A Brief Guide to E-Prescribing

by Ankita Sagar, MD, MPH

We are now in the midst of Holiday Season and soon we will start planning for the New Year – 2015! This winter, prescribers should keep in mind that New York State will require all prescriptions, including those for controlled substances, to be submitted in electronic format by March 27, 2015. This is in accordance with legislation enacted in 2012.

This blog post can serve as a quick overview of the mandate.

1. What is an electronic prescription?

It is a prescription for controlled substances, non-controlled substances, syringes, and other medical devices that is:

• Created, recorded, transmitted or stored by electronic means
• Issued and validated with the prescriber’s electronic signature
• Electronically encrypted to prevent unauthorized access, alteration or use of the prescription
• Transmitted electronically directly from the prescriber to a pharmacy or pharmacist
• Is addressed to a pharmacy within New York State

 

2. What must be included on an electronic prescription?

• NPI Number for the physician
• Electronic signature of the physician
• Whether the medication is to be “Dispensed As Written” (DAW)

 

3. What is required of me (as a prescriber) before I can start e-prescribing?

You must ensure that you have the following licenses/certifications in order, prior to e-prescribing:

• NPI number issued by CMS (cms.hhs.gov/nationalProvIdentstand)
• DEA number issued by the US-Dept of Justice-Drug Enforcement Agency (DEAdiversion.USDOJ.gov)
• Health Commerce System (HCS) Account from NYS-DOH (health.ny.gov/professionals/narcotic)
• Registration of “Certified” Electronic Prescribing Computer Applications (ask your EHR vendor for this information)
• Medicaid Provider Number (if prescribing for Medicaid beneficiaries)

 

4. Is my EHR vendor compliant with this application?

You must discuss this individually with your EHR vendor. There are over 140 active vendors in NYS. At this time, BNE representatives are not expecting to delay this mandate if the vendor is not compliant. However, BNE is committed to working with all parties to overcome the difficulties in compliance.

 

5. Are there any exceptions to the mandate?

E-prescribing regulations include several exceptions to the mandate including when:

• Electronic prescribing is not available due to temporary technological or electronic failure
• The prescriber has a waiver granted by the New York State Commissioner of Health
• The prescriber reasonably determines that it would be impractical for the patient to obtain substances prescribed by electronic prescription in a timely manner
• The prescription will be dispensed at a pharmacy located outside New York State

 

6. How can a prescriber obtain a waiver for this mandate?

If the practitioner’s ability to issue electronic prescriptions is unduly burdened by economic hardship or technological limitations that are not reasonably within the control of the practitioner, NYS may be able to grant a waiver for the practitioner.

 

7. Does this mandate apply to retired practitioners?

Yes. The e-prescribing mandate is applicable to retired practitioners since they are expected to utilize e-prescribing software to issue prescriptions. BNE reports that they are unlikely to grant waivers for retired physicians.

 

8. Can a prescriber e-mail a prescription to a pharmacy?

No. E-mail transmissions will not meet the criteria for the mandate.

 

9. Can a prescriber “call-in” an emergency prescription for a patient?

A prescriber may issue a prescription by other than electronic means if he/she believes that the electronic prescription would not be transmitted in a timely manner and the delay will cause adversity or significant harm to the health of the patient. If a controlled substance is being prescribed, the quantity of controlled substances cannot exceed a five day supply. In addition, the prescriber must file information about this non-electronic prescription with the NYS Health Department within 48 hours of the date of prescription.

 

10. I have more questions – who do I contact?

1. New York State Boards for Medicine & Veterinary Medicine (518) 474-3817 ext. 560; Fax (518) 486-4846; E-mail: medbd@mail.nysed.gov
2. New York State Health Department – Bureau of Narcotic Enforcement, (518) 402-0707; E-mail: Narcotic@health.state.ny.us.
3. New York State Health Department – Electronic Prescribing of Controlled Substances: http://www.health.ny.gov/professionals/narcotic/electronic_prescribing