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EHR Association to CMS: Align for Common Standards


Comments come in response to proposed rule for Medicare e-prescribing, prior authorization.

Doctor with EHR tablet

The Electronic Health Record Association (EHRA), representing the EHR industry, voiced its support for a proposed Medicare rule aligning e-prescribing standards with those used for prior authorization in Medicare Part D.

But the industry groups are asking federal regulators to delay the implementation until two years after the publication of the final rules — and they’re also requesting the Centers for Medicare & Medicaid Services make all the standards more uniform.

“The EHR Association understands that some states are pursuing different standards for electronic prior authorization,” the organization wrote in its Aug. 16 letter, on behalf of its 32 member companies. “We recommend that CMS work with states to align on common standards, in order to reduce redundant development and maintenance efforts for the same capabilities.”

The group, in commenting on version 2017071 of the National Council for Prescription Drug Programs SCRIPT Standard, also recommended the prevailing federal health privacy law be updated, additionally.

“To further align prior authorization for e-prescribing across other federal programs, we recommend that HIPAA be updated to reference the same standards, with the aim of upgrading any subsequent standards in concert,” they write.

CMS proposed the rule in June, saying it would improve patients’ access to medications through the updates to the prior-authorization process, through ensuring security while expediting the prior authorizations. Prescribers would be able to complete such prior authorization online, typically in real-time—and even before a prescription is transmitted to a pharmacy.

“This proposed rule would reduce the time it takes for a patient to receive needed medications and ease the prescriber burden by giving clinicians the flexibility and choice to complete prior authorization transactions electronically,” said Seema Verma, MPH, the CMS administrator, in a statement at the time.

The EHRA said it would ask the changing standards over the next 24 months take account of the improving technologies the industry is bringing to market, they added.

“While the EHR Association supports the use of the NCPDP SCRIPT 2017071 standard for electronic prior authorization for prescriptions under Medicare Part D, we note the various current and candidate standards being used, particularly as HL78 FHIR is playing an increasing role in web-based APIs that enable real-time interactions using more current technology,” the Association wrote. “These technologies are not sufficiently mature, but efforts by HL7, DA Vinci, NCPDP, and X12 should be looked at for future direction in this space.”

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