House File 2506      

                            AN ACT
RELATING TO ELECTRONIC AND FACSIMILE PRESCRIPTIONS AND MAKING
   PENALTIES APPLICABLE.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

   Section 1.  Section 124.101, Code 2003, is amended by
adding the following new subsections:
   NEW SUBSECTION.  13A.  "Electronic prescription" means a
prescription which is transmitted by a computer device in a
secure manner, including computer=to=computer transmission and
computer=to=facsimile transmission.
   NEW SUBSECTION.  13B.  "Facsimile prescription" means a
prescription which is transmitted by a device which sends an
exact image to the receiver.
   Sec. 2.  Section 124.308, subsections 1 and 3, Code 2003,
are amended to read as follows:
   1.  Except when dispensed directly by a practitioner, other
than a pharmacy, to an ultimate user, no controlled substance
in schedule II may be dispensed without the written
prescription of a practitioner or without the electronic or
facsimile prescription of a practitioner in accordance with
subsection 1A.
   3.  Except when dispensed directly by a practitioner, other
than a pharmacy, to an ultimate user, a controlled substance
included in schedule III or IV, which is a prescription drug
as determined under chapter 155A, shall not be dispensed
without a written or oral prescription of a practitioner or
without an electronic or facsimile prescription in accordance
with subsection 3A.  The prescription may not be filled or
refilled more than six months after the date thereof or be
refilled more than five times, unless renewed by the
practitioner.
   Sec. 3.  Section 124.308, Code 2003, is amended by adding
the following new subsections:
   NEW SUBSECTION.  1A.  A practitioner, other than a
pharmacy, or a practitioner's authorized agent may transmit an
electronic prescription or facsimile prescription to a
pharmacy for a schedule II controlled substance, provided that
the electronic prescription complies with section 155A.27 and
provided that the original signed prescription is presented to
the pharmacist prior to the dispensing of the schedule II
controlled substance.  If permitted by federal law, and in
accordance with federal requirements, the electronic or
facsimile prescription shall serve as the original signed
prescription and the practitioner shall not provide the
patient or the patient's authorized representative with a
signed, written prescription.
   NEW SUBSECTION.  3A.  A practitioner, other than a
pharmacy, or the practitioner's authorized agent may transmit
an electronic prescription or a facsimile prescription to a
pharmacy for a schedule III, IV, or V controlled substance,
provided that the prescription complies with section 155A.27,
and provided that the original signed prescription is
presented to the pharmacist prior to the dispensing of the
controlled substance, or if the prescription is electronic, an
oral prescription or a facsimile prescription is provided.  If
permitted by federal law, and in accordance with federal
requirements, the electronic or facsimile prescription shall
serve as the original signed prescription and the practitioner
shall not provide the patient or the patient's authorized
representative with a signed, written prescription.
   Sec. 4.  Section 126.2, Code 2003, is amended by adding the
following new subsections:
   NEW SUBSECTION.  8A.  "Electronic prescription" means a
prescription which is transmitted by a computer device in a
secure manner, including computer=to=computer transmission and
computer=to=facsimile transmission.
   NEW SUBSECTION.  8B.  "Facsimile prescription" means a
prescription which is transmitted by a device which sends an
exact image to the receiver.
   Sec. 5.  Section 126.11, subsection 3, paragraph a,
unnumbered paragraph 2, Code 2003, is amended to read as
follows:
   Such a drug shall be dispensed only upon a written,
electronic, or facsimile prescription of a practitioner
licensed by law to administer the drug, or upon an oral
prescription of such a practitioner which is reduced promptly
to writing and filed by the pharmacist, or by refilling any
such written, electronic, facsimile, or oral prescription if
the refilling is authorized by the prescriber either in the
original written, electronic, or facsimile prescription or by
oral order which is reduced promptly to writing and filed by
the pharmacist.  The act of dispensing a drug contrary to this
paragraph while the drug is held for sale results in the drug
being misbranded.
   Sec. 6.  Section 126.11, subsection 3, paragraph b, Code
2003, is amended to read as follows:
   b.  A drug dispensed by filling or refilling a written,
electronic, facsimile, or oral prescription of a practitioner
licensed by law to administer the drug is exempt from section
126.10, except subsection 1, subsection 9, paragraphs "b" and
"c", and subsections 11 and 12, and the packaging requirements
of subsections 7, 8, and 16, if the drug bears a label
containing the name and address of the dispenser, the date of
the prescription or of its filling, the name of the
prescriber, and, if stated in the prescription, the name of
the patient, and the directions for use and cautionary
statements, if any, contained in the prescription.  This
exemption does not apply to a drug dispensed in the course of
the conduct of the business of dispensing drugs pursuant to
diagnosis by mail, or to a drug dispensed in violation of
paragraph "a" of this subsection.
   Sec. 7.  Section 126.11, subsection 3, Code 2003, is
amended by adding the following new paragraph:
   NEW PARAGRAPH.  f.  All electronic or facsimile
prescriptions transmitted under this section shall comply with
section 155A.27.
   Sec. 8.  Section 147.107, subsection 2, unnumbered
paragraph 3, Code Supplement 2003, is amended to read as
follows:
   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.
   Sec. 9.  Section 147.108, subsection 1, Code 2003, is
amended to read as follows:
   1.  A person shall not dispense or adapt contact lenses
without first receiving authorization to do so by a written,
electronic, or facsimile prescription, except when authorized
orally under subsection 2, from a person licensed under
chapter 148, 150, 150A, or 154.  The board of optometry
examiners shall adopt rules relating to electronic or
facsimile transmission of a prescription under this section.
   Sec. 10.  Section 147.109, subsection 1, Code 2003, is
amended to read as follows:
   1.  A person shall not dispense or adapt an ophthalmic
spectacle lens or lenses without first receiving authorization
to do so by a written, electronic, or facsimile prescription
from a person licensed under chapter 148, 150, 150A, or 154.
For the purpose of this section, "ophthalmic spectacle lens"
means one which has been fabricated to fill the requirements
of a particular spectacle lens prescription.  The board of
optometry examiners shall adopt rules relating to electronic
or facsimile transmission of a prescription under this
section.
   Sec. 11.  Section 155A.3, Code 2003, is amended by adding
the following new subsections:
   NEW SUBSECTION.  15A.  "Electronic order" or "electronic
prescription" means an order or prescription which is
transmitted by a computer device in a secure manner, including
computer=to=computer transmission and computer=to=facsimile
transmission.
   NEW SUBSECTION.  15B.  "Facsimile order" or "facsimile
prescription" means an order or prescription which is
transmitted by a device which sends an exact image to the
receiver.
   Sec. 12.  Section 155A.3, subsection 31, Code 2003, is
amended to read as follows:
   31.  "Prescription drug order" means a written, electronic,
or facsimile order from a practitioner or an oral order from a
practitioner or the practitioner's authorized agent who
communicates the practitioner's instructions for a
prescription drug or device to be dispensed.
   Sec. 13.  Section 155A.23, subsection 1, paragraph b, Code
2003, is amended to read as follows:
   b.  Forgery or alteration of a written, electronic, or
facsimile prescription or of any written, electronic, or
facsimile order.
   Sec. 14.  Section 155A.23, subsection 4, Code 2003, is
amended to read as follows:
   4.  Make or utter any false or forged oral, written,
electronic, or facsimile prescription or oral, written,
electronic, or facsimile order.
   Sec. 15.  Section 155A.27, subsection 1, unnumbered
paragraph 1, Code 2003, is amended to read as follows:
   If written, or electronic, or facsimile shall contain:
   Sec. 16.  Section 155A.27, Code 2003, is amended by adding
the following new subsections:
   NEW SUBSECTION.  1A.  If electronic:
   a.  The practitioner shall ensure that the electronic
system used to transmit the electronic prescription has
adequate security and system safeguards designed to prevent
and detect unauthorized access, modification, or manipulation
of the prescription.
   b.  The practitioner shall provide verbal verification of
the electronic prescription upon the request of the pharmacy.
   NEW SUBSECTION.  1B.  a.  If facsimile, in addition to the
requirements of subsection 1, shall contain all of the
following:
   (1)  The identification number of the facsimile machine
which is used to transmit the prescription.
   (2)  The time and date of transmission of the prescription.
   (3)  The name, address, telephone number, and facsimile
number of the pharmacy to which the prescription is being
transmitted.
   b.  A practitioner shall provide verbal verification of the
facsimile prescription upon the request of the pharmacy.
   Sec. 17.  Section 155A.32, subsections 1 and 3, Code 2003,
are amended to read as follows:
   1.  If an authorized prescriber prescribes, either in
writing, electronically, by facsimile, or orally, a drug by
its brand or trade name, the pharmacist may exercise
professional judgment in the economic interest of the patient
by selecting a drug product with the same generic name and
demonstrated bioavailability as the one prescribed for
dispensing and sale to the patient.  If the cost of the
prescription or any part of it will be paid by expenditure of
public funds authorized under chapter 249A, the pharmacist
shall exercise professional judgment by selecting a drug
product with the same generic name and demonstrated
bioavailability as the one prescribed for dispensing and sale.
If the pharmacist exercises drug product selection, the
pharmacist shall inform the patient of the savings which the
patient will obtain as a result of the drug product selection
and pass on to the patient no less than fifty percent of the
difference in actual acquisition costs between the drug
prescribed and the drug substituted.
   3.  If selection of a generically equivalent product is
made under this section, the pharmacist making the selection
shall note that fact and the name of the manufacturer of the
selected drug on the prescription presented by the patient or
the patient's adult representative or transmitted by the
prescriber or the prescriber's authorized agent.


                                                            
                              CHRISTOPHER C. RANTS
                              Speaker of the House


                                                            
                              JEFFREY M. LAMBERTI
                              President of the Senate

   I hereby certify that this bill originated in the House and
is known as House File 2506, Eightieth General Assembly.


                                                            
                              MARGARET THOMSON
                              Chief Clerk of the House
Approved                , 2004


                           
THOMAS J. VILSACK
Governor