QUESTION: Is a Medical Review Officer (MRO) permited to accept an employee’s prescription for medication obtained over the Internet?
ANSWER: An MRO is authorized to ac- cept an employee’s prescription for medica- tion obtained over the Internet only if there is proof that a legitimate doctor-patient relationship had been established.
Te following four elements generally serve as an indication that a legitimate doctor- patient relationship has been established: • A patient has a medical complaint; • A medical history has been taken;
• A physical examination has been per- formed; and
• Some logical connection exists between the complaint, the medical history, the physical examination, and the drug prescribed.
Standing alone, the completion of an online questionnaire reviewed later by a pharmacy-employed doctor fails to estab- lish a proper doctor-patient relationship.
Te MRO should, at a minimum, consider the following items when verifying the test result: • Te name, physical location, and state(s) of licensure of the prescribing practitioner;
• Whether the employee was profession- ally evaluated for the current medical complaint by the prescribing practitio- ner, and the last time the employee was in direct contact with the prescribing practitioner;
• Whether the employee initiated the request to the pharmacy for a particular medication; and
• Whether a proper doctor-patient rela- tionship existed.
It is the employee’s responsibility to pro- vide sufficient documentation to address MRO inquiries as to whether there was a legitimate doctor-patient relationship. ❚
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