IMPORTANT: Illinois’ E-Prescribing Mandate Takes Effect January 1

September 15, 2023

Here’s what doctors need to do NOW

Effective Jan. 1, 2024, Illinois will require all healthcare professionals who write prescriptions for controlled substances to provide them electronically – unless eligible for a waiver and/or exemption.

The law does include several exemptions but does not provide details about how they will be issued. ISMS has requested further guidance from the Illinois Department of Financial and Professional Services (IDFPR) as to how physicians and other healthcare professionals can obtain appropriate waivers and/or exemptions. At this time, however, we do not have any specific information. It is recommended that practices reach out to their attorneys with any questions, such as appropriate documentation of a waiver and/or exemption in the medical record when e-prescribing is not used. Examples of exemptions include:

  • Prescribers issuing 150 prescriptions or less annually are exempt from the mandate until Jan. 1, 2029. After that, anyone annually issuing 50 prescriptions or less is exempt.

  • Prior to Jan. 1, 2026, waivers will be granted to prescribers who demonstrate a financial hardship. After Jan. 1, 2026, prescribers who offer proof of receiving a waiver from the federal CMS e-prescribing mandate will be waived from the state mandate.

  • If physicians experience any temporary technological or electric failures that prevent a prescription from being transmitted electronically, they will be granted an exception on a case-by-case basis.

To review all of the exemptions and waivers pertaining to the e-prescribing mandate, access ISMS’ 2023 Legislative Report. Scroll to Page 11 of the PDF (Page 7 of the document) and look for the heading “Exemptions/Waivers to E-Prescribing Mandate.”

ISMS will provide more information to members about how to obtain appropriate waivers and/or exemptions once IDFPR guidance and other details become known.

To help our members prepare for the mandate, ISMS offers these resources:


If you have questions, please contact ISMS Senior Vice President of State Legislative Affairs Erin O'Brien by email.

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