§ 21-28-3.18 - Prescriptions.
SECTION 21-28-3.18
§ 21-28-3.18 Prescriptions. – (a) An apothecary in good faith may sell and dispense controlled substances inschedule II to any person upon a written prescription by a practitionerlicensed by law to prescribe or administer those substances, dated and signedby the person prescribing on the day when issued and bearing the full name andaddress of the patient to whom, or of the owner of the animal for which thesubstance is dispensed and the full name, address and registration number underthe federal law of the person prescribing, if he or she is required by that lawto be registered. If the prescription is for an animal, it shall state thespecies of the animal for which the substance is prescribed.
(b) The apothecary filling the prescription shall sign his orher full name and shall write the date of filling on the face of theprescription.
(c) The prescription shall be retained on file by theproprietor of the pharmacy in which it was filled for a period of two (2) yearsso as to be readily accessible for inspection by any public officer or employeeengaged in the enforcement of this chapter.
(d) Prescriptions for controlled substances in schedule IIshall be filed separately and shall not be refilled.
(2) The director of health may, after appropriate notice andhearing pursuant to § 42-35-3, promulgate rules and regulations for thepurpose of adopting a system for electronic data transmission of prescriptionsfor controlled substances in schedule II and III.
(e) A prescription for a schedule II narcotic substance to becompounded for the direct administration to a patient by parenteral,intravenous, intramuscular, subcutaneous, or intraspinal infusion may betransmitted by the practitioner or practitioner's agent to the pharmacy byfacsimile. The facsimile will serve as the original prescription.
(f) A prescription written for a schedule II substance for aresident of a long term care facility may be transmitted by the practitioner orthe practitioner's agent to the dispensing pharmacy by facsimile. The facsimileserves as the original prescription.
(g) A prescription for a schedule II narcotic substance for apatient residing in a hospice certified by Medicare under title XVIII of theSocial Security Act, 42 U.S.C. § 1395 et seq., or licensed by the state,may be transmitted by the practitioner or practitioner's agent to thedispensing pharmacy by facsimile. The practitioner or the practitioner's agentwill note on the prescription that the patient is a hospice patient. Thefacsimile serves as the original written prescription.
(h) An apothecary, in lieu of a written prescription, maysell and dispense controlled substances in schedules III, IV, and V to anyperson upon an oral prescription of a practitioner. In issuing an oralprescription the prescriber shall furnish the apothecary with the sameinformation as is required by subsection (a) of this section in the case of awritten prescription for controlled substances in schedule II, except for thewritten signature of the person prescribing, and the apothecary who fills theprescription, shall immediately reduce the oral prescription to writing andshall inscribe the information on the written record of the prescription made.This record shall be filed and preserved by the proprietor of the pharmacy inwhich it is filled in accordance with the provisions of subsection (c) of thissection. In no case may a prescription for a controlled substance listed inschedules III, IV, or V be filled or refilled more than six (6) months afterthe date on which the prescription was issued and no prescription shall beauthorized to be refilled more than five (5) times. Each refilling shall beentered on the face or back of the prescription and note the date and amount ofcontrolled substance dispensed, and the initials or identity of the dispensingapothecary.
(i) In the case of an emergency situation as defined infederal law, an apothecary may dispense a controlled substance listed inschedule II upon receiving an oral authorization of a prescribing practitionerprovided that:
(1) The quantity prescribed and dispensed is limited to theamount adequate to treat the patient during the emergency period and dispensingbeyond the emergency period must be pursuant to a written prescription signedby the prescribing practitioner.
(2) The prescription shall be immediately reduced to writingand shall contain all the information required in subsection (a) of thissection.
(3) The prescription must be dispensed in good faith in thenormal course of professional practice.
(4) Within seven (7) days after authorizing an emergency oralprescription, the prescribing practitioner shall cause a written prescriptionfor the emergency quantity prescribed to be delivered to the dispensingapothecary. The prescription shall have written on its face "Authorization foremergency dispensing" and the date of the oral order. The written prescriptionupon receipt by the apothecary shall be attached to the oral emergencyprescription which had earlier been reduced to writing.
(j) The partial filling of a prescription for a controlledsubstance listed in schedule II is permissible, if the apothecary is unable tosupply the full quantity called for in a written prescription or emergency oralprescription and he or she makes a notation of the quantity supplied on theface of the written prescription or oral emergency prescription which has beenreduced to writing. The remaining portion of the prescription may be filledwithin seventy-two (72) hours of the first partial filling, however, if theremaining portion is not, or cannot be filled within seventy-two (72) hours,the apothecary shall notify the prescribing practitioner. No further quantitymay be supplied beyond seventy-two (72) hours without a new prescription.
(2) A prescription for a schedule II controlled substancewritten for a patient in a long term care facility (LTCF), or for a patientwith a medical diagnosis documenting a terminal illness, may be filled inpartial quantities to include individual dosage units. If there is a questionwhether a patient may be classified as having a terminal illness, thepharmacist must contact the practitioner prior to partially filling theprescription. Both the pharmacist and the prescribing practitioner have acorresponding responsibility to assure that the controlled substance is for aterminally ill patient.
(ii) The pharmacist must record on the prescription whetherthe patient is "terminally ill" or an "LTCF patient." A prescription that ispartially filled, and does not contain the notation "terminally ill" or "LTCFpatient", shall be deemed to have been filled in violation of this chapter.
(iii) For each partial filling, the dispensing pharmacistshall record on the back of the prescription (or on another appropriate record,uniformly maintained, and readily retrievable), the:
(A) Date of the partial filling;
(B) Quantity dispensed;
(C) Remaining quantity authorized to be dispensed; and
(D) Identification of the dispensing pharmacist.
(iv) The total quantity of schedule II controlled substancesdispensed in all partial fillings must not exceed the total quantity prescribed.
(v) Schedule II prescriptions for patients in a LTCF, orpatients with a medical diagnosis documenting a terminal illness, are valid fora period not to exceed sixty (60) days from the issue date, unless soonerterminated by the discontinuance of medication.
(k) Automated data processing systems. As analternative to the prescription record keeping provision of subsection (h) ofthis section, an automated data processing system may be employed for therecord keeping system, if the following conditions have been met:
(1) The system shall have the capability of producingsight-readable documents of all original and refilled prescription information.The term "sight-readable" means that an authorized agent shall be able toexamine the record and read the information. During the course of an on-siteinspection, the record may be read from the CRT, microfiche, microfilm,printout, or other method acceptable to the director. In the case ofadministrative proceedings, records must be provided in a paper printout form.
(2) The information shall include, but not be limited to, theprescription requirements and records of dispensing as indicated in subsection(h) of this section.
(3) The individual pharmacist responsible for completenessand accuracy of the entries to the system must provide documentation of thefact that prescription information entered into the computer is correct. Indocumenting this information, the pharmacy shall have the option to either:
(i) Maintain a bound log book, or separate file, in whicheach individual pharmacist involved in the dispensing shall sign a statementeach day, attesting to the fact that the prescription information entered intothe computer that day has been reviewed and is correct as shown. The book orfile must be maintained at the pharmacy employing that system for a period ofat least two (2) years after the date of last dispensing; or
(ii) Provide a printout of each day's prescriptioninformation. That printout shall be verified, dated, and signed by theindividual pharmacist verifying that the information indicated is correct. Theprintout must be maintained at least two (2) years from the date of lastdispensing.
(4) An auxiliary record keeping system shall be establishedfor the documentation of refills, if the automated data processing system isinoperative for any reason. The auxiliary system shall ensure that all refillsare authorized by the original prescription, and that the maximum number ofrefills is not exceeded. When this automated data processing system is restoredto operation, the information regarding prescriptions filled and refilledduring the inoperative period, shall be entered into the automated dataprocessing system within ninety-six (96) hours.
(5) Any pharmacy using an automated data processing systemmust comply with all applicable state and federal laws and regulations.
(6) A pharmacy shall make arrangements with the supplier ofdata processing services or materials to ensure that the pharmacy continues tohave adequate and complete prescription and dispensing records if therelationship with the supplier terminates for any reason. A pharmacy shallensure continuity in the maintenance of records.
(7) The automated data processing system shall containadequate safeguards for security of the records, to maintain theconfidentiality and accuracy of the prescription information. Safeguardsagainst unauthorized changes in data after the information has been entered andverified by the registered pharmacist shall be provided by the system.
(l) Prescriptions for controlled substances as found inschedules II, will become void unless dispensed within ninety (90) days of theoriginal date of the prescription, and in no event shall more than a thirty(30) day supply be dispensed at any one time.
(1) In prescribing controlled substances in schedule II,practitioners may write up to three (3) separate prescriptions, each for up toa one-month supply, each signed and dated on the date written. For thoseprescriptions for the second and/or third month, the practitioner must writethe earliest date each of those subsequent prescription may be filled, withdirections to the pharmacist to fill no earlier than the date specified on theface of the prescription.
(m) The prescriptions in schedules III, IV, and V will becomevoid unless dispensed within one hundred eighty (180) days of the original dateof the prescription. For purposes of this section, a "dosage unit" shall bedefined as a single capsule, tablet or suppository, or not more than one five(5) ml. of an oral liquid.
(1) Prescriptions in Schedule III cannot be written for morethan one hundred (100) dosage units and not more than one hundred (100) dosageunits may be dispensed at one time.
(2) Prescriptions in Schedule IV and V may be written for upto a ninety (90) day supply based on directions. No more than three hundred andsixty (360) dosage units may be dispensed at one time.