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<strong>CMS</strong>-1403-FC<br />

We also received unsolicited comments on this issue during<br />

the comment period for the November 16, 2007 Part D e-<br />

prescribing proposed rule (proposing the adoption of<br />

certain final Part D e-prescribing standards and the use of<br />

NPI in Part D e-prescribing transactions) (72 FR 64900).<br />

As a result of the new information, we reexamined this<br />

issue and proposed additional modifications to the<br />

computer-generated facsimile exemption in the CY 2009 PFS<br />

proposed rule (73 FR 38502).<br />

Dispensers have indicated that they use<br />

computer-generated facsimiles for the majority of<br />

prescription refill requests, in particular when<br />

communicating with prescribers that have not adopted<br />

e-prescribing. Currently, regardless of how the initial<br />

prescription was received by the pharmacy (that is, orally,<br />

via e-prescribing, telephone, paper, or facsimile) nearly<br />

all prescription refill requests from chain pharmacies to<br />

prescribers are sent electronically, either via an<br />

e-prescribing application or via computer-generated<br />

facsimile. When a prescription is received by a dispenser<br />

electronically, the prescription refill request is sent to<br />

the prescriber via the same technology. However, where the<br />

dispenser knows that the prescriber lacks e-prescribing<br />

capability or <strong>has</strong> not activated it, or where the prescriber<br />

332

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