This week, the Joint Committee on Mental Health, Substance Use, and Recovery held a public hearing for H.4033, known as the CARE Act, an omnibus opioid bill filed by Governor Baker. A major component of this bill is a new requirement for health care providers and pharmacies to use electronic prescribing technology for opioids and other controlled substances, also known as “EPCS,” a proposal initially filed by Representative Carolyn Dykema (D-Holliston) in H.2453 at the beginning of this session.
H.4033 will eliminate written prescribing for Schedule II narcotics and mandate electronic prescribing of these substances statewide. Prescribers will be required to utilize electronic methods in accordance with federal regulations to write and fill opioid prescriptions, which will not only curb fraud but also lead to increased efficiency and convenience for those with chronic conditions who currently must visit a provider to obtain a paper prescription for each refill. For smaller providers who may require additional time to acquire EPCS technology, the legislation allows for a waiver process for prescribers with economic or technological limitations and directs DPH to promulgate regulations for exemptions.
Representative Dykema was joined by several of her colleagues in both parties and legislative chambers in submitting a letter of support for the EPCS provisions in the CARE Act. The American College of Surgeons recommended EPCS implementation in October 2017 as part of a national response to the opioid crisis.
“Ensuring that prescriptions are written and filled in a safe and secure manner is critical to delivering quality health care while curbing fraud and misuse,” said Rep. Dykema. “Since e-prescribing became legal, more and more states and stakeholders are embracing the technology to an important prevention tool in the fight against the opioid epidemic.”
Six other states have passed similar legislation. Many of these states border Massachusetts, including New York, Connecticut, Rhode Island, and Maine, creating an environment where EPCS is poised to become a regional norm. Since mandatory e-prescribing was implemented in New York, the Bureau of Narcotics Enforcement reports a 70 percent drop in lost and stolen prescriptions from 2015 to 2016.
“The CARE Act will enable Massachusetts policymakers to focus on upstream solutions to the opioid epidemic by employing already-existing E-Prescribing technology that is proven and usable,” said Dr. Sean Kelly, Chief Medical Officer for Imprivata and an emergency physician at a leading teaching hospital in Boston. “Six states have already enacted legislation mandating electronic prescribing of controlled substances. A mandate in Massachusetts would quickly increase the beneficial impact that technology can have in preventing addiction before it happens and reducing the loss of life due to the opioid epidemic.”
Both Rep. Dykema’s legislation and the Governor’s are now being considered in their respective committees. The legislature is required to act on each bill by February 7th.