In 2010, the U.S. Drug Enforcement Administration (DEA) published an interim final rule allowing Electronic Prescribing of Controlled Substances (EPCS) in all states. On October 24, 2018, President Trump signed into law the “SUPPORT for Patients and Communities Act,” a comprehensive bill designed to address the opioid abuse epidemic. Included in the law is a mandate for electronic prescribing for controlled substances (EPCS) for prescriptions covered under a Medicare Part-D drug plan (or an MA-PD plan). The deadline to comply with this section of the new law is January 1, 2021.
As a result, many states have already implemented EPCS mandates, some have laws starting in 2020, and many more have laws on the books. If you regularly prescribe medicines in or near one of the six states requiring EPCS-certification on January 1, 2020, you should be sure to have corrections in place to meet the mandate and be able to prescribe controlled substances after January 1. If you have not met the mandate requirements and you are located in one of the six states listed below, you will be unable to prescribe controlled substances until your systems are updated to meet the mandate.
Arizona, Iowa, Massachusetts, North Carolina, Oklahoma, and Rhode Island are the first states mandated to use EPCS by the federal government. The requirements differ from state to state, so you’ll need to check the particulars for your organization.
In order for an EPCS system to be considered in compliance with the DEA requirements, it must include:
The Centers for Medicare & Medicaid Services (CMS) has proposed a one-year delay to a congressionally mandated requirement that Medicare Part D providers transmit all prescriptions for controlled substances electronically beginning January 1, 2021.
The SUPPORT Act—the major law passed in 2018 that addressed the opioid crisis—requires there to be electronic prescribing for controlled substances (EPCS) in the Medicare Part D Prescription Drug Program beginning in 2021. As discussed in last week’s Regs & Eggs, in its proposed 2021 physician fee schedule, the Centers for Medicare & Medicaid Services (CMS) proposes delaying this EPCS requirement to 2022 due the ongoing response to the COVID-19 public health emergency. ACEP supports this delay.
However, CMS also released a separate request for information (RFI) on how it should implement the requirement going forward. In this RFI, CMS seeks comments on three issues: 1) compliance with the requirement; 2) enforcement and penalties; and 3) potential exceptions to the requirement.
Last week, ACEP submitted a detailed response to the RFI—particularly focusing on the burden associated with EPCS and whether an exception should be granted to emergency physicians in certain cases.
The Centers for Medicare and Medicaid Services (CMS) in the 2021 proposed physician payment rule floated the idea of postponing the electronic prescribing for controlled substances requirement until 2022 due to the ongoing COVID-19 public health emergency.
Paul Hudson, FACHE
Chief Operating Officer