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Medicare Drug Prescriptions Must Be Sent
Electronically
New e-prescribing designed for improved safety,
service
Nov. 1, 2005 - HHS Secretary Mike Leavitt today
announced adoption by regulation of a set of standards for the
electronic prescription of Part D drugs, which he says will make the use
of prescription drugs easier and safer for Medicare beneficiaries.
The final rule establishes a set of foundation
standards for electronic prescribing or “e-prescribing” of drugs covered
by Medicare. The industry is already sufficiently experienced with these
foundation standards, which will be available for immediate use when
Medicare’s new prescription drug benefit begins Jan. 1, 2006, according
to the announcement.
Electronic prescribing enables a physician to
transmit a prescription electronically to a patient’s pharmacy of
choice. This not only can be easier for the physician, pharmacy, and
patient than paper prescriptions, but it also is designed to improve
patient safety and reduce avoidable health care costs by decreasing
prescription errors caused by hard-to-read handwriting and communication
errors, and by automating the process of checking for drug interactions
and allergies.
“These standards will allow Medicare, physicians,
hospitals, group practices, other health providers, and prescription
drug plan sponsors and Medicare Advantage organizations to take
advantage of e-prescribing technology, to improve medication prescribing
for Medicare beneficiaries that participate in the new prescription drug
program,” Secretary Leavitt said.
“All of the Medicare prescription drug plans must
comply with these newly established foundation standards for
e-prescribing, which will improve drug safety and reduce costs,” said
Mark B. McClellan, M.D., Ph.D., administrator of Centers for Medicare &
Medicaid Services (CMS). “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.”
E-prescribing will ultimately help physicians,
pharmacies, and patients obtain timely and relevant information on the
most effective and least costly drug based on the latest medical
evidence. They will also be able to obtain information from drug plans
about a patient’s eligibility. Having access to this information at the
point of care will make writing, transmitting and filling prescriptions
quicker and easier, and will also ensure that physicians can make
informed decisions about alternative, lower-cost, therapeutically
appropriate medications.
The Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 created a new voluntary prescription drug
benefit under Medicare, which is administered by CMS. Although
e-prescribing will be optional for physicians and pharmacies, Medicare
will require drug plans participating in the new prescription benefit to
support electronic prescribing. Compliance with these standards will be
required on Jan. 1, 2006, so that they will be ready for immediate use
when the Medicare drug benefit begins.
The foundation standards are:
-
NCPDP SCRIPT Version 5.0 for transactions
between prescribers and dispensers for new prescriptions, refill
requests and response, prescription change request and response,
prescription cancellation request and response, and related
messaging and administrative transactions.
-
ASC X12N 270/271, Version 4010 and addenda, for
eligibility and benefits queries and responses between prescribers
and Part D sponsors.
-
NCPDP Telecommunication Standard, Version 5.1,
and supporting NCPDP Batch Standard, Version 1.1, for eligibility
queries between dispensers and Part D sponsors.
Along with the start of the Medicare drug benefit
and implementation of the foundation standards on Jan. 1, 2006, Medicare
will begin a pilot project to test “initial” e-prescribing standards,
which may be included in a final rule to be issued no later than April
1, 2008. Any initial standards that are adopted in that final rule will
be effective no later than one year from the date the final rule is
issued.
These initial standards include those for
information on formulary and benefits, patient instructions, prior
authorization messages and clinical drug terminology. Collectively,
these additional standards can make it easier for the appropriate drugs
that are reimbursed under the new Medicare drug benefit to be selected,
refilled and dispensed which will enhance the benefits to patients,
doctors and pharmacists.
In addition, CMS has awarded a grant to MedCo
Health Solutions, Inc. to evaluate the impact of the Southeastern
Michigan Electronic Prescribing Initiative. This study will be
complementary to the pilot project and should provide short-term lessons
learned from one of the nation’s largest electronic prescribing
programs.
The final rule went on display at the Federal
Register today and will be published on Nov. 7, 2005.
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