Electronic Prescriptions and Medication Orders

PURPOSE: This rule establishes guidelines for electronic prescriptions and medication orders. (1) Definitions. (A) Electronic image transmission—An exact visual image of a paper prescription or medication order that is electronically received by a pharmacy from a licensed prescriber or the prescriber’s authorized agent (e.g., a facsimile/scan). (B) Electronic prescription—Any prescription or medication order, other than an electronic image transmission, which is electronically transmitted from a licensed prescriber or the prescriber’s authorized agent to a pharmacy. (C) Electronic signature—An exact electronic replica of the prescriber’s signature or a confidential digital key code, number, or other identifier attached to or logically associated with a record that is executed or adopted by a prescriber with the intent to sign the record. AND INSURANCE (2) Prescriptions or medication orders may be transmitted to a pharmacy by the prescriber or the prescriber’s authorized agent as an electronic image transmission or an electronic prescription. (A) Electronic image transmissions and electronic prescriptions must contain all information required by state and federal law, including, designation of whether generic substitution is authorized. Electronic image transmissions must be formatted as required by section 338.056, RSMo, and bear the prescriber’s manual or electronic signature. (B) Controlled substance prescriptions and medication orders must comply with state and federal controlled substance laws and regulations and must be signed in accordance with state and federal law. (C) A pharmacist shall be responsible for verifying the authenticity of any electronic image transmission or electronic prescription prior to dispensing by taking measures which, in his/her professional judgment, may be necessary to ensure the prescription or medication order was initiated or authorized by the prescriber. (3) In lieu of a manually signed prescription or medication order, a pharmacist may accept a paper prescription or medication order with an electronic signature if the prescription/medication order is applied to paper that utilizes security features that will detect or otherwise identify if the prescription/medication order is subject to any form of copying and/or alteration. AUTHORITY: sections 338.095, 338.140, and 338.280, RSMo 2016, and section 338.010, RSMo Supp. 2017.* This rule originally filed as 4 CSR 220-2.085. Original rule filed Sept. 25, 1995, effective April 30, 1996. Amended: Filed July 28, 2000, effective Jan. 30, 2001. Amended: Filed April 16, 2001, effective Nov. 30, 2001. Moved to 20 CSR 2220-2.085, effective Aug. 28, 2006. Amended: Filed Dec. 15, 2017, effective June 30, 2018. *Original authority: 338.010, RSMo 1939, amended 1951, 1989, 1990, 2007, 2009, 2011, 2014, 2017; 338.095, RSMo 1993, 2007; 338.140, RSMo 1939, amended 1981, 1989, 1997, 2011; and 328.280, RSMo 1951, amended 1971, 1981.