1. Except when dispensed directly by a prescriber to an ultimate user, a prescription drug shall not be dispensed without a prescription that is authorized by a prescriber and based on a valid patient-prescriber relationship.

Terms Used In Iowa Code 155A.27

  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Authorized agent: means an individual designated by a practitioner who is under the supervision of the practitioner and for whom the practitioner assumes legal responsibility. See Iowa Code 155A.3
  • Board: means the board of pharmacy. See Iowa Code 155A.3
  • Controlled substance: means a drug substance, immediate precursor, or other substance listed in subchapter II of chapter 124. See Iowa Code 155A.3
  • Department: means the Iowa department of public health. See Iowa Code 154A.1
  • Device: means a medical device, as classified by the United States food and drug administration, intended for use by a patient that is required by the United States food and drug administration to be ordered or prescribed for a patient by a practitioner. See Iowa Code 155A.3
  • Dispense: means to deliver a prescription drug, device, or controlled substance to an ultimate user or research subject by or pursuant to the lawful prescription drug order or medication order of a practitioner, including the prescribing, administering, packaging, labeling, or compounding necessary to prepare the substance for that delivery. See Iowa Code 155A.3
  • drug: means a drug, as classified by the United States food and drug administration, that is required by the United States food and drug administration to be prescribed or administered to a patient by a practitioner prior to dispensation. See Iowa Code 155A.3
  • 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. See Iowa Code 155A.3
  • Electronic signature: means a confidential personalized digital key, code, or number used for secure electronic transmissions which identifies and authenticates the signatory. See Iowa Code 155A.3
  • facsimile prescription: means an order or prescription which is transmitted by a device which sends an exact image to the receiver. See Iowa Code 155A.3
  • following: when used by way of reference to a chapter or other part of a statute mean the next preceding or next following chapter or other part. See Iowa Code 4.1
  • Licensing board: means a party state's regulatory body responsible for advanced practice registered nurse licensure or authority to practice. See Iowa Code 152E.3
  • Pharmacist: means a person licensed by the board to practice pharmacy. See Iowa Code 155A.3
  • Pharmacy: means a location where prescription drugs are compounded, dispensed, or sold by a pharmacist and where prescription drug orders are received or processed in accordance with the pharmacy laws. See Iowa Code 155A.3
  • Practitioner: means a physician, dentist, podiatric physician, prescribing psychologist, veterinarian, optometrist, physician assistant, advanced registered nurse practitioner, or other person licensed or registered to prescribe, distribute, or dispense a prescription drug or device in the course of professional practice in this state or a person licensed by another state in a health field in which, under Iowa law, licensees in this state may legally prescribe drugs. See Iowa Code 155A.3
  • Signature: includes an electronic signature as defined in section 554D. See Iowa Code 4.1
  • Ultimate user: means a person who has lawfully obtained and possesses a prescription drug or device for the person's own use or for the use of a member of the person's household or for administering to an animal owned by the person or by a member of the person's household. See Iowa Code 155A.3
  • year: means twelve consecutive months. See Iowa Code 4.1
 2. a. Beginning January 1, 2020, every prescription issued for a prescription drug shall be transmitted electronically as an electronic prescription to a pharmacy by a prescriber or the prescriber’s authorized agent unless exempt under paragraph “b”.

 b. Paragraph “a” shall not apply to any of the following:

 (1) A prescription for a patient residing in a nursing home, long-term care facility, correctional facility, or jail.
 (2) A prescription authorized by a licensed veterinarian.
 (3) A prescription for a device.
 (4) A prescription dispensed by a department of veterans affairs pharmacy.
 (5) A prescription requiring information that makes electronic transmission impractical, such as complicated or lengthy directions for use or attachments.
 (6) A prescription for a compounded preparation containing two or more components.
 (7) A prescription issued in response to a public health emergency in a situation where a non-patient specific prescription would be permitted.
 (8) A prescription issued for an opioid antagonist pursuant to section 135.190 or a prescription issued for epinephrine pursuant to section 135.185.
 (9) A prescription issued during a temporary technical or electronic failure at the location of the prescriber or pharmacy, provided that a prescription issued pursuant to this subparagraph shall indicate on the prescription that the prescriber or pharmacy is experiencing a temporary technical or electronic failure.
 (10) A prescription issued pursuant to an established and valid collaborative practice agreement, standing order, or drug research protocol.
 (11) A prescription issued in an emergency situation pursuant to federal law and regulation and rules of the board.
 c. A practitioner, as defined in section 124.101, subsection 27, paragraph “a”, who violates paragraph “a” is subject to an administrative penalty of two hundred fifty dollars per violation, up to a maximum of five thousand dollars per calendar year. The assessment of an administrative penalty pursuant to this paragraph by the appropriate licensing board of the practitioner alleged to have violated paragraph “a” shall not be considered a disciplinary action or reported as discipline. A practitioner may appeal the assessment of an administrative penalty pursuant to this paragraph, which shall initiate a contested case proceeding under chapter 17A. A penalty collected pursuant to this paragraph shall be deposited into the drug information program fund established pursuant to section 124.557. The board shall be notified of any administrative penalties assessed by the appropriate professional licensing board and deposited into the drug information program fund under this paragraph.
 d. A pharmacist who receives a written, oral, or facsimile prescription shall not be required to verify that the prescription is subject to an exception under paragraph “b” and may dispense a prescription drug pursuant to an otherwise valid written, oral, or facsimile prescription. However, a pharmacist shall exercise professional judgment in identifying and reporting suspected violations of this section to the board or the appropriate professional licensing board of the prescriber.
 3. For prescriptions issued prior to January 1, 2020, or for prescriptions exempt from the electronic prescription requirement in subsection 2, paragraph “b”, a prescriber or the prescriber’s authorized agent may transmit a prescription for a prescription drug to a pharmacy by any of the following means:

 a. Electronically.
 b. By facsimile.
 c. Orally.
 d. By providing an original signed prescription to a patient or a patient’s authorized representative.
 4. A prescription shall be issued in compliance with this subsection. Regardless of the means of transmission, a prescriber shall provide verbal verification of a prescription upon request of the pharmacy.

 a. If written, electronic, or facsimile, each prescription shall contain all of the following:

 (1) The date of issue.
 (2) The name and address of the patient for whom, or the owner of the animal for which, the drug is dispensed.
 (3) The name, strength, and quantity of the drug prescribed.
 (4) The directions for use of the drug, medicine, or device prescribed.
 (5) The name, address, and written or electronic signature of the prescriber issuing the prescription.
 (6) The federal drug enforcement administration number, if required under chapter 124.
 b. If electronic, each prescription shall comply with all of the following:

 (1) The prescriber shall ensure that the electronic system used to transmit the electronic prescription has adequate security and safeguards designed to prevent and detect unauthorized access, modification, or manipulation of the prescription.
 (2) Notwithstanding paragraph “a”, subparagraph (5), for prescriptions that are not controlled substances, if transmitted by an authorized agent, the electronic prescription shall not require the written or electronic signature of the prescriber issuing the prescription.
 c. If facsimile, in addition to the requirements of paragraph “a”, each prescription shall contain all of the following:

 (1) The identification number of the facsimile machine which is used to transmit the prescription.
 (2) The date and time of transmission of the prescription.
 (3) The name, address, telephone number, and facsimile number of the pharmacy to which the prescription is being transmitted.
 d. If oral, the prescriber issuing the prescription shall furnish the same information required for a written prescription, except for the written signature and address of the prescriber. Upon receipt of an oral prescription, the recipient shall promptly reduce the oral prescription to a written format by recording the information required in a written prescription.
 e. A prescription transmitted by electronic, facsimile, or oral means by a prescriber’s agent shall also include the name and title of the prescriber’s agent completing the transmission.
 5. An electronic, facsimile, or oral prescription shall serve as the original signed prescription and the prescriber shall not provide a patient, a patient’s authorized representative, or the dispensing pharmacist with a signed written prescription. Prescription records shall be retained pursuant to rules of the board.
 6. This section shall not prohibit a pharmacist, in exercising the pharmacist’s professional judgment, from dispensing, at one time, additional quantities of a prescription drug, with the exception of a prescription drug that is a controlled substance as defined in section 124.101, up to the total number of dosage units authorized by the prescriber on the original prescription and any refills of the prescription, not to exceed a ninety-day supply of the prescription drug as specified on the prescription.
 7. A prescriber, medical group, institution, or pharmacy that is unable to timely comply with the electronic prescribing requirements in subsection 2, paragraph “a”, may petition the board for an exemption from the requirements based upon economic hardship, technical limitations that the prescriber, medical group, institution, or pharmacy cannot control, or other exceptional circumstances. The board shall adopt rules establishing the form and specific information to be included in a request for an exemption and the specific criteria to be considered by the board in determining whether to approve a request for an exemption. The board may approve an exemption for a period of time determined by the board, not to exceed one year from the date of approval, and may be annually renewed subject to board approval upon request.
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