Prior to dispensing, when is it not necessary for the pharmacist (or pharmacy employee) to
OFFER to counsel? - ANSWER - not "practicable"
- person picking up is not the patient
- pharmacist determine that offer should be make in writing (if in writing, should tell pt that
counseling can be done in person or over the phone)
What is an instance in which the pharmacist does not have to counsel? - ANSWER -
patient refuses/declines or is unable/ cannot provide info requested
**MUST document counseling or refusal/inability to accept counseling or give info. Keep
records for 3years
What are the requirements for maintaining Medicaid patient's profiles? - ANSWER -
demographic info (name, address, phone, DOB/age, gender)
- pt history (disease state, drug rxns, allergies)
- comprehensive list of drugs, relevant devices dispenses within last 180days
- pharmacist's comments relevant to drug therapy
For Medicaid recipients, what are pharmacists required to maintain a DUR of drugs within
the last 180days for? - ANSWER - therapeutic duplication
1
,- drug-disease state contraindications
- drug-drug interactions
- incorrect dosage or duration of therapy
- drug-allergy interactions
- clinical abuse/misuse/ inappropriate drug use
For Medicaid recipients, what are the standards for DUR? - ANSWER - American Hospital
Formulary Service Drug Information
- the United States Pharmacopoeia Drug Information
- the American Medical Association Drug Evaluations and the peer-reviewed medical
literature
**may be applicable to general DURs
For Medicaid patients, what are the EXCEPTIONS to the requirement for pharmacists offer
counsel? - ANSWER - the person obtaininng the prescription is not the patient
- the pharmacist determines it is appropriate to make such offer in writing (writing must
offer to counsel in person or by phone)
What should Medicaid patient counseling include? - ANSWER - name & description of
medication
2
,- dosage form, dose, route, duration
- special directions/ precautions for preparation, administration, and use of drug
- common severe ADEs, interactions, and therapeutic contraindications or precautions
- self-monitoring techniques
- proper storage
- refill info
- action to be taken if a dose is missed
When is emergency refill of a non-controlled prescription without prescriber authorization
allowed? - ANSWER - unable to contact prescriber after reasonable effort
- failure to refill might result in interruption of therapeutic regimen or create patient
suffering
- patient/ representative informed that prescription is being dispensed without
authorization
- prescriber is informed at earliest reasonable time that authorization is required for future
refills
- unauthorized refill quantity must not exceed 72 hour supply
3
, Pharmacist may immediately prescribe and dispense </=30days of which diabetic products
(under special circumstances)? - ANSWER - diabetic ketoacidosis device
- insulin drug
- glucagon
- diabetes device necessary to administer the insulin or glucagon
What are the conditions in which pharmacist can prescribe and dispense diabetes products?
- ANSWER - patient claims to have <7day supply of the diabetes products
AND
- the pharmacist determines (using professional judgement) that pt will likely suffer
significant physical harm within 7 days if the diabetes products is/are not obtained
AND
- the pharmacist that no pharmacist prescribed (and dispensed) the diabetes products in the
preceding 12 months because the pharmacist: reviewed PDMP, contacted the pharmacy that
most recently filled a prescription for diabetes, examined another prescription database, or
reviewed a prescription label with the most recent prescription information
AND
- within 72 hours, provides notice to the practitioner who most recently prescribed the
diabetes products
AND
4
OFFER to counsel? - ANSWER - not "practicable"
- person picking up is not the patient
- pharmacist determine that offer should be make in writing (if in writing, should tell pt that
counseling can be done in person or over the phone)
What is an instance in which the pharmacist does not have to counsel? - ANSWER -
patient refuses/declines or is unable/ cannot provide info requested
**MUST document counseling or refusal/inability to accept counseling or give info. Keep
records for 3years
What are the requirements for maintaining Medicaid patient's profiles? - ANSWER -
demographic info (name, address, phone, DOB/age, gender)
- pt history (disease state, drug rxns, allergies)
- comprehensive list of drugs, relevant devices dispenses within last 180days
- pharmacist's comments relevant to drug therapy
For Medicaid recipients, what are pharmacists required to maintain a DUR of drugs within
the last 180days for? - ANSWER - therapeutic duplication
1
,- drug-disease state contraindications
- drug-drug interactions
- incorrect dosage or duration of therapy
- drug-allergy interactions
- clinical abuse/misuse/ inappropriate drug use
For Medicaid recipients, what are the standards for DUR? - ANSWER - American Hospital
Formulary Service Drug Information
- the United States Pharmacopoeia Drug Information
- the American Medical Association Drug Evaluations and the peer-reviewed medical
literature
**may be applicable to general DURs
For Medicaid patients, what are the EXCEPTIONS to the requirement for pharmacists offer
counsel? - ANSWER - the person obtaininng the prescription is not the patient
- the pharmacist determines it is appropriate to make such offer in writing (writing must
offer to counsel in person or by phone)
What should Medicaid patient counseling include? - ANSWER - name & description of
medication
2
,- dosage form, dose, route, duration
- special directions/ precautions for preparation, administration, and use of drug
- common severe ADEs, interactions, and therapeutic contraindications or precautions
- self-monitoring techniques
- proper storage
- refill info
- action to be taken if a dose is missed
When is emergency refill of a non-controlled prescription without prescriber authorization
allowed? - ANSWER - unable to contact prescriber after reasonable effort
- failure to refill might result in interruption of therapeutic regimen or create patient
suffering
- patient/ representative informed that prescription is being dispensed without
authorization
- prescriber is informed at earliest reasonable time that authorization is required for future
refills
- unauthorized refill quantity must not exceed 72 hour supply
3
, Pharmacist may immediately prescribe and dispense </=30days of which diabetic products
(under special circumstances)? - ANSWER - diabetic ketoacidosis device
- insulin drug
- glucagon
- diabetes device necessary to administer the insulin or glucagon
What are the conditions in which pharmacist can prescribe and dispense diabetes products?
- ANSWER - patient claims to have <7day supply of the diabetes products
AND
- the pharmacist determines (using professional judgement) that pt will likely suffer
significant physical harm within 7 days if the diabetes products is/are not obtained
AND
- the pharmacist that no pharmacist prescribed (and dispensed) the diabetes products in the
preceding 12 months because the pharmacist: reviewed PDMP, contacted the pharmacy that
most recently filled a prescription for diabetes, examined another prescription database, or
reviewed a prescription label with the most recent prescription information
AND
- within 72 hours, provides notice to the practitioner who most recently prescribed the
diabetes products
AND
4
