Feb 17, 2021

[Update] CMS Delays EPCS Compliance Enforcement for Medicare Part D to January 1, 2023

Helen Farnen  |  Updated June 8


In 2018, the SUPPORT for Patients and Communities Act mandated that Medicare Part D prescribers use Electronic Prescribing for Controlled Substances (EPCS) by January 1st, 2021. However, in December 2020, the Centers for Medicare & Medicaid Services (CMS) issued a final ruling that delayed enforcement of compliance penalties by one year until 2022 before just recently delaying again until January 1, 2023.

Throughout 2021, CMS solicited input on appropriate actions for non-compliance and how any penalties will be imposed. Comments were submitted and the Calendar Year (CY) 2022 Medicare Physician Fee Schedule Final Rule was released and is accessible at cms.gov as of November 2nd, 2021. As of November 2021, CMS compliance actions “will consist of sending letters to prescribers that we believe are violating the EPCS requirement during that period of time. These letters will consist of a notification to prescribers that they are violating the EPCS requirement, information about how they can come into compliance, the benefits of EPCS, an information solicitation as to why they are not conducting EPCS, and a link to the CMS portal to request a waiver.” However, between now and the enforcement deadline in 2023, CMS will re-evaluate whether further compliance actions and penalties are necessary.

What Does The Enforcement Delay Mean For Your Practice?

While enforcement and CMS “compliance action” has been delayed, the mandate is currently in effect and there are still clear advantages to EPCS adoption as soon as possible. Namely, increasing practice efficiency and patient satisfaction by decreasing pharmacy interactions, repeat doctor visits, and increasing administrative work, minimizing prescription errors and issues, decreasing prescription fraud and “doctor shopping” for medications, and mitigating the national opioid epidemic by requiring drug databases and limits on controlled substances.

From the 2022 Medicare Physician Fee Schedule Final Rule – Section § 423.160, “Beginning on January 1, 2021, prescribers must, except in the circumstances described [below], conduct prescribing for at least 70 percent of their Schedule II, III, IV, and V controlled substances that are Part D drugs electronically … Compliance actions against prescribers who do not meet the compliance threshold based on other prescriptions will commence on or after January 1, 2023.” There are a few exemptions and waivers to the 2023 compliance deadline, such as prescribers who meet the following criteria:

  • “Prescriber and dispensing pharmacy are the same entity.”
  • “Prescriber issues 100 or fewer controlled substance prescriptions for Part D drugs per calendar year as determined using CMS claims data as of December 31st of the preceding year.”
  • “Prescriber has an NCPDP database address in the geographic area of an emergency or disaster declared by a Federal, State, or local government entity.”
  • “Prescriber has received a CMS-approved waiver because the prescriber is unable to conduct electronic prescribing of controlled substances (EPCS) due to circumstances beyond the prescriber’s control.”

Why EPCS Matters (For The Entire United States) In 2022

The intent of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act is to help combat the opioid crisis which spiked to its highest level of 81,000 deaths in the 12-month period between June 2019 and May 2020. According to research outlined in Surescripts National Progress Report 2020, over 84% of prescribers use electronic prescribing, but only 58% are enabled for EPCS controlled substance prescribing, leaving room for greater implementation of EPCS-certified solutions. And smaller practices are less likely to use e-prescribing software than larger practices and hospitals due to the perceived cost, time, and effort of implementation.

If your practice doesn’t already use e-prescribing for controlled substances or have EPCS-enabled software, time is running out before penalties will kick in! January 2023 will arrive sooner than you think. Plus, many states already require EPCS usage, with more states on the way every year. In 2022 alone, seven states had deadlines: CaliforniaIndianaMarylandMichiganNebraskaNew HampshireUtah, and Washington state. That means now is a perfect time to enroll in RXNT’s proven, award-winning E-Prescribing software that is DEA-certified for EPCS.

Check out how an RXNT client capitalized on our E-Prescribing and Electronic Health Records software to increase his patient load by 25%. As a solo practitioner, he’s been able to write an average of 30 prescriptions electronically per day; a massive increase with the time savings compared to writing, copying, and filing prescriptions manually.

Ready To Get Started With EPCS-Certified Software?

With state deadlines looming and federal deadlines already in place (with enforcement coming soon), a quick software implementation is critical to keep your practice workflow steady. RXNT’s affordable eRx software is fully HIPAA-compliant, EPCS-certified, meets DEA requirements, provides integrated access to state PDMPs, and is a five-time Surescripts award winner. We’ll have you writing prescriptions within 10 business days of enrolling and completing the self-paced training.

Schedule a free demonstration with one of our specialists by completing the demo form, calling (800) 943-7968, or sending an email. Visit our dedicated guide to EPCS for information on state mandates, and read this short article that covers the advantages of EPCS adoption.

The information in this article is current as of December 2021 and is for general information purposes only. RXNT makes no warranties or representations of any kind, express or implied, about the accuracy, completeness, or reliability of the information in this article. RXNT assumes no liability for any damages caused by inaccuracies in this content. All users should consult with their jurisdiction for the most up-to-date and accurate information about any existing or pending legislation.

Ready to improve your practice?

See why our integrated, award-winning healthcare software is the right fit for your medical practice! Since 1999, we've developed certified, cloud-based Electronic Health Records (EHR) with Patient Portal, E-Prescribing (eRx), and Practice Management with Medical Billing and Scheduling.

Scroll to Top