147.107 - DRUG DISPENSING, SUPPLYING, AND PRESCRIBING -- LIMITATIONS.
147.107 DRUG DISPENSING, SUPPLYING, AND PRESCRIBING
-- LIMITATIONS.
1. A person, other than a pharmacist, physician, dentist,
podiatric physician, or veterinarian who dispenses as an incident to
the practice of the practitioner's profession, shall not dispense
prescription drugs or controlled substances.
2. a. A pharmacist, physician, dentist, or podiatric
physician who dispenses prescription drugs, including but not limited
to controlled substances, for human use, may delegate nonjudgmental
dispensing functions to staff assistants only when verification of
the accuracy and completeness of the dispensing is determined by the
pharmacist or practitioner in the pharmacist's or practitioner's
physical presence. However, the physical presence requirement does
not apply when a pharmacist or practitioner is utilizing an automated
dispensing system or when a pharmacist is utilizing a tech-check-tech
program, as defined in section 155A.3. When using an automated
dispensing system the pharmacist or practitioner shall utilize an
internal quality control assurance plan that ensures accuracy for
dispensing. When using a tech-check-tech program the pharmacist
shall utilize an internal quality control assurance plan, in
accordance with rules adopted by the board of pharmacy, that ensures
accuracy for dispensing. Verification of automated dispensing and
tech-check-tech accuracy and completeness remains the responsibility
of the pharmacist or practitioner and shall be determined in
accordance with rules adopted by the board of pharmacy, the board of
medicine, the dental board, and the board of podiatry for their
respective licensees.
b. A dentist, physician, or podiatric physician who dispenses
prescription drugs, other than drug samples, pursuant to this
subsection, shall report the fact that they dispense prescription
drugs with the practitioner's respective board at least biennially.
c. A physician, dentist, or podiatric physician who dispenses
prescription drugs, other than drug samples, pursuant to this
subsection, shall offer to provide the patient with a written
prescription that may be dispensed from a pharmacy of the patient's
choice or offer to transmit the prescription orally, electronically,
or by facsimile in accordance with section 155A.27 to a pharmacy of
the patient's choice.
3. A physician assistant or registered nurse may supply, when
pharmacist services are not reasonably available or when it is in the
best interests of the patient, on the direct order of the supervising
physician, a quantity of properly packaged and labeled prescription
drugs, controlled substances, or contraceptive devices necessary to
complete a course of therapy. However, a remote clinic, staffed by a
physician assistant or registered nurse, where pharmacy services are
not reasonably available, shall secure the regular advice and
consultation of a pharmacist regarding the distribution, storage, and
appropriate use of such drugs, substances, and devices.
4. Notwithstanding subsection 3, a physician assistant shall not
dispense prescription drugs as an incident to the practice of the
supervising physician or the physician assistant, but may supply,
when pharmacist services are not reasonably available, or when it is
in the best interests of the patient, a quantity of properly packaged
and labeled prescription drugs, controlled substances, or medical
devices necessary to complete a course of therapy. However, a remote
clinic, staffed by a physician assistant, where pharmacy services are
not reasonably available, shall secure the regular advice and
consultation of a pharmacist regarding the distribution, storage, and
appropriate use of such drugs, substances, and devices. Prescription
drugs supplied under the provisions of this subsection shall be
supplied for the purpose of accommodating the patient and shall not
be sold for more than the cost of the drug and reasonable overhead
costs, as they relate to supplying prescription drugs to the patient,
and not at a profit to the physician or the physician assistant. If
prescription drug supplying authority is delegated by a supervising
physician to a physician assistant, a nurse or staff assistant may
assist the physician assistant in providing that service. Rules
shall be adopted by the board of physician assistants, after
consultation with the board of pharmacy, to implement this
subsection.
5. Notwithstanding subsection 1 and any other provision of this
section to the contrary, a physician may delegate the function of
prescribing drugs, controlled substances, and medical devices to a
physician assistant licensed pursuant to chapter 148C. When
delegated prescribing occurs, the supervising physician's name shall
be used, recorded, or otherwise indicated in connection with each
individual prescription so that the individual who dispenses or
administers the prescription knows under whose delegated authority
the physician assistant is prescribing. Rules relating to the
authority of physician assistants to prescribe drugs, controlled
substances, and medical devices pursuant to this subsection shall be
adopted by the board of physician assistants, after consultation with
the board of medicine and the board of pharmacy. However, the rules
shall prohibit the prescribing of schedule II controlled substances
which are listed as depressants pursuant to chapter 124.
6. Health care providers shall consider the instructions of the
physician assistant to be instructions of the supervising physician
if the instructions concern duties delegated to the physician
assistant by a supervising physician.
7. Notwithstanding subsection 1, a family planning clinic may
dispense birth control drugs and devices upon the order of a
physician. Subsections 2 and 3 do not apply to a family planning
clinic under this subsection.
8. Notwithstanding subsection 1, but subject to the limitations
contained in subsections 2 and 3, a registered nurse who is licensed
and registered as an advanced registered nurse practitioner and who
qualifies for and is registered in a recognized nursing specialty may
prescribe substances or devices, including controlled substances or
devices, if the nurse is engaged in the practice of a nursing
specialty regulated under rules adopted by the board of nursing in
consultation with the board of medicine and the board of pharmacy.
9. Notwithstanding section 147.86, a person, including a
pharmacist, who violates this section is guilty of a simple
misdemeanor. Section History: Recent Form
84 Acts, ch 1006, § 1; 88 Acts, ch 1232, § 1; 91 Acts, ch 238, §
1; 91 Acts, ch 239, § 1; 92 Acts, ch 1163, § 37; 92 Acts, ch 1183, §
10; 94 Acts, ch 1134, §1; 95 Acts, ch 108, §5; 2002 Acts, ch 1108,
§13; 2003 Acts, ch 93, §3, 14; 2003 Acts, ch 108, §39; 2004 Acts, ch
1036, §8; 2004 Acts, ch 1101, § 22; 2006 Acts, ch 1094, §1; 2007
Acts, ch 10, §78; 2007 Acts, ch 218, §202; 2008 Acts, ch 1016, §1;
2008 Acts, ch 1088, §43
Referred to in § 154.1, 155A.2, 155A.4, 280.16
See also § 154.1, 155A.4