24.174.840    TRANSMISSION OF PRESCRIPTIONS BY ELECTRONIC MEANS

(1) A pharmacist may dispense directly any legend drug, which requires a prescription to dispense (except as provided in (2) and (3) below for Schedule II, III, IV, and V, controlled substances) pursuant to either a written prescription signed by a practitioner or a prescription transmitted by the practitioner or the practitioner's agent to the pharmacy by electronic means, or pursuant to an oral prescription made by an individual practitioner and promptly reduced to hardcopy by the pharmacist, containing all information required. The prescription shall be maintained in accordance with ARM 24.174.512.

(2) A pharmacist may dispense directly a controlled substance in Schedule II, which is a prescription drug as determined by the Federal Food, Drug, and Cosmetic Act (FD&C Act), pursuant to a written prescription signed by the practitioner. In addition, a prescription for a Schedule II controlled substance may be transmitted by the practitioner or the practitioner's agent to a pharmacy by electronic means, provided the original written, signed prescription is presented to the pharmacist for review prior to the actual dispensing of the controlled substance or by electronic means that meet all of the federal guidelines for controlled substances that are electronically prescribed. The original prescription shall be maintained in accordance with ARM 24.174.512.

(a) A signed prescription for a Schedule II narcotic substance to be compounded for the direct administration to a patient by parenteral, intravenous, intramuscular, subcutaneous, or intraspinal infusion may be transmitted by the practitioner or the practitioner's agent to the pharmacy by electronic means. The electronic transmission serves as the original written prescription for the purpose of this rule and it shall be maintained in accordance with ARM 24.174.512.

(b) A signed prescription for a Schedule II substance for a resident of a long-term care facility may be transmitted by the practitioner or the practitioner's agent to the dispensing pharmacy by electronic means. The electronic transmission serves as the original written prescription for purposes of this rule and it shall be maintained in accordance with ARM 24.174.512.

(c) A signed prescription for a Schedule II substance for a patient enrolled in a hospice care program, certified and/or paid for by Medicare under Title XVIII of the Social Security Act, or a hospice program which is licensed by the state of Montana, may be transmitted by the practitioner or the practitioner's agent to the dispensing pharmacy by electronic means. The practitioner or the practitioner's agent shall note on the prescription that the patient is a hospice patient. The electronic transmission serves as the original written prescription for purposes of this rule and it shall be maintained in accordance with ARM 24.174.512.

(3) A pharmacist may dispense directly a controlled substance listed in Schedule III, IV, or V, which is a prescription drug as determined under the FD&C Act, only pursuant to either a written prescription signed by a practitioner or a copy of a written, signed prescription transmitted by the practitioner or the practitioner's agent to the pharmacy by electronic means, or pursuant to an oral prescription made by an individual practitioner and promptly reduced to hardcopy by the pharmacist, containing all information required or by electronic means that meet all of the federal guidelines for controlled substances that are electronically prescribed. The prescription shall be maintained in accordance with ARM 24.174.512.

(4) Prescriptions may be transmitted electronically directly from an authorized prescriber or his/her authorized agent to the pharmacy of the patient's choice without alteration by any other party, providing the following requirements are met:

(a) Both prescriber and pharmacist must have a secure (encrypted or encoded) system for electronic transmission from computer to computer that ensures patient confidentiality;

(b) The receiving electronic device shall be located within the pharmacy department to ensure security and confidentiality;

(c) An electronically transmitted prescription shall contain all information required by state and federal law, including the date and time of transmission, the prescriber's telephone number for verbal confirmation, and the name of the prescriber's agent transmitting the order, if other than the prescriber;

(d) The prescriber's electronic signature or other secure (encrypted or encoded) method of validation shall be provided with the electronically transmitted order. Faxed prescription orders shall contain the identifying number of the sending fax machine;

(e) A printed, nonfading copy of an electronically transcribed prescription will be maintained in the pharmacy for a period of two years;

(f) The prescription shall be marked "electronically transmitted prescription" or be otherwise identified for easy retrieval;

(g) An electronically transmitted prescription shall be transmitted only to the pharmacy of the patient's choice;

(h) The pharmacist is responsible for assuring the validity of the electronically transmitted prescription;

(i) A pharmacist or pharmacy shall not enter into any agreement to provide or receive a computer or computer modem, personal digital assistant, facsimile machine, or any other electronic device which would adversely affect a patient's freedom to select the pharmacy of the patient's choice; and

(j) A pharmacist or pharmacy shall not provide a computer or computer modem, personal digital assistant, facsimile machine, or any other electronic device to a prescriber or healthcare facility for the purpose of providing an incentive to refer patients to a particular pharmacy.

(5) Computer-generated, electronically signed prescriptions that are handed directly to a patient or to a patient's agent must be authenticated by the prescriber with the prescription hand-signed, with the actual signature of the prescriber.

(6) Two or more pharmacies sharing common electronic files to maintain dispensing information are not required to transfer prescription information between these pharmacies, providing all common electronic files maintain complete and accurate records of each prescription and refill dispensed, and the total number of refills authorized is not exceeded.

(a) Any pharmacy sharing a common electronic file for prescription records shall post the following notice in readily readable form in a conspicuous place within the pharmacy:

"This pharmacy maintains its prescription information in a secure electronic file that is shared by the following pharmacies: (list names of pharmacies which share the prescription information). If refills are authorized, your prescriptions may be refilled at any of the above locations. If you do not want your prescriptions to be maintained in this way, please notify the pharmacist at the time of filling."

(b) Pharmacies sharing common electronic files will have policies and procedures in place for handling these exceptions.

History: 37-7-201, 50-32-103, MCA; IMP, 37-1-101, 37-7-102, 37-7-201, 50-32-208, MCA; NEW, 1995 MAR p. 2689, Eff. 12/8/95; AMD, 2002 MAR p. 178, Eff. 2/1/02; TRANS, from Commerce, 2002 MAR p. 904; AMD, 2006 MAR p. 1615, Eff. 6/23/06; AMD, 2010 MAR p. 74, Eff. 1/15/10; AMD, 2012 MAR p. 896, Eff. 4/27/12; AMD and TRANS, from ARM 24.174.523, 2015 MAR p. 302, Eff. 3/27/15.