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What is a Qualified eRx System?


A qualified eRx system is one that is capable of ALL of the following:

1. Generates a complete active medication list incorporating electronic data received from applicable pharmacies and pharmacy benefit managers (PBMs), if available.

2. Selects medications, prints prescriptions, electronically transmits prescriptions, and conducts all alerts (defined below).

3. Provides information related to lower cost, therapeutically appropriate alternatives, if any (the availability of an eRx system to receive tiered formulary information would meet this requirement for 2010).

4. Provides information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient’s drug plan,if available.

The system must employ, for the capabilities listed, the eRx standards adopted by the Secretary of the Department of Health and Human Services (HHS) for Medicare Part D by virtue of the 2003 Medicare Modernization Act (MMA).

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