; requirements and restrictions

Section 23. (a) A written or electronic prescription for a controlled substance in Schedule II shall become invalid 30 days after the date of issuance.(b) A written or electronic prescription for a controlled substance in schedule II shall not be refilled. Written prescriptions for a controlled substance in schedule II shall be kept in a separate file.(c) The pharmacist filling a written or electronic prescription for a controlled substance in Schedule II shall endorse his own signature on the face thereof.[ Subsection (d) effective until July 1, 2024. For text effective July 1, 2024, see below.](d) In regard to a controlled substance in Schedule II or III, no prescription shall be filled for more than a thirty-day supply of such substance upon any single filling; provided, however, that with regard to dextro amphetamine sulphate and methyl phenidate hydrochloride, a prescription may be filled for up to a sixty-day supply of such substance upon any single filling if said substance is being used for the treatment of minimal brain dysfunction or narcolepsy; provided further, that subject to regulations of the department and the board of pharmacy, prescriptions for implantable infusion pumps consisting of Schedule II or Schedule III controlled substances may be filled for a maximum of 90 days.[ Subsection (d) as amended by 2024, 140, Sec. 110 effective July 1, 2024. See 2024, 140, Sec. 264. For text effective until July 1, 2024, see above.](d) Unless otherwise prohibited by statute, prescriptions for the following controlled substances in Schedule II or III may be filled for a maximum of a 90-day supply of such substance upon a single filling for: (i) the treatment of opioid use disorder, including, but not limited to, buprenorphine; (ii) non-opioid controlled substances, including, but not limited to, methylphenidate and testosterone; and (iii) implantable infusion pumps. All other prescriptions for controlled substances in Schedule II or III may be filled for a maximum of a 30-day supply of such substance upon a single filling. Notwithstanding this subsection, the department may provide by regulation that a prescription for a substance in Schedule II or III may be filled for a maximum of less than a 90-day supply upon a single filling if the secretary of health and human services or the board of pharmacy determines that such restriction is needed to address increased abuse of the substance.(e) All prescriptions for controlled substances shall be kept for two years by the pharmacy and shall be subject to inspection pursuant to the provisions of this chapter.(f) No prescription for a controlled substance shall be refilled unless the original prescription provides for such refilling and unless the number of refills has been specified in said prescription.(g) Prescribers shall issue an electronic prescription for all controlled substances and medical devices. The department shall promulgate regulations setting forth standards for electronic prescriptions.(h) The commissioner, through regulation, shall establish exceptions to section 17 and subsection (g) authorizing the limited use of a written and oral prescription where appropriate. The exceptions shall be limited to: (i) prescriptions that are issued by veterinarians; (ii) prescriptions issued or dispensed in circumstances where electronic prescribing is not available due to temporary technological or electrical failure; (iii) a time-limited waiver process for practitioners who demonstrate economic hardship, technological limitations that are not reasonably within the control of the practitioner, or other exceptional circumstance; (iv) prescriptions that are issued or dispensed in emergency situations as defined by the commissioner pursuant to said section 17, including situations where the electronic prescription requirement would result in a delay that would adversely impact the patient's medical condition; (v) when a prescription cannot be issued electronically under federal or state law or regulations; (vi) prescriptions issued outside the jurisdiction of the commonwealth; and (vii) other exceptions to said section 17 and said subsection (g) as the commissioner determines necessary; provided, however, that 90 days before promulgating or amending any regulations regarding other exceptions to said section 17 and said subsection (g), the commissioner shall file with the house and senate committees on ways and means, the joint committee on public health, and the joint committee on mental health, substance use and recovery a written report setting forth justification for such changes.(i) All written prescriptions shall be written in ink, indelible pencil or by other means on a tamper resistant form consistent with federal requirements for Medicaid and signed by the prescribing practitioner.