§329-38
Prescriptions. (a) No controlled substance in schedule II may be
dispensed without a written prescription of a practitioner, except:
(1) In the case of an
emergency situation, a pharmacist may dispense a controlled substance listed in
schedule II upon receiving oral authorization from a prescribing practitioner;
provided that:
(A) The quantity
prescribed and dispensed is limited to the amount adequate to treat the patient
during the emergency period (dispensing beyond the emergency period must be
pursuant to a written prescription signed by the prescribing practitioner);
(B) If the prescribing practitioner is
not known to the pharmacist, the pharmacist shall make a reasonable effort to
determine that the oral authorization came from a registered practitioner,
which may include a callback to the prescribing practitioner using the phone
number in the telephone directory or other good faith efforts to identify the
prescriber; and
(C) Within seven
days after authorizing an emergency oral prescription, the prescribing
practitioner shall cause a written prescription for the emergency quantity
prescribed to be delivered to the dispensing pharmacist. In addition to
conforming to the requirements of this subsection, the prescription shall have
written on its face "Authorization for Emergency Dispensing". The
written prescription may be delivered to the pharmacist in person or by mail,
and if by mail, the prescription shall be postmarked within the seven-day
period. Upon receipt, the dispensing pharmacist shall attach this prescription
to the oral emergency prescription, which had earlier been reduced to writing.
The pharmacist shall notify the administrator if the prescribing practitioner
fails to deliver a written prescription to the pharmacy within the allotted
time. Failure of the pharmacist to do so shall void the authority conferred by
this paragraph to dispense without a written prescription of a prescribing
individual practitioner. Any practitioner who fails to deliver a written
prescription within the seven-day period shall be in violation of section
329-41(a)(1);
(2) When dispensed
directly by a practitioner, other than a pharmacist, to the ultimate user. The
practitioner in dispensing a controlled substance in schedule II shall affix to
the package a label showing:
(A) The date of
dispensing;
(B) The name,
strength, and quantity of the drug dispensed;
(C) The dispensing
practitioner's name and address;
(D) The name of the
patient;
(E) The "use
by" date for the drug, which shall be:
(i) The expiration
date on the manufacturer's or principal labeler's container; or
(ii) One year from
the date the drug is dispensed, whichever is earlier; and
(F) Directions for
use, and cautionary statements, if any, contained in the prescription or as
required by law.
A complete and
accurate record of all schedule II controlled substances ordered, administered,
prescribed, and dispensed shall be maintained for five years. Prescriptions
and records of dispensing shall otherwise be retained in conformance with the
requirements of section 329-36. No prescription for a controlled substance in
schedule II may be refilled; or
(3) In the case of an
electronic prescription, a pharmacist may dispense a controlled substance
listed in schedule II upon receiving an electronic prescription.
(b) A schedule II
controlled substance prescription shall:
(1) Be filled within seven
days following the date the prescription was issued to the patient; and
(2) Be supplied to a
patient only if the prescription has been filled and held by the pharmacy for
not more than seven days.
(c) The transfer of original prescription
information for a controlled substance listed in schedule III, IV, or V for the
purpose of dispensing is permissible between pharmacies on a one time basis
only. However, pharmacies electronically sharing a real-time, online database
may transfer up to the maximum refills permitted by law and the prescriber's
authorization. Transfers are subject to the following requirements:
(1) The transfer shall be
communicated directly between two licensed pharmacists, and the transferring
pharmacist shall:
(A) Write or
otherwise place the word "VOID" on the face of the invalidated
prescription;
(B) Record on the
reverse of the invalidated prescription the name, address, and Drug Enforcement
Administration registration number of the pharmacy to which it was transferred
and the name of the pharmacist receiving the prescription information; and
(C) Record the date
of the transfer and the name of the pharmacist transferring the information;
(2) The pharmacist
receiving the transferred prescription information shall reduce to writing the
following:
(A) Write or
otherwise place the word "transfer" on the face of the transferred
prescription;
(B) Record all
information required to be on a prescription, including:
(i) The date of
issuance of original prescription;
(ii) The original
number of refills authorized on original prescription;
(iii) The date of
original dispensing;
(iv) The number of
valid refills remaining and dates and locations of previous refills;
(v) The pharmacy's
name, address, Drug Enforcement Administration registration number, and
original prescription number from which the prescription information was
transferred;
(vi) The name of the
transferor pharmacist; and
(vii) The pharmacy's
name, address, and Drug Enforcement Administration registration number, along
with the prescription number from which the prescription was originally filled;
(3) Both the original and transferred
prescription shall be maintained for a period of five years from the date of
last refill; and
(4) Any pharmacy
electronically accessing a prescription record shall satisfy all information
requirements of a manual mode prescription transferal.
Failure to comply
with this subsection shall void the authority of the pharmacy to transfer
prescriptions or receive a transferred prescription to or from another
pharmacy.
(d) A pharmacy and
an authorized central fill pharmacy may share information for initial and
refill prescriptions of schedule III, IV, or V controlled substances. The
following requirements shall apply:
(1) A pharmacy may
electronically transmit, including by facsimile, prescriptions for controlled
substances listed in schedule III, IV, or V to a central fill pharmacy. The
pharmacy transmitting the prescription information shall:
(A) Ensure that all
information required to be on a prescription pursuant to subsection (g) is
transmitted to the central fill pharmacy either on the face of the prescription
or electronically; and
(B) Keep a record
of receipt of the filled prescription, including the date of receipt, the
method of delivery (private, common, or contract carrier) and the identity of
the pharmacy employee accepting delivery; and
(2) The central fill
pharmacy receiving the transmitted prescription shall:
(A) Keep for five
years a copy of a prescription received by facsimile or an electronic record of
all the information transmitted by the pharmacy, including the name, address,
and Drug Enforcement Administration registration number of the pharmacy
transmitting the prescription;
(B) Keep a record
of the date of receipt of the transmitted prescription, the name of the
licensed pharmacists filling the prescription, and the dates the prescription
was filled or is refilled; and
(C) Keep a record
of the date the filled prescription was shipped to the pharmacy.
(e) No controlled
substance in schedule III, IV, or V may be dispensed without a written,
facsimile of a written, oral prescription of a practitioner, or receipt of an
electronic prescription, except when a controlled substance is dispensed
directly by a practitioner, other than a pharmacist, to an ultimate user. The
practitioner, in dispensing a controlled substance in schedule III, IV, or V,
shall affix to the package a label showing:
(1) The date of
dispensing;
(2) The name, strength,
and quantity issued of the drug;
(3) The dispensing
practitioner's name and business address;
(4) The name of the
patient;
(5) The "use by"
date for the drug, which shall be:
(A) The expiration
date on the manufacturer's or principal labeler's container; or
(B) One year from
the date the drug is dispensed, whichever is earlier;
(6) Directions for use;
and
(7) Cautionary statements,
if any, contained in the prescription or as required by law.
A complete and accurate
record of all schedule III, IV, and V controlled substances administered,
prescribed, and dispensed shall be maintained for five years. Prescriptions
and records of dispensing shall be retained in conformance with the
requirements of section 329-36 unless otherwise provided by law. Prescriptions
may not be filled or refilled more than three months after the date of the
prescription or be refilled more than two times after the date of the
prescription, unless the prescription is renewed by the practitioner.
(f) The
effectiveness of a prescription for the purposes of this section shall be
determined as follows:
(1) A prescription for a
controlled substance shall be issued for a legitimate medical purpose by an
individual practitioner acting in the usual course of the practitioner's
professional practice. The responsibility for the proper prescribing and
dispensing of controlled substances shall be upon the prescribing practitioner,
but a corresponding responsibility shall rest with the pharmacist who fills the
prescription. An order purporting to be a prescription issued not in the usual
course of professional treatment or for legitimate and authorized research shall
not be deemed a prescription within the meaning and intent of this section, and
the person who knowingly fills such a purported prescription, as well as the
person who issues the prescription, shall be subject to the penalties provided
for violations of this chapter;
(2) A prescription may not
be issued to allow an individual practitioner to obtain controlled substances
for supplying the individual practitioner for the purpose of general dispensing
to patients;
(3) A prescription may not
be issued for the dispensing of narcotic drugs listed in any schedule for the
purpose of "detoxification treatment" or "maintenance
treatment" except as follows:
(A) The
administering or dispensing directly (but not prescribing) of narcotic drugs
listed in any schedule to a narcotic drug-dependent person for
"detoxification treatment" or "maintenance treatment" shall
be deemed to be "in the course of a practitioner's professional practice
or research" so long as the practitioner is registered separately with the
department and the federal Drug Enforcement Agency as required by section
329-32(e) and complies with Title 21 Code of Federal Regulations section 823(g)
and any other federal or state regulatory standards relating to treatment
qualification, security, records, and unsupervised use of drugs; and
(B) Nothing in this
section shall prohibit a physician or authorized hospital staff from
administering or dispensing, but not prescribing, narcotic drugs in a hospital
to maintain or detoxify a person as an incidental adjunct to medical or
surgical treatment of conditions other than addiction;
(4) An individual
practitioner shall not prescribe or dispense a substance included in schedule
II, III, IV, or V for that individual practitioner's personal use, except in a
medical emergency; and
(5) A pharmacist shall not
dispense a substance included in schedule II, III, IV, or V for the
pharmacist's personal use.
(g) Prescriptions
for controlled substances shall be issued only as follows:
(1) All prescriptions for
controlled substances shall originate from within the State and be dated as of,
and signed on, the day when the prescriptions were issued and shall contain:
(A) The first and
last name and address of the patient; and
(B) The drug name,
strength, dosage form, quantity prescribed, and directions for use. Where a
prescription is for gamma hydroxybutyric acid, methadone, or buprenorphine, the
practitioner shall record as part of the directions for use, the medical need
of the patient for the prescription.
Except for electronic
prescriptions, controlled substance prescriptions shall be no larger than eight
and one-half inches by eleven inches and no smaller than three inches by four
inches. A practitioner may sign a prescription in the same manner as the
practitioner would sign a check or legal document (e.g., J.H. Smith or John H.
Smith) and shall use both words and figures (e.g., alphabetically and
numerically as indications of quantity, such as five (5)), to indicate the
amount of controlled substance to be dispensed. Where an oral order or
electronic prescription is not permitted, prescriptions shall be written with
ink or indelible pencil or typed, shall be manually signed by the practitioner,
and shall include the name, address, telephone number, and registration number
of the practitioner. The prescriptions may be prepared by a secretary or agent
for the signature of the practitioner, but the prescribing practitioner shall
be responsible in case the prescription does not conform in all essential
respects to this chapter and any rules adopted pursuant to this chapter. In
receiving an oral prescription from a practitioner, a pharmacist shall promptly
reduce the oral prescription to writing, which shall include the following
information: the drug name, strength, dosage form, quantity prescribed in
figures only, and directions for use; the date the oral prescription was
received; the full name, Drug Enforcement Administration registration number,
and oral code number of the practitioner; and the name and address of the
person for whom the controlled substance was prescribed or the name of the
owner of the animal for which the controlled substance was prescribed.
A
corresponding liability shall rest upon a pharmacist who fills a prescription
not prepared in the form prescribed by this section. A pharmacist may add a
patient's missing address or change a patient's address on all controlled
substance prescriptions after verifying the patient's identification and noting
the identification number on the back of the prescription document on file.
The pharmacist shall not make changes to the patient's name, the controlled
substance being prescribed, the quantity of the prescription, the
practitioner's Drug Enforcement Administration number, the practitioner's name,
the practitioner's electronic signature, or the practitioner's signature;
(2) An intern, resident,
or foreign-trained physician, or a physician on the staff of a Department of
Veterans Affairs facility or other facility serving veterans, exempted from registration
under this chapter, shall include on all prescriptions issued by the physician:
(A) The
registration number of the hospital or other institution; and
(B) The special
internal code number assigned to the physician by the hospital or other institution
in lieu of the registration number of the practitioner required by this
section.
The hospital or other
institution shall forward a copy of this special internal code number list to
the department as often as necessary to update the department with any
additions or deletions. Failure to comply with this paragraph shall result in
the suspension of that facility's privilege to fill controlled substance
prescriptions at pharmacies outside of the hospital or other institution. Each
written prescription shall have the name of the physician stamped, typed, or
hand-printed on it, as well as the signature of the physician;
(3) An official exempted
from registration shall include on all prescriptions issued by the official:
(A) The official's
branch of service or agency (e.g., "U.S. Army" or "Public Health
Service"); and
(B) The official's
service identification number, in lieu of the registration number of the
practitioner required by this section. The service identification number for a
Public Health Service employee shall be the employee's social security or other
government issued identification number.
Each prescription
shall have the name of the officer stamped, typed, or handprinted on it, as
well as the signature of the officer; and
(4) A physician assistant
registered to prescribe controlled substances under the authorization of a
supervising physician shall include on all controlled substance prescriptions
issued:
(A) The Drug
Enforcement Administration registration number of the supervising physician;
and
(B) The Drug
Enforcement Administration registration number of the physician assistant.
Each written
controlled substance prescription issued shall include the printed, stamped,
typed, or hand-printed name, address, and phone number of both the supervising
physician and physician assistant, and shall be signed by the physician
assistant. The medical record of each written controlled substance
prescription issued by a physician assistant shall be reviewed and initialed by
the physician assistant's supervising physician within seven working days.
(h) A prescription
for controlled substances may only be filled by a pharmacist acting in the
usual course of the pharmacist's professional practice and either registered
individually or employed in a registered pharmacy, central fill pharmacy, or
registered institutional practitioner. A central fill pharmacy authorized to
fill prescriptions on behalf of a pharmacy shall have a contractual
relationship with the pharmacy that provides for this activity or shall share a
common owner with the pharmacy. A central fill pharmacy shall not prepare
prescriptions for any controlled substance listed in schedule II.
(i) Partial filling
of controlled substance prescriptions shall be determined as follows:
(1) The partial filling of
a prescription for a controlled substance listed in schedule II is permissible
if the pharmacist is unable to supply the full quantity called for in a
written, electronic prescription, or emergency oral prescription and the pharmacist
makes a notation of the quantity supplied on the face of the written
prescription (or written record of the electronic prescription or emergency
oral prescription). The remaining portion of the prescription may be filled
within seventy-two hours of the first partial filling; provided that if the
remaining portion is not or cannot be filled within the seventy-two-hour
period, the pharmacist shall notify the prescribing individual practitioner.
No further quantity shall be supplied beyond seventy-two hours without a new
prescription;
(2) The partial filling of
a prescription for a controlled substance listed in schedule III, IV, or V is
permissible; provided that:
(A) Each partial
filling is recorded in the same manner as a refilling;
(B) The total
quantity dispensed in all partial fillings does not exceed the total quantity
prescribed;
(C) No dispensing
occurs more than three months after the date on which the prescription was
issued; and
(D) The
prescription is refilled no more than two times after the initial date of the
prescription, unless the prescription is renewed by the practitioner; and
(3) A prescription for a
schedule II controlled substance issued for a patient in a long-term care
facility or for a patient with a medical diagnosis documenting a terminal
illness may be filled in partial quantities to include individual dosage
units. If there is any question whether a patient may be classified as having
a terminal illness, the pharmacist shall contact the practitioner prior to partially
filling the prescription. Both the pharmacist and the prescribing practitioner
have a corresponding responsibility to assure that the controlled substance is
for a terminally ill patient. The pharmacist shall record on the prescription
document on file whether the patient is "terminally ill" or a
"long-term care facility patient". For the purposes of this section,
"TI" means terminally ill and "LTCF" means long-term care
facility. A prescription that is partially filled and does not contain the
notation "TI" or "LTCF patient" shall be deemed to have
been filled in violation of this section. For each partial filling, the
dispensing pharmacist shall record on the back of the prescription (or on
another appropriate record, uniformly maintained, and readily retrievable) the
date of the partial filling, quantity dispensed, remaining quantity authorized
to be dispensed, and the identification of the dispensing pharmacist. The
total quantity of schedule II controlled substances dispensed in all partial
fillings shall not exceed the total quantity prescribed, nor shall a
prescription be partially filled more than three times after the initial date
of the prescription. Schedule II controlled substance prescriptions for
patients in a long-term care facility or patients with a medical diagnosis
documenting a terminal illness shall be valid for a period not to exceed thirty
days from the issue date unless sooner terminated by the discontinuance of
medication.
(j) A prescription for a
schedule II controlled substance may be transmitted by the practitioner or the
practitioner's agent to a pharmacy by facsimile equipment; provided that the
original written, signed prescription is presented to the pharmacist for review
prior to the actual dispensing of the controlled substance, except as noted in
subsections (k), (l), and (m). The original prescription shall be maintained
in accordance with section 329-36. A prescription for a schedule III, IV, or V
controlled substance may be transmitted by the practitioner or the
practitioner's agent to a pharmacy by facsimile; provided that:
(1) The information shall
be communicated only between the prescribing practitioner or the prescriber's
authorized agent and the pharmacy of the patient's choice. The original
prescription shall be maintained by the practitioner in accordance with section
329-36;
(2) The information shall
be communicated in a retrievable, recognizable format acceptable to the
intended recipient and shall include the physician's oral code designation and
the name of the recipient pharmacy;
(3) No electronic system,
software, or other intervening mechanism or party shall alter the
practitioner's prescription, order entry, selection, or intended selection
without the practitioner's approval on a per prescription per order basis.
Facsimile prescription information shall not be altered by any system,
software, or other intervening mechanism or party prior to receipt by the
intended pharmacy;
(4) The prescription
information processing system shall provide for confidentiality safeguards
required by federal or state law; and
(5) Prescribing
practitioners and pharmacists shall exercise prudent and professional judgment
regarding the accuracy, validity, and authenticity of any facsimile
prescription information. The facsimile shall serve as the original written
prescription for purposes of this section and shall be maintained in accordance
with section 329-36.
(k) A prescription
prepared in accordance with subsection (g) written for a narcotic listed in schedule
II to be compounded for the direct administration to a patient by parenteral,
intravenous, intramuscular, subcutaneous, or intraspinal infusion, but does not
extend to the dispensing of oral dosage units of controlled substances, may be
transmitted by the practitioner or the practitioner's agent to the pharmacy by
facsimile. The original prescription shall be maintained by the practitioner
in accordance with section 329-36. The pharmacist shall note on the face of
the facsimile prescription in red ink "Home Infusion/IV" and this
facsimile shall serve as the original written prescription for purposes of this
section and it shall be maintained in accordance with section 329-36.
(l) A prescription
prepared in accordance with subsection (g) written for a schedule II substance
for a patient enrolled in a hospice care program certified or paid for by
medicare under Title XVIII or a hospice program that is licensed by the State
may be transmitted by the practitioner or the practitioner's agent to the dispensing
pharmacy by facsimile. The original prescription shall be maintained by the
practitioner in accordance with section 329-36. The practitioner or
practitioner's agent shall note on the prescription that the patient is a
hospice patient. The pharmacist shall note on the face of the facsimile
prescription in red ink "HOSPICE" and this facsimile shall serve as
the original written prescription for purposes of this section and it shall be
maintained in accordance with section 329-36.
(m) A prescription
prepared in accordance with subsection (g) written for a schedule II controlled
substance for a resident of a state-licensed long-term care facility may be
transmitted by the practitioner or the practitioner's agent to the dispensing
pharmacy by facsimile. The original prescription shall be maintained by the
practitioner in accordance with section 329-36. The pharmacist shall note on
the face of the facsimile prescription in red ink "LTCF" and this
facsimile shall serve as the original written prescription for purposes of this
section and it shall be maintained in accordance with section 329-36.
(n) An electronic
prescription for a schedule II, III, IV, or V controlled substance may be
electronically transmitted by the practitioner to a pharmacy; provided that:
(1) The information shall
be communicated only between the prescribing practitioner and the pharmacy of
the patient's choice. The electronic prescription shall be maintained by
the practitioner in accordance with section 329-36;
(2) The information shall
be communicated in a retrievable, recognizable format acceptable to the
intended recipient;
(3) No electronic system,
software, or other intervening mechanism or party shall alter the
practitioner's prescription, order entry, selection, or intended selection
without the practitioner's approval on a per-prescription, per-order basis.
Transmitted prescription information shall not be altered by any electronic
system, software, or other intervening mechanism or party prior to receipt by
the intended pharmacy;
(4) The prescription
information processing system shall provide for confidentiality safeguards
required by any applicable federal or state law; and
(5) Prescribing
practitioners and pharmacists shall exercise prudent and professional judgment
regarding the accuracy, validity, and authenticity of any electronic
prescription information. [L 1972, c 10, pt of §1; am L 1973, c 206, §1; am L
1979, c 194, §5; am L 1984, c 25, §2; am L 1986, c 214, §6; am L 1988, c 59,
§4; am L 1991, c 159, §§10 to 12; am L 1996, c 206, §2; am L 1997, c 280, §3;
am L 1999, c 90, §2 and c 252, §4; am L 2002, c 165, §3; am L 2003, c 151, §8;
am L 2006, c 69, §3; am L 2008, c 131, §3 and c 186, §4; am L 2009, c 117, §5;
am L 2013, c 20, §3]
Cross References
Prescription requirements not
applicable to medical use of marijuana, see §329-131.
