Over the past few decades, we have observed technological improvement in the healthcare sector with the introduction of different billing techniques, concepts, and equipment. With those terms and conditions, there have been different changes that needs to be implemented in almost every practice, and prescription drugs are just another domain.
AMA and CMS changes to EPCS – Electronic Prescription Controlled Substances are crucial when making online prescriptions. Practitioners need to get familiarized with ECP to clearly implement the suggested amendments. But what is EPCS?
As a provider, you need to keep a close eye on the mandatory requirements of EPCS that will ultimately impact your drug prescription process. To know more about EPCS, their nature, their place in the prescription industry, and how the United States implement them.
What is EPCS?

The core purpose of Electronic Prescribing of Controlled Substances is to minimize the paperwork in the industry and enable prescribers to make online prescriptions for prescription drugs or controlled substances electronically. With this digitalization, prescriptions will be trackable and so the pharmacy that issued drugs and the prescriber who prescribed them.
To date, more than half of practices and pharmacies in the United States have implemented the mandate and the rest are in the process of taking effect. However, implementation of the mandate takes enough time for the organizations as not only the process takes time but compliance with EPCS guidelines is the other thing that needs to be ensured. If you are still looking after EPCS mandating updates, then you should act now before the deadline hits.
Besides, hospitals and private practices should be aware of the implementation of electronic prescriptions, which is a more effective and efficient way of dealing with the prescription than doing it manually. It can also help in identifying an overdose of a certain drug, which can be determined at the pharmacy counter. The importance of the prescription mandate is addressed so importantly that e-prescription has become the part of Every Prescription Conveyed Securely mandate which is required by the federal government in 2021. However, the deadline for the first implementation date was January 1, 2020.
States that are required to implement EPCS till January 2021

Federally mandated EPCS required these states to implement the procedure first till January 1, 2021.
This means that Arizona, North Carolina, Iowa, Rhode Island, Oklahoma, and Massachusetts require EPCS by January 1, 2021.
But how should these implementations take place? Managers, Healthcare providers, and Pharmacies should remain prepared for the appropriate deployment of the relevant technology and software in order to meet the federally designated requirements. These requirements are regulated to use of Electronic Prescription for Controlled Substances in the Part D program of Medicare. In the process of integrating software into the industry, the organization noticed that not only complying with the US regulation is challenging but meeting the requirements also has the same toll to bear. However, there are emerging benefits of this implementation that should be noticed as well.
For instance, healthcare with a range of resources selected the software which was compatible with the vendor’s OneSign single sign-on solution which the facility already had. It eventually proved to be useful as it complied with the major requirements issued as permission to use the electronic prescription for controlled substances.
The right technology for the e-prescription process
To date, approximately 99% of healthcare facilities are equipped with electronic prescriptions for controlled substances. This goes positively on both patients and practitioners. It saves practitioners time to select the right medicines, sends a prescription electronically, and saves long waiting hours at pharmacies for patients.
To make the most of the technology, it is vital for the system to sync with each other to be on the same page and bring out effective outcomes. Before EPCS implementations, the guidelines regulated for a prescription by the state and federal governments were not synchronized. And this lack of arrangements made the prescription process more complicated. For instance, one entity might be treating a substance controlled and another one does not.

Issues that EPCS resolves also contain ‘doctor shopping’ where patients seek multiple prescriptions from different doctors in order to get prescriptions for a controlled substance. When hospitals and organizations decide to use paperless/e-prescriptions, thefts, scams attributed to stealing, and blank prescription forgeries can be declined.
The best software that is programmed for a healthcare facility is EHR, which automatically reduces the number of days for drugs/opioids from a standard 30 days to 10-15 days.
In the end, with EHR and e-prescription in place, you’ll have the chance to flag patients who do not fill the prescriptions on time and switch from less expensive products to non-preferred drugs.
How to integrate EPCS with EHR?
Of course, you’ll not want your organization to be left behind due to the regulatory environment and changing regulations. To proceed with your practice in an effective way, the first thing that you should do is to ensure that your EHR allows you to transmit and create electronic prescriptions. With this, you’ll be able to provide quality care in the most appropriate means to patients with extensive healthcare needs while at the same time complying with the mandates given by state, federal, and private entities.
With the amendments and regulatory updates in the healthcare industry, e-prescriptions have grown in popularity with a range of clear benefits. electronic prescription for controlled substances greatly helps in cutting down the abuse of drug abuse by tracking the use of certain drugs electronically. To minimize the chances of drug abuse and misuse of controlled substances, many states have legalized such regulations that mandate electronic prescriptions for controlled substances to track patterns of using prescriptions virtually. At the same time, many private facilities and even the federal government have begun forming EPCS mandatory to implement at each and every medical facility.
Related Article: Types of Electronic Health Record Systems
EPCS federal requirements and legislation
It was in 2010 when the United States Drug Enforcement Agency (USDEA) started consenting healthcare providers to EPCS. With this consent, healthcare facilities started implementing EPCS systems with constructive guidelines from USDEA. The implementation after 2010 also was important as many healthcare IT vendors, pharmacies, and providers have been shifted to EPCS.
In order to integrate the EPCS system, USDEA proposed some mandatory requirements, which include;
- When signing ab e-prescription, two-step verification is required from providers
- Certification of using EHR/e-prescription software or application.
- Proof that the provider has the authority to advise controlled substances
- Logical access control with two-step verification that allows the provider to use EPCS
- Comprehensive compliance with detailed reporting that determines events and incidents by audits.
What triggered the integration of EPCS regulation
Drug abuse has massively affected the United States in the past few years. In just 2018, due to drug overdose, the US witnessed the deaths of over 70,000 drug abusers. Over two-thirds of these individuals were involved in prescription drugs or illegal drug abuse as US Centers for Disease Control and Prevention stated.
Thus, death sprung and the desire to minimize and eliminate the number of death due to drug abuse triggered EPCS regulation. EPCS systems not only just introduced effective ways to prevent drug abuse but it shows ways to combat the drug crisis.

To apply these changes and restrict the death count, many states have implemented EPCS according to the updated laws of 2020. If your practice is linked with the six states mentioned above that need EPCS certification, ensure that your practice meets the mandate which allows providers to prescribe opioids and controlled substances as of January 1, 2020.
On the other hand, if your practice does not meet mandate requirements, you may not be able to prescribe controlled substances till your practice or prescription system does not meet the updated EPCS mandate.
Frequently Asked Questions (FAQs)
1. What is EPCS?
Electronic prescription for controlled substances or EPCS is an online solution to address drug abuse issues in the United States. Through EPCS, providers are allowed to write and prescribe controlled substances through electronic prescriptions. These prescriptions are also sent to pharmacies, pharmacists can dispense and archive them using the system online.
2. What are the responsibilities of a provider towards controlled substances?
A huge responsibility is over a provider when prescribing controlled substances according to USDEA title 21. First, unless a provider is registered in DAE and doesn’t have a DEA number, they will not be able to prescribe prescription drugs or controlled substances.
Once registered and received numbers, they need to keep the authentication credentials in sole possession and should not share them with anyone.
3. How are EHR responsibilities defined?
EHR or any other technology that providers integrate into their practice should be certified by a third-party or federal body according to DEA 21 requirements. A certified system ensures signing, properly creating, and prescription of controlled substances are auditable.
The integrated technology must also provide two-factor authentication for a provider to access the system and meet the DAE requirements. Also, this technology must link healthcare providers and their practices with DEA through registration making sure that providers are prescribing drugs by just signing them electronically.