TMA Urges CMS to Nix Penalties Related to E-Prescribing Controlled Substances
By Emma Freer

The Texas Medical Association is pushing back against proposed penalties for physicians who don’t electronically prescribe controlled substances. 

The Centers for Medicare & Medicaid Services (CMS) plans to implement financial penalties for noncompliant prescribers starting in 2025, according to its 2023 proposed Medicare physician fee schedule.  

TMA expressed support for CMS’ plan to delay enforcement by two years in a September letter responding to the proposal. However, the association did ask the agency to consider scrapping financial penalties altogether, citing unintended consequences.  

“While TMA recognizes the value of [e-prescribing of controlled substances], TMA emphatically asks CMS not to impose penalties for noncompliance,” the letter states. 

One major reason: the already high rate of compliance among existing prescribers, says Ogechika Alozie, MD, an infectious disease specialist in El Paso and chair of TMA’s Committee on Health Information Technology. 

“We should be celebrating the fact that [more than] 70% of prescribers are now EPCS-enabled,” he recently told Texas Medicine, citing Surescript’s 2021 National Progress Report. “That’s quite an achievement.” 

TMA emphasized in its comments that non-compliant physicians either don’t prescribe controlled substances, or can’t afford to adopt yet another unfunded mandate. Those in the latter camp likely work in small and rural primary care practices, which serve as “the bedrock of health care in many underserved communities,” TMA wrote. 

As a result, TMA urged CMS to incentivize such prescribers to adopt e-prescribing of controlled substances rather than penalize them, commenting: “Financial penalties impose unintended consequences, such as limited access to care or physicians not prescribing necessary medications to patients.” 

TMA also asked CMS to consider a waiver for physicians who prescribe compounded medications that qualify as controlled substances but cannot be e-prescribed because they’re not included on the prescribing software’s medication list.  

The 984-page Medicare fee schedule proposal includes other changes – including yet another physician pay cut and tweaks to quality programs – that pose similar challenges to practices trying to keep their doors open. TMA continues to fight their implementation while also calling for comprehensive Medicare physician payment reform

The final 2023 Medicare physician fee schedule is expected in November, and most provisions will take effect Jan. 1. TMA continues to monitor the development process and will help prepare Texas physicians for impending changes once the final version is released.  

Physicians in search of more information about e-prescribing can find it on TMA’s dedicated webpage.  

Last Updated On

October 14, 2022

Originally Published On

October 14, 2022

Emma Freer

Associate Editor

(512) 370-1383

Emma Freer is a reporter for Texas Medicine. She previously worked in local news, covering city politics, economic development, and public health. A native Clevelander, she graduated from Columbia Journalism School and the University of St. Andrews.

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