Today I was attending a Pharmacists’ seminar and one of the presenters was a Board of Pharmacy (BOP) inspector for the state of Kentucky. During the presentation, there was a list of actions taken by the BOP on various issues and one category was CONFIDENTIALITY …
I asked the inspector if the BOP had the legal authority to enforce HIPAA… and apparently the BOP of KY considers a HIPPA violation as UNPROFESSIONAL CONDUCT and takes actions – in the form of fines – against Pharmacists/Techs who violates the confidentially of the pt.
After the presentation, I talked to the inspector about Pharmacists refusing to fill legit/on time/medically necessary prescriptions.. because they “felt uncomfortable”… of course… the inspector’s reply was that they couldn’t force a Pharmacist to fill a prescriptions and I questioned… could the BOP… consider such a refusal as UNPROFESSIONAL CONDUCT… when a refusal was not based on medical facts but just personal feelings, opinions, biases, phobias.
The inspector’s reply was that documentation had been proven hard to obtain because the BOP had had complaints filed both by pts and prescribers.
It appears that we are back to the recommendation that I have made uncountable times before… that pts needs to audio/video all interactions with Rx dept staff.
This does not mean that every BOP will take this position of what constitutes unprofessional conduct. I was at the special committee meeting of the FL BOP back in the summer of 2015 and a chronic pain doc asked the attorney for the BOP if a Pharmacist lying to a pt about not having inventory of a particular medication as the reason not filling a prescription.. and the attorney’s response was that he was not aware of any portion of the practice act that would cover that as being unprofessional conduct.
So it would appear that the “bar” that has to be crossed to determine if a Pharmacist is involved in unprofessional conduct depends on the interpretation of the particular BOP and some bars are very low and others are very HIGH.
So… unless pts/prescribers do audio/video recordings of the interactions and use that as the documentation of what was said/done and/or not said/not done… and take that documentation to the BOP along with a complaint of unprofessional conduct… no one will ever know where the bar is in any particular state
Filed under: General Problems
This leads me to the idea of “Arbitrary and Capricious”. Apparently there is a “loophole” of sorts to force a government bureaucracy to “do its job”.
Section 706(2)(A) of the Administrative Procedure Act (APA) instructs courts reviewing regulation to invalidate any agency action found to be “arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law.” The arbitrary-or-capricious test is used by judges when reviewing the factual basis for agency rulemaking. Courts can overturn agency rules if they find the underlying rationale or factual assertions to be unreasonable.
In decisions made after formal adjudication and formal rulemakings, the APA requires a different test, the “substantial evidence” test. But in practice, there is little difference between the two tests.
Source: The Regulatory Group, Inc., available at reg-group.com/glossary.shtml.
http://www.foreffectivegov.org/node/2625
The above is from the website Center for Effective Government. Now I’m assuming that the above “Chapter and Verse” cited is an element of Federal Law. If this indeed the case, there might be a mechanism to force the various licensing boards to “do their job”. I have no idea if this has ever been pursued, but it might be worth taking a look at. It’s sort of a Hail Mary at this point, but there has to be enough recent actions on the books to use as a “foot in the door” if you will to begin setting precedents for future decisions and actions.
This is the kind of information we need . Thank you
ditto,,thanx u LesPaul,,mary
Connie…It all falls back on the insensibility as articulated by the late and not so great Vladimir Lenin and his bullet point statement of government and it’s relationship to the exercise of power. Lenin stated, ” It all depends on who does what to whom.”
Les Paul, sadly you are right and it seems to be politically correct to stick it to those of us who live in pain and try to get relief in a legal and responsible manner.
It amazes me that a pharmacist can refuse to fill a legitimate prescription based on personal feelings or prejudice but a bakery can’t refuse to bake a cake for the same reasons. There is something terribly wrong with this picture!
This is just sad. When did it become OK for pharmacists and pharmacy technicians to outright lie to the patient for any reason. Medical care personal must be trust worthy and honest for the health, safety and care for the patient. If a patient does not trust the pharmacist and other medical professionals that can cause great harm to the entire medical system. For a state official who is responsible to maintain the ethical standards of pharmacists to say that lying to patient is not a problem, is not only shocking but may decreases the trust that patients may have for every pharmacist that they deal with in the future. Allowing this is setting a very dangerous precedences when this is viewed exceptable behavior for pharmacists.
DITTO,,mary