CMS Proposes to Update e-Prescribing Standards

June 21, 2019
Health Policy

On June 17, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule  that would update the Part D e-prescribing program by adopting standards that ensure secure transmissions and expedite prior authorizations.

Under the proposed change, clinicians would be able to choose to complete prior authorizations online, reducing burden for providers through a more streamlined process for performing prior authorization for Part D prescriptions. Clinicians who select the electronic option will typically be able to satisfy the terms of a prior authorization in real time and before a prescription is transmitted to a pharmacy, so patients do not arrive at a pharmacy counter to find that their prescription cannot be filled.

The proposed rule would implement new prior authorization transaction standards for the Part D e-Prescribing program as required by the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act. The proposed standards would begin in January 2021.

The proposed rule (CMS-4189-P) can be downloaded from the Federal Register.