Standards for E-Prescribing Proposed

Department of Health and Human Services Secretary Michael O. Leavitt recently announced new proposed regulations to support electronic prescribing (e-prescribing) for Medicare when the Part D prescription drug benefit goes into effect in January 2006. The proposed regulations will serve as the foundation standards or the first set of final uniform standards for an e-prescribing platform under the Medicare Prescription Drug, Improvement and Modernization Act of 2003. Furthermore, additional standards will be tested through a pilot program and recommended for adoption in a final rule to be issued no later than April 1, 2008. The standards will take effect no later than 1 year from the date the standards are issued.

The proposed e-prescribing regulations will include standards for the following:

• Transactions between prescribers and dispensers for new prescriptions, prescription refill request and response, prescription change request and response, and prescription cancellation request and response
• Eligibility and benefit inquiries and responses between drug prescribers and prescription drug plans
• Eligibility and benefit inquiries and responses between dispensers and Part D sponsors
• Formulary and benefit coverage information, including information on the availability of lower cost, therapeutically appropriate alternative drugs