- Mandatory Electronic Prescribing
- Governor Andrew Cuomo has signed legislation into law extending the deadline for required e-prescribing of medications for one year, to March 27, 2016. All prescribers should continue to diligently establish their e-prescribing capability as required by the law so that they will be in compliance by the new effective date. (March 18, 2015)
- Effective March 27, 2015, a new law will require nurse practitioners, midwives, dentists, podiatrists, physicians, physician assistants and optometrists in New York State ("prescribers") to issue prescriptions electronically directly to a pharmacy, with limited exceptions. The law will not require a prescriber to issue a prescription electronically 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; or,
- The prescription will be dispensed at a pharmacy located outside New York State.
The new law requires electronic prescribing for all types of medications (controlled substances and non-controlled substances) and for syringes and other medical devices dispensed at a pharmacy in New York.
Information about this law (Public Health Law §281) is available on the New York State Department of Health website.
An electronic prescription is a prescription 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; and,
- Transmitted electronically directly from the prescriber to a pharmacy or pharmacist.
Electronic prescription computer technology must comply with federal and New York regulations. These regulations require prescribers and pharmacists to have a secure (encrypted and encoded) system for electronic transmission of the prescription from computer to computer in order to protect the confidentiality and security of patient information. Electronic prescribing computer applications must also be “certified” (i.e. audited by an organization or certified by the federal Drug Enforcement Agency to ensure it meets technical standards acceptable to federal government).
EMAILed prescriptions are NOT considered electronic prescriptions since EMAIL is not considered a secure method of electronically transmitting a prescription. A faxed prescription is NOT considered an electronic prescription.
Prescribers must personally generate and transmit electronic prescriptions to pharmacies or pharmacists and are not legally allowed to delegate this responsibility to other individuals. Electronic prescriptions must include the same information that written prescriptions do except that:
- All electronic prescriptions must include an NPI number;
- Electronic prescriptions must be electronically signed; and,
- The prescriber must specify whether a prescription must be dispensed as written, if a brand-name product is therapeutically required.
For more information, visit: www.health.ny.gov/professionals/narcotic/.
Government Requirements for Electronic Prescribing
Prescribers must obtain a number of government approvals and identification numbers and register their “certified electronic prescribing computer application” in order to issue electronic prescriptions to pharmacies. Here’s a brief summary of these requirements.
- A National Provider Identifier (NPI) issued by the US Center for Medicaid and Medicare Services (CMS). All electronic prescriptions issued in New York State must include a NPI. Federal law requires health care providers (including hospitals and prescribers) to use NPIs on electronic health care transactions (i.e., processing claims, status inquiries, eligibility inquiries). CMS issues NPIs to institutional health care providers (i.e., hospitals) and to licensed prescribers. If a prescriber works in a hospital, the prescriber may use the hospital’s NPI when issuing prescriptions. In most other cases, the prescriber must include his or her personal NPI on the prescription. For more information about applying for a NPI, visit: www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand/. Applications can be submitted online or by regular mail.
- A Federal Drug Enforcement Administration Registration (DEA) Number issued by the US Department of Justice- Drug Enforcement Administration. In New York, a DEA number must be on every prescription for a controlled substance issued by a prescriber. The DEA issues DEA numbers to institutional health care providers (i.e., hospitals) and to licensed prescribers. In most cases, a prescriber must obtain a DEA number in order to prescribe or dispense controlled substances. In some cases, prescribers who are employed at a hospital may, when acting in the usual course of employment, may dispense or prescribe controlled substances under the DEA number of the hospital. For more information about applying for a DEA number visit, www.DEAdiversion.USDOJ.gov or call 1-877-883-5789, 1-800-882-9539 or 212-337-1593. Prescibers who do not prescribe controlled substances do not need a DEA number.
- A Health Commerce System Account (HCSA) from the New York State Department of Health. All prescribers must have a HCSA in order access an online Prescription Monitoring Registry when prescribing controlled substances. New York Law requires prescribers, when prescribing controlled substances, to consult the registry, which contains information about prescriptions for controlled by substances obtained their patients. Instructions for establishing a Health Commerce System Account are available at the New York State Department of Health’s web site: www.health.ny.gov/professionals/narcotic/ Prescribers who do not prescribe controlled substances do need an HCSA account.
- Registration with the New York State Department of Health’s Bureau of Narcotic Enforcement. Each prescriber must register with the New York State Health Department’s Bureau of Narcotic Enforcement in order to prescribe controlled substances. The registration must be renewed every 2 years. Instructions on registering are available at the New York State Department of Health’s Bureau of Narcotic Enforcement web site: www.health.ny.gov/professionals/narcotic/ Prescribers who do not prescribe controlled substances do not need to register as a prescriber of controlled substances with the New York State Department of Health’s Bureau of Narcotic Enforcement.
- Registration of "Certified" Electronic Prescribing Computer Applications Prescribers must ensure that they issue electronic prescriptions using electronic prescribing computer applications that meet federal regulatory criteria for protecting the confidentiality and security of patient information. Information relating to federal criteria for electronic prescribing computer applications is available at: www.deadiversion.usdoj.gov/ecomm/e_rx/thirdparty.htm Prescribers should verify with the computer company that licenses that their electronic prescribing computer application that the application is "certified" (i.e. audited by an organization or certified by the federal Drug Enforcement Agency to ensure that the application meets technical standards acceptable to federal government). Prescribers must then complete a "Practitioner EPCS Registration Form" and file it with the New York State Department of Health’s Bureau of Narcotics Enforcement. On the form, the prescriber must identify the “certified” electronic prescribing computer application that he or she uses. For information about registration send an email to firstname.lastname@example.org Include "Electronic Prescribing" in the subject. Additional, information about electronic prescribing is at: www.health.ny.gov/professionals/narcotic/electronic_prescribing/
- A Medicaid Provider Number. Prescribers must obtain a Medicaid Provider Number in order to prescribe for Medicaid beneficiaries. To access application forms for Medicaid reimbursement, go to www.emedny.org and click on the provider enrollment tab at the top of the page. If a prescriber will not be participating as a provider in New York’s Medicaid Program, the prescriber does not need to obtain a Medicaid Provider Number.