The Centers for Medicare and Medicaid Services is proposing to revoke a rule that has allowed doctors sending prescriptions from their computers under the Medicare prescription drug benefit to use computer-generated faxes rather than digital data.
CMS does not require doctors to use e-prescribing, but when they generate and send Medicare Part D prescriptions electronically, they must comply with standards issued by the Department of Health and Human Services in November 2005, including the Script rule for transmissions.
The agency has allowed an exemption for computer-generated faxes since the e-prescribing rule took effect Jan. 1, 2006. However, it now has announced plans to eliminate that exemption as of Jan. 1, 2008.
“CMS expected that entities using computer-generated fax software would adopt the use of the Script standard over time, but this has not occurred to date,” according to a CMS fact sheet. “CMS expects the impact on prescribers to be minimal.”
Officials at SureScripts, an e-prescribing data exchange that links doctors with pharmacies, said the change would affect more than 150,000 doctors. Many of those doctors have software that would communicate digitally with pharmacies, but they have not been trained to use it or their computers have not been configured to use it, said Rick Ratliff, chief operating officer at SureScripts.
Often a doctor knows how to write a prescription on the computer and send it to a chosen pharmacy, but the doctor does not realize that the computer actually is creating and sending a fax, Ratliff said.
“The majority of electronic medical records systems do have the capability” to do e-prescribing transmissions that comply with the HHS standard, Ratliff said. He said vendors of the e-medical records or e-prescribing software need to make return visits to their customers and get them using true computer-to-computer communications.
The CMS fact sheet states that faxes received at a pharmacy must be entered manually into the pharmacy’s computer system, a step that takes time and can permit errors.
“With today’s announcement, [HHS] Secretary [Mike] Leavitt is delivering on his promise to use the federal government’s leverage as the nation’s largest health care insurer to promote health [information technology] adoption,” said Kevin Hutchinson, president and chief executive officer of SureScripts.
CMS is accepting comments on its proposed rule until Aug. 31.
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