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Entries categorized as ‘Pharmacy’

Clinician e-Prescribing Guidelines Released at CMS Conference

October 11, 2008 · Leave a Comment

In recent months, the Center for Medicare and Medicaid Services (CMS) has been publicizing its support for e-prescribing, i.e. electronically generating and transmitting prescriptions via computer in lieu of traditional paper. CMS has even announced its intention to pay financial incentives (2%) to encourage providers to begin “e-prescribing” in 2009.

To support CMS efforts, a consortium calling itself the “eHealth Initiative,” in collaboration with
the American Medical Association and various other physician groups, has issued a guide to assist providers in transition from paper to e-prescribing. Their “Clinician’s Guide to Electronic Prescribing” was released last week at the CMS National e-Prescribing Conference in Boston and is available online here.

Recommended Action:
Transitioning to e-prescribing is not going to be without cost and effort, but there are significant potential advantages and options to minimize expenses. Beyond the 2% bonus that CMS will be paying to early adopters, e-prescribing holds out the potential for greater safety (e.g. appropriate dosing, drug interaction, and allergy verification), fewer errors in physician-pharmacy communications (e.g. from illegible handwriting or medication errors), less risk of patient abuse, and less need for front-office personnel to administer and relay prescriptions. Physicians dissuaded by the anticipated software expense should explore several free web-based options for e-prescribing, including the National ePrescribing Patient Safety Initiative (NEPSI).

Harry Nelson is a partner in Fenton & Nelson, LLP. Fenton & Nelson counsels physicians and other healthcare providers on regulatory compliance and business matters. For additional information, please contact him at harry@fentonnelson.com

©Harry Nelson 2008

Categories: Medicare · Pharmacy
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Congress Passes New Controlled Substance Prescribing Limits

October 2, 2008 · Leave a Comment

Both the House or Representatives and the Senate have passed the so-called “Ryan Haight Act,” a new federal law that limits physician prescribing. Haight, an 18-year-old from La Mesa, died of an overdose after providing false information online and ordering Vicodin from an Internet pharmacy in 2000. (New York Times, 7/09/08.) The new law requires physicians to conduct at least one face-to-face exam before dispensing medication in order to determine the medical need. The sole, narrow exception recognized by the statute allows a “covering practitioner” to prescribe after evaluating the patient (not in-person) at the request of a practitioner who has previously evaluated the patient but is “temporarily unavailable.” In addition, the law imposes disclosure requirements upon pharmacies and limitations on online advertisement and Internet sales of controlled substances by pharmacies.

Recommended Action: The Ryan Haight Act appears to bring to an end the Internet pharmacy business in its current form. Even though its application is limited by its terms to Internet prescribing, the law serves as yet another reminder of the importance of documenting an in-person physical exam prior to prescribing controlled substances.

Harry Nelson is a partner in Fenton & Nelson, LLP. Fenton & Nelson advises providers on medical practice management, including prescribing issues, and defends regulatory investigations and enforcement actions involving controlled substances. For additional information, please contact him at harry@fentonnelson.com

©Harry Nelson 2008

Categories: DEA · Pharmacy
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