Electronic prescribing for controlled substances (EPCS) has gained popularity in recent months as a way to better track opioid use and reduce fraud and misuse. Many states have already implemented their own EPCS mandates, but the federal government and even private companies also have gotten involved.
Federal Legislation and Requirements for EPCS
The U.S. Drug Enforcement Agency (DEA) gave providers permission to use EPCS in 2010, along with a set of standards for the EPCS systems that providers, pharmacies, and health IT vendors use. To be DEA compliant, an EPCS system must include:
Certification of the EHR/e-prescribing application
Identity proofing to confirm that a provider is authorized to prescribe controlled substances
Two-step logical access control to provide EPCS permissions to approved prescribers
Two-factor authentication for providers who sign an EPCS prescription
Comprehensive and detailed reporting to demonstrate compliance and to identify auditable events and security incidents
In October 2017, President Trump declared the opioid addiction epidemic a Nationwide Public Health Emergency. One year later, he signed the SUPPORT for Patients and Communities Act. This 250-page law includes multiple initiatives intended to address opioid misuse and addiction, and requires EPCS for all controlled substances under Medicare Part D by January 1, 2021.
Individual State EPCS Mandates
Due to the effectiveness of EPCS in curbing fraud, many individual states passed their own mandates. New York first mandated EPCS in 2016, with others quickly following.
Pennsylvania’s deadline for moving to EPCS is October 24, 2019. Arizona, Iowa, Massachusetts, North Carolina, Oklahoma, and Rhode Island all have mandates that will take effect January 1, 2020.
In September 2018, California passed a law that requires electronic prescribing for all medications—not just controlled substances. This law is scheduled to take effect January 1, 2022.
In many states, EPCS mandates are designed to work in conjunction with prescription drug monitoring programs (PDMPs). Under these programs, pharmacies submit information on the controlled prescriptions they dispense. These programs help identify patients who may exhibit drug-seeking behavior, and provide data on controlled medication use.
Pharmacy and Private Company EPCS Requirements
Pharmacies and other organizations also have implemented private mandates regarding EPCS. For example, Walmart pharmacies will no longer accept paper prescriptions for controlled substances after January 1, 2020. This is part of the company’s Opioid Stewardship Initiative to curb opioid misuse.
This year, the McKesson Corporation, a U.S. pharmaceutical distributor, will stop selling opioids to customers who cannot accept EPCS. To help with this change, the company has announced an intention to work with customers that have yet to make the transition to e-prescribing.
Health IT solutions developer DrFirst, which provides software used in BestNotes EHR, has updated its e-medication management platform. The company will discontinue its Rcopia3 software on January 1, 2020, and is requiring all users to move to Rcopia4. Available since 2016, Rcopia4 offers new features, including a unified integrated workflow experience for writing narcotic prescriptions and checking PDMPs.
Using EPCS with your EHR
Don’t get left behind in the changing regulatory environment. Make sure your EHR system allows for e-prescribing so you can continue to offer appropriate, high-quality care for your behavioral health patients while remaining compliant with state, federal, and private mandates.
BestNotes EHR and CRM solutions are tailored specifically for mental health and addiction treatment providers, with e-prescribing and other medication management options. Contact us today to learn more.