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From: g woodall
Password: orange
Date: 03 May 2007
Time: 18:16:50 -0700
Remote Name: 24.91.148.147
While this was not a DOT drug screen, their guidance is a very defensible standard:
QUESTION: Is a Medical Review Officer (MRO) permitted to accept an employee’s prescription for medication obtained over the Internet?
ANSWER:
• An MRO is authorized to accept an employee’s prescription for medication obtained over the Internet only if there is proof that a legitimate doctor-patient relationship had been established.
• The 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 performed; 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 establish a proper doctor-patient relationship.
• The MRO should, at a minimum, consider the following items when verifying the test result: -- The name, physical location, and state(s) of licensure of the prescribing practitioner; -- Whether the employee was professionally evaluated for the current medical complaint by the prescribing practitioner, 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 relationship existed.
• It is the employee’s responsibility to provide sufficient documentation to address MRO inquiries as to whether there was a legitimate doctor-patient relationship.