Electronic Prescribing - Mpje

1. Identify the required notation for a faxed Schedule II prescription for a hospice patient to be valid as original.

   Prescriber must note the patient is a hospice patient. DEA requires this notation to confirm the prescription qualifies for the hospice exception, enabling fax to serve as the original.

2. What documentation must the pharmacy obtain for a faxed Schedule II hospice prescription treated as the original?

   Hospice program identification (e.g., hospice name) on the Rx. Pharmacies must verify and document hospice status per DEA to ensure compliance with the exception allowing fax as original for Schedule II.

3. What is the pharmacist's required workflow response to a prescriber request to change a Schedule II eRx after transmission?

   Require a new prescription; do not edit required elements. Post-transmission changes to Schedule II require a new prescription under DEA to preserve the integrity of the original record.

4. Identify the correct action if an e-prescription is received for the wrong patient due to prescriber selection error.

   Hold dispensing; contact prescriber to cancel and reissue. Errors in patient selection invalidate the prescription, requiring prescriber cancellation and reissuance to maintain accuracy and compliance.

5. What is the correct action when a prescriber sends a controlled substance prescription by standard eRx (non-EPCS)?

   Reject/decline; request EPCS or other lawful method. Standard e-prescribing lacks EPCS security, violating DEA rules for controlled substances, thus requiring rejection and proper resubmission.

6. What is the legal status of a faxed Schedule III–V prescription under federal law?

   Valid if it contains all required elements and is properly signed. Federal regulations permit faxed Schedule III–V prescriptions as originals provided they meet signature and content requirements for validity.

7. What is the federal maximum refill allowance for Schedule III–IV prescriptions once received by valid eRx or fax?

   Up to 5 refills within 6 months of issue date. Federal limits for Schedule III–IV balance access with diversion prevention, applying to validly received eRx or fax prescriptions.

8. What is the DEA-required method for transmitting a Schedule II controlled substance prescription?

   Written paper or EPCS; fax only for limited exceptions. DEA regulations mandate secure transmission methods for Schedule II drugs to prevent diversion, allowing fax only in specific cases like hospice or LTCF.

9. Identify the workflow rule for receiving controlled substance prescriptions at a pharmacy's general fax number.

   Only accept if fax is lawful for that schedule and scenario. Pharmacies must evaluate fax legality based on drug schedule and patient scenario to ensure DEA compliance before acceptance.

10. Which record must a pharmacy maintain to demonstrate EPCS compliance for controlled substance e-prescriptions?

    Electronic audit trail and prescription record retention. DEA requires pharmacies to retain these records for EPCS to enable audits and demonstrate compliance with controlled substance regulations.

11. Identify the correct action if a prescriber faxes a Schedule II for an outpatient not in LTCF, not hospice, not home infusion.

    Do not treat fax as original; require paper original or EPCS. Without qualifying exceptions, faxed Schedule II do not meet DEA original prescription requirements for outpatient dispensing.

12. What is the general federal rule for refills on Schedule II prescriptions received by eRx or fax?

    No refills permitted for Schedule II. DEA prohibits refills for Schedule II to minimize diversion risk, regardless of transmission method like eRx or fax.

13. What is the legal status of a faxed Schedule II prescription for general outpatient dispensing?

    Not valid as the original; original paper/EPCS is required. DEA rules prohibit faxed Schedule II prescriptions from serving as originals for outpatient use to maintain chain of custody and security.

14. What is the appropriate workflow step if two identical e-prescriptions are received for the same drug and patient?

    Verify with prescriber; dispense only one valid intended order. Duplicates may indicate errors or system issues, so verification ensures only the intended prescription is dispensed per workflow standards.

15. What is the legal status of an electronically transmitted Schedule III–V prescription under federal law?

    Valid if transmitted by EPCS (DEA-compliant) system. DEA mandates EPCS compliance for electronic transmission of Schedule III–V to provide security features like authentication and audit trails.

16. Which transmission method is permitted for an emergency Schedule II prescription when called in to the pharmacy?

    Oral emergency order allowed; follow-up written/EPCS required. DEA permits oral transmission for Schedule II emergencies to enable immediate care, with mandatory follow-up for documentation.

17. What is the key workflow requirement when a pharmacy receives an e-prescription with missing directions?

    Contact prescriber for clarification before dispensing. Pharmacist duty under professional standards requires clarification of incomplete e-prescriptions to ensure safe and accurate dispensing.

18. What is the required prescriber identity assurance concept in EPCS that prevents repudiation?

    Two-factor authentication with audit trails (nonrepudiation). EPCS incorporates two-factor authentication and trails to verify prescriber identity and prevent denial of issuance under DEA rules.

19. What is the correct processing step when an e-prescription includes a prescriber NPI mismatch with the displayed name?

    Verify prescriber identity with sender; resolve before dispensing. NPI mismatches suggest potential errors or fraud, requiring identity verification to meet DEA standards for secure prescribing.

20. Which three situations allow a faxed Schedule II prescription to serve as the original?

    Hospice, LTCF resident, or home infusion/IV pain therapy. These exceptions under DEA allow fax to act as original for Schedule II to facilitate urgent care in institutional or palliative settings.

21. Identify the appropriate action if an e-prescription appears altered or corrupted in transmission.

    Do not dispense; verify directly with prescriber and document. Suspected alterations compromise prescription integrity, necessitating prescriber verification to comply with DEA security requirements.

22. What is the legal status of an electronic prescription for a noncontrolled legend drug?

    Valid if issued by an authorized prescriber and properly transmitted. Noncontrolled drugs lack DEA restrictions, allowing standard electronic transmission if prescriber is authorized and system is secure.

23. What is the only electronic method permitted to prescribe controlled substances under federal law?

    EPCS (DEA-compliant electronic prescribing of controlled substances). Federal law requires EPCS for electronic controlled substance prescriptions to ensure identity verification, audit trails, and nonrepudiation.

24. What is the pharmacist's workflow duty when receiving an oral emergency Schedule II prescription?

    Reduce to writing immediately and document emergency details. Immediate documentation ensures accurate recording of emergency details, complying with DEA requirements for oral Schedule II orders.

25. Which action is permitted if an e-prescription includes an invalid SIG abbreviation that creates ambiguity?

    Clarify with prescriber; do not assume meaning before dispensing. Ambiguous abbreviations risk misinterpretation, mandating prescriber clarification to uphold patient safety and regulatory compliance.

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