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I-STOP startup: An FAQ on New York's paperless prescription program

The handwriting has been on the wall for handwritten prescriptions in New York for several years now. In 2012, the State Legislature passed the Internet System for Tracking Over-Prescribing Act, better known as I-STOP.

I-STOP was supposed to go into effect in 2013. But it's a complicated law and there have been various enforcement delays.

This week, however, New York began requiring electronic prescriptions (with various exceptions). In this post, we will address some common questions about the new law.

Why was I-STOP passed?

One reason was to prevent fraudulent or stolen prescriptions. Attorney General Eric Schneiderman has contended that such prescriptions become a form of criminal currency because they can potentially be used in health care fraud.

Another concern that I-STOP seeks to address is patient safety. It isn't only that e-prescriptions could reduce errors caused by doctors' poor handwriting on paper scripts. There is also a very particular concern with preventing excessive access to opioid-based prescription painkillers that are highly addictive.

How does the new law work?

Doctors and other health care professionals who prescribe medications are supposed to send the prescriptions directly to pharmacies. This replaces the traditional method of writing the prescription on a slip of paper that the patient takes to a pharmacy to be filled.

Before writing a prescription for certain controlled substances, doctors are supposed to consult a database with information about patients' prescription history. This has required substantial investments in software systems by health care providers.

There will also be reporting requirements for pharmacies to the state when certain types of prescriptions are filled.

In order to force doctors to participate in the program, I-STOP allows for fines for doctors who don't follow the new procedures for prescriptions. New York is the first state in the country to implement a law that contains such fines. And doctors might well wonder whether lack of compliance could affect their licenses.

Is the law fully in effect?

More than 60,000 health care providers are already using the I-STOP system. But many others -- perhaps 40 percent of all providers -- are not yet in compliance with the new law.

The State Health Department has issued waivers to about 2,600 medical providers are still working on coming into compliance.

That said, the March 27 rollout of the new law received considerable press attention. Authorities say they will be patient with providers who make a good faith effort to comply. But clearly a new era has begun.

What are the downsides of I-STOP?

One concern is that I-STOP may have the unintended consequence of encouraging heroin use. This is because making it more difficult to obtain opioid-based prescription painkillers may cause some people with addiction problems to turn to heroin instead.

Other critics say that the new law is too one-dimensional. It pours lots of resources into enforcement, but doesn't address the need for treatment for people with addiction issues.

How will the new law affect criminal charges?

This is all still very new. If you are facing prescription drug charges, it's important to get knowledgeable legal counsel.

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