By Poojah Babbrah, Practice Lead, PBM Services
Providers, pharmacies and technology vendors in the state of New York are breathing a collective sigh of relief. This afternoon, Governor Cuomo signed into law Bill S.2486 that delays, by one year, the implementation of the state’s I-STOP electronic prescribing mandate, which was adopted in 2012. The Governor has basically just given the collective New York health care community a “hall pass.”
I-STOP, which stands for Internet System for Tracking of Over Prescribing, was signed into law on August 27, 2012, by the New York State Legislature in order to help combat the rising issues around the misuse of prescription medication. The I-STOP legislation consists of five key components:
- Prescription Monitoring Program Registry
- Electronic Prescribing Mandate
- Controlled Substance Schedule Update
- Prescription Pain Medication Awareness Program
- Safe Disposal of Prescription Drugs
The one year delay specifically impacts the Electronic Prescribing Mandate requiring all providers in the state of New York to send all prescriptions (both controlled and non-controlled substances) electronically to the pharmacy; handwritten paper prescriptions will not be allowed. This mandate was supposed to go into effect on March 27, 2015, but it is now delayed by one year and will take effect on March 27, 2016.
For many, this “hall pass” has come just in time. Delays in vendor certifications, problems with identity proofing and even worse, delays in just purchasing a certified system, were all reasons given as to why the legislation should be delayed. Those are all valid reasons, but what about those in the community who were able to meet the deadline? I liken it to spending hours and hours studying for an exam, just to come in the morning of the test to find out the teacher has delayed it because of a group of students who just weren’t ready. Frustrating? Yes. However, the other way to look at it is that you are all done and ready to go. No more prep needed! Hat’s off to those of you who prepared and were ready for the deadline. You are already making an impact on the real issue that the I-STOP legislation is meant to solve which is to reduce the abuse of controlled substances and improve patient safety as it relates to their prescription medications.
For providers and provider offices who are still not ready for electronic prescribing, you now have a pass valid for one year, but that does not mean you can relax. Choosing, implementing and enabling an EHR or stand-alone ePrescribing system takes time. If you prescribe controlled substances, there are added steps on top of the initial system implementation. One year may seem like a lot, but given the fact that this deadline was nearly 2.5 years after the initial approval of the legislation, the one year you now have to get up and running is comparatively short so get started now.
Already have a certified system in place? There is still plenty of work to do in your practice including making sure all providers have completed the identity-proofing process, obtained a two-factor authentication device that is compatible with the system and your providers are enabled to send EPCS prescriptions. In addition, there are policies and procedures that must be followed by your practice to ensure you are meeting the DEA regulations outlined in the Interim Final Rule (IFR) for electronic prescribing of controlled substances. Many providers assume that they are all set once they have a certified system, however the regulations put much of the onus on the provider and the practice to ensure the system is being used and monitored correctly.
IT Vendor Considerations
For the IT vendors who are in the midst of getting their systems ready for EPCS, I can’t stress enough the importance of getting through certification as quickly as possible. Having been through it, I know that the auditing and certification process takes time and can be a challenge to navigate. Because there is no standard outline for the audit process, the DEA regulations are left to interpretation by the individual auditor and may vary widely from one auditing organization to another. Also, ensuring that your system will meet all regulations outlined in the IFR can also be challenge for some vendors.
One year may seem like a lot of time, but keep in mind, it’s not just certification; you will also need time to ensure that 100% of your providers that use your system in the state of New York are enabled to sign and send EPCS prescriptions through your system. This can also be a challenge as I mentioned above, primarily because the providers assume that the burden of implementation is on the IT vendor, when truly, the practice and the provider carry much of the burden themselves.
As Point-of Care Partners (POCP) recently wrote in HISTalk, “I-STOP may be the biggest health IT game changer of all.” (You can read the blog here.) This still holds true but keep in mind your 1-year hall pass WILL expire and when it does, you don’t want to be caught in the middle of the hallway with an expired pass and nowhere to turn.
Point-of-Care Partners (POCP) has long been active in ePrescribing and EPCS. If you are an IT Vendor, POCP can help you efficiently transition your prescribers to EPCS in New York and in states that are expected to enact legislation similar to I-STOP. Our ePrescribing State Law Review is the most succinct yet comprehensive analysis of federal and state rules, regulations and statutes governing electronic prescriptions, including EPCS. To learn more about the Law Review or subscribe to our complimentary ePrescribing State Law Capsule, visit our Regulatory Resource Center.
Pooja Babbrah is a health care information technology consultant with Point-of-Care Partners, a leading Health IT Management consulting firm. Pooja has spent more than 20 years in the health care industry and launched DrFirst’s EPCS Gold product, the health care industry’s first certified platform for e-prescribing of controlled substances.