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 CMS Seeks Updates to e-Prescribing Standards in Proposed Rule

In a proposed rule, the Centers for Medicare & Medicaid Services (CMS) said it wants to update e-prescribing standards to reduce the regulatory burden on providers and speed access to needed medications for Medicare Part D beneficiaries.

In doing so, the agency said the proposal would implement “key” provisions of the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act.

CMS said improved patient access would result from an update to the prior authorization process for Medicare Part D. “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,” CMS said.

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. “This is so patients do not arrive at a pharmacy counter only to find that their prescription cannot be filled,” the agency said.

The proposed rule would implement new prior authorization transaction standards for the Part D e-Prescribing program as required by the SUPPORT for Patients and Communities Act and start in January 2021. If made final, the new rule would require all Medicare Part D plans to support electronic prior authorization transaction standards that were developed by the National Council for Prescription Drug Plans.

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

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