Patients who are eligible to enroll in Medicare’s prescription drug program are expected to experience greater safety, increased use of lower-cost generic equivalents, and more efficient communication between their doctor and pharmacy as a result of a new regulation issued by the Centers for Medicare & Medicaid Services (CMS), it says. The final rule establishes Part D e‑prescribing standards for four types of information: formulary and benefits, medication history, fill status notification, and identification of individual healthcare providers.
- Formulary and benefits: This standard will allow doctors and other prescribers to communicate with Part D sponsors about which drugs are covered by a Medicare eligible individual's prescription drug benefit plan. Prescribers can also learn which generic prescription drugs might offer lower-cost options for the individual.
- Medication history: This standard will allow doctors and other providers, as well as dispensers and Part D sponsors, to communicate among themselves about prescribed medications a beneficiary has taken or is taking, including those prescribed by other providers.
- Fill status notification: This standard will allow providers to receive an e-mail notice from pharmacy or other dispenser telling them that a patient’s prescription has been picked up, not picked up, or has been partially filled.
- Provider identifier: The final rule requires providers, dispensers, and Part D sponsors to use the National Provider Identifier (NPI) to identify individual healthcare providers in Part D e‑prescribing transactions.
According to CMS, prescribers, dispensers and other providers are not required to implement e‑prescribing, but those who do must comply with the new Medicare standards when using e-prescribing to send prescriptions and prescription related information for covered drugs prescribed for Part D eligible individuals.
This final rule on Part D e‑prescribing standards (CMS-0016-F/CMS-0018-F) and the earlier final rule establishing e‑prescribing foundation standards (CMS-0011-F) are available online.
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