Five states rang in the new year with an Electronic Prescribing for Controlled Substances (EPCS) mandate going into effect in an effort to combat the opioid epidemic and abuse of prescription drugs. On January 1, 2020 Arizona, Iowa, North Carolina, Oklahoma, and Rhode Island joined 5 other states with mandates already in effect (Connecticut, Maine, Minnesota, New York and Pennsylvania). While Massachusetts was initially scheduled to go into effect on January 1, 2020, it was recently announced that the mandate has been delayed to January 1, 2021. Additionally, Florida has an effective date upon license renewal beginning January 1, 2020 and no later than July 1, 2021.
EPCS can help reduce fraud and abuse of controlled substances, as it is a Drug Enforcement Agency (DEA) certified solution mandated at the state level that requires identity proofing to ensure that only an authorized prescriber is issuing prescriptions. It has the potential to help reduce medication errors, prescription theft, and forgery, and helps ensure prescriptions are securely transmitted from provider to retail or mail-order pharmacies.
EPCS requires two-factor authentication (2fa), which means more than 2 types of identification components are needed for access to ePrescribing. Typically, the 2 factors include a user-created password and a one-time password (OTP) produced by a hard or soft token. The most common form of 2fa is used at automated teller machines (ATMs). An ATM requires the user to possess a physical card, as well as provide a personal identification number (PIN). For EPCS, a third-party provider typically supports the use of the token and a fee is charged directly to the provider for the hardware, OTP token, and identity proofing subscription. One token is required for each prescribing provider in the practice.
EPCS adoption is expected to increase as Medicare Part D requires EPCS by January 1, 2021 for all controlled substances as a result of the SUPPORT for Patients and Communities Act signed into federal law in October 2018. The state laws similarly require that all controlled substances under Medicare Part D be electronically prescribed and received by the filling pharmacy.
To summarize, of the 50 states and 4 US territories, 27 have enacted laws:
- 10 states currently have laws in effect
- 1 state (Virginia) has an effective date of July 1, 2020
- CMS Part D controlled substance prescriptions have an effective date of January 1, 2021 in all states and territories
- 1 state (Florida) has an effective date upon license renewal beginning January 1, 2020 and no later than July 1, 2021
- 12 additional states have a future effective date of January 1, 2021
- 2 states have an effective date of July 1, 2021 for non-Part D business (Colorado, Kansas) and 1 state (California) has a future effective date of January 1, 2022
EPCS mandates: effective dates
* Effective upon license renewal and no later than July 1, 2021
Aggressive legislative activity is expected over the next 6 to 9 months in the remaining states and territories in preparation for the January 1, 2021 Medicare Part D mandate. With the majority of state legislatures adjourned for the year, you may wish to keep an eye out for additional activity in 2020.
Quanum ePrescribing is an electronic prescription solution that will help you meet current or future EPCS mandates. Our service enables you to manage prescriptions quickly and conveniently through your Quanum EHR, or it can be purchased separately for a low monthly fee.