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RULE §354.1863Prescription Requirements

(a) Payment for pharmaceuticals can be made only when these pharmaceuticals are prescribed by a practitioner that is either:

  (1) licensed to prescribe legend drugs and enrolled as a Texas Medicaid provider; or

  (2) a physician resident participating in a postgraduate training program and under the supervision of a teaching physician who is enrolled as a Texas Medicaid provider.

(b) The pharmacist must ensure that the original prescription conforms to the Texas State Board of Pharmacy rules concerning the records to be maintained by a pharmacy. A signed prescription must be maintained in the dispenser's file and available for audit at any reasonable time. Telephone orders, where legal, must be documented in writing. The name of the prescriber and the signature of the dispensing pharmacist must be documented. If a pharmacy maintains prescription records in a data processing system, a hard copy of the prescription must be retained on file unless the daily log includes all the information required in §354.1901 of this title (relating to Pharmacy Claims). The provider must conform to all regulations issued by the Drug Enforcement Administration and Texas State Board of Pharmacy concerning the recording of prescriptions in a data processing system.

(c) Pharmaceuticals dispensed in disasters under §354.1868 of this subchapter (relating to Exceptions in Disasters) are not subject to the requirements in subsection (b) of this section.

(d) Prescriptions for covered pharmaceuticals submitted to a pharmacy in written form are eligible for payment only if the prescription is executed on tamper-resistant prescription paper, as required by §1903(i)(23) of the Social Security Act (42 U.S.C. §1936b(i)(23)).

(e) The dispensing pharmacist must date the prescription and initial the refills.

(f) A teaching physician as described in subsection (a) of this section is not required to co-sign orders written by a resident, provided the Medicaid recipient's medical record clearly documents the teaching physician's identifiable supervision of the resident.

Source Note: The provisions of this §354.1863 adopted to be effective November 16, 1987, 12 TexReg 3553; amended to be effective July 1, 1993, 18 TexReg 1584; transferred effective September 1, 1993, as published in the Texas Register September 7, 1993, 18 TexReg 5978; transferred effective September 1, 2001, as published in the Texas Register May 24, 2002, 27 TexReg 4562; amended to be effective June 19, 2003, 28 TexReg 4541; amended to be effective September 23, 2008, 33 TexReg 7993; amended to be effective May 15, 2016, 41 TexReg 3291; amended to be effective January 15, 2018, 42 TexReg 7576

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