AMA urges Walmart, OptumRx to delay EPCS requirements
Citing patient safety concerns, regulatory barriers and misalignment with state and federal policy, the AMA urged Walmart to delay implementation of its requirement for all controlled substances to be electronically prescribed, set to go into effect Jan. 1.
The AMA supports electronic prescribing of controlled substances (EPCS), but currently only 44% of physicians are EPCS-enabled due to a variety of factors. The Walmart policy does not appear to have any exceptions.
"If Walmart does not delay implementation, patients in every state will likely suffer negative consequences from not having their necessary medications dispensed," wrote AMA Executive Vice President and CEO James L. Madara, MD. "This includes patients receiving care for opioid use disorder, anxiety, depression, attention deficit hyperactivity disorder, auto-immune diseases, HIV/AIDS and painful conditions like sickle cell disease. Losing access to medications to help treat chronic disease could have devastating, potentially fatal consequences."
Dr. Madara highlighted several issues, including the lack of updated U.S. Drug Enforcement Administration requirements, misalignment with state and federal laws that do not require EPCS until Jan. 1, 2021, and the Walmart policy stands in direct conflict with state licensing and regulatory authority that has created multiple exceptions to a one-size-fits-all EPCS mandate.
The AMA has heard concerns from multiple medical societies, and Arkansas Medical Society (AMS) further emphasized the need for a delay in implementation. Executive Director David Wroten said that while the AMS was not opposed to EPCS, Arkansas law was designed to go into effect to align with federal law, slated for Jan. 1, 2021. "The failure of Walmart to postpone the implementation of this policy will create a myriad of problems and health consequences for prescribers, patients and even Walmart employees," said Wroten.
Dr. Madara sent a similar letter to OptumRx (PDF), which will require EPCS for all home delivery prescriptions beginning Jan. 1, 2020.
Read the full AMA letter (PDF).
Colorado legislative package focuses on evidence-based approaches to end opioid epidemic
The Colorado Legislature's Opioid and Other Substance Use Disorders Study Committee has drafted a five-bill legislative package that demonstrates the leading edge of policymaking for Colorado's patients. Among the evidence-based approaches put forward:
- Removing step therapy and prior authorization barriers for non-opioid pain care
- Placing non-opioid pain care options on the lowest cost-sharing tier of a health insurance company formulary
- Increasing access to naloxone by requiring the carrier to reimburse hospitals that provide naloxone to covered patients upon discharge
- Removing certain restrictions on establishing needle and syringe programs
- Requiring correctional facilities to provide at least one opioid agonist and one opioid antagonist as well as improved continuity of care provisions upon release
The package also has provisions to support medical, evidence-based criteria for the treatment of opioid use disorder; funds for loan repayment for service in underserved areas; and provisions for housing assistance, behavioral health coverage and other services.
Many of the elements in the legislative package also are part of the recommendations in the recently released AMA-Manatt Health national opioid roadmap (PDF), which contains policy provisions that the AMA recommends for all states to pursue. The national roadmap was created after an in-depth review of the work being done in four states, including Colorado.
Please contact the AMA Advocacy Resource Center at [email protected] with any questions about the Colorado legislation or national roadmap.
