New York ePrescribe Mandate
As part of New York’s I-STOP legislation, electronic prescribing of both controlled and non-controlled substances becomes mandatory on March 27, 2016. The new e-prescribing requirement will result in a number of benefits for you and your patients, including more accurate, safe and secure prescriptions.
• Pharmacists should be able to more accurately dispense the drugs prescribed because they will no longer need to interpret doctors’ handwriting.
• Patients will not be able to tamper with prescriptions by changing the prescribed amount or other information on the prescription.
• Theft of prescription pads will be reduced or eliminated.
Most physicians and many physician assistants and nurse practitioners in New York now prescribe electronically. E-prescribing software allows them to interface with the Prescription Monitoring Program to query patients’ drug histories prior to writing prescriptions for controlled drugs. This software includes drop-down reference menus to assist in selecting specific drugs, identifying interactions and contraindications and determining appropriate doses. E-prescribing software also interfaces with electronic patient records, simplifying recordkeeping.
Realistically, there are only two exceptions to the e-prescribing requirements. The first is for veterinarians. The second is where the practitioner is issuing a prescription to be dispensed by a pharmacy located outside New York State. A practitioner who issues a paper prescription to be filled in another state must file information about the issuance of such prescription with the Department of Health within 48 hours of the date of issue. If you claim an exception to do a written prescription, the prescription must still be issued on an official New York State prescription form.
Three additional exceptions are included in the regulations which only apply to very limited situations.
1. Prescriptions issued in circumstances where electronic prescribing is not available due to temporary technological or electrical failure.
A practitioner who claims this exception must file information about the issuance of such prescription with the Department of Health as soon as practicable, but in no instance more than 72 hours following the end of the technological or electrical failure that prevented the issuance of an electronic prescription. Temporary technological or electrical failure is defined as: any failure of a computer system, application, or device, or the loss of electrical power to that system, application, or device, or any other service interruption to a computer system, application, or device in such a manner that it reasonably prevents a practitioner from utilizing his or her certified electronic prescribing application to transmit an electronic prescription. In the instance of a temporary technological or electrical failure, a practitioner shall, without undue delay, seek to correct any cause for the failure that is reasonably within his or her control.
2. Prescriptions issued by practitioners who have received a waiver or a renewal of a waiver for a specified period determined by the Commissioner of Health, not to exceed one year, pursuant to a process established by the Commissioner of Health due to economic hardship, technological limitations that are not reasonably within the control of the practitioner or other exceptional circumstance demonstrated by the practitioner.
To obtain a waiver from the Commissioner of Health, the practitioner must submit a sworn statement of facts detailing the circumstances in support of a waiver, accompanied by any and all other information which would be relevant to the commissioner’s determination.
A practitioner who has been granted a waiver must notify the department in writing within five business days upon gaining the capability to issue an electronic prescription. Without regard to the original expiration date, the waiver granted to the practitioner shall terminate within a reasonable period of time as determined by the Health Department, allowing for the practitioner to make accommodations to begin issuing electronic prescriptions.
3. Prescriptions issued by a practitioner under circumstances where, notwithstanding the practitioner’s ability to make an electronic prescription, the practitioner reasonably determines that it would be impractical for the patient to obtain substances prescribed electronically in a timely manner and such delay would adversely impact the patient’s medical condition, and further provided that for a controlled substance, no more than a five day supply can be prescribed under such circumstances;
Any practitioner who claims this exception must file information about the issuance of such prescription with the Department of Health within 48 hours of the date of issue.
Regulations for Prescribing Controlled Drugs
Since August 2013, all practitioners who prescribe or dispense controlled medications have been required to query the controlled drug Registry each time they prescribe or dispense a controlled substance, regardless of the amount. To access the Registry, prescribers must establish an online Health Commerce System (HCS) account.
Any doctor that directly dispenses any controlled substance in any Schedule in any quantity to a patient must input into the registry the information concerning the controlled drug they dispensed to that patient. Additional information on the HCS online account system is available from the HCS account system at either: 866-529-1890, option 1; or 866-811-7957, option 1; as well as on the Health Commerce System website.
ePrescribing and Software Registration Requirements
In order to prescribe controlled substances electronically, practitioners are required to register their certified electronic prescribing computer application with the New York State Department of Health, Bureau of Narcotic Enforcement (BNE).
To register the computer application with BNE, practitioners must complete a ROPES form online by following these steps:
- Login to the Health Commerce System.
- Select "My Content" at the top of the page.
- Scroll down and select "All Applications"
- Scroll over and select "R"
- Scroll down and select ROPES
- Follow the prompts to complete the form.
The form requires the practitioner to identify the “third party audit certifying organization” and the date of the third party audit/certification. However, the prescriber is not responsible for having an audit. The software vendor is responsible for having the audit performed – not the doctor. The vendor should provide the prescriber/software purchaser with the “audit/certification."
Questions regarding the ROPES form or process may be directed to BNE by emailing email@example.com or by calling 1-866-811-7957, option 1.
Practitioners must also meet the federal security requirements for EPCS as detailed in the Drug Enforcement Administration’s Electronic Prescriptions for Controlled Substances Interim Final Rule. The applicable rule can be accessed online.