CMS finalizes e-prescribing rules

Official notice of the standard

Just in time to take effect along with the Medicare prescription drug benefit on Jan. 1, the Centers for Medicare and Medicaid Services has made official its starter set of standards for Medicare e-prescribing.

Although doctors and pharmacies are not required to use e-prescribing as part of the Medicare Part D drug benefit, those choosing to do so must abide by the standards, which were announced in October. They are posted on the CMS Web site and will be published in the Federal Register.

“We are making e-prescribing easier to implement to accelerate the use of e-prescribing in Medicare and throughout the nation’s health care system,” said Dr. Mark McClellan, CMS administrator.

Besides being more efficient, e-prescribing can prevent medication errors by:

• Eliminating obscure handwriting and transcription errors,

• Allowing doctors or computer systems to check for patient allergies or harmful interactions with other drugs the patient is taking,

• Providing information to doctors about the correct dosage and other aspects of the prescription.

Medication errors are one of the most common causes of preventable injuries to patients. By one estimate, at least 8.8 million adverse drug effects occur outside hospitals and nursing homes each year.

Physicians have been slow to adopt e-prescribing not only because the systems are costly, but also because of the need to synchronize their systems with those used by pharmacies and insurance companies. “E-prescribing rates vary somewhere between 5 percent and 18 percent for physicians, although usage is slowly increasing,” according to the standards.

The standards adopted as of Jan. 1 are Version 5.0 of the National Council for Prescription Drug Standards (NCPDP) Script standard, developed for transmitting prescriptions from physicians to pharmacies; ASC X12N 270/271 Version 4010, for doctors to use in checking eligibility for benefits; and NCPDP Telecommunications Standard 5.1, for pharmacies to use in checking eligibility.

They are known as foundation standards because they support minimal functionality in e-prescribing and are already widely used, CMS officials said.

Next year CMS also will test additional standards for information on formulary and benefits, patient instructions, clinical drug terminology and prior authorization messages. The tests are likely to lead to additional e-prescribing standards.