e-Prescribing (eRx) is the electronic transmission of a drug prescription directly to a pharmacy through EHR technology, or via a standalone electronic prescribing suite. eRx has potential advantages in making prescribing more efficient and safer: calls from the pharmacist to clarify prescriptions could be significantly reduced; it’s less likely scripts will be filled incorrectly; and clinicians should receive notifications at the point of care for potential interactions with medications prescribed by other physicians. Electronic prescribing is a requirement for eligible clinicians (ECs) as a part of CMS' Merit Based Incentive Payment System (MIPS). See below for additional information on MIPS.
In addition, some states and major pharmacy chains now require that physicians use eRx for all prescriptions. To check whether your state currently mandates eRx, you can visit MD Toolbox, which offers an interactive map. Simply click on your state to view applicable laws and regulations around eRx. Alternatively, you can also check with your District Branch if this is a concern or issue for you.
While policies vary state-to-state, by January 1, 2023, Medicare Part D participants will be required to utilize e-prescribing for prescribing controlled substances. APA has historically requested that CMS relax certain requirements around e-prescribing due to various barriers to its use.
Resources for eRx
The Centers for Medicare and Medicaid Services (CMS) Merit-Based Incentive Payment System (MIPS) and Electronic Prescribing
Eligible clinicians (ECs) accepting patients under Medicare Part B are required to meet certain electronic prescribing thresholds under the MIPS Promoting Interoperability (PI) performance category, as long as they meet the low volume threshold. For more information on this requirement, visit the Promoting Interoperability section of APA's Payment Reform Toolkit.
Surescripts is the largest network of prescribing information in the U.S. It supports the flow of this information amongst providers and suppliers of pharmaceuticals by maintaining databases that are accessible from most clinical software that provides e-prescribing functionality. Their website contains comprehensive lists of this software which includes EHRs and standalone e-prescribing products, including those that support controlled prescriptions (EPCS).
The purpose of this toolset is to provide your practice with the knowledge and resources to implement e-prescribing successfully. The toolset is designed for use by a diverse range of provider organizations, from small, independent offices to large medical groups.
Electronic Prescribing of Controlled Substances (EPCS)
EPCS is now permitted in all fifty states, including Washington, D.C. The rules around EPCS differ from eRx of non-controlled pharmaceuticals. The Drug Enforcement Administration (DEA) offers a FAQ on the topic. Surescripts also provides guidance on EPCS. Finally, if you are interested in utilizing telemedicine (i.e. telepsychiatry) in conjunction with EPCS, you must comply with the law around the Ryan Haight Online Pharmacy Consumer Protection Act of 2008. APA summarizes the requirements of Ryan Haight in our Telepsychiatry Toolkit.
To get started with EPCS, the American Academy of Family Practitioners offers video modules for solo and small medical practices.