Texas: e-Prescribing of Controlled Substances

The Practice Fusion EHR provides advanced electronic prescribing capabilities, including electronic prescribing of controlled substances (EPCS).*

Practice Fusion: Using an EHR system to meet Texas state mandates for certified EPCS. EPCS allows you to:

• e-Prescribe scheduled drugs right from the Practice Fusion EHR
• Use one workflow for all prescriptions
• Minimize patient wait times at pharmacies
• Reduce unnecessary office visits
• Improve safety and reduce fraud and abuse
• Integrate with your state’s Prescription Drug Monitoring Program (PDMP) to check for patients with duplicate prescriptions or other signs of “doctor shopping”
• Fully integrate with the Practice Fusion EHR and e-prescribing workflow
• Use a streamlined process for fast identity verification
• Automatically check patient-specific formularies and perform drug and allergy checks
• Automatically receive Electronic Prior Authorizations (ePA) for prescriptions

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Texas State Mandates

Electronic Prescribing of Controlled Substances (EPCS)

Federal Mandate: Medicare Advantage & Medicare Part D Practitioners In 2018, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act was passed by the federal government.^1,2 This Act includes legislation that requires Medicare Advantage and Medicare Part D practitioners to begin electronically prescribing controlled substances January 1, 2021. Medicare Advantage and Medicare Part D prescribers in every state are subject to the above mandate and must comply. Due to the COVID-19 health emergency, the Centers for Medicare & Medicaid Services has postponed penalties for noncompliance; however, enforcement of those penalties will begin January 1, 2022.^2,3

Texas State Mandate: All Prescribers The state of Texas requires EPCS for all controlled substances.^4,5 In addition, Medicare Advantage and Medicare Part D prescribers in Texas are also subject to the federal mandate to e-prescribe schedule II, III, IV, and V controlled substances.6 Prescribers subject to the federal mandate may choose to e-prescribe controlled substances for all patients, regardless of payer. Prescribers not subject to the federal mandate may also choose to e-prescribe controlled substances. Doing so may reduce burden, improve workflow productivity, and increase safety and security.

Practice Fusion will continue to monitor legislative changes in the state of Texas and will alert providers of any upcoming regulatory changes or requirements.

Prescription Drug Monitoring Program (PDMP)

Review of the Prescription Monitoring Program (PMP)—also known as PDMP, Rx AWARE, or PMP AWARxE—became mandatory for both prescribers and pharmacists in 2020 with limited exceptions, such as prescriptions for patients diagnosed with cancer, for terminally ill patients, or for patients in inpatient treatment. Prescribers and pharmacists (or their delegates) must query the PMP to check the patient’s prescription history before prescribing or dispensing opioids, benzodiazepines, barbiturates, or carisoprodol, no matter the duration of the prescription. Prescribers and pharmacists are also required to query the PMP if they observe patient behavior that might suggest possible drug diversion or abuse.^4,7,8

Prescribers are not required to review the PMP at regular intervals after the initial prescription.

Why choose Practice Fusion in Texas for EPCS

Whether you just need a simple solution to address state mandates or are interested in more robust features such as text message appointment reminders or charting, Practice Fusion has the right features to meet your needs. We offer advanced e-prescribing capabilities including EPCS, prior authorization management, and allergy alerts. Your subscription will also include features such as:

• Charting
• Electronic lab and imaging test ordering and results
• Compliance tracking
• Appointment scheduling
• Text message appointment reminders
• Support for quality payment programs

In addition, Practice Fusion is able to integrate directly with Texas’s PDMP database, or Rx AWARE. This means prescribers can consult Rx AWARE from within their existing workflow.

References:

1. Centers for Medicare & Medicaid Services (CMS). Medicare Program: Electronic Prescribing of Controlled Substances; Request for Information (RFI). Federal Register: The Daily Journal of the United States Government. Updated August 4, 2020. Accessed September 16, 2021, https://www.federalregister.gov/documents/2020/08/04/2020-16897/medicare-program-electronic-prescribing-of-controlled-substances-request-for-information-rfi.
   
2. CMS delays enforcement of e-prescribing requirement for controlled substances. California Medical Association. Updated December 15, 2020. Accessed September 16, 2021, https://www.cmadocs.org/newsroom/news/view/ArticleId/49150/CMS-delays-enforcement-of-e-prescribing-requirement-for-controlled-substances.
   
3. CMS formally delays EPCS enforcement. National Community Pharmacists Association. Updated December 4, 2020. Accessed August 22, 2021, https://ncpa.org/newsroom/qam/2020/12/04/qam-ad-cms-formally-delays-epcs-enforcement.
   
4. State PDMP Profiles and Contacts. Prescription Drug Monitoring Program Training and Technical Assistance Center. Updated July 7, 2021. Accessed August 19, 2021, https://www.pdmpassist.org/State.
   
5. What is a PDMP (Prescription Drug Monitoring Program)? Practice Fusion. Updated September 1, 2021. Accessed September 16, 2021, https://www.practicefusion.com/blog/what-is-a-pdmp/.
   
6. Public Law No: 115-271 (10/24/2018) H.R.6 - SUPPORT for Patients and Communities Act (Congress.gov - U.S. Governnent Publishing Office).
   
7. About the Texas PMP. Texas Prescription Monitoring Program. Accessed August 10, 2021, https://txpmp.org/about.
   
8. Texas Prescription Monitoring Program. Texas State Board of Pharmacy. Accessed August 6, 2021, https://www.pharmacy.texas.gov/pmp/.

*Electronic Prescriptions for Controlled Substances (EPCS) is only available in the 50 US states and the District of Columbia