This appears to be from 2018, I find it interesting that the TXBOP will hold a PHARMACY responsible for the failure to detect patterns of inappropriate dispensing of prescription drugs is unprofessional practice and constitutes grounds for disciplinary action. A person/entity that has a pharmacy permit to operate a pharmacy, can only do so.. if there is a state licensed Pharmacist on staff and there is a Pharmacist that is registered with the BOP to be “Pharmacist in charge” and responsible to the BOP for the legal operation of the Rx dept. With the SCOTUS recently passing down a decision that “RED FLAGS” when involved in the confiscating a individual guns is UNCONSTITUTIONAL. Could it be considered a “confiscation of a pt’s medication therapy” by a Pharmacist who fails to properly adjudicate perceived RED FLAGS and refuses to fill a pt’s (controlled ) medication ? I am sure that other states have similar written “red flag rules” , implied or presumed to exist. Hopefully, that many of these – potentially unconstitutional laws/rules – will be challenged in the not too distant future.
Click to access You_might_be_a_pill_mill_if.pdf
Texas State Board of Pharmacy “Red Flags” Checklist for Pharmacies YOU MIGHT BE A PILL MILL IF… Check all that apply: (1) Your pharmacy fills a discernable pattern of prescriptions for prescribers who write essentially the same prescriptions for numerous persons, indicating a lack of individual drug therapy. (2) Your pharmacy operates with limited hours of operation or closes after a certain threshold of controlled substance prescriptions are dispensed, and has overall low prescription dispensing volume. (3) Prescriptions presented to the pharmacy are for controlled substances with popularity as street drugs, such as opiates, benzodiazepines, muscle relaxants, psychostimulants, and/or cough syrups, or any combination of these drugs. (4) The prescriptions for controlled substances contain nonspecific or no diagnoses. (5) The prescriptions are commonly for the highest strength of the drug and/or for large quantities. (6) Dangerous drugs or OTC products (such as multi-vitamins or laxatives) are added to the controlled substance prescriptions, maintaining relatively consistent 1:1 ratio of controlled substances to dangerous drugs and/or OTC products dispensed as prescriptions. (7) Prescriptions are authorized by the same prescriber with what appears to be different handwriting on the hardcopy prescription drug order forms. (8) Upon contact with the prescriber’s office, you are unable to engage in comprehensive discussion with the actual prescriber, or he/she is unconcerned about your apprehensions regarding his/her prescribing practices or unwilling to provide additional information, such as treatment goals and/or prognosis with prescribed drug therapy. (9) You rely solely on the prescriber’s representation, or on the representation of the individual answering the phone at the number on the prescription, that prescriptions are legitimate. (10) The prescriber’s clinic is not registered as a pain management clinic by the Texas Medical Board, despite routinely receiving prescriptions from the prescriber for opiates, benzodiazepines, and/or muscle relaxants. (11) Drugs prescribed are inconsistent with the prescriber’s area of practice. (12) The prescriber of the drugs is located a significant distance from your pharmacy. (13) The prescriber has been subject to disciplinary action by the licensing board, had his/her DEA registration removed, or been subject to criminal action. (14) The Texas PMP system indicates that persons are obtaining prescriptions for the same drugs from multiple prescribers or that persons are filling prescriptions for the same drugs at multiple pharmacies. (15) The person’s address is a significant distance from your pharmacy and/or from the prescriber’s office. (16) Multiple persons with the same address present prescriptions from the same prescriber. (17) Persons pay with cash or credit card more often than through insurance. (18) Persons presenting controlled substance prescriptions are doing so in such a manner that varies from seeking routine pharmacy services (e.g., willing to wait in long lines to receive drugs, persons arrive in the same vehicle with prescriptions from same prescriber, one person presents to pick up prescriptions for multiple others, persons refer to drugs by “street names” and/or comment on drug’s color, persons seek early refills, persons travel from outside reasonable trade area of pharmacy). (19) Your pharmacy charges and persons are willing to pay more for controlled substances than they would at nearby pharmacies. (20) Your pharmacy routinely orders controlled substances from more than one drug supplier, or your pharmacy has been discontinued by a drug supplier related to controlled substance orders. (21) Sporadic and non-consistent dispensing volume (including zero dispensing) varies from day to day and week to week, and your pharmacy does not maintain operational hours each week on Monday through Friday. (22) Your pharmacy employs or contracts security personnel during operational hours to prevent problems. (23) Your pharmacy has been previously warned or disciplined by the Texas State Board of Pharmacy for inappropriate dispensing of controlled substances (i.e., corresponding responsibility). If you checked any of the above items, you should review the laws and rules regarding corresponding responsibility and non‐therapeutic dispensing, especially Board rule §291.29, in the law book or on our website: www.pharmacy.texas.gov (click on Texas Pharmacy Rules and Laws). Additional educational material is available at: http://www.pharmacy.texas.gov/Nontherapeutic.asp. Failure of pharmacies and pharmacists to detect patterns of
inappropriate dispensing of prescription drugs is unprofessional practice and constitutes grounds for disciplinary action.
Filed under: General Problems
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