Yesterday, the Michigan House and Senate Health Policy Committees separately considered legislation to require the use of e-prescribing, including the prescribing of controlled substances. The legislation in the House – House Bill 4217 – and in the Senate – Senate Bills 248 – would require that all prescriptions be electronically transmitted to the pharmacy beginning in 2020 with some exceptions and a waiver process, including an exception for temporary technological failure, cases where it is impractical for the patient to obtain the prescription drug in a timely manner; and when a prescription is orally prescribed, among others. A prescriber could seek a waiver from the Department of Licensing and Regulatory Affairs if he or she cannot meet the requirements due to 1) an economic hardship 2) a technological limitation that is not reasonably within the control of the prescriber and 3) another exceptional circumstance. Another bill, Senate Bill 254, which would only require the electronic prescribing of opioids and benzodiazepines, was also under consideration.
Brad Uren, MD, MSMS member and Chair of the Committee on State Legislation and Regulations, and Christin Nohner, MSMS Director of State and Federal Government Relations, testified before both committees expressing MSMS’s reservations with the bills, as currently written. While MSMS, agreed that adoption of e-prescribing should be encouraged, the concerns expressed centered on the existing barriers to adoption of electronic prescribing of controlled substances, including interoperability concerns and the often, prohibitive costs of the electronic prescribing of controlled substances (EPCS) software. Doctor Uren emphasized in his testimony that the barriers are significant and that before the state requires use improvements need to be made to the system first to maximize efficiency and safety. If Michigan is to pursue a mandate, MSMS requested that the state tie implementation to the Medicare Part D requirement, which is scheduled to take effect in 2021, for consistency. MSMS has also asked for changes that align exceptions with hardship exemptions recognized by CMS in its various incentive and quality programs. Finally, he called on the legislature to use this opportunity to put some pressure on the vendors to be better actors in this space in light of the opioid crisis.
Both Committees took testimony and no vote was taken. It was widely acknowledged that changes will need to be made to the bills before any further consideration.
Doctor Uren's full testimony is available in the documents below.