The Standards

The government’s push for e-prescribing began in 2003 with the Medicare Modernization Act, which gave birth to Part D, the voluntary Medicare prescription drug benefit. It also included provisions to foster e-prescribing by requiring certain standards and allowing third parties, such as hospitals, to offset the costs.

By the beginning of 2006, CMS had standards in place covering transactions for new prescriptions as well as requests for prescription refills, changes and cancellations. CMS also adopted standards for eligibility and benefits queries.

In November 2007, CMS published the results of pilot tests for five new standards: formulary and benefit information, medication history, prescription fill-status notification, structured and codified SIG and prior authorization.

CMS was satisfied with the standards for the first three tools but not the latter two. Accordingly, on April 2, 2008, it adopted those three standards only – in addition to mandating that providers use their NPI when prescribing electronically.

Here is a look at the benefits of e-prescribing systems that include the types of information covered by the new standards:

Next: Formulary and Benefit Information