Arkansas Controlled Substance Prescription Requirements

To prescribe a controlled substance in Arkansas, you must send the prescription electronically for any drug in Schedules II through VI, follow the refill and validity limits set for each schedule, check the Prescription Drug Monitoring Program before writing opioids or a patient’s first benzodiazepine, and sign the prescription using a DEA-compliant two-factor system. Arkansas controlled substance prescription requirements are set out in Arkansas Code § 5-64-308 and enforced with a $250 civil penalty per violation, on top of federal DEA and CMS rules that govern how your prescribing system is set up and how you treat Medicare Part D patients.

The Electronic Prescribing Mandate

Every prescription for a controlled substance in Schedule II through Schedule VI must be transmitted electronically unless an exception applies.¹ Most states stop at the federal five-schedule system. Arkansas adds a sixth schedule covering marijuana, tetrahydrocannabinols, salvia divinorum, and several classes of synthetic cannabinoids, and prescriptions involving those substances fall under the mandate as well.²

The rule is now fully in effect. Enforcement originally lined up with a federal certification date; CMS later set its federal enforcement date to January 1, 2022, which pushed Arkansas’s practical compliance deadline to the same point.³

When You Can Still Use Paper, Oral, or Fax

The statute lets you fall back on written, oral, or faxed prescriptions in a defined set of situations:

Veterinary prescribers are fully exempt from the electronic requirement.
Prescriptions filled at a pharmacy located outside Arkansas may use a non-electronic method.
When the FDA requires a prescription to include information that electronic systems cannot capture, you may use an alternative format.
Standing orders, approved drug therapy protocols, collaborative drug management orders, and prescriptions issued during a public health emergency are not subject to the mandate.
Controlled substances prescribed under a research protocol are exempt.
When e-prescribing is unavailable because of a system outage or electrical failure, you can revert to written, oral, or faxed methods.¹

Pharmacists on the receiving end are not required to independently verify that a non-electronic prescription qualifies for one of these exceptions. A pharmacist may dispense from an otherwise valid written, oral, or faxed prescription that is consistent with state and federal law.³

Validity and Refills by Schedule

Schedule II

A Schedule II controlled substance cannot be dispensed without a practitioner’s prescription, whether written, oral, faxed, or electronic, and the prescription must comply with federal law. Schedule II carries no refill allowance under federal or Arkansas law. Each new supply requires a new prescription.⁴

Schedules III and IV

A prescription for a Schedule III or IV drug expires six months from the date it was issued. Within that window, it may be refilled up to five times. After five refills or six months, whichever comes first, you have to write a new prescription.⁴

Schedule V

Schedule V substances may only be distributed or dispensed for a medical purpose. The statute does not spell out numeric refill limits for Schedule V the way it does for III and IV, but the medical-purpose requirement means a practitioner must have a documented clinical reason behind every dispensing event.⁴

PDMP Checks Before Prescribing

You must query the state Prescription Drug Monitoring Program every time you prescribe a Schedule II or III opioid, and the first time you prescribe a benzodiazepine to a patient.⁵ Licensed oncologists follow a different schedule: a check at the initial malignant diagnosis and then every three months while treatment continues.

The PDMP check does not apply in several clinical settings. Controlled substances administered immediately before, during, or after surgery in a healthcare facility are exempt. So are medications given at the scene of an emergency, in a ground or air ambulance, or in an intensive care unit. Hospice and palliative care prescriptions are excluded, as are prescriptions for residents of licensed nursing home facilities. When the PDMP itself is inaccessible because of a technological or electrical failure, the check is excused.⁵

Federal DEA Standards for Signing Prescriptions

Complying with Arkansas’s mandate also means satisfying DEA rules on how electronic prescriptions for controlled substances are produced and signed. Both the prescribing application and the pharmacy application have to meet DEA security standards before any controlled substance prescription can be transmitted electronically.⁶

Before you can sign, you have to complete identity proofing through a federally approved credential service provider or certification authority at NIST Special Publication 800-63 Assurance Level 3. In-person and remote proofing are both acceptable. In institutional settings such as hospitals, a designated person must verify your government-issued photo ID and confirm your state license and DEA registration before issuing you a credential.

Each prescription must be signed with two-factor authentication, combining two of three: something you know (a password or PIN), something you have (a hard token stored separately from the prescribing computer), or something you are (a biometric such as a fingerprint). You must keep sole possession of the hard token. Sharing credentials or allowing anyone else to sign prescriptions on your behalf is not permitted.⁶

Medicare Part D Prescribers: The 70% Rule

If you write any controlled substance prescriptions for Medicare Part D beneficiaries, CMS requires that at least 70% of your qualifying Schedule II through V Part D controlled substance prescriptions be transmitted electronically.⁷ The program applies whether or not you formally participate in Medicare, as long as you issued Part D controlled substance prescriptions during the measurement year.

CMS calculates your compliance automatically from Part D claims data, so you do not file anything to be measured. Prescriptions for beneficiaries in long-term care facilities are excluded from the calculation until January 1, 2028. Prescribers who write 100 or fewer qualifying controlled substance prescriptions during the measurement year, and those located in a disaster or emergency area as determined by CMS, receive automatic exceptions. Prescribers who cannot meet the 70% threshold because of circumstances beyond their control may apply for a waiver through the CMS EPCS Prescriber Portal in the fall after the measurement year. Non-compliance can be flagged in CMS fraud, waste, and abuse assessments and, where evidence of fraud is present, may lead to law enforcement referrals or revocation of billing privileges.⁸

Recordkeeping

Federal law requires every DEA registrant to retain controlled substance records for at least two years from the date of the inventory or record. That covers purchasing records, shipping documents, inventories, usage logs, and disposal paperwork.⁹ Electronic prescriptions generate their own audit trail, but the two-year floor still applies to the underlying records. If any records are copied during a DEA inspection, keep them for an additional two years from the date of copying.

Penalties for Non-Compliance

A prescriber who fails to use electronic prescribing when required faces a civil penalty of $250 per violation, imposed by the prescriber’s licensing board.¹ The statute describes this penalty as “in addition to other penalties available under this chapter,” so licensing boards keep their existing disciplinary authority over prescribing violations and can impose additional sanctions depending on the pattern and severity.

The per-violation structure means costs climb quickly. A practice that routinely sends even a few dozen non-qualifying paper prescriptions a month can run up thousands of dollars in penalties. Prescribers who also treat Medicare Part D patients carry a second layer of exposure, because dropping below the 70% electronic threshold can trigger federal fraud and abuse reviews.⁸

1
Justia. Arkansas Code 5-64-308 – Prescriptions – Mandatory Electronic Prescribing
2
Justia. Arkansas Code 5-64-215 – Substances in Schedule VI
3
Arkansas Department of Health. Electronic Prescriptions for Controlled Substances – Delay in Implementation for Enforcement
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Justia. Arkansas Code 5-64-308 – Prescriptions
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Arkansas Department of Health. Rules Pertaining to Arkansas Prescription Drug Monitoring Program
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DEA Diversion Control Division. Electronic Prescriptions for Controlled Substances (EPCS) Q&A
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CMS.gov. CMS EPCS Program Requirement At-A-Glance
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CMS.gov. CMS Electronic Prescribing for Controlled Substances (EPCS) Program
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eCFR. 21 CFR 1304.04 – Maintenance of Records and Inventories