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Vermont News: Electronic Prescribing of Controlled Substances
Published in the June 2008 Vermont Board of Pharmacy Newsletter
Is it legal for a licensed prescriber to create electronic prescriptions for Schedule III through V drugs on his or her e-prescribing software and transmit them electronically to either the pharmacy’s fax machine or the pharmacy’s computer with an electronic signature? The answer is no. Electronic prescribing of Schedule III through V drugs is still not legal.
Although Part C, Section 19.3.1.1 of the rules allows for electronic transmission either by fax or e-mail, federal law does not allow e-prescribing of Schedule III through V drugs. The most stringent law is to be followed (ie, the federal Drug Enforcement Administration (DEA) guidelines). Therefore, it is not acceptable for a prescriber to create an electronic prescription for a Schedule III through V drug and affix an electronic signature and then send the prescription to a pharmacy’s fax or computer. This is not a valid prescription. If pharmacists receive this type of prescription they may call the prescriber and verify the prescrip¬tion – in actuality they “get an oral prescription from the prescriber.” The prescription can then be filled not based on the faxed prescription (which is invalid), but rather based on the valid oral telephoned prescription.
Another acceptable prescription would be for the prescriber to write out a prescription (or type) for a Schedule III through V drug, physically sign the prescription, and then fax that prescription to the pharmacy’s fax machine. It is considered a legal prescription by DEA. Electroni¬cally signed prescriptions are not acceptable for Schedule III through V drugs and are not valid.
Schedule II prescriptions may be faxed to pharmacies (again they are not allowed to be electronically signed) but the original, manually signed prescription must be presented to the pharmacist prior to the dispensing of the Schedule II drug. There are only three circumstances in which a faxed prescription for a Schedule II drug may serve as the original prescription and does not require the original written prescription. They are: (1) A prescription for a Schedule II substance for a resident of a long-term care facility; (2) A prescription for a Schedule II substance for hospice patient. The prescriber must write on the prescription that it is for a hospice patient; or (3) A prescription for a Schedule II substance to be compounded for the direct administration to a patient by parenteral, intravenous, intramuscular, subcutaneous, or intraspinal infusion.
DEA is currently revising its regulations regarding the electronic transmission of controlled substance prescriptions. It announced in December of 2007, that public comment on the revised rules will most likely take place between June 2008 and September 2008. Until the revised regulations are finalized, electronic controlled substance prescriptions are not allowed.
Please keep in mind that in all cases, it is the pharmacist who is held responsible for determining the authenticity and legitimacy of every controlled substance prescription they dispense!
