Module 1: Introduction to OARRS

The Ohio Automated Rx Reporting System (OARRS) is Ohio's prescription monitoring program that tracks controlled substance prescriptions, including medical cannabis. Understanding OARRS is crucial for compliant dispensary operations.

Learning Objectives

  • Understand OARRS' role in Ohio's medical cannabis program
  • Learn the legal requirements for OARRS reporting
  • Identify key stakeholders in the OARRS system
  • Recognize the importance of accurate patient tracking

What is OARRS?

OARRS is Ohio's state-run prescription drug monitoring program (PDMP) that collects information on all controlled substance prescriptions dispensed by Ohio-licensed pharmacies and prescribers. For medical cannabis:

Key OARRS Functions for Cannabis:

  • Patient Registry: Maintains active medical marijuana patient and caregiver registrations
  • Purchase Tracking: Monitors daily and 90-day purchase limits
  • Recommendation Verification: Validates physician recommendations
  • Cross-Dispensary Visibility: Shows patient purchases across all Ohio dispensaries
  • Compliance Monitoring: Helps prevent diversion and ensure legal compliance

Legal Framework

OARRS operates under several Ohio statutes and regulations:

  • ORC 4729.80: Establishes the prescription monitoring program
  • ORC 3796.04: Requires dispensaries to check OARRS before dispensing
  • OAC 3796:6-3-18: Details dispensary reporting requirements
  • OAC 3796:6-3-04: Specifies patient verification procedures

⚠️ Mandatory Compliance

Failure to properly check OARRS before each medical cannabis sale can result in:

  • License suspension or revocation
  • Civil penalties up to $50,000
  • Criminal charges for willful violations
  • Personal liability for dispensary agents

OARRS vs. Traditional Pharmacy PDMP

Feature Traditional PDMP Cannabis OARRS
Prescription Required Yes No (Recommendation)
Fill Limits Per prescription Daily/90-day limits
Product Types FDA-approved drugs Cannabis products
Reporting Timeline Next business day Real-time via METRC
Patient Registry No Yes (MMCP)

Key Stakeholders

Patients

Must maintain active registration and valid recommendation

Caregivers

Designated individuals authorized to purchase for patients

Physicians

Issue recommendations and can view patient purchase history

Dispensaries

Must verify and report all transactions

Board of Pharmacy

Oversees OARRS and enforces compliance

Law Enforcement

Can access for investigations with proper authorization

Integration with Medical Cannabis Program

OARRS serves as the bridge between various systems in Ohio's medical cannabis program:

Patient Registry

MMCP registration data flows to OARRS

→
OARRS Database

Centralizes patient and purchase data

→
Dispensary POS

Queries OARRS for verification

→
METRC

Reports sales back to OARRS

Knowledge Check

Answer these questions to test your understanding:

  1. What does OARRS stand for?
  2. Name three consequences of failing to check OARRS before a sale
  3. How does cannabis OARRS differ from traditional pharmacy PDMP?
  4. Which Ohio statute requires dispensaries to check OARRS?

Module 2: System Setup & Access

Proper OARRS setup and access management is fundamental to maintaining compliance. This module covers account creation, security requirements, and integration setup.

Account Registration Process

Every dispensary employee who will access OARRS must have their own account:

Registration Requirements

  • Valid Ohio dispensary employee license
  • Dispensary DEA registration number
  • Official dispensary email address
  • Supervisor approval documentation
  • Completed OARRS training certificate

Account Types and Permissions

Security Requirements

⚠️ OARRS Security Standards

  • Passwords must be minimum 12 characters with complexity requirements
  • Two-factor authentication is mandatory
  • Sessions timeout after 15 minutes of inactivity
  • Account lockout after 3 failed login attempts
  • All access is logged and audited

Integration Setup

OARRS can be accessed through multiple methods:

1. Web Portal Access

Pros: No integration needed, always current

Cons: Manual process, slower workflow

Best for: Small volume dispensaries

2. API Integration

Pros: Automated checks, fast response

Cons: Technical setup required

Best for: High volume operations

3. POS Integration

Pros: Seamless workflow, automatic compliance

Cons: Depends on POS vendor support

Best for: Most dispensaries

API Configuration

For automated integration, follow these steps:

API Endpoint Configuration

Production URL: https://oarrs.pharmacy.ohio.gov/api/v2/
Test URL: https://oarrs-test.pharmacy.ohio.gov/api/v2/

Required Headers:
- Authorization: Bearer [API_TOKEN]
- X-Facility-ID: [DISPENSARY_LICENSE_NUMBER]
- Content-Type: application/json

Testing Your Connection

Verification Checklist

  1. Test with known patient ID in test environment
  2. Verify response includes all required fields
  3. Check error handling for invalid requests
  4. Confirm timeout handling (30 second max)
  5. Test failover to manual process

Integration Best Practices

  • Always maintain manual backup access
  • Test integration daily before opening
  • Monitor API response times
  • Keep credentials in secure vault
  • Document all configuration changes

Module 3: Patient Registration & Verification

Accurate patient verification is the cornerstone of OARRS compliance. This module covers the complete verification process, from initial registration check to handling edge cases.

Patient Verification Workflow

Step 1: ID Verification

Check government-issued photo ID

Step 2: Registry Lookup

Search OARRS by patient ID or name/DOB

Step 3: Status Check

Verify active registration and recommendation

Step 4: Limit Review

Check daily and 90-day purchase limits

Step 5: Document

Record verification in POS/METRC

Registration Status Types

Status Meaning Action Required
Active Valid registration and recommendation Proceed with purchase limit check
Expired Registration or recommendation expired Cannot dispense; advise renewal
Suspended Temporary hold by state Cannot dispense; check reason
Revoked Permanently cancelled Cannot dispense; refer to Board
Pending Awaiting state approval Cannot dispense until active

Caregiver Verification

Caregivers require additional verification steps:

Additional Requirements

  • Verify caregiver registration is active
  • Confirm patient-caregiver relationship in OARRS
  • Check caregiver is designated for specific patient
  • Verify caregiver photo ID matches registration
  • Purchases count against patient's limits

⚠️ Common Verification Errors

  • Name Mismatch: Check for nicknames, maiden names, Jr./Sr.
  • Address Changes: OARRS may show old address; ID is primary
  • Duplicate Registrations: Report to Board immediately
  • System Lag: New registrations may take 24-48 hours

Handling Special Situations

Out-of-State Visitors

Ohio has limited reciprocity. Check current agreements and special requirements.

Veterans

May have fee waivers; registration still required through standard process.

Minors

Require designated caregiver; additional documentation needed.

Hospice Patients

Special expedited registration available; verify with Board.

Documentation Requirements

Maintain records of all verification attempts:

  • Screenshot of OARRS lookup result
  • Time and date of verification
  • Employee who performed check
  • Any discrepancies noted
  • Resolution of any issues

Module 4: Daily Purchase Limits

Understanding and enforcing daily purchase limits is critical for compliance. Ohio has specific limits for medical cannabis patients that must be strictly followed.

Ohio's Daily Limit System

Ohio uses a unique "whole day unit" system for calculating purchase limits:

The 90-Day Supply

  • Patients can purchase up to a 90-day supply
  • 90-day period is rolling, not calendar-based
  • Each product type has different unit values
  • Maximum 45% THC daily limit for most patients

Whole Day Unit Calculations

Product Type Tier I (≤23% THC) Tier II (>23% THC)
Flower (per 1/10 oz) 1 unit 1.8 units
Edibles (110mg pack) 1 unit N/A
Concentrates (590mg) 4.85 units 8.75 units
Topicals No limit No limit

Key Limit Rules

  • Standard patients: 90 units per 90 days
  • Terminal patients: 138 units per 90 days
  • Veterans/indigent: Same limits, reduced fees
  • Limits reset on rolling 90-day basis

Checking Limits in OARRS

  1. Access patient record in OARRS
  2. View "90-Day Supply" section
  3. Check units purchased vs. available
  4. Calculate remaining units
  5. Ensure sale won't exceed limit

Common Limit Scenarios

Scenario 1: Near Limit

Patient has 5 units remaining, wants 10 units of product

Action: Can only sell 5 units, explain rolling reset

Scenario 2: Mixed Tiers

Patient buying Tier I and Tier II products

Action: Calculate each separately, total must not exceed limit

Module 5: Medical Recommendations

Medical recommendations are the foundation of legal access to medical cannabis in Ohio. Understanding recommendation requirements and verification is essential for dispensary compliance.

Recommendation Requirements

Valid recommendations must meet specific criteria:

Essential Elements

  • Issued by certified Ohio physician
  • For approved qualifying condition
  • Active status in OARRS
  • Not expired (max 1 year)
  • Matches patient registration

Qualifying Conditions

Ohio Approved Conditions

  • AIDS/HIV
  • Alzheimer's disease
  • Amyotrophic lateral sclerosis (ALS)
  • Cancer
  • Chronic traumatic encephalopathy
  • Crohn's disease
  • Epilepsy or seizure disorders
  • Fibromyalgia
  • Glaucoma
  • Hepatitis C
  • Inflammatory bowel disease
  • Multiple sclerosis
  • Pain (chronic, severe, or intractable)
  • Parkinson's disease
  • PTSD
  • Sickle cell anemia
  • Spinal cord injury/disease
  • Tourette syndrome
  • Traumatic brain injury
  • Ulcerative colitis

Verification Process

Recommendation Verification

  1. Check recommendation status in OARRS
  2. Verify physician is certified
  3. Confirm recommendation date validity
  4. Match patient ID to recommendation
  5. Note any special provisions (terminal status)

⚠️ Red Flags

  • Recommendation from out-of-state physician
  • Expired or soon-to-expire recommendation
  • Physician not found in certified list
  • Condition not on approved list

Module 6: Dispensing Workflow

An efficient dispensing workflow ensures compliance while providing excellent patient care. This module covers the complete dispensing process from entry to exit.

Complete Dispensing Process

Step-by-Step Workflow

  1. Patient Entry
    • Verify age at door
    • Check for valid ID
    • No consumption on premises
  2. Check-In Process
    • Scan ID into system
    • Verify OARRS status
    • Check purchase limits
    • Create patient queue entry
  3. Consultation
    • Review patient needs
    • Provide product education
    • Make recommendations
    • Discuss pricing
  4. Product Selection
    • Show only products in stock
    • Verify against limits
    • Confirm THC content
    • Check test results
  5. Transaction Processing
    • Enter sale in POS
    • Sync with METRC
    • Process payment
    • Print receipts
  6. Final Verification
    • Bag and seal products
    • Attach exit labels
    • Provide patient education
    • Document completion

Best Practices

  • Double-check limits before finalizing sale
  • Never rush the consultation process
  • Always provide receipt and exit bag
  • Document any unusual circumstances
  • Maintain patient privacy throughout

Module 7: Reporting Requirements

Accurate and timely reporting to OARRS is mandatory. This module covers all reporting obligations and best practices for maintaining compliance.

Mandatory Reporting

Dispensaries must report specific information to OARRS:

Required Data Points

  • Patient identification
  • Product dispensed (type, quantity, THC content)
  • Date and time of sale
  • Dispensing agent information
  • Units consumed from 90-day supply
  • Method of payment

Reporting Timelines

Report Type Deadline Method
Daily Sales Real-time via METRC Automatic
Inventory Discrepancies Within 24 hours METRC + Written
Theft/Loss Immediately Phone + Written
System Outages Within 72 hours Email to Board

Common Reporting Errors

Avoid These Mistakes

  • Delayed reporting due to technical issues
  • Incorrect product categorization
  • Missing caregiver documentation
  • Failure to report refused sales
  • Incomplete patient information

Backup Procedures

When OARRS is unavailable:

  • Document all sales manually
  • Use paper logs with timestamps
  • Enter data immediately when system returns
  • Notify Board of extended outages

Module 8: POS Integration

Seamless integration between your POS system and OARRS streamlines compliance and reduces errors. This module covers setup, optimization, and troubleshooting.

Integration Benefits

  • Automatic limit checking
  • Real-time verification
  • Reduced manual errors
  • Faster checkout process
  • Comprehensive reporting
  • Audit trail maintenance

Common POS Systems

System OARRS Integration Key Features
Flowhub Full API integration Auto-sync, limit alerts
Dutchie Direct connection Online ordering, delivery
Treez Real-time sync Multi-location support
BLAZE Automated reporting Loyalty programs

Configuration Best Practices

Optimization Steps

  1. Map all product categories correctly
  2. Set up automatic unit calculations
  3. Configure limit warnings
  4. Enable real-time syncing
  5. Test with sample transactions
  6. Train staff on error messages

Troubleshooting Common Issues

Issue: Sync Failures

Solution: Check API credentials, verify network connectivity, review error logs

Issue: Incorrect Limits

Solution: Verify product mapping, check tier assignments, recalculate manually

Issue: Timeout Errors

Solution: Increase timeout settings, check OARRS status page, use manual backup

Module 9: Compliance & Auditing

Regular auditing ensures ongoing OARRS compliance and prepares you for state inspections. This module covers internal audit procedures and inspection readiness.

Internal Audit Program

Recommended Audit Frequency

  • Daily: Transaction reconciliation
  • Weekly: Limit compliance review
  • Monthly: Full OARRS audit
  • Quarterly: System integration check
  • Annually: Comprehensive compliance review

Audit Checklist

Key Audit Points

  • All sales properly recorded in OARRS
  • Patient verifications documented
  • Limit calculations accurate
  • Refused sales logged
  • Caregiver relationships verified
  • System access logs reviewed
  • Error corrections documented
  • Training records current

State Inspection Preparation

Inspector Focus Areas

  • Random transaction verification
  • Patient limit compliance
  • System integration testing
  • Documentation review
  • Staff knowledge assessment

⚠️ Common Violations

  • Failure to check OARRS before sale
  • Exceeding patient limits
  • Incomplete documentation
  • System access by unauthorized personnel
  • Delayed error corrections

Corrective Action Plans

When violations are found:

  1. Document the issue immediately
  2. Identify root cause
  3. Implement correction
  4. Retrain affected staff
  5. Monitor for recurrence
  6. Report to management/Board as required

Module 10: Troubleshooting Common Issues

Even with the best systems, issues arise. This module provides solutions to the most common OARRS-related problems dispensaries face.

System Access Issues

Problem: Cannot log into OARRS

Solutions:

  1. Verify username and password
  2. Check account isn't locked (3 failed attempts)
  3. Ensure account is active and approved
  4. Clear browser cache and cookies
  5. Try different browser
  6. Contact OARRS help desk

Patient Lookup Problems

Common Lookup Errors

Error Cause Solution
Patient not found Name mismatch, new registration Try variations, check ID carefully
Multiple matches Common name Use DOB and address to verify
Inactive status Expired recommendation Cannot dispense, advise renewal

Limit Calculation Discrepancies

When Limits Don't Match

  • Verify all recent purchases are showing
  • Check for purchases at other dispensaries
  • Confirm product tier classifications
  • Look for pending transactions
  • Calculate manually to verify

Emergency Procedures

When OARRS is Down

  1. Check OARRS status page
  2. Attempt manual web access
  3. If confirmed down:
    • Switch to paper logs
    • Limit sales to known patients
    • Reduce limits by 50% for safety
    • Document everything
  4. Enter all sales when system returns

OARRS Support Contacts

  • Help Desk: 1-800-XXX-XXXX
  • Email: support@oarrs.ohio.gov
  • Hours: Monday-Friday, 8am-5pm
  • Emergency: Follow phone prompts

Prevention Strategies

Minimize Issues By:

  • Testing systems daily before opening
  • Maintaining current patient information
  • Regular staff training refreshers
  • Documenting all workarounds
  • Building good vendor relationships
  • Keeping backup systems ready

Additional Resources

Quick Reference

Forms & Documents

Support Contacts