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Mandatory Electronic Prescribing

Mandatory Electronic Prescribing

Effective March 27, 2016, all prescriptions issued in New York State shall be electronic prescriptions, with certain limited exceptions. Prescribers are required to issue prescriptions for controlled and non-controlled substances electronically, directly to a pharmacy. The law does not require a prescriber to issue a prescription electronically when:

  • Electronic prescribing is not available due to temporary technological or electronic failure;
  • The prescriber is in possession of 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 law requires electronic prescribing for all types of medications, including both controlled substances and non-controlled substances dispensed at a pharmacy located in New York.

More information about the Public Health Law § 281 (PHL Ch. 45, Art. 2-a, Title III, § 281) and exceptions to electronic prescribing can be found on the New York State Department of Health’s website.   

Electronic Prescriptions

An electronic prescription is a prescription that is:

Issued with an electronic signature and transmitted by electronic means in accordance with regulations of the commissioner and the commissioner of education, and consistent with federal requirements.  A prescription generated on an electronic system that is printed out or transmitted via facsimile is not considered an electronic prescription and must be manually signed. (New York Public Health Law, Ch. 45, Art. 33, Title I, § 3302 [35]).

  • Created, recorded, transmitted or stored by electronic means (PHL § 3302 [37]);
  • Issued and validated with the prescriber’s electronic signature (PHL § 3302 [38]);
  • Electronically encrypted to prevent unauthorized access, alteration or use of the prescription (8 NYCRR Pt. 63 §63.6 (a.)(7)(ii.)(b.)); and,
  • Transmitted electronically directly from the prescriber to a pharmacy or pharmacist (PHL § 3302 [36]).

The computer technology utilized for electronic prescriptions must comply with federal requirements and New York regulations (PHL § 3302[35]). The 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 (PHL § 3302[36]).

The signing and transmission of an electronic prescription are two distinct actions. Only the prescriber may review and electronically sign the prescription. Once signed, an agent or employee of the practitioner may transmit the prescription on behalf of the practitioner (PHL § 3302[38]). The act of transmission must be independent of the review and signature process.


All electronic prescriptions must include the same information that written prescriptions do, except that all electronic prescriptions:
•    Must include an NPI number;
•    Must be electronically signed; and,
•    The prescriber must specify whether the prescription must be dispensed as written if a brand-name product is therapeutically required.

For more information, visit the New York State Department of Health website. 

Government Requirements for Electronic Prescribing

In order to issue electronic prescriptions to pharmacies, prescribers must obtain the necessary government approvals, the applicable identification numbers, and register their “certified electronic prescribing computer application.” A brief summary of those requirements can be found here: 

  • 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 an 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 is responsible for the issuance of 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 with the prescription. For more information about applying for a NPI, visit the Centers for Medicare & Medicaid Services website. 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 is responsible for the issuance of 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 their employment, dispense or prescribe controlled substances under the DEA number of the hospital. More information about applying for a DEA number can be found on the DEA website, or by calling 1-877-883-5789, 1-800-882-9539 or 212-337-1593.  Prescribers 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 an HCSA to access the online Prescription Monitoring Registry when prescribing controlled substances. New York Law requires that prescribers, when prescribing controlled substances, consult the registry which contains information about prescriptions for controlled substances obtained by their patients. Instructions for establishing an HCSA are available on the New York State Department of Health's website. Prescribers who do not prescribe controlled substances do need an HCSA account.
  • Registration of "Certified" Electronic Prescribing Computer Applications. Prescribers must ensure, when issuing electronic prescriptions, that they are utilizing electronic prescribing computer applications that meet federal regulatory criteria for protecting the confidentiality and security of patient information. Information relating to the federal criteria for electronic prescribing computer applications is available on the DEA website. Prescribers should verify with the company that licenses the software utilized by the prescriber that their electronic prescribing computer application is "certified" (i.e. audited by an organization or certified by the federal Drug Enforcement Agency to ensure that the application meets acceptable technical standards). Prescribers will have to 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 they utilize in their practice. For additional information about registration, the prescriber should send an email to narcotic@health.ny.gov, and be sure to include "Electronic Prescribing" in the subject line of the email. 

Additional information about electronic prescribing can be found on the New York State Department of Health’s website.

  • 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 the eMedNY website 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.