The ongoing abuse of opioids has pushed states around the U.S. to establish mandates around the prescription of controlled substances. Workers in the healthcare industry now have to pay strict attention to prescription drugs and how they handle their usage when making electronic prescriptions. Technology is now being used to fight the national epidemic through Electronic Prescribing for Controlled Substances, which seeks to eliminate paper prescriptions by replacing them with digital and traceable e-prescriptions. 

Almost all states now mandate the use of Electronic Prescribing for Controlled Substances (EPCS), and the few that haven’t are expected to have it set out by the start of 2023. This has seen more than 82% of retail pharmacies in the U.S. make transitions to support controlled substance prescriptions electronically.

The Benefits of Mandatory Electronic Prescribing 

ECPS is thought to be the long-waited solution to combat fraud and abuse of controlled substances. It eliminates some of the complications of paper prescriptions by sealing loopholes that drug-seekers exploit to access prescription drugs unjustly. Some of the ways e-prescribing will make a difference in the fight against controlled substance abuse include:

• E-prescribing enhances patient safety by reducing common errors in written prescriptions, such as illegible handwriting, unclear dosages, and misinterpreted abbreviations. It works along a patient’s Electronic Health Records (EHR) and issues clinical alerts that prevent drug-to-drug and drug to allergy. Based on your medication history, the systems offer automated clinical support that enables providers to avoid prescribing medications that could lead to an unwanted drug event.
• Prescriptions are sent directly from a clinical practitioner to the pharmacy, which reduces errors and also seals gaps for forgery and alterations.
• Reduces drug misuse and abuse since providers can see a patient’s medication history and determine if they are ‘doctor shopping’ or showing tendencies associated with drug abuse.
• It streamlines all prescribing functions into a single workflow.

EPCS Compliance Requirements 

ECPS is not new; it goes as far back as 2010 when the U.S. Drug Enforcement Agency (DEA) agreed to allow healthcare providers to issue e-prescriptions. ECPS was then implemented along with the standards for the systems used by I.T. vendors, providers, and pharmacies. The federal law put up an electronic prescription standard for controlled substances included in the Medicare Part D drugs. It also requires all states to establish their own EPCS rules and regulations; therefore, compliance requirements will vary.

However, for the systems to be used in EPCS, the DEA outlined compliance guidelines they need to meet, which include:

• Include a two-factor authentication process for providers signing an EPCS prescription
• Must have an EHR/E-prescribing application certification
• Proof of Identity to verify that a provider is authorized to prescribe controlled substances
• Two-steps access control that gives the EPCS permissions to approved prescribers
• Comprehensive reporting that details compliance and highlights auditable events and any breaches of security. 

Are There Exceptions to the Mandate?

You can be exempted from compliance actions for ECPS in a few special circumstances if:

• The same entity issues the prescription for the controlled substance, i.e., the prescriber and pharmacy are one entity.
• You are a prescriber that issues 100 or fewer qualifying Medicare Part D controlled substances in a calendar year.
• Centers for Medicare and Medicaid Services (CMS) determine whether you are in a geographic area of an emergency or disaster as determined by the Federal, State, or local government.
• CMS approved your waiver because you cannot provide electronic prescribing of controlled circumstances due to circumstances beyond your control. 

Upcoming EPCS Mandates by State

As a healthcare provider, it is important to determine if EPCS regulations are already in effect in your state and what you need to do to stay compliant.

Illinois, IL E-Prescribing Mandates

Illinois is known to have recorded higher opioid-related overdose deaths compared to the national average. To tackle dependence on prescription opioids, the state passed laws in 2010 and 2015 that made Opioid Reversal drugs easier to obtain and increased training initiatives for law enforcement, schools, and emergency responders. They even set up a 2-hour Opioid Crisis hotline.

In the consistency to fight opioid dependency issues, Illinois state mandate now requires that all prescriptions for schedule II, III, IV, or V controlled substances be issued electronically. This is according to the recently amended Illinois Controlled Substances Act that goes into effect on January 1st, 2023. In the meantime, Medicare Advantage and Medicate Part D prescribers are still subjected to the federal mandate. They must electronically prescribe schedule II, III, IV, and V controlled substances before the given date. 

However, prescribers who certify to the Department of Financial and Professional Regulation that they will not issue more than 25 prescriptions in a calendar year are not required to issue e-prescriptions. 

Utah, UT E-Prescribing Mandates

As of January 1^st, 2022, all schedules II, III, IV, and V controlled providers are required to electronically prescribe substances in Utah. Failure to comply with this would violate Utah state law, and the offenders could be punished.

Ohio, OH E-Prescribing Mandates

On September 23, 2022, Ohio’s EPCS mandate went into effect requiring the use of electronic prescribing for all Schedule II controlled substances.

Maryland, MD E-Prescribing Mandates

On 8th May 2020, Maryland Governor Larry Hogan signed Senate Bill 0166 into law. The act requires prescribers to issue e-prescriptions for all controlled substances that contain opioids. This is part of the effort put in by the state to combat opioid abuse and addiction. At its highest, the number of opioid-related deaths in Maryland stood at 33.7 per 100,000 people. Both prescription and synthetic opioids are widely abused, and the Electronic Prescribing of Controlled Substances (EPCS) is anticipated to help reduce the menace. It will enhance prescription security and reduce cases of fraudulent prescriptions. 

The mandate was to become effective by January 1^st, 2022, but on November 2nd, 2021, compliance actions for the law were delayed by the CMS to January 1st, 2023. Any healthcare practitioner unable to electronically issue prescriptions for controlled substances must request a waiver which will only be granted in 2022. Otherwise, e-prescribing is currently not mandated in Maryland but is still widely used.

Michigan, MI E-Prescribing Mandates

On January 1st, 2023, Michigan will require the use of e-prescribe for all prescriptions, including Schedule II-V controlled substances. Failure to comply can result in penalties, fines, or worse for your practice.

How NewCrop Rx Helps You Comply with EPCS Mandates

As an award-winning provider of electronic prescribing services, NewCrop Rx has the solutions to help make the prescribing process efficient. We can help you connect data from different sources at every stage of the process, which streamlines workflow, facilitates medication reconciliation, and supports medication adherence. Soon the law will require all facilities to be ECPS compliant, and there is no reason for you to be caught off-guard. You can trust us to help you navigate all the complexities of ECPS to ensure compliance and security. Contact NewCrop today to learn more about how our solutions can integrate into your practice to help you do what you do best.