Electronic Signatures and Controlled Rx

[JMH5145]

We are currently having a debate between our PIC and some local doctor's offices regarding the law when it comes to electronic signatures on controlled rx scripts. These scripts are electronically generated and then converted to be faxed to the pharmacy. Our PIC says that if it doesn't have the MD's handwritten signature on it, we must either fax it back with a note to have the MD sign the script or we must call the office to verify the script's validity. The doctor's offices say that the electronic signature is enough.

I might note that our store is catching people calling in fake scripts on a regular basis these days. The detective that investigates these crimes is in our store about once every 2 or 3 weeks, and one of the pharmacists and a tech just got subpoenas to appear in court next week on a case. It's getting harder and harder to tell the difference between fake prescriptions and legit ones. I swear I could call in a prescription for myself soooo easily or make a script on the computer in about 2 minutes (not that I would ever even be tempted to do such a thing)

Does anyone know the law regarding this?? I'd really appreciate it...I spend way too much time chasing after doctors and apologizing to the customers for this.

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[Shmy2008]

I just worked on some law stuff for my summer internship, so as far as I remember...

An electronic signature is acceptable for anything but C-II's (obviously, since you can't fax a C-II, the issue wouldn't come up). Now, I can't remember if thats a state or a federal law...

 

[sdn1977]

Right now..you are operating under state law. The federal law still requires you to "verify" electronic transmissions. However, this is under discussion.

In fact, you can access testimony on behalf of the APhA from July 11 to the DEA on behalf of electronic signature transmission. The profession, generally, is behind it as well as physicians. It was reported in the July 17 edition of APhA Focus.

But...there is much to get thru before it gets implemented. First...they will use NPI probably - National Provider numbers to be co-verified in some way with a DEA # which you can document what schedule of drug the provider can prescribe. NPI's won't become standard until May 2007.

Then...there needs to be uniform method of encryption - similar to that used in financial institutions. Currently, there are many companies that offer electronic transmission, but there is no standard & none, so far, that offer complete security.

Practically, each pharmacist has to make their own decision right now, in view of what their current state law allows (if state law is more strict than federal law, then state law takes precedence). In my case....when I get an electronic rx for a controlled drug, I choose to decide on its validity based on many factors. I can also see what phone # it generates from.

It sounds as though your PIC has had trouble before & is justifiably covering all his bases. This is sometimes what happens when you become known as an "easy" place to get controlled substances......

 

[bananaface]

You can accept a faxed CII for a hospice patient. Most pharmacists would still insist on a non-electronic signature, though.

In my state the electronic prescribing systems have to be registered to be valid. Usually they are sent with a cover sheet that introduces them as being generated by a state approved and registered electronic prescribing system. It shows the names of both the generating and authorizing individuals. A registered electronic signature is as good as a handwritten one. If there is a question as to the authenticity of any prescription, you can hold off until it is verified.

 

[sdn1977]

You can accept a faxed CII for a hospice patient. Most pharmacists would still insist on a non-electronic signature, though.

In my state the electronic prescribing systems have to be registered to be valid. Usually they are sent with a cover sheet that introduces them as being generated by a state approved and registered electronic prescribing system. It shows the names of both the generating and authorizing individuals. A registered electronic signature is as good as a handwritten one. If there is a question as to the authenticity of any prescription, you can hold off until it is verified.

We can't in CA - it has to be a verbal for a hospice & reduce to writing by us. Again....state law presides in this case. We never need the actual rx if it is a hospice pt - verbal will always work, but we will take a written one. Never a fax unless the fax is verbally transmitted to us first, in which case, its redundant.