I-STOP and the New York Prescription Monitoring Program

Beginning August 27, 2013, New York State practitioners became responsible to  review a patient’s prescription history before prescribing certain medications. The Internet System for Tracking Over-Prescribing (I-STOP) Act was enacted in 2012 to address the growing problem of prescription drug abuse by eliminating “doctor shopping” and identifying patterns of abuse in patients, doctors, and pharmacists.[1] I-STOP requires the online Prescription Monitoring Program (PMP) to be updated in “real time,” to give practitioners and pharmacists access to accurate and up-to-date prescription drug history.[2]

Under the law, practitioners must consult the PMP and review a patient’s prescription drug history before prescribing a Schedule II, III or IV controlled substance.[3] Alternately, practitioners may designate and train an employee to consult the registry; however, the practitioner is ultimately responsible for determining whether to prescribe the substance.[4] There are limited exceptions to the requirement to consult the PMP.[5] For example, there is no duty to consult the PMP if the substance is administered in the prescriber’s office or in a hospital or clinic, or if technological failure prevents access to the PMP. An exception will also apply if a practitioner cannot access the PMP in a timely manner and there is no other practitioner or designee who can consult on the practitioner’s behalf, as long as the prescription is for no more than a five day supply of the substance.[6]

Practitioners must document the consultation in the patient’s chart. If one of the exceptions applies, the practitioner must document the reasons why the consultation was not performed.[7]

To access the PMP, practitioners need to establish an account with the Health Commerce System.[8] The large influx of applicants for accounts may result in delays in processing.[9] The Department of Health has indicated that “practitioners who are making a good faith effort to apply but are unable to establish HCS accounts, should continue to provide treatment to their patients in the same manner as they currently do, including the prescribing of controlled substances without accessing PMP Registry.” This transition period may last through October.

Please contact Feldman Kieffer by email or at (716) 852-5875 if you have questions or concerns about your responsibilities under I-STOP.


[1] N.Y. Office of the Attorney General, Internet System for Tracking Over-Prescribing Act: A Proposal Addressing New York’s Prescription Drug Abuse and Drug Diversion Epidemic, http://www.ag.ny.gov/sites/default/files/press-releases/2012/ISTOP%20REPORT%20FINAL%201.10.12.pdf.

[2] NY CLS Pub. Health. L. § 3343-a(1)(a).

[3]Id. § 3343-a(2)(a).

[4]Id. § 3343-a(2)(b).

[5]Id. § 3343-a(2)(a).

[6] For a complete list of exceptions, see NY CLS Pub. Health L. § 3343-a(2)(a).

[7] 10 NYCRR § 80.63(c)(1).

[8] A Health Commerce System Account can be established at the New York State Department of Health’s website, https://apps.health.ny.gov/pub/top.html.

[9] Dep’t of Health, I-STOP/PMP, “Prescription Monitoring Program Registry” http://www.health.ny.gov/professionals/narcotic/prescription_monitoring/.

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