CMS creates exemption for computer-generated faxed prescriptions

WASHINGTON According to the Federal Register, a proposed rule about Medicare payment policies for physicians for next year includes an exemption about the pending elimination of computer-generated faxes for prescriptions and refills. In the proposed rule, the Centers for Medicare and Medicaid Services also turns down requests to reimburse for remote critical care consultations and diabetes self-management training via telehealth systems.

Medicare, as of Jan. 1, 2009, was to prohibit the use of computer-generated faxes to transmit prescriptions and refill requests, except in instances of temporary network transmission failures. Many electronic prescription systems don’t actually send an electronic prescription or refill request to a pharmacy, but generate a fax. The new policy was designed to move vendors to build—and physicians to use—“true” electronic prescribing systems.

The proposal did not mandate electronic prescribing. Rather, it sought to eliminate computer-generated faxes from e-prescribing systems that physicians were using. Comments on the proposal, however, convinced policymakers that the industry is not yet ready to transition from computerized faxes to true electronic transmissions to pharmacies.

Consequently, CMS now proposes to permit computer-generated faxes “when the prescriber is incapable of receiving electronic transmissions using the National Counsel for Prescription Drug Programs SCRIPT standard,” according to the proposed rule. The agency will periodically revisit the issue and is seeking comments on what constitutes an adequate time to transition to the electronic standards.

On the issue of remote diabetes self-management training, CMS reviewed numerous studies and concluded that there is no compelling evidence that individual or group diabetes training done via telehealth “is an adequate substitute for the face-to-face encounter between the practitioner and the patient.”

CMS also turned down a request for Medicare reimbursement of critical care specialists using telehealth technology to remotely consult with on-site clinicians.