Opioid analgesics are FDA-approved prescription medications that can provide pain control for moderate to severe pain when appropriately prescribed; however, inappropriate prescribing can lead to opioid abuse, diversion, and deadly overdoses.1
According to the Centers for Disease Control and Prevention (CDC), the number of drug overdose deaths was four times higher in 2018 than in 1999 despite a recent decrease and, of those 67,367 deaths in 2018, nearly 70 percent involved an opioid and 14 percent involved prescription opioids. As stated by the CDC, “the best ways to prevent opioid overdose deaths are to improve opioid prescribing, reduce exposure to opioids, prevent misuse, and treat opioid use disorder.”2
Benefits of Electronic Prescribing of Controlled Substances
Electronic prescribing of controlled substances (EPCS) allows physicians to transmit controlled substance prescriptions securely to their patient’s pharmacy. The use of EPCS reduces prescription fraud and diversion by removing the risk of prescription forgery and alterations. It also decreases prescribing errors that are often caused by illegible handwriting and use of unapproved abbreviations. And, because the electronic prescription data flows into state prescription drug monitoring program (PDMP) databases, EPCS can help provide physicians with insight into a patient’s controlled substance prescription history, thus helping to identify “doctor shopping” behaviors and opioid overuse.3
Current Usage and Future Requirements
EPCS is now legal in all fifty states, yet it is not widely adopted. Less than 60 percent of all United States prescribers are currently EPCS-enabled, despite having 96 percent of US retail pharmacies capable of receiving electronic controlled substance prescriptions.4 However, individual state and federal regulations will soon change that.
The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, passed by Congress in 2018 to help combat the opioid crisis, requires EPCS for all controlled substances prescriptions covered under a Medicare Part D prescription drug plan or Medicare Advantage Prescription Drug (MA-PD) Plan, beginning January 1, 2021.5 Recently, Centers for Medicare & Medicaid Services (CMS) announced that they will delay enforcement until January 1, 2022.6 Despite the delay in enforcement, many states are continuing to pass their own EPCS-required mandates to help address the opioid crisis. Twelve states have already required the use of EPCS prior to December 31, 2020 and an additional 15 states will begin requiring EPCS this year.7
How Your Facility Can Make an Impact in Your Community
MEDHOST EPCS solution is DEA-compliant, Surescripts-certified, and is available in both MEDHOST Emergency Department Information System (EDIS) and MEDHOST Enterprise Electronic Health Records (EHR). To learn more about how MEDHOST can help your facility reduce opioid prescription fraud, improve patient safety, enhance physician workflow, and meet EPCS state and federal requirements, please reach out to us at firstname.lastname@example.org or call 1.800.383.6278.
1Preuss, C.V., Kalava, A., & King, K.C. (2020). Prescription of Controlled Substances: Benefits and Risks. StatPearls [Internet]. Retrieved from here.
2Centers for Disease Control and Prevention (CDC). (2020, March 19). Opioid Overdose. Retrieved from https://www.cdc.gov/drugoverdose/index.html
3The Office of the National Coordinator for Health Information Technology (ONC). (2019, December 18). Health IT Playbook: Opioid Epidemic & Health IT. Retrieved from https://www.healthit.gov/playbook/opioid-epidemic-and-health-it/
4Surescripts. (2020, December). Electronic Prescribing for Controlled Substances. Retrieved from https://surescripts.com/EPCS/
5Center for Medicare & Medicaid Services. (2020). Medicare Program: Electronic Prescribing of Controlled Substances; Request for Information (RFI). Federal Register 85:150 p. 47151-47157. Codified at 42 CFR §423. Retrieved from https://www.govinfo.gov/content/pkg/FR-2020-08-04/pdf/2020-16897.pdf
6Center for Medicare & Medicaid Services. (2020). Medicare Program; CY 2021 Payment Policies Under the Physician Fee Scheduled and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Medicaid Promoting Interoperability Program Requirements for Eligible Professionals; Quality Payment Program; Coverage of Opioid Use Disorder Services Furnished by Opioid Treatment Programs; Medicare Enrollment of Opioid Treatment Programs; Electronic Prescribing for Controlled Substances for a Covered Part D Drug; Payment for Office/ Outpatient Evaluation and Management Services; Hospital IQR Program; Establish New Code Categories; Medicare Diabetes Prevention Program (MDPP) Expanded Model Emergency Policy; Coding and Payment for Virtual Check-in Services Interim Final Rule Policy; Coding and Payment for Personal Protective Equipment (PPE) Interim Final Rule Policy; Regulatory Revisions in Response to the Public Health Emergency (PHE) for COVID–19; and Finalization of Certain Provisions from the March 31st, May 8th and September 2nd Interim Final Rules in Response to the PHE for COVID–19. Federal Register 85:248 p. 84472-85377. Codified at 42 CFR §400, 410, 414, 415, 423, 424, and 425. Retrieved from https://www.govinfo.gov/content/pkg/FR-2020-12-28/pdf/2020-26815.pdf
7Imprivata. (n.d). Federal and State Regulations. Retrieved from https://www.imprivata.com/federal-and-state-regulations. Accessed January 3, 2021.