On December 28, 2017, the Centers for Medicare and Medicaid Services (CMS) published a memo to state survey agency directors clarifying its position on the use of text messaging among health care providers. In its memo, CMS stated that it does not permit texting of patient orders by health care providers, as texting of patient orders does not comply with the applicable Medicare conditions of participation (COPs), specifically 42 C.F.R. § 489.24. Instead of texting patient orders, CMS states that its preference is for health care providers to either hand-write an order into the patient’s medical record or enter the order via computerized provider order entry (CPOE). The CPOE should allow for an immediate download into the provider’s electronic health record system.

While CMS is maintaining a hardline approach with respect to patient orders, it recognizes the prevalence of texting as an important means of communication among providers. Consequently, CMS states that texting patient information among health care providers is permissible, provided that it occurs through a secure and encrypted platform in compliance with HIPAA, the COPs, and/or conditions for coverage. CMS also said it expects that health care providers and organizations will routinely assess the texting platforms for security and integrity.

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