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      Medical Practices Face Penalties if not E-Prescribing Controlled Substances

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      Are you meeting the requirements of the SUPPORT ACT? If not, then know this: Beginning Jan. 1, 2022, the Centers for Medicare and Medicaid Services (CMS) will begin enforcing penalties on those not complying with provisions that require them to electronically prescribe all controlled substances.

      CMS Enforcing SUPPORT Act Beginning January 1, 2022

      Earlier this year, the CMS was considering extending the compliance deadline until January of 2023. However, the agency announced this month that it is sticking with its Jan. 1, 2022 deadline. This means that CMS will begin enforcing the act on that date – and penalizing practices, not in compliance.

      How do You avoid being penalized?

      In short, you must electronically transmit prescriptions for all controlled substances under schedules II, III, IV, and V of Medicare Part D, per Section 2003 of the SUPPORT Act. Medicare Part D includes those Medicare Advantage plans and Part D stand-alone plans administering the Part D benefit.

      Also, the CMS is mandating that Medicare Part D sponsors must have implemented an Electronic Real-Time Benefit tool capable of integrating with at least one prescriber's EHR by January 1, 2021. Also known as a Real-Time Benefit Check or Real-Time Prescription Benefit, this interoperable tool help ensure patient coverage for prescription drugs at the most affordable prices.

      Thirty-one states already have adopted laws mirroring Section 2003 or are expanding to include all medications. For providers, it is vital to understand the laws applying to electronic prescribing in their state and for those Medicare beneficiaries they are serving.

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      What are the penalties for non-compliance?

      The CMS has not yet explained how compliance will be enforced or what the penalties will be for non-compliance. In fact, the agency has been soliciting input regarding appropriate punishment and how that punishment should be administered.

      Will there be exceptions and allowances for some practices?

      Depending on circumstances, yes. The statute gives the CMS Secretary discretion to grant waivers or exceptions to the Electronic Prescribing for Controlled Substances (EPCS) requirement based on several specific types of exceptions. Certain exceptions to the EPCS requirement will apply if a prescriber meets any of the following criteria:

      • The prescriber and dispensing pharmacy are the same entity
      • The prescriber issues 100 or fewer controlled substance prescriptions for Part D drugs per calendar year, and …
      • The prescriber is in the geographic area of an emergency or disaster declared by a federal, state, or local government entity, or …
      • The prescriber has been granted a CMS-approved waiver based on extraordinary circumstances, such as technical failures or cybersecurity attacks, or other emergencies

      What’s in it for you?

      Maintaining compliance with this new law protects your practice from fraud and doctor shopping. It requires 2-factor authentication as well as identity-proofing. To prevent your practice from falling behind, an electronic health records system — or an integration with one — is required.

      Other benefits of EPCS include:

      • Reduction of medication errors
      • Increased patient safety
      • Reduction of overprescribing
      • Increased prescription accuracy – reduced callbacks to the provider to verify information or attempt to read poor handwriting
      • Reduction of fraud and diversion, such as forged, altered, or stolen paper prescriptions
      • Increased overall cost savings of staff time
      • Reduction of storage of paper records

      Why do we need this law?

      In response to the growing opioid crisis, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (known as the SUPPORT for Patients and Communities Act) was passed into federal law in 2018. This legislation contains several measures supporting the prevention and treatment of opioid abuse, including never-before covered services for Medicaid recipients and increased monies for training new providers.

      According to the most recent figures from the CMS, nearly 97,000 Americans died from drug overdoses during the 12-month period from March 2020 – when the COVID-19 pandemic began to take off – until March 2021. This represents a 29.6% increase in drug overdose deaths over the previous 12-month period. These numbers, however, are provisional, and the U.S. Centers for Disease Control and Prevention (CDC) is predicting the total number of deaths for this time period to reach more than 99,000.

      Why the one-year wait until enforcement?

      Although the SUPPORT Act became law on January 1, 2021, the compliance/enforcement date was delayed until January 1, 2022. The reason this time gap was created was to allow for providers to implement their EPCS while allowing the CMS to define its compliance actions.

      If your practice has not yet adopted EPCS, the time to start is now to avoid enforcement actions. The safety of your patients and community depends on this action.

      Enjoy the Benefits of EHR Software Designed for Your Specialty Practice Needs

      schedule a demo with insync healthcare solutions

      If you've decided that now is the time for your practice to start looking for a new EHR software system,  remember that InSync Healthcare Solutions specializes in EHR software that is designed specifically for behavioral health practices and includes everything from group scheduling and group notes to telehealth, e-Prescribing, eMAR, and custom forms.

      For a closer look at how our interoperable, mobile-friendly and configurable software system can increase efficiencies and workflows in your mental health practice grows, schedule a demo now with one of our experts. We're happy to answer questions and explain how we can tailor our system to meet your needs while saving you time and money. 


      Centers for Medicare & Medicaid Services: Calendar Year 2022 Medicare Physician Fee Schedule Final Rule

      Federal Register: Medicare Program: Electronic Prescribing of Controlled Substances

      U.S. News & World Report: CDC Reports Record High 12-Month Drug Overdose Death Toll

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