CLARIFICATION OF PRESCRIPTION SIGNATURE REQUIREMENTS
The Mississippi Board of Pharmacy is charged with the protection of the public health as it relates to patient safety, patient health, patient access, and patient services. Governor Reeves declared a state of emergency on March 14, 2020, concerning the coronavirus and the potential spread of COVID-19. As a result of COVID-19 many patients are sheltering at home creating an increased need for home / residential delivery. All of us are concerned about personal/physical contact during this crisis.
The Board has received numerous questions concerning the shipment, mail or delivery of prescription drugs. In the past few days, some Pharmacy Benefit Managers (PBMs) have issued statements regarding the shipment, mailing or delivery of prescription medications as it relates to signatures.
Pharmacists must use their professional judgment in determining your specific procedures but must, at minimum, follow all state and federal laws and rules as it relates to this issue. Mississippi law may not supersede certain federal program requirements such as CMS, Mississippi Medicaid or laws such as ERISA.
CONTROLLED SCHEDULE II PRESCRIPTIONS-
Mississippi law (§ 41-29-125, 2.) reads in part
(2) Whenever a pharmacy ships, mails or delivers any Schedule II controlled substance listed in Section 41-29-115 to a private residence in this state, the pharmacy shall arrange with the entity that will actually deliver the controlled substance to a recipient in this state that the entity will: (a) deliver the controlled substance only to a person who is eighteen (18) years of age or older; and (b) obtain the signature of that person before delivering the controlled substance. The requirements of this subsection shall not apply to a pharmacy serving a nursing facility or to a pharmacy owned and/or operated by a hospital, nursing facility or clinic to which the general public does not have access to purchase pharmaceuticals on a retail basis.
All pharmacies must follow the requirements as stated above in the shipment, delivery or mailing of SCHEDULE II controlled substances.
NON-CONTROLLED PRESCRIPTIONS-
Mississippi law (§ 73-[21-183), known as the PHARMACY AUDIT INTEGRITY ACT, reads in part:
Section (1), (l)
Any prescription that complies with state law and rule requirements may be used to validate claims in connection with prescriptions, refills or changes in prescriptions; …(r) A recoupment shall not be based on:
(i) Documentation requirements in addition to or exceeding requirements for creating or maintaining documentation prescribed by the State Board of Pharmacy; or…
(ii) A requirement that a pharmacy or pharmacist perform a professional duty in addition to or exceeding professional duties prescribed by the State Board of Pharmacy;
MISSISSIPPI MEDICAID-
Rule 1.12: Beneficiary Signature
A. The pharmacy must obtain the signature of the beneficiary or his/her representative signature and their relationship to the beneficiary for each prescription received with the exception of beneficiaries living in long-term care facilities, i.e. nursing facilities, intermediate care facilities for individuals with intellectual disabilities (ICF/IID) facilities and/or psychiatric residential treatment facilities (PRTF).
1. Electronic signatures are acceptable.
2. One signature per prescription is required.
3. The pharmacist may sign for a prescription if the beneficiary or his/her representative is not capable of signing. When signing the pharmacist must:
a) Document the circumstances preventing the beneficiary or his/her representative from signing for the prescription, and
b) Sign the prescription signature record with his/her own name and the beneficiary’s name.
4. For shipped or delivered prescriptions, the pharmacy must obtain the signature of the beneficiary or his/her representative and their relationship to the beneficiary.
a) The pharmacy must maintain signatures on-site and in an auditable manner.
b) The Division of Medicaid will not reimburse for medications lost in transit and/or not received by the beneficiary
B. Prescription signature records for received prescriptions must include the prescription serial number, date medication is received and the beneficiary or his/her representative’s signature and their relationship to the beneficiary.
1. Prescription signature records must be retained for a period of five (5) years for audit purposes.
2. Prescription signature records for shipped prescriptions must be retained for a period of five (5) years and must include the delivery confirmation for audit purposes.
3. Prescription signature records must be maintained on-site and in an auditable manner.
C. The beneficiary or provider cannot waive the receipt signature requirement nor does “signature on file” meet this obligation.
Source: Miss. Code Ann. § 43-12-121.
History: Miss Admin. Code, Part 214, Chapter 1, Rule 1.12 A.-E. added 07/01/13 to include 04/01/12 compilation omission
TO SIMPLIFY-
-Mississippi law DOES REQUIRE a signature from a person who is 18 years of age or older in the shipment, mailing or delivery of SCHEDULE ll CONTROLLED SUBSTANCE PRESCRIPTIONS.
-Mississippi law nor the Board of Pharmacy rules DO NOT REQUIRE a signature in the shipment, mailing or delivery of NON-CONTROLLED PRESCRIPTIONS.
-MISSISSIPPI MEDICAID and their MCOs DO have specific requirements as stated above. The pharmacist may sign for a prescription if the beneficiary or his/her representative is not capable of signing, and document the circumstances preventing the beneficiary or his/her representative from signing for the prescription.
This document is being sent electronically to all Mississippi licensed Pharmacists and Pharmacy Benefit Managers.