While 2018 brought the nation’s first drop in drug-associated deaths in 25 years, the next year was grim, setting a new record for mortality in 2019. And, with pre-pandemic opioid death rates already staggeringly high in the United States, 2020 suffered an even sharper rise. The combination of an immense loss during the global pandemic, recent increases in drug-related deaths, and demands to change the way healthcare is delivered is significantly and continually affecting the future of controlled substance prescriptions.
CMS’s EPCS Legislation: Where Are We Now?
With the healthcare landscape rapidly shifting, gone are the days of handwritten prescriptions. The U.S. government has already taken measures to address the ongoing drug abuse crisis with greater controls around prescription opioids and the expansion of treatment and recovery options. Electronic Prescribing for Controlled Substances (EPCS) is one measure, requiring that clinical prescribers write controlled medications electronically. EPCS began in 2010 as a proposal by the Drug Enforcement Agency (DEA) to block the abuse of controlled substances by creating a more transparent and accountable system for prescribers and pharmacies.
January 1, 2021 was the original deadline for states to comply with federal EPCS mandates. In December 2020, due to complications of COVID-19, the Centers for Medicare and Medicaid Services (CMS) extended enforcement of EPCS for Medicare Part D until January 1, 2022. However, CMS is still encouraging adoption as soon as possible. At the same time, at least half of the United States now fall under individual state mandates. Whether your state has current requirements or not, it’s only a matter of time before deadlines and mandates affect your practice. To ensure compliance with EPCS mandates, the process should be undertaken proactively as it may take several months to gather all of your necessary information and find a certified solution
Where States Stand on EPCS
In 2016, New York was the first state to enact legislation addressing EPCS due to 2,166 drug overdose deaths in the previous year. In 2018, the state reported its first decline in drug-related deaths since 2009, a 4.1% reduction from 2017. Other states have since followed suit and with EPCS regulations in place, saw similar trends of drug-related deaths declining. Of note are some of the hardest-hit states such as Maine, Connecticut, Delaware, and West Virginia. Other states that currently have instituted EPCS mandates include:
- North Carolina
- Rhode Island
- South Carolina
These states can provide longitudinal data regarding EPCS, proving that electronic or e-prescription tools are much more than an efficient and transparent method to prescribe; they’re also effective in the prevention against drug overdoses. Providing a “paper trail” of comprehensive medication history at providers’ and pharmacists’ fingertips, EPCS helps to inform and improve prescribing decisions and help reduce overprescribing, overuse, and resulting drug addiction. EPCS also improves the security of controlled substance prescriptions, helping to reduce fraud and diversion. This is underscored by the fact that e-prescribing is now part of the “Every Prescription Conveyed Securely” mandate.
Upcoming EPCS State Mandate Deadlines
Providers should be aware of upcoming deadlines and be proactive in preparation for these deadlines, as the collection of materials may take several months unless you are using a third party that can expedite the process. As of August 1, 2021, these deadlines apply to the following states:
- Washington – September 30, 2021
- Michigan – October 1, 2021
- California – January 1, 2022
- Indiana – January 1, 2022
- Maryland – January 1, 2022
- Nebraska – January 1, 2022
- New Hampshire – January 1, 2022
- Utah – January 1, 2022
Your healthcare institution should stay vigilant about state mandates. Follow your state’s guidelines to stay up to date.
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