N.M. Admin. Code § 16.19.6.23

Current through Register Vol. 35, No. 21, November 5, 2024

Section 16.19.6.23 - PRESCRIPTIONS

A. A valid prescription is an order for a dangerous drug given individually for the person for whom prescribed, either directly from the prescribing practitioner to the pharmacist, or indirectly by means of a written order signed by the practitioner. Signed by the practitioner includes handwritten signature, stamped or printed images of the practitioners handwritten signature or electronic signature as defined in Paragraph (1) of Subsection F of 16.19.6.23 NMAC. Every prescription record shall contain the name and address of the prescriber, the name and address of the patient, the name and strength of the drug, the quantity prescribed, directions for use, the date of issue, and preferably the diagnosis or indication.

B. A prescription may be prepared by a secretary or agent, i.e., office nurse under supervision, for the signature of the practitioner and where applicable; a prescription may be communicated to the pharmacist by an employee or agent of the registered practitioner. The prescribing practitioner is responsible in case the prescription does not conform in all essential respects to the law and regulation.

C. Prescription information received from a patient, other than a signed written prescription from a practitioner, has no legal status as a valid prescription. A pharmacist receiving such prescription information must contact the prescribing physician for a new prescription.

D. Exchange of prescription information between pharmacies for the purpose of filling or refilling is authorized under the following conditions only.

(1) The original prescription entry shall be marked in the pharmacy computer system. Pharmacies not using a computer shall mark the hard copy.

(2) The prescription shall indicate that it has been transferred and pharmacy location and file number of the original prescription.

(3) In addition to all information required to appear on a prescription, the prescription shall show the date of original fillings as well as the number of valid refills remaining.

(4) An original unfilled non-controlled substance prescription that is transferred shall be subject to the same record keeping requirements as filled prescriptions.

(5) Transfer or forwarding of controlled substance prescriptions shall not be allowed electronically except as permitted by federal law.

(6) A pharmacy may not refuse to transfer original prescription information to another pharmacy who is acting on behalf of a patient and who is making a request for this information as specified in this subsection. The transfer of original prescription information must be done in a timely manner.

E. Fax Machines: Fax prescription means a valid prescription which is transmitted by an electronic device which sends an exact image of a written prescription signed by the practitioner to a pharmacy. The prescribing of controlled substances by fax must comply with all state and federal laws. No pharmacist may dispense a drug solely on the basis of a prescription received by fax except under the following circumstances:

(1) the pharmacist shall exercise professional judgment regarding the accuracy and authenticity of the prescription consistent with existing federal and state statutes and regulations;

(2) the original fax prescription shall be printed and stored in the pharmacy as required by state and federal law and board rules, and may serve as the record of the prescription;

(3) the fax prescription shall include name and fax number of the pharmacy, the prescriber's phone number, for verbal confirmation, time and date of transmission, as well as any other information required by federal and state statute or regulation;

(4) in institutional practice, the fax machine operator must be identified by a statement in the facility policy and procedures manual;

(5) the receiving fax machine must be physically located in a restricted area to protect patient confidentiality;

(6) electronically generated prescriptions may be transmitted directly to the pharmacy via telephone lines or indirectly through one or more "contracted" parties via valid "network vendors" directly to a pharmacy's fax machine;

(7) electronically generated prescriptions faxed from a practitioner's office computer shall include the prescriber's name, phone and fax number, time and date of transmission as well as any other information required by federal and state statutes or regulation;

(8) electronically generated prescriptions faxed from a practitioner's "contracted" "point of care vendor" directly to the pharmacy must include the name and phone number of the "point of care vendor";

(9) "point of care vendors", "network vendors" or other prescription transmission intermediaries not compliant with the requirements of this section will be considered an invalid source;

(10) the pharmacist shall exercise professional judgment regarding the accuracy and authenticity of prescriptions consistent with federal and state statutes and regulations; in the absence of unusual circumstances requiring further inquiry, the pharmacy and each of its associated pharmacists is entitled to rely on the accuracy and authenticity of electronically transmitted prescriptions from a "point of care vendor" or "network vendor" which has not been prohibited by the board.

F. Electronic Transmission of Prescriptions

(1) Requirements for electronically transmitted prescriptions or drug orders, including controlled substances as permitted by federal law.

(a) The receiving computer or other similar electronic device used to view the prescription shall be located within the pharmacy or pharmacy department with only authorized personnel having access.

(b) The electronically transmitted prescription or drug order shall contain all information required by state and federal law including the prescriber's name, address and phone number, time and date of transmission.

(c) The prescribing practitioner's electronic signature, or other secure method of validation shall be provided with the electronically transmitted prescription or drug order.

(d) The electronically transmitted prescriptions may serve as the hard copy record of the prescription so long as the electronically transmitted prescription information can be stored in the original format as when received and is readily retrievable so as to comply with federal and state recordkeeping requirements.

(e) The electronic transmission of a prescription or drug order shall maintain patient confidentiality with no intervening person or other entity accessing or altering the prescription content. The accessing or altering prohibition does not include format modification for transmission purposes by approved secure electronic prescribing networks.

(f) Electronically transmitted prescriptions or drug orders shall be sent only to the pharmacy of the patient's choice.

(2) "Point of care vendors", "network vendors" or other prescription transmission intermediaries not compliant with the requirements of this section will be considered an invalid source.

(3) The pharmacist shall exercise professional judgment regarding the accuracy and authenticity of prescriptions consistent with federal and state statutes and regulations. In the absence of unusual circumstances requiring further inquiry, the pharmacy and each of its associated pharmacists is entitled to rely on the accuracy and authenticity of electronically transmitted prescriptions from a "point of care vendor" or "network vendor" which has not been prohibited by the board.

G. Transmission of prescriptions to answering machines and electronic voice recording devices. Prescription information retrieved by a pharmacist from an answering machine or voice recording device from an authorized practitioner or approved agent is considered to be a direct transmission of a prescription order.

H. Confidentiality of patient records and prescription drug orders.

(1) Confidential information. As provided in 61-11-2.D, confidential information in the patient record, including the contents of any prescription or the therapeutic effect thereof or the nature of professional pharmaceutical services rendered to a patient; the nature, extent, or degree of illness suffered by any patient; or any medical information furnished by the prescriber, may be released only as follows:

(a) pursuant to the express written consent or release of the patient or the order of direction of a court;

(b) to the patient or the patient's authorized representative;

(c) to the prescriber or other licensed practitioner then for the patient;

(d) to another licensed pharmacist where the best interest of the patient require such release;

(e) to the board or its representative or to such other person or governmental agencies duly authorized by the law to receive such information; a pharmacist shall utilize the resources available to determine, in the professional judgment of the pharmacist, that any person requesting confidential patient information pursuant to this rule are entitled to receive that information;

(f) in compliance with Health Insurance Portability and Accountability Act regulations regarding protected health information.

(2) Exceptions. Nothing in this rule shall prohibit pharmacists from releasing confidential patient information as follows:

(a) transferring a prescription to another pharmacy as required by the provision of patient counseling;

(b) providing a copy of a non-refillable prescription to the person for whom the prescription was issued which is marked "For Information Purposed Only";

(c) providing drug therapy information to physicians or other authorized prescribers for their patients;

(d) as required by the provision of patient counseling regulations.

I. Prescription adaptation: A pharmacist, using professional judgment, may determine in filling a new non-controlled substance prescription whether it is necessary to attempt to contact the prescriber before performing the following adaptations:

(1) change the quantity, dosage, dosage form, or directions for use of the medication dispensed if it meets the intent of the prescriber, or

(2) complete missing information on a prescription if there is sufficient evidence to support the change.

(3) The pharmacist will document the prescription adaptation as part of the original prescription record.

(4) The pharmacist will notify the prescriber of the prescription adaptation within 24 hours; and will maintain documentation of notification.

(5) The pharmacist will provide patient counseling, in accordance with Subsection F of 16.19.4.16 NMAC, to include information pertinent to the prescription adaptation.

N.M. Admin. Code § 16.19.6.23

16.19.6.23 NMAC - Rp 16 NMAC 19.6.23, 03-30-02; A, 06-30-06, Amended by New Mexico Register, Volume XXVI, Issue 05, March 16, 2015, eff. 3/22/2015, Amended by New Mexico Register, Volume XXXI, Issue 23, December 15, 2020, eff. 12/15/2020, Amended by New Mexico Register, Volume XXXIV, Issue 19, October 10, 2023, eff. 10/10/2023