Bill Text: IA SSB3074 | 2017-2018 | 87th General Assembly | Introduced
Bill Title: A bill for an act relating to the electronic prescribing of prescription drugs including controlled substances, making penalties applicable, and providing penalties.
Spectrum: Committee Bill
Status: (N/A - Dead) 2018-02-07 - Subcommittee recommends amendment and passage. [SSB3074 Detail]
Download: Iowa-2017-SSB3074-Introduced.html
Senate
Study
Bill
3074
-
Introduced
SENATE/HOUSE
FILE
_____
BY
(PROPOSED
BOARD
OF
PHARMACY
BILL)
A
BILL
FOR
An
Act
relating
to
the
electronic
prescribing
of
prescription
1
drugs
including
controlled
substances,
making
penalties
2
applicable,
and
providing
penalties.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
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Section
1.
Section
124.308,
Code
2018,
is
amended
by
1
striking
the
section
and
inserting
in
lieu
thereof
the
2
following:
3
124.308
Prescriptions.
4
1.
Except
when
dispensed
directly
by
a
practitioner
to
an
5
ultimate
user,
a
prescription
drug
as
defined
in
section
155A.3
6
that
is
a
controlled
substance
shall
not
be
dispensed
without
7
a
prescription,
unless
such
prescription
is
authorized
by
a
8
practitioner
and
complies
with
this
section,
section
155A.27,
9
applicable
federal
law
and
regulation,
and
rules
of
the
board.
10
2.
a.
Beginning
July
1,
2019,
every
prescription
issued
11
for
a
controlled
substance
shall
be
transmitted
electronically
12
as
an
electronic
prescription
pursuant
to
the
requirements
in
13
subsection
2,
paragraph
“b”
,
unless
exempt
under
subsection
2,
14
paragraph
“c”
.
15
b.
Except
for
prescriptions
identified
in
paragraph
“c”
,
16
a
prescription
that
is
transmitted
pursuant
to
paragraph
“a”
17
shall
be
transmitted
to
a
pharmacy
by
a
practitioner
or
the
18
practitioner’s
authorized
agent
in
compliance
with
federal
19
law
and
regulation
for
electronic
prescriptions
of
controlled
20
substances.
The
practitioner’s
electronic
prescription
system
21
and
the
receiving
pharmacy’s
dispensing
system
shall
comply
22
with
federal
law
and
regulation
for
electronic
prescriptions
of
23
controlled
substances.
24
c.
Paragraph
“b”
shall
not
apply
to
any
of
the
following:
25
(1)
A
prescription
for
a
patient
residing
in
a
nursing
home,
26
long-term
care
facility,
correctional
facility,
or
jail.
27
(2)
A
prescription
authorized
by
a
licensed
veterinarian.
28
(3)
A
prescription
dispensed
by
a
department
of
veterans
29
affairs
pharmacy.
30
(4)
A
prescription
requiring
information
that
makes
31
electronic
submission
impractical,
such
as
complicated
or
32
lengthy
directions
for
use
or
attachments.
33
(5)
A
prescription
for
a
compounded
preparation
containing
34
two
or
more
components.
35
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(6)
A
prescription
issued
in
response
to
a
public
health
1
emergency
in
a
situation
where
a
non-patient
specific
2
prescription
would
be
permitted.
3
(7)
A
prescription
issued
pursuant
to
an
established
and
4
valid
collaborative
practice
agreement,
standing
order,
or
drug
5
research
protocol.
6
(8)
A
prescription
issued
during
a
temporary
technical
or
7
electronic
failure
at
the
prescriber’s
or
pharmacy’s
location.
8
(9)
A
prescription
issued
in
an
emergency
situation
9
pursuant
to
federal
law
and
regulation
rules
of
the
board.
10
d.
A
practitioner,
as
defined
in
section
124.101,
subsection
11
27,
paragraph
“a”
,
who
violates
paragraph
“a”
is
subject
12
to
an
administrative
penalty
of
two
hundred
fifty
dollars
13
per
violation,
up
to
a
maximum
of
five
thousand
dollars
per
14
calendar
year.
The
assessment
of
an
administrative
penalty
15
pursuant
to
this
paragraph
by
the
appropriate
licensing
board
16
of
the
practitioner
alleged
to
have
violated
paragraph
“a”
17
shall
not
be
considered
a
disciplinary
action
and
shall
not
be
18
released
or
reported
as
discipline.
A
practitioner
may
appeal
19
the
assessment
of
an
administrative
penalty
pursuant
to
this
20
paragraph,
which
shall
initiate
a
contested
case
proceeding
21
under
chapter
17A.
A
penalty
collected
pursuant
to
this
22
paragraph
shall
be
deposited
into
the
drug
information
program
23
fund
established
pursuant
to
section
124.557.
The
board
shall
24
be
notified
of
any
administrative
penalties
assessed
by
the
25
appropriate
professional
licensing
board
and
deposited
into
the
26
drug
information
program
fund
under
this
paragraph.
27
3.
A
prescription
issued
prior
to
July
1,
2019,
or
a
28
prescription
that
is
exempt
from
the
electronic
prescription
29
requirement
in
subsection
2,
paragraph
“c”
,
may
be
transmitted
30
by
a
practitioner
or
the
practitioner’s
authorized
agent
to
a
31
pharmacy
in
any
of
the
following
ways:
32
a.
Electronically,
if
transmitted
in
accordance
with
33
the
requirements
for
electronic
prescriptions
pursuant
to
34
subsection
2.
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b.
By
facsimile
for
a
schedule
III,
IV,
or
V
controlled
1
substance,
or
for
a
schedule
II
controlled
substance
only
2
pursuant
to
federal
law
and
regulation
and
rules
of
the
board.
3
c.
Orally
for
a
schedule
III,
IV,
or
V
controlled
substance,
4
or
for
a
schedule
II
controlled
substance
only
in
an
emergency
5
situation
pursuant
to
federal
regulation
and
rules
of
the
6
board.
7
d.
By
providing
an
original
signed
prescription
to
a
patient
8
or
a
patient’s
authorized
representative.
9
4.
If
permitted
by
federal
law
and
in
accordance
with
10
federal
requirements,
an
electronic
or
facsimile
prescription
11
shall
serve
as
the
original
signed
prescription
and
the
12
practitioner
shall
not
provide
a
patient,
a
patient’s
13
authorized
representative,
or
the
dispensing
pharmacy
with
a
14
signed,
written
prescription.
An
original
signed
prescription
15
shall
be
retained
for
a
minimum
of
two
years
from
the
date
of
16
the
latest
dispensing
or
refill
of
the
prescription.
17
5.
A
prescription
for
a
schedule
II
controlled
substance
18
shall
not
be
filled
more
than
six
months
after
the
date
19
of
issuance.
A
prescription
for
a
schedule
II
controlled
20
substance
shall
not
be
refilled.
21
6.
A
prescription
for
a
schedule
III,
IV,
or
V
controlled
22
substance
shall
not
be
filled
or
refilled
more
than
six
months
23
after
the
date
on
which
the
prescription
was
issued
or
be
24
refilled
more
than
five
times.
25
7.
A
controlled
substance
shall
not
be
distributed
or
26
dispensed
other
than
for
a
medical
purpose.
27
8.
A
practitioner,
medical
group,
or
pharmacy
that
is
unable
28
to
timely
comply
with
the
electronic
prescribing
requirements
29
in
subsection
2,
paragraph
“b”
,
may
petition
the
board
for
an
30
exemption
from
the
requirements
based
upon
economic
hardship,
31
technical
limitations
that
the
practitioner,
medical
group,
or
32
pharmacy
cannot
control,
or
other
exceptional
circumstances.
33
The
board
shall
adopt
rules
establishing
the
form
and
specific
34
information
to
be
included
in
a
request
for
an
exemption
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and
the
specific
criteria
to
be
considered
by
the
board
in
1
determining
whether
to
approve
a
request
for
an
exemption.
The
2
board
may
approve
an
exemption
for
a
period
of
time
determined
3
by
the
board
not
to
exceed
one
year
from
the
date
of
approval,
4
and
may
be
renewed
annually
upon
request
subject
to
board
5
approval.
6
Sec.
2.
Section
155A.27,
Code
2018,
is
amended
by
striking
7
the
section
and
inserting
in
lieu
thereof
the
following:
8
155A.27
Requirements
for
prescription.
9
1.
Except
when
dispensed
directly
by
a
prescriber
to
an
10
ultimate
user,
a
prescription
drug
shall
not
be
dispensed
11
without
a
prescription,
authorized
by
a
prescriber,
and
based
12
on
a
valid
patient-prescriber
relationship.
13
2.
a.
Beginning
July
1,
2019,
every
prescription
issued
for
14
a
prescription
drug
shall
be
transmitted
electronically
as
an
15
electronic
prescription
to
a
pharmacy
by
a
prescriber
or
the
16
prescriber’s
authorized
agent
unless
exempt
under
paragraph
17
“b”
.
18
b.
Paragraph
“a”
shall
not
apply
to
any
of
the
following:
19
(1)
A
prescription
for
a
patient
residing
in
a
nursing
home,
20
long-term
care
facility,
correctional
facility,
or
jail.
21
(2)
A
prescription
authorized
by
a
licensed
veterinarian.
22
(3)
A
prescription
for
a
device.
23
(4)
A
prescription
dispensed
by
a
department
of
veterans
24
affairs
pharmacy.
25
(5)
A
prescription
requiring
information
that
makes
26
electronic
transmission
impractical,
such
as
complicated
or
27
lengthy
directions
for
use
or
attachments.
28
(6)
A
prescription
for
a
compounded
preparation
containing
29
two
or
more
components.
30
(7)
A
prescription
issued
in
response
to
a
public
health
31
emergency
in
a
situation
where
a
non-patient
specific
32
prescription
would
be
permitted.
33
(8)
A
prescription
issued
for
an
opioid
antagonist
pursuant
34
to
section
135.190
or
a
prescription
issued
for
epinephrine
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pursuant
to
section
135.185.
1
(9)
A
prescription
issued
during
a
temporary
technical
2
or
electronic
failure
at
the
location
of
the
prescriber
or
3
pharmacy.
4
(10)
A
prescription
issued
pursuant
to
an
established
and
5
valid
collaborative
practice
agreement,
standing
order,
or
drug
6
research
protocol.
7
(11)
A
prescription
issued
in
an
emergency
situation
8
pursuant
to
federal
law
and
regulation
and
rules
of
the
board.
9
c.
A
practitioner,
as
defined
in
section
124.101,
subsection
10
27,
paragraph
“a”
,
who
violates
paragraph
“a”
is
subject
11
to
an
administrative
penalty
of
two
hundred
fifty
dollars
12
per
violation,
up
to
a
maximum
of
five
thousand
dollars
per
13
calendar
year.
The
assessment
of
an
administrative
penalty
14
pursuant
to
this
paragraph
by
the
appropriate
licensing
board
15
of
the
practitioner
alleged
to
have
violated
paragraph
“a”
16
shall
not
be
considered
a
disciplinary
action
and
shall
not
be
17
released
or
reported
as
discipline.
A
practitioner
may
appeal
18
the
assessment
of
an
administrative
penalty
pursuant
to
this
19
paragraph,
which
shall
initiate
a
contested
case
proceeding
20
under
chapter
17A.
A
penalty
collected
pursuant
to
this
21
paragraph
shall
be
deposited
into
the
drug
information
program
22
fund
established
pursuant
to
section
124.557.
The
board
shall
23
be
notified
of
any
administrative
penalties
assessed
by
the
24
appropriate
professional
licensing
board
and
deposited
into
the
25
drug
information
program
fund
under
this
paragraph.
26
3.
For
prescriptions
issued
prior
to
July
1,
2019,
or
27
for
prescriptions
exempt
from
the
electronic
prescription
28
requirement
in
subsection
2,
paragraph
“b”
,
a
prescriber
or
the
29
prescriber’s
authorized
agent
may
transmit
a
prescription
for
a
30
prescription
drug
to
a
pharmacy
by
any
of
the
following
means:
31
a.
Electronically.
32
b.
By
facsimile.
33
c.
Orally.
34
d.
By
providing
an
original
signed
prescription
to
a
patient
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or
a
patient’s
authorized
representative.
1
4.
A
prescription
shall
be
issued
in
compliance
with
2
this
subsection.
Regardless
of
the
means
of
transmission,
a
3
prescriber
shall
provide
verbal
verification
of
a
prescription
4
upon
request
of
the
pharmacy.
5
a.
If
written,
electronic,
or
facsimile,
each
prescription
6
shall
contain
all
of
the
following:
7
(1)
The
date
of
issue.
8
(2)
The
name
and
address
of
the
patient
for
whom,
or
the
9
owner
of
the
animal
for
which,
the
drug
is
dispensed.
10
(3)
The
name,
strength,
and
quantity
of
the
drug
prescribed.
11
(4)
The
directions
for
use
of
the
drug,
medicine,
or
device
12
prescribed.
13
(5)
The
name,
address,
and
written
or
electronic
signature
14
of
the
prescriber
issuing
the
prescription.
15
(6)
The
federal
drug
enforcement
administration
number,
if
16
required
under
chapter
124.
17
b.
If
electronic,
each
prescription
shall
comply
with
all
18
of
the
following:
19
(1)
The
prescriber
shall
ensure
that
the
electronic
system
20
used
to
transmit
the
electronic
prescription
has
adequate
21
security
and
safeguards
designed
to
prevent
and
detect
22
unauthorized
access,
modification,
or
manipulation
of
the
23
prescription.
24
(2)
Notwithstanding
paragraph
“a”
,
subparagraph
(5),
25
for
prescriptions
that
are
not
controlled
substances,
if
26
transmitted
by
an
authorized
agent,
the
electronic
prescription
27
shall
not
require
the
written
or
electronic
signature
of
the
28
prescriber
issuing
the
prescription.
29
c.
If
facsimile,
in
addition
to
the
requirements
of
30
paragraph
“a”
,
each
prescription
shall
contain
all
of
the
31
following:
32
(1)
The
identification
number
of
the
facsimile
machine
33
which
is
used
to
transmit
the
prescription.
34
(2)
The
date
and
time
of
transmission
of
the
prescription.
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(3)
The
name,
address,
telephone
number,
and
facsimile
1
number
of
the
pharmacy
to
which
the
prescription
is
being
2
transmitted.
3
d.
If
oral,
the
prescriber
issuing
the
prescription
4
shall
furnish
the
same
information
required
for
a
written
5
prescription,
except
for
the
written
signature
and
address
6
of
the
prescriber.
Upon
receipt
of
an
oral
prescription,
7
the
recipient
shall
promptly
reduce
the
oral
prescription
to
8
a
written
format
by
recording
the
information
required
in
a
9
written
prescription.
10
e.
A
prescription
transmitted
by
electronic,
facsimile,
11
or
oral
means
by
a
prescriber’s
agent
shall
also
include
12
the
name
and
title
of
the
prescriber’s
agent
completing
the
13
transmission.
14
5.
An
electronic,
facsimile,
or
oral
prescription
15
shall
serve
as
the
original
signed
prescription
and
the
16
prescriber
shall
not
provide
a
patient,
a
patient’s
authorized
17
representative,
or
the
dispensing
pharmacist
with
a
signed
18
written
prescription.
Prescription
records
shall
be
retained
19
pursuant
to
rules
of
the
board.
20
6.
This
section
shall
not
prohibit
a
pharmacist,
21
in
exercising
the
pharmacist’s
professional
judgment,
22
from
dispensing,
at
one
time,
additional
quantities
of
a
23
prescription
drug,
with
the
exception
of
a
prescription
drug
24
that
is
a
controlled
substance
as
defined
in
section
124.101,
25
up
to
the
total
number
of
dosage
units
authorized
by
the
26
prescriber
on
the
original
prescription
and
any
refills
of
27
the
prescription,
not
to
exceed
a
ninety-day
supply
of
the
28
prescription
drug
as
specified
on
the
prescription.
29
7.
A
prescriber,
medical
group,
institution,
or
pharmacy
30
that
is
unable
to
timely
comply
with
the
electronic
prescribing
31
requirements
in
subsection
2,
paragraph
“a”
,
may
petition
32
the
board
for
an
exemption
from
the
requirements
based
upon
33
economic
hardship,
technical
limitations
that
the
prescriber,
34
medical
group,
institution,
or
pharmacy
cannot
control,
or
35
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other
exceptional
circumstances.
The
board
shall
adopt
rules
1
establishing
the
form
and
specific
information
to
be
included
2
in
a
request
for
an
exemption
and
the
specific
criteria
to
be
3
considered
by
the
board
in
determining
whether
to
approve
a
4
request
for
an
exemption.
The
board
may
approve
an
exemption
5
for
a
period
of
time
determined
by
the
board,
not
to
exceed
one
6
year
from
the
date
of
approval,
and
may
be
annually
renewed
7
subject
to
board
approval
upon
request.
8
Sec.
3.
Section
155A.29,
subsection
4,
Code
2018,
is
amended
9
to
read
as
follows:
10
4.
An
authorization
to
refill
a
prescription
drug
order
may
11
shall
be
transmitted
to
a
pharmacist
pharmacy
by
a
prescriber
12
or
the
prescriber’s
authorized
agent
through
word
of
mouth,
13
note,
telephone,
facsimile,
or
other
means
of
communication
14
initiated
by
or
directed
by
the
practitioner.
The
transmission
15
shall
include
the
information
required
pursuant
to
section
16
155A.27
,
except
that
prescription
drug
orders
for
controlled
17
substances
shall
be
transmitted
pursuant
to
section
124.308,
18
and,
if
not
transmitted
directly
by
the
practitioner,
19
shall
identify
by
also
include
the
name
and
title
of
the
20
practitioner’s
agent
completing
the
transmission.
21
EXPLANATION
22
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
23
the
explanation’s
substance
by
the
members
of
the
general
assembly.
24
This
bill
relates
to
the
electronic
prescribing
of
25
prescription
drugs,
including
controlled
substances.
The
26
bill
requires
all
prescriptions
for
prescription
drugs
to
27
transmitted
to
a
pharmacy
electronically,
effective
July
1,
28
2019.
The
bill
also
requires
prescriptions
for
controlled
29
substances
that
are
issued
electronically
to
comply
with
30
federal
law
for
the
electronic
transmittal
of
prescriptions
31
for
controlled
substances.
The
bill
provides
exemptions
32
from
this
requirement
in
certain
circumstances
and
provides
33
alternative
methods
for
the
transmittal
of
prescriptions
in
34
those
circumstances
and
for
prescriptions
transmitted
prior
to
35
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July
1,
2019.
The
bill
also
allows
a
person
subject
to
the
1
requirements
of
the
bill
to
petition
the
board
of
pharmacy
2
for
exemption
from
the
requirements
of
the
bill
based
on
3
economic
hardship,
technical
limitations,
or
other
exceptional
4
circumstances.
The
bill
requires
refills
for
prescription
5
drugs
and
controlled
substances
to
be
transmitted
in
the
same
6
manner
as
required
for
initial
prescriptions.
7
A
practitioner
who
does
not
transmit
a
prescription
8
drug
order
electronically
as
required
by
the
bill
shall
be
9
subject
to
an
administrative
penalty
of
$250
per
violation,
10
up
to
a
maximum
of
$5,000
per
calendar
year.
Such
a
penalty
11
shall
be
assessed
by
the
professional
licensing
board
of
the
12
practitioner
alleged
to
have
committed
the
violation.
A
13
practitioner
may
contest
such
penalty,
which
shall
initiate
a
14
contested
case
proceeding
under
Code
chapter
17A.
Any
such
15
penalty
collected
by
a
professional
licensing
board
shall
be
16
deposited
into
the
drug
information
program
fund
and
reported
17
to
the
board.
18
A
person
who
does
not
comply
with
Code
section
124.308
19
is
guilty
of
an
aggravated
misdemeanor
pursuant
to
Code
20
section
124.402.
An
aggravated
misdemeanor
is
punishable
by
21
confinement
for
no
more
than
two
years
and
a
fine
of
at
least
22
$625
but
not
more
than
$6,250.
23
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