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SCRIPTS System Must be Reviewed to Prescribe Schedule II Mediation

On May 19, 2017, Governor Henry McMaster signed into law the mandate that all licensed professionals with prescriptive authority, including physicians, physician assistants, dentists, optometrists, advanced practice nurses and podiatrists, implement and review a patient's history in the South Carolina Reporting and Identification Prescription Tracking System  ("SCRIPTS") before prescribing Schedule II pain medication.

The SCRIPTS system review requirement allows a designated staff member to review the SCRIPTS system on behalf of the licensed practitioner. If a designated staff member reviews patient information in the SCRIPTS system on behalf of the licensed professional, the licensed professional must discuss the patient's prescription history in the SCRIPTS system with the delegate before prescribing a Schedule II controlled substance. The communication must be reflected in writing in the patient’s chart.  When prescribing a Schedule II medication, licensed professionals should document the medication and the quality of pills prescribed in the patient's chart to ensure compliance with the relevant LLR practice act.

Failure to use the SCRIPTS system as required can result in consequences, including referral to the appropriate South Carolina Department of Labor, Licensing, and Regulation Board for  investigation and potential disciplinary action.  Our professional licensing attorneys routinely defend LLR investigations including South Carolina Board of Nursing complaints, Medical Board complaints, and Dental Board complaints.  

Registering for the SCRIPTS System

There is no charge to register for the SCRIPTS system. Registration for the SCRIPTS system can be accessed here.  Any delegate authorized by the practice to access and review SCRIPTS must be separately registered.

Information Contained in SCRIPTS

According to the South Carolina Department of Health and Environmental Control, SCRIPTS includes prescription information for Schedule II, III, and IV drugs. The System tracks medication dispensed by all retail and outpatient hospital pharmacies.  It does not include most long term care or assisted living administered medication, information from a methadone clinic, emergency room prescribing less than a 2 day supply or medication dispensed by a veterinarian. Information contained in the SCRIPTS system includes the practitioner who prescribed the medication, the duration and amount of controlled medication prescribed, and the pharmacy who dispensed the prescription.

Exceptions to the SC SCRIPTS System Mandate

Although review of the SCRIPTS system is generally required, there are certain exceptions when use of the SCRIPTS system is not mandated.  Exceptions to the new South Carolina law include:

  • Prescribing a Schedule II controlled substance to treat a hospice-certified patient;
  • Prescribing a Schedule II controlled substance that does not exceed a five-day supply for a patient;
  • Prescribing a Schedule II controlled substance for a patient with whom the practitioner has an established relationship for the treatment of a chronic condition.  If an established relationship is maintained, the practitioner must review the patient's controlled substance history maintained in the SCRIPTS system at least every three months;
  • Approving the administration of a Schedule II controlled substance by a health care provider licensed in South Carolina;
  • Prescribing a Schedule II controlled substance for a patient in a skilled nursing facility, nursing home, community residential care facility, or an assisted living facility provided that the patient's medications are stored, given, and monitored by staff; or
  • A practitioner unable to immediately access the prescription monitoring program due to exigent circumstances. In the event of an emergency, the exigent circumstances and the potential adverse impact to the patient if the prescription is not issued timely must be documented in the patient's medical record.

A South Carolina professional with prescriptive authority is compliant with this section if the practitioner utilizes technology that automatically displays the patient's controlled substance prescription history from the prescription monitoring program in the practitioner's electronic medical record system. Deployment of the EMR system is all that is required; no additional documentation is required in the patient's medical record.

Other pain management guidelines including the Joint Revised Pain Management Guidelines devised by the South Carolina Board of Medical Examiners, Dentistry, and Nursing remain in effect.

If you have questions concerning how and whether the SCRIPTS system may apply to your practice, give us a call today.

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