Texas Medical Board

E-Prescribing Waiver

Controlled Substance Electronic Prescribing Requirement

Effective January 1, 2021, Texas Health and Safety Code, §§481.0755 requires that prescriptions for controlled substances to be issued electronically, except in limited circumstances, or unless a waiver has been granted by the appropriate agency.

A prescription for a controlled substance is not required to be issued electronically and may be issued in writing if the prescription is issued:

by a veterinarian;
in circumstances in which electronic prescribing is not available due to temporary technological or electronic failure, as prescribed by board rule;
by a practitioner to be dispensed by a pharmacy located outside this state, as prescribed by board rule;
when the prescriber and dispenser are in the same location or under the same license;
in circumstances in which necessary elements are not supported by the most recently implemented national data standard that facilitates electronic prescribing;
for a drug for which the United States Food and Drug Administration requires additional information in the prescription that is not possible with electronic prescribing;
for a non-patient-specific prescription pursuant to a standing order, approved protocol for drug therapy, collaborative drug management, or comprehensive medication management, in response to a public health emergency or in other circumstances in which the practitioner may issue a non-patient-specific prescription;
for a drug under a research protocol;
by a practitioner who has received a waiver from the requirement to use electronic prescribing;
under circumstances in which the practitioner has the present ability to submit an electronic prescription but reasonably determines that it would be impractical for the patient to obtain the drugs prescribed under the electronic prescription in a timely manner and that a delay would adversely impact the patient's medical condition; or
before January 1, 2021.

A physician may apply for a waiver from the electronic prescribing requirement by:

submitting a waiver request to the TMB and providing required information, and
demonstrating circumstances necessitating a waiver from the requirement, including
- economic hardship, including:
  - any special situational factors affecting either the cost of compliance or ability to comply;
  - the likely impact of compliance on profitability or viability; and
  - the availability of measures that would mitigate the economic impact of compliance;
- technological limitations not reasonably within the control of the physician; or
- other exceptional circumstances.

Request a waiver

The Electronic Prescribing Waiver form is available for submission through your MyTMB account.

Verification of an approved waiver will be displayed on the physician profile once granted.
Once approved, waivers will be issued for a period of one year.
Physicians may apply for a subsequent waiver no more than 30 days before an active waiver expires.

Please contact Registrations@tmb.state.tx.us if you have any questions or need assistance.

How can I apply for a waiver?

To apply for a waiver, go to your MyTMB portal and sign in. Once you sign in, you can click on the e-prescribing waiver icon. This will take you to the online waiver application. The e-prescribing waiver icon looks like this:

Electronic Prescribing Waiver Icon

What do I need to submit to TMB in order to qualify for a waiver?

At this time, all you must do is fill out the waiver application. No additional information is currently required.

How do I qualify for the waiver?

There are three different ways you can qualify for a waiver. If you or your practice is experiencing any of the following, you may qualify for a waiver:

By experiencing economic hardship. When evaluating whether you are experiencing economic hardship, consider:
1. special situational factors which affect either the cost of compliance or your ability to comply;
2. the likely impact of compliance on profitability or viability; and
3. the availability of measures that would mitigate the economic impact of complying.

If your practice has technological limitations not reasonably within your control.
Other exceptional circumstances that would lead to you or your practice being unable to set up an e-prescribing process.

On the waiver form, you will have to specify any of the above categories you are experiencing.

How will I be notified if I am granted a waiver?

If you are granted a waiver, it will be displayed on your public physician profile. This alone will serve as proof of your waiver. Generally, waiver requests are determined within 2-3 business days. You are encouraged to check your profile daily upon submitting your waiver request. You may also choose to print a simple copy of the ‘Verified Information’ section of your profile, which includes your waiver status, by choosing the “Print Verification” option on your profile.

Does everyone at my practice have to apply for a waiver or just the medical director?

Currently, each individual physician who needs a waiver will have to apply for their own individual waiver. Although this may change in the future, TMB is currently unable to track waivers by group.

Do delegates who have prescribing authority have to apply for their own waiver or are they covered by the supervising physician’s waiver?

If the supervising physician has a waiver, then the prescribing delegate is also covered under that waiver. So long as the prescribing delegate is prescribing under the authority of a physician who has been granted a waiver, then the prescribing delegate may use non-electronic prescribing means. If a prescribing delegate is issuing a prescription under the authority of a physician who does not have a waiver, then the prescribing delegate must issue the prescription via e-prescribing.

If an individual wants to look up whether a prescribing delegate has a waver they can do so as listed below:

For physician assistants: A PA’s waiver status will not be viewable on their TMB public profile. Each PA’s public profile has a link to their supervising physician’s profile page. The physician’s profile page will list the waiver status.

For nurse practitioners: APRN waivers are determined by the Texas Board of Nursing. Information on the waiver process for the APRNs is available on the Texas Board of Nursing Website.

Do I need a waiver for each of my practice locations?

No. If you are granted a waiver, it applies to all your Texas practice locations.

How can someone determine if a practitioner has a waiver?

If a physician has a waiver from e-prescribing, it is viewable on their public profile page, under the section entitled “Verified Information.” If you want to verify that a PA or nurse practitioner has a waiver, you will have to look at the delegating physician’s public profile. You can look up a prescriber’s public profile here: Look up a License

NOTE: Per the Texas State Board of Pharmacy, a “pharmacist is not responsible for ensuring there is a waiver. In addition, there is no requirement of the pharmacist to ensure an appropriate waiver is granted.”