Yesterday, the Senate Health Policy Committee unanimously passed legislation that would, among other things, require the electronic transmission of prescriptions, including controlled substances, to the pharmacy.
The bills that were ultimately approved were substitutes (S-1) for Senate Bills 248 and Senate Bill 254. SB 248 (S-1) includes some exceptions and a waiver process, including an exception for temporary technological failure, cases in which it is impractical for the patient to obtain the prescription drug in a timely manner; and when a prescription is orally prescribed, among others.
Under the bills, a prescriber could seek a waiver from the Department of Licensing and Regulatory Affairs if he or she cannot meet the requirements due to a "technological limitation that is not reasonably within the control of the prescriber." The new substitute clarifies the "technological limitation" to include internet connectivity and the use of certified electronic health record technology that cannot support electronic prescribing, or "another exceptional circumstance".
The substitute also pushes the implementation date to 2021 and includes a change giving LARA the discretion to delay the state's implementation date if the Federal Centers for Medicare and Medicaid Services delays the Medicare requirement, currently scheduled to go into effect in 2021. These changes improved the bill but ultimately does not go far enough to help mitigate the substantial burden placed on providers who will have to comply with the new mandate.
Meanwhile, the substitute removed "economic hardship" as criteria for obtaining a waiver -- which runs counter to the challenges stemming from the high cost of adoption that have been consistently highlighted. Taken together, the changes included in the substitute did not move MSMS's opposing position.
While MSMS's position is to encourage rather than require e-prescribing due to the substantial barriers that exist, MSMS is hopeful that there will be an opportunity to continue to work on changes to the bill in both chambers that align the state with federal requirements so there is consistency when the federal government imposes its requirement for Medicare Part D.