SB 5380 Waiver Attestation Forms

Electronic Prescribing Waiver Attestation Form
Electronic prescribing waiver attestation form image

Washington State law mandates all health care practitioners to communicate prescriptions and prescriptions refills for Schedule II-V controlled substances. These scripts must be sent electronically.

The law also allows a waiver from complying with the mandate under certain circumstances. Any practitioner meeting one of the below qualifications for a waiver may automatically receive one by submitting an attestation form.

Attestations last for one year and may be renewed two (2) times for a total of three (3) waivers, except in the case of other exceptional circumstance waivers. Other exceptional circumstance waivers may be submitted an unlimited number of times.

Please note: Waivers are valid for one calendar year. Beginning in December each year you may submit a waiver for the following year. Waivers submitted part way through the year are valid for that calendar year and will not be prorated.

Only one reason is needed per attestation form.

Attestation form qualifications

Economic hardship may only be renewed twice.

1. Bankruptcy: A bankruptcy in the previous year or submitted an attestation for a waiver under this chapter due to a bankruptcy in the previous year

2. Opening new: Opening a new practice after January 1, 2020

3. Discontinue operating: Intent to discontinue operating in Washington prior to December 31, 2022

4. Low-income clinic: Operating a low-income clinic (Defined as a clinic serving a minimum of thirty percent Medicaid patients)

Technological Limitations: (May only be renewed twice)

5. Technological limitations: Technological limitations outside the control of the practitioner if the practitioner is in the process of transitioning to an electronic prescription system

Unforeseen circumstances: (Must be renewed annually)

6. Free clinic: The practitioner is providing services at a free clinic

7. Low number of prescriptions: The practitioner generates fewer than one hundred prescriptions of Schedules II through V drugs in a one-year period, including both new and refill prescriptions

8. Location: The practitioner is in an area without sufficient internet access to comply with the e-prescribing mandate

9. Unforeseen circumstances: Unforeseen circumstances that stress the practitioner or health care system in such a way that compliance is not possible. (Examples may include, but are not limited to, natural disasters, wide-spread health care emergencies, unforeseeable barriers to electronic prescribing, or unforeseen events that result in a statewide emergency.)

Submit your attestation form

Please note: Practitioners who are exempted from the electronic prescribing mandate do not need to submit a waiver. Before submitted a waiver, consider if one of the following waivers applies.

  • Prescriptions issued by veterinarians.
  • Prescriptions issued for a patient of a long-term care facility or a hospice program.
  • When the electronic system used for the communication of prescription information is unavailable due to a temporary technological or electronic failure.
  • Prescriptions issued that are intended for prescription fulfillment and dispensing outside Washington state.
  • When the prescriber and pharmacist are employed by the same entity, or employed by entities under common ownership or control
  • Before submitted a waiver, consider if one of the following waivers applies.
  • Any controlled substance prescription that requires compounding.
  • Prescriptions issued for the dispensing of a non-patient specific prescription under a standing order, approved protocol for drug therapy, collaborative drug therapy agreement, in response to a public health emergency, or other circumstances allowed by statute or rule where a practitioner may issue a non-patient specific prescription.
  • Prescriptions issued under a drug research protocol.
  • Prescriptions issued by a practitioner with the capability of electronic communication of prescription information under this section, when the practitioner reasonably determines it is impractical for the patient to obtain the electronically communicated prescription in a timely manner, and such delay would adversely impact the patient's medical condition.
  • Prescriptions issued by a prescriber who has received a waiver from the department.

The Department of Health may audit waiver attestations submitted by a practitioner to determine compliance. Knowingly submitting a false attestation is grounds for disciplinary action against a practitioner's license by the appropriate disciplinary authority.

Any questions please contact your program manager, executive director, or program staff.

Frequently asked questions coming soon!

EHR/PMP Integration Waiver Attestation Form
EHR-PMP integration waiver attestation form

Washington State law requires all facilities, entities, offices, or provider groups with ten(10) or more prescribers using a federally certified electronic health records (EHR) system must demonstrate that EHR system is able to fully integrate data to and from the prescription monitoring program using a mechanism approved by the Department of Health.

The department may issue a waiver of this requirement to any facility, entity, office, or provider group that meets one of the qualifications for a waiver. Waivers will be granted upon submittion of an attestation form.

Attestations last for one year and may be renewed two (2) times for a total of three (3) waivers, except in the case of other exceptional circumstance waivers. Other exceptional circumstance waivers may be submitted an unlimited number of times.

Please note: Waivers are valid for one calendar year. Beginning in December each year you may submit a waiver for the following year. Waivers submitted part way through the year are valid for that calendar year and will not be prorated.

Only one reason is needed per attestation form.

Attestation form qualifications

Economic hardship may only be renewed twice.

1. Bankruptcy: A bankruptcy in the previous year or submitted an attestation for a waiver under this chapter due to a bankruptcy in the previous year

2. Opening new: Opening a new practice after January 1, 2020

3. Discontinue operating: Intent to discontinue operating in Washington prior to December 31, 2022

4. Low-income clinic: Operating a low-income clinic (Defined as a clinic serving a minimum of thirty percent Medicaid patients)

Technological Limitations (may only be renewed twice)

5. Integration in process: Integration of electronic health records system with the PMP through a method approved by the department is in process but has not yet been completed

Other Exceptional Circumstances (must be renewed annually)

6. Free clinic: Providing services at a free clinic

7. Internet Speed: The internet speed or bandwidth required to integrate an electronic health record with the prescription monitoring program through a method approved by the department is not available

8. No Integration Method: The technology to connect the electronic health record of the entity requesting the waiver to the prescription monitoring program through a method approved by the department does not exist

9. Few prescriptions: Fewer than one hundred prescriptions for Schedule II-V drugs are generated in a calendar year

10. Unforeseen circumstances: Unforeseen circumstances that stress the practitioner or health care system in such a way that compliance is not possible. (Examples may include, but are not limited to, natural disasters, wide-spread health care emergencies, unforeseeable barriers to electronic prescribing, or unforeseen events that result in a statewide emergency.)

Submit your attestation form.

If you have any questions please contact the PMP department.

Frequently asked questions coming soon!