Pharmacy Law Frequently Asked Questions

These questions are frequently asked by healthcare professionals. Click here to submit a question.

Prescribers

May an agent of a prescriber phone or send fax to fax a prescription for a prescriber?

A person who is an employee of the prescriber may phone or send fax to fax a non-controlled prescription or syringes and needles prescription to a pharmacy as ordered by that prescriber (§6810.4.(A))

A health care professional in article 28 facilities (General Hospitals, Nursing Homes, RHCF),mental health hospitals, or developmental centers may phone or send fax to fax a non-controlled prescription or a syringe and needles prescription if the caller and prescriber are both employed by the same institution. (§6810.4.(B))

However only the prescriber may phone or send fax to fax any controlled substance prescription. (§80.68,§80.70)

Can practitioners give controlled substance samples?

Samples of controlled substances are not allowed in NYS. (§80.25, §3319, §6816[1b], PDMA section 5)

What happens if a practitioner does not have a DEA certified system when a prescription is sent to the pharmacy?

The pharmacy’s system will not receive the prescription.

Expedited Partner Therapy

What is EPT?

EPT allows healthcare providers to provide patients and their sexual partners with antibiotics or written prescription.

How do you know if this a prescription covered under the EPT program?

Pharmacists will receive a prescription for chlamydia as a single dose of azithromycin 1g orally EG. 250mg x 4

The prescription must say EPT in the body of the prescription above the drug name and may or may not have the sexual partner’s name, address, and date of birth. Pharmacists may still fill the prescription without that information.

Is EPT covered under insurance?

EPT may or may not be covered under the patient’s insurance depending on the insurance company. Pharmacists are encouraged to check with the insurance carrier.

References:
Summary of Expedited Partner Therapy for Health Care Providers in New York State

Prescriptions for Non-Controlled Substances and Syringes and Needles

Can an official NYS prescription be filled that contains more than one drug?

No prescription written for a drug in this state may authorize dispensing or compounding of any other drug on the same blank. Pharmacists should use their professional judgment and contact the prescriber to take care of the patient.  (§6810[7])

If a prescription goes to the wrong pharmacy can you transfer it via verbal, fax to fax, or electronic to the correct pharmacy?

Yes, a prescription can be transferred from one pharmacy to another pharmacy verbally,  fax to fax, or by electronic transmission one filling at a time. (§63.6(8))

Must a pharmacy transfer a prescription?

No, the pharmacy may transfer a prescription to another pharmacy but is under no obligation to transfer a prescription. (§63.6(8))

May an agent of the prescriber phone in a prescription for hypodermic syringes and needles?

Yes.  A prescriber’s agent who is employed by that prescriber may phone in prescriptions to the pharmacy. (§80.131, §3381)

May hypodermic syringe and needle prescriptions be electronically prescribed?

Yes, hypodermic syringe and needle prescriptions may now be prescribed in written, faxed or electronic format. (§80.131, §3381)

Are hypodermic syringe and needle prescriptions limited to #100 over the telephone?

No longer.  Pharmacists may take any quantity (within reason) over the telephone with refills.  The number of refills are not restricted but are good only for 2 years.  (§80.131, §3381)

Do the changes in the hypodermic syringe and needles regulations affect the Expanded Syringe Access Program?

No.  The ESAP program remains the same. (§81.37, Reference)

Out-of-State Prescriptions

Must out of state written prescriptions be on Official New York State Prescription Blanks?

No.  You may accept other state blanks from a prescriber of that state as long as you can verify that the practitioner is legitimate.  (§281(1))

We receive prescriptions from a VA hospital in our area on their “white” blanks.  Must they be on Official New York State Prescription Blanks?

No.  Just like out-of-state blanks, prescribers from the VA and other federal facilities (e.g. Indian Health Services) may use their own “white” blanks. However, prescribers must have a DEA number for controlled substances when filling outside of the VA. (§281(1))

A patient comes into the pharmacy with a controlled substance prescription from another state.  May I fill it? 

Yes.  But the pharmacist must ensure that the practitioner is legally allowed to prescribe in the state that he/she is practicing in. The practitioner must also be able to prescribe controlled substances in that specific state as well. For controlled substances, pharmacists have a corresponding liability and responsibility to ensure that the medication is properly prescribed for a legitimate medical purpose.    Pharmacists should refer to the 2010 DEA Manual under “Corresponding Responsibility” for a complete discussion on the topic.  Pharmacists should only refer to the specific state in which they are practicing in (ex. NYS) and not the laws of the state the prescriber is practicing in.

Retail Pharmacy

Can a pharmacy supply drugs to the nearby medical clinic?

No. Not unless the pharmacy possesses a wholesaler’s license

Is there a quantity limitation to dextromethorphan?

No. There is only an age limitation, but pharmacists should use their professional judgment. (Reference, General Business Law Article 26 §391-s)

Do needles and syringes have to be behind the counter?

Yes (ESAP)

E-prescribing

Who certifies the pharmacy software to allow electronic controlled substance prescriptions?

An outside credential service provider which is hired by the DEA. Pharmacists are reminded that a copy of the DEA certification must be sent to the BNE. (Reference)

If the prescriber calls in a 5 day verbal emergency supply how should the follow-up prescription be given?

The follow-up prescription may be received physically (written) or electronically. (§80.69)

If an electronic controlled substance prescription is received must this prescription be printed and endorsed manually?

No, the prescription can be signed electronically. (§80.69, §80.74, 21 CFR 1311)

Is controlled substance e-prescribing allowed today if all requirements met?

Yes (Reference)

Medicaid

Medicaid allows a maximum of 180 days or 5 refills, when does the 180 days begin from?

The 180 days begins from the date the prescription was issued NOT when it was dispensed (Reference)

Immunization

If an immunization protocol is properly signed, does this protocol cover all patients?

The immunization protocol covers any patient visiting your pharmacy as long as the protocol is signed from a physician or nurse practitioner located in the specific county where your pharmacy is located. (§ 6527, 6801, and 6909)

Controlled Substances

A prescription is written for: Percocet 5/325  #90 Sig: 1 tid prn. The patient requests only 30. What do you do?

The pharmacist should phone the prescriber and obtain permission to change the quantity to 30. The remaining quantity will become void.

Are benzodiazepines allowed refills in NYS?

No (§80.67)

If you transfer a hydrocodone combination product between pharmacies, does a DEA form 222 have to used?

Yes (Reference)

If a controlled substance prescription is written for a month supply but written with a code, what is that maximum quantity a pharmacist can dispense?

A one month supply, but a pharmacist could phone the prescriber and obtain a larger quantity with the prescriber’s permission.

What should the pharmacist do if a code is wrong on a controlled substance prescription?

The pharmacist may phone the prescriber to obtain permission to change the code. The pharmacist should document the reason.(Reference)

What code should be used for anxiety?

There is no code for anxiety because code A is for a panic attack. (§80.67, §80.69, §80.71)

Can a controlled substance prescription be sent fax to fax?

Yes. Pharmacists are reminded that fax to fax prescriptions must be on an official NYS prescription with the precriber’s signature. The same rules apply as verbal orders. (§ 80.67, § 80.68, §80.71, § 80.72. § 80.73)

If a pharmacist compounds with an anabolic steroid what CS schedule is it?

The compounded drug would be considered a CII in any dosage form. (§3306)