It is the responsibility of the licensee to determine the
type, dosage, form, frequency of application and number of refills of any
controlled substances prescribed to a patient. The following requirements apply
to all prescriptions for controlled substances written by a licensee with
controlled substance prescriptive authority:
A. All prescriptions for controlled
substances must be written in strict compliance with Mississippi Code, Sections
41-29-101
through
41-29-311
and Title 21 of U.S. Code of Federal Regulations, Part 1306.
B. On all prescriptions of controlled
substances wherein refills are permitted, licensees must indicate the
appropriate refills, not to exceed five (5), or mark "none."
C. Each licensee must insure that the
complete name and address of the patient to whom the licensee is prescribing
the controlled substance appears on the prescription.
D. A licensee must not permit any
prescription for controlled substances to be signed by anyone in the place of
or on behalf of the licensee.
E. A
licensee must not pre-sign prescription pads or order forms.
F. A licensee must not utilize prescription
pads or order forms upon which the signature of the licensee has been affixed
by any means other than manual signature. This prohibition includes the
e-mailing of any controlled substance prescription. A hard copy prescription
generated from an electronic prescription system must contain a manual
signature unless:
(i) the prescription is
printed on security paper that ensures it is not subject to copying or
alteration, and
(ii) an electronic
or digital signature is affixed. Electronic transmission of Schedule III-V
controlled substance prescription information is limited to computer to
facsimile (fax) transmissions or traditional fax to fax transmissions.
Electronic transmission of Schedule II controlled substance prescription
information is permitted under limited circumstances. Requirements for fax
prescription orders and systems utilized for faxing prescriptions are as
follows:
1. The prescription order must
contain the date, time, telephone number and location of the transmitting
device. Prescription blanks utilized in this manner must bear a preprinted
heading that indicates the blank is a "Fax Prescription Form." Fax prescription
orders must contain a manual or authenticated electronic/digital signature of
the prescriber. Only Schedule II narcotic substances that are to be prepared or
compounded for the direct administration to a patient by parenteral,
intravenous, intramuscular, subcutaneous or intra spinal infusion may be
transmitted by the licensee or the licensee's agent to a pharmacy of the
patient's choice by facsimile. All original hardcopy faxed prescriptions must
immediately be voided after successfully completing the fax transmission by
writing across the face of the prescription from corner to corner the notation
"faxed." The original prescription (or copy) must be retained in the licensee's
patient file with additional information included on the back of the
prescription as to the date it was faxed, the name or initials of the person
faxing the prescription and the name/location of the pharmacy receiving the fax
transmission.
In addition to filing the original prescription (or copy) in
the patient file, a perpetual, chronological logbook of fax transactions must
be established and maintained. Such a logbook would serve to protect the
prescribing licensee in the event the original prescription is somehow lost or
misfiled. The information contained in such a logbook must include the
patient's name and address, date of issuance, name, strength and quantity of
the drug prescribed and the name and fax number of the receiving pharmacy and a
personal identifier of the person faxing the prescription. Such logs must be
maintained in the licensee's clinic in a readily retrievable manner, and kept
for at least seven (7) years after the original record is established. The
requirements set forth in this rule are in addition to documentation required
in Part 2640, Rule
1.4.
2. When prescribing any controlled substance
for a resident of a Long-term Care Facility (LTCF)(as defined in Section
1301.01(25), Code of Federal Regulations), such prescription may be transmitted
by the licensee or the licensee's agent to the dispensing pharmacy by
facsimile. The licensee or the licensee's agent must note on the prescription
that the patient is a resident of a LTCF. The original prescription (or copy)
and fax transaction log will be prepared and maintained in the same manner as
described in Part 2640, Rule 1.10.F.1.
3. When prescribing any controlled substance
for a patient residing in a hospice certified by Medicare under Title XVIII or
licensed by the state, such prescription may be transmitted by the licensee or
the licensee's agent to the dispensing pharmacy by facsimile. The licensee or
the licensee's agent must note on the prescription that the patient is a
hospice patient. The original prescription (or copy) and fax transmission log
will be maintained in the same manner as described in Part 2640, Rule 1.10.F.1.
G. No more
than one (1) controlled substance shall be issued on a single prescription
blank.
H. Prescriptions for
Benzodiazepines must be limited to a one (1) month supply, with no more than
two (2) refills, or a ninety (90) day supply with no refills. The MPMP must be
checked each time a prescription for benzodiazepines is authorized and evidence
of such check must be noted within the patient file.
