After urging from AMA, Walmart pharmacies will continue to accept paper prescriptions for controlled substances

The sign at the front of a Walmart store
With many physicians unable to comply, Walmart has backtracked on a plan to only accept electronic prescriptions for controlled substances. (Jonathan Weiss/Shutterstock)

Walmart has decided to delay a new policy originally set to begin January 1 that would have required electronic prescriptions for controlled substances at its pharmacies.

The American Medical Association (AMA) had raised worries that the planned change could leave patients unable to fill prescriptions for controlled substances at the retailer’s almost 4,600 locations and in a letter asked Walmart to delay implementation.

The problem is that only 44% of providers are currently set up to meet the requirement for electronic prescriptions for controlled substances, the AMA said in a letter to Walmart.

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As some states have already done, Walmart planned to only accept electronic prescriptions for controlled substances, which include opioid painkillers and antidepressants.

But that has changed for Walmart and Sam’s Club customers. “We recognize not all provider networks and prescribers will have the technology and systems in place to accommodate this requirement, so we will continue to take non-electronic prescriptions so patients are not unintentionally negatively affected by this process,” Walmart spokeswoman Marilee McInnis said in an emailed statement Wednesday.

“We will continue to work collaboratively with prescribers to encourage their use of e-prescribing for controlled substances, as e-prescribing has the potential to reduce errors, misuse, abuse and diversion of prescription medications,” she said.

The AMA had expressed concern that patients being treated for a range of conditions including opioid use disorder, anxiety, depression, attention deficit hyperactivity disorder, autoimmune diseases, HIV/AIDS and painful conditions such as sickle cell disease could be left unable to fill their prescriptions at Walmart pharmacies if their provider did not have the proper technology.

The AMA sent a November 26 letter to Walmart’s chief medical and analytics officer Thomas Van Gilder, M.D., opposing the new policy and urging the retailer to delay implementation.

“The AMA is greatly concerned that this will lead to considerable disruption in patient care given the fact that only about 44% of physicians currently have the technology, hardware, and certifications required for EPCS [electronic prescriptions for controlled substances],” wrote James Madara, M.D., the AMA’s CEO.

Walmart had planned the move to digital prescriptions as part of its push to curtail the country’s opioid epidemic. Electronic prescribing potentially reduces fraud and prevents patients from getting multiple prescriptions for the same drug.

The AMA welcomed Walmart’s reversal. “The AMA welcomes Walmart’s decision to delay implementation of an electronic prescribing mandate that would have resulted in harm to millions of Americans, including many in rural areas who rely on Walmart as the only pharmacy in reasonable distance," said Patrice Harris, M.D., AMA president and chair of the AMA Opioid Task Force, in a statement emailed to Fierce Healthcare.

"The policy, which the AMA urged Walmart to delay, was not developed in consultation with the nation’s physicians, who support electronic prescribing of controlled substances, but want to see it implemented in a manner that supports—rather than disrupts—patient care,” said Harris. 

It’s unclear if Walmart will set a new cutoff date for accepting paper prescriptions.

RELATED: Rapid opioid cutoff risky too, feds warn

Starting January 1, six more states—Arizona, Florida, Iowa, North Carolina, Oklahoma and Rhode Island—will require electronic or e-prescriptions for controlled substances, according to USA Today.

Medicare Part D will require controlled substances prescriptions to be submitted electronically starting in January 2021.

In the letter to Walmart, Madara urged Walmart to align its timeframe for requiring electronic prescriptions for controlled substances with a change in federal law. As part of the SUPPORT for Patients and Communities Act, which President Donald Trump signed in October 2018 to combat the opioid epidemic, some Medicare prescriptions must be sent electronically starting Jan. 1, 2021.

There are significant regulatory barriers that have prevented widespread electronic prescribing for controlled substances, Madara said, including the need to update Drug Enforcement Administration (DEA) regulations, including a requirement for biometric authentication. He said requiring electronic prescriptions for controlled substances prior to those regulatory changes is likely to have unintended consequences.

The SUPPORT Act requires the agency to modify these requirements and the DEA is currently working to make these modifications.

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