EPCS 101: Everything You Need to Know

As organizations across the U.S. continue to move away from outdated paper processes, more and more are turning to ePrescribing to replace the paper, fax, email, and phone processes for placing prescription orders. Not only does this undertaking need to be done to streamline processes, but it is also necessary for complying with new regulations related to Electronic Prescriptions for Controlled Substances (EPCS) coming into effect. In this blog, we’ll tell you everything you need to know about EPCS, why is it necessary, and why you need to ensure you are ready to comply with future regulations. Here’s your EPCS 101 crash course.

First, what is ePrescribing?

Electronic Prescribing, or ePrescribing, refers to the process by which a prescription is electronically created, validated, and transmitted directly from the practitioner to a pharmacy or pharmacist. The key benefits of ePrescribing are:

• Improved patient safety and quality of care.
• Reduced time on phone calls to or from pharmacies.  
• Increased medication compliance and outcomes.
• Improved formulary adherence, resulting in lower drug costs.

What is EPCS?
EPCS is a special instance of ePrescribing, that follows a set of requirements established by the Drug Enforcement Administration (DEA) for security, authentication, and audit.

Why do we need EPCS?
Errors in medication prescribing and filling are some of the most common types of medical errors. In the United States, an estimated 200,000 deaths occur yearly from preventable medical mistakes and hospital infections. We are also currently facing an opioid crisis. In 2019, 70,630 people died from drug overdose, and in the last year alone 10.1 million people misused prescription opioids.

In states that have enacted ePrescribing legislation, studies have shown significant benefits. Error rates decreased from 42.5 per 100 prescriptions to 6.6 per 100 prescriptions, nearly a seventh of the previous level, in just one year after the adoption of e-Prescribing. Adding EPCS to this equation provides for a singular workflow, with an improved level of security and assurance over paper formats.

However, there is still a lot of work to be done in order to achieve this across the US. Today, just 81% of prescribers are enabled for EPCS nationwide, compared with nearly 96% of pharmacies. Furthermore, in 2018, 96% of non-controlled substances were prescribed electronically, compared to just 31% of controlled substances.

EPCS Regulations

In order to push this forward at both the federal and state level, regulations are being enacted. A federal rule, the SUPPORT Act, which was effective as of January 1, 2021, started to be enforced as of January 1, 2023. Compliance actions for long-term care (LTC) were exempted from that effective date but are scheduled to begin on January 1, 2025. The intent of this rule is that EPCS will be required for all controlled substances covered under Medicare Part D. A detailed review reveals that this rule does include exceptions, such as for LTC patients that are dual-eligible for Medicare and Medicaid. A waiver process is also available in specified circumstances. 

Many states are following the lead of this rule and creating their own legislation for EPCS requirements. Some states have a different deadline, or have excluded LTC from their requirements. It is worth noting that states may choose to create more prohibitive rules, but many states may simply rely upon the SUPPORT act.

Next Steps
The key to complying with the regulation is to get started early! We encourage you start preparing as soon as possible, and to do that, you need to bring awareness to your organization. Follow these steps to start your preparations now and stay tuned to our blog for more updates.

• Determine EPCS mandate status
  • Federal and State regulations around EPCS specific to your operation should be reviewed and understood.
  • Determine qualifications for exemptions or waivers, and consult with your legal counsel to be sure to be aware of all obligations.
  • Engage your Prescribers
    • Prescriber buy-in is key to success. Education of and engagement by Prescribers will be key. They will need to get used to signing orders electronically, and may need time and training to get used to the new workflows.
    • Be creative in getting prescribers to engage! A new mobile app for signing orders, reviews, access to resident information, etc., can help improve their experience.
  • Evaluate Integration & Applications
    • Do you have the optimal technology in place? PointClickCare integrations and applications can provide the capabilities you need: eMAR, Integrated Medication Management (IMM), and Practitioner Engagement (mobile).

This information is provided for information purposes only – it does not constitute legal advice. ​