Canadian docs who co-sign Rx left without coverage

Modern Healthcare, January 19, 2004 — The Canadian Medical Protective Association soon will announce that Canadian doctors who co-sign prescriptions for U.S. patients will not be covered under its liability insurance policies if the doctor is sued for malpractice regarding the prescription.

The association, which provides 95% of Canadian doctors with liability insurance and legal defense against malpractice suits, changed its policy because several Canadian regulatory agencies now ban the practice of co-signing prescriptions without direct physical examination of the patient, said a spokeswoman for the insurer.

Previously, the association’s guidelines left open the possibility of coverage for doctors who were sued in relation to a co-signed prescription, but the organization for many years has had concerns about whether such lawsuits can be defended, she said.

Under the U.S. Food, Drug and Cosmetic Act, it is illegal for anyone other than the original manufacturer to reimport prescription drugs into the U.S. However, the practice has become popular because prescription drugs generally cost from 30% to 80% less in Canada because of government-imposed price controls. The policy change could have a significant impact on drug reimportation because about 95% of all doctors licensed to practice in Canada are insured by the association.

Under Canadian law, any prescription signed by an American doctor must be co-signed by a Canadian physician before a Canadian pharmacy can fill the prescription. However, the regulatory agencies responsible for licensing physicians have advised doctors that co-signing a prescription without the possibility of direct patient assessment is improper and could result in disciplinary action. Last year, the College of Physicians and Surgeons of New Brunswick penalized and reprimanded a physician for engaging in the practice, and other regulatory bodies have taken similar action.

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