Regulatory Compliance
C D A J O U R N A L , V O L 5 0 , Nº 1
The Road to E-Prescribing CDA Practice Support
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alifornia prescribers had to switch to electronic prescribing by Jan. 1, 2022, as did prescribers in Utah, Nebraska, New Hampshire, Michigan and Maryland. California is now part of a majority of states that require the use of e-prescribing. In 2011, Minnesota was the first to require it, and in 2016, New York was the first to impose penalties.1 In addition to state mandates, the Centers for Medicare and Medicaid Services (CMS) are set to implement a rule requiring that Medicare Part D prescriptions for schedule II, III, IV and V controlled substances be prescribed electronically.2 Although the move to e-prescribing seems swift, it began in 2003 when the Medicare Modernization Act required the establishment of standards for e-prescribing.3 This was followed by the publication of a 2006 Institute of Medicine report, which found that medication errors are the most common medical errors and the cost of treating related injuries was over $3.5 billion annually. The report included among its many recommendations that all prescriptions be written electronically by 2010.4 Not long after the release of that report, the California Healthcare Foundation published in 2008 an issue brief on the status of e-prescribing in the state. The brief included recommendations to get health care payers, pharmacies and health care providers on board to adopt e-prescribing.5 The DEA’s adoption of an e-prescribing regulation in 2010 was one of the necessary steps to standardizing the e-prescribing process. The DEA
regulation establishes standards for ensuring that only authorized prescribers can prescribe controlled substances. Although CMS established in 2005 the first e-prescribing standards, it has since adopted the SCRIPT standard established by the National Council for Prescription Drug Program (NCPDP), a nonprofit, multistakeholder organization. The NCPDP standard facilitates the transfer of prescription data between prescribers, pharmacies, payers, health
care facilities and intermediaries. E-prescribing software applications must comply with both of these standards. The country’s opioid crisis was declared a public health emergency in 2017 and led policymakers to lean on e-prescribing to reduce drug diversion and protect against drug misuse.6 The California legislation, which established the e-prescribing requirement, cites that e-prescribing for controlled substances would “significantly reduce,
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