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Notice: This CMS-approved document has been submitted - Philips ... Notice: This CMS-approved document has been submitted - Philips ...

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CMS-1403-FC other than transient/temporary network transmission failures) specifically included comments requesting amendments to the computer-generated facsimile exemption that would address when a prescriber or dispenser is prohibited from using the NCPDP SCRIPT standard for e- prescribing. The commenter noted that the Drug Enforcement Administration’s (DEA) prohibition of e-prescribing of controlled substances would prevent a provider from prescribing such controlled substances under the Part D program in accordance with the adopted standards. One commenter stated that vendors would have to disable electronic communication of prescriptions from their client prescribers through the prescription information exchange network to those pharmacies that are only computer- generated facsimile-enabled. The vendor assumed that if their client prescriber attempts to send those prescriptions electronically that the prescription will be rejected by the prescription information exchange network because the pharmacy is not activated with the network for electronic transactions using the NCPDP SCRIPT standard. This same commenter noted that the network has heretofore insulated the prescriber from having to be concerned with whether or not the patient’s choice of pharmacy was enabled to receive prescriptions in a particular way. After the 354

CMS-1403-FC proposed January 2009 compliance date, the commenter felt that additional burdens would be placed on the prescriber to obtain this information from the patient up front, or could compel patients to make different pharmacy choices which could result in lost business for pharmacies that are only facsimile-enabled. Response: The DEA has authority through the Controlled Substances Act over the electronic prescribing of controlled substances, and does not currently allow for the electronic prescribing of Schedule II drugs. As such substances currently may not be prescribed electronically, there is no conflict of law at this time. As noted previously, e-prescribing under Medicare Part D is voluntary for prescribers and dispensers – they are not required to issue prescriptions in electronic form. Although the DEA has published a notice of proposed rulemaking to allow for the electronic prescribing of controlled substances, we have no indication as to when the DEA will make a final determination on this issue. We continue to work with the DEA to help facilitate a solution that addresses both their enforcement requirements with respect to the electronic prescribing of controlled substances, and the needs of the healthcare community for a 355

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

proposed January 2009 compliance date, the commenter felt<br />

that additional burdens would be placed on the prescriber<br />

to obtain this information from the patient up front, or<br />

could compel patients to make different pharmacy choices<br />

which could result in lost business for pharmacies that are<br />

only facsimile-enabled.<br />

Response: The DEA <strong>has</strong> authority through the<br />

Controlled Substances Act over the electronic prescribing<br />

of controlled substances, and does not currently allow for<br />

the electronic prescribing of Schedule II drugs. As such<br />

substances currently may not be prescribed electronically,<br />

there is no conflict of law at this time. As noted<br />

previously, e-prescribing under Medicare Part D is<br />

voluntary for prescribers and dispensers – they are not<br />

required to issue prescriptions in electronic form.<br />

Although the DEA <strong>has</strong> published a notice of proposed<br />

rulemaking to allow for the electronic prescribing of<br />

controlled substances, we have no indication as to when the<br />

DEA will make a final determination on this issue. We<br />

continue to work with the DEA to help facilitate a solution<br />

that addresses both their enforcement requirements with<br />

respect to the electronic prescribing of controlled<br />

substances, and the needs of the healthcare community for a<br />

355

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