CMS Proposes E-Prescribing Standards

Healthcare Financial Management Association (HFMA): On Nov. 13, HHS Secretary Mike Leavitt announced that the department, through the Centers for Medicare and Medicaid Services (CMS), is proposing rules to adopt new standards to advance the use of electronic prescribing (e-prescribing) for formulary and benefit as well as medication history transactions used under the Medicare prescription drug benefit. The proposed standards will be published in the Nov. 16 Federal Register.

The Medicare Modernization Act of 2003 requires CMS to adopt final standards for e-prescribing. All providers and pharmacies transmitting prescriptions electronically for Medicare-covered drugs are required to comply with any CMS standards in effect. The standards cover:

• Transactions between prescribers and dispensers for new prescriptions; refill requests and responses; prescription change requests and responses; prescription cancellation, request, and response; and related messaging and administrative transactions
• Eligibility and benefits queries and responses between prescribers and Part D sponsors
• Eligibility queries between dispensers and Part D sponsors

Download the proposed standards.