Senators urge DEA to legalize e-prescribing of controlled substances

A Democratic senator from Rhode Island was joined by Republican colleagues today in insisting that the Drug Enforcement Administration open the door to e-prescribing of controlled substances.

Sen. Sheldon Whitehouse (D-R.I.) accused DEA of foot-dragging and demanded a timetable for the agency to act. The agency has been working for years on regulations that would permit e-prescribing of controlled substances.

Meanwhile, Health and Human Services Secretary Mike Leavitt said the Medicare bill being drafted in the Senate Finance Committee “should require physicians to implement health information technology that meets department standards in order to be eligible for higher payments from Medicare.”

Leavitt’s statement was not specific about what kinds of health IT should be required, but in a blog on the HHS Web site he said that “the benefits of utilizing interoperable health information technology for keeping electronic health records, prescribing drugs electronically and other purposes are clear.”

In a special meeting of his advisory committee, the American Health Information Community, last week, e-prescribing was the only mandate discussed in connection with Medicare reimbursements.

Whitehouse, presiding over a Senate Judiciary Committee hearing, described the DEA ban on e-prescribing narcotics as a major barrier to widespread use of e-prescribing. Joining with him were Sen. Arlen Specter of Pennsylvania, the ranking Republican; Sen. Edward Kennedy (D-Mass.) and Sen. Tom Coburn (R-Okla.)

But Joseph Rannazzisi, who heads the DEA’s Office of Diversion Control, said abuse of prescription drugs now exceeds abuse of cocaine, heroin, hallucinogens, Ecstasy and inhalants, combined. “In the absence of appropriate controls,” he said, “allowing electronic prescriptions for controlled substances would certainly exacerbate a growing epidemic of prescription drug abuse in the United States.”

Pointing to the potential advantages of e-prescribing for controlling health care costs and improving medication safety, Coburn accused Rannazzisi of following a bureaucratic rule that says, “Never do what’s best when you can do what’s safe.”

Witnesses at the hearing also testified that e-prescriptions would be easier to police than the current system of writing prescriptions on pieces of paper or calling them into a pharmacy. “Any e-prescribing technology is going to be more secure than the paper-based system that’s currently used today,” said David Miller, chief security officer at Compuware Covisint.

Whitehouse agreed. “We target bombers, engage in billion-dollar financial transactions, transmit national security information and engage in countless important private electronic communications every day,” he said. “I can’t believe we can’t figure out a way to prescribe Vicodin.”

Tony Trenkle, director of ehealth and standards services for the Centers for Medicare and Medicaid Services, was among those testifying that it would be difficult for doctors to use two prescribing systems, e-prescribing for most drugs and paper for controlled substances.

Whitehouse extracted from a reluctant Rannazzisi a promise to provide the committee within 60 days with a timetable for DEA action on new regulations clearing the way for e-prescribing.

About the Author

Nancy Ferris is senior editor of Government Health IT.

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