657—21.6(124,155A) Electronic prescription applications. Each prescription shall be transmitted electronically to a pharmacy except as provided in rule 657—21.8(124,155A). The prescription drug order shall contain all information required by Iowa Code section 155A.27. The receiving pharmacist shall be responsible for verifying the authenticity of an electronically prescribed prescription pursuant to rule 657—8.19(124,126,155A). A prescription that is subject to exemption as provided in rule 657—21.8(124,155A) may be transmitted to a pharmacy via electronic or facsimile transmission or printed in hard-copy format for delivery to the pharmacy. A prescription that is transmitted by a prescriber’s agent via electronic or facsimile transmission shall include the first and last names and title of the agent responsible for the transmission.
	21.6(1) Electronic transmission. A prescription prepared pursuant to this rule shall be transmitted electronically to a pharmacy, unless exempt pursuant to rule 657—21.8(124,155A). A pharmacy shall be certified compliant with DEA regulations relating to electronic prescriptions prior to electronically receiving prescriptions for controlled substances. The electronic record shall serve as the original record and shall be maintained for two years from the date of last activity on the prescription. Any annotations shall be made and retained on the electronic record.
	a. 	An electronically prepared and transmitted prescription that is printed following transmission shall be clearly labeled as a copy, not valid for dispensing.
	b. 	The authenticity of a prescription transmitted via electronic transmission between a DEA-certified electronic prescription application and a DEA-certified electronic automated data processing system shall be deemed verified by virtue of the security processes included in those applications.
	c. 	A pharmacy shall ensure that no intermediary has the ability to change the content of the prescription drug order or compromise its confidentiality during the transmission process. The electronic format of the prescription drug order may be changed by the intermediary to facilitate the transmission between electronic applications as long as the content of the prescription drug order remains unchanged.
	d. 	In addition to the information requirements for a prescription, an electronically transmitted prescription shall identify the transmitter’s telephone number for verbal confirmation, the telephone number where the prescriber can be contacted for timely consultation about patient care matters, the time and date of transmission, and the pharmacy intended to receive the transmission as well as any other information required by federal or state laws, rules, or regulations.
	e. 	If the transmission of an electronic prescription fails, the prescriber may print the prescription, manually sign the printed prescription, and deliver the prescription to the pharmacy via facsimile transmission in accordance with subrule 21.6(2).
	21.6(2) Printed (hard-copy) prescriptions. A prescription that is exempt from the electronic prescription mandate as provided in rule 657—21.8(124,155A) may be printed in hard-copy format for facsimile transmission or delivery to the pharmacy.
	a. 	A prescription for a controlled substance shall include the prescriber’s manual signature. Printed or hard-copy prescriptions for Schedule II controlled substances shall not be transmitted to a pharmacy via facsimile transmission, except as authorized in rule 657—21.7(124,155A).
	b. 	If the prescriber authenticates a prescription for a noncontrolled prescription drug utilizing an electronic signature, the printed prescription shall be printed on security paper. Security features of the paper shall ensure that prescription information is not obscured or rendered illegible when transmitted via facsimile or when scanned into an electronic record system.
	c. 	If the facsimile transmission of a printed prescription is a result of a failed electronic transmission, the facsimile shall indicate that it was originally transmitted to the named pharmacy, the date and time of the original electronic transmission, and the fact that the original transmission failed.
[ARC 3640C, IAB 2/14/18, effective 3/21/18; ARC 4580C, IAB 7/31/19, effective 9/4/19; ARC 5350C, IAB 12/30/20, effective 2/3/21; ARC 6077C, IAB 12/15/21, effective 1/19/22]