Controlled Substance Laws

Question 1

What constitutes an emergency oral prescription of a Schedule II controlled substance? Select all that apply:

Answer 1

• Immediate administration of the drug is necessary for proper treatment
• there is no alternative treatment available
• the prescriber is unable to issue a written prescription at the time.

Question 2

In an emergency situation, a prescriber may orally prescribe a Schedule IV controlled substance (except benzodiazepines) for not more than a:

Answer 2

30-day supply or 100 dosage units (whichever is less)

Question 3

Out-of-state prescriptions for controlled substances must be filled within how many days from the issue date?

Answer 3

Out-of-state prescriptions for schedule II-V controlled substances may be filled in the state of NY, but must be filled within 30 days from the issue date. Take all usual precautions. A serial number (check lower right hand corner) of “ZZZZZZZZ” indicates an out-of-state prescription (e.g., VA hospitals and clinics, military bases and Indian Reservations)

Question 4

In an emergency situation, a prescriber may orally prescribe a benzodiazepine for not more than a:

Answer 4

• 5-day supply (benzos are treated as CII in NY state)

* For other Schedule IV oral prescriptions, a prescriber can give 30-day supply or 100 dosage units

Question 5

Mrs. Sterling comes in with a prescription for Lyrica dated for today. What are the refill restrictions for this prescription?

Answer 5

• May not be refilled more than 5 times within a 6-month period
• Schedule III-V medications may not be refilled more than 5 times within a 6-month period from the date written.
• These medications cannot be filled past 6 months from the date written.

Question 6

Prescriptions for Schedule II controlled substances can be faxed when they are for (select all that apply):

Answer 6

• Compounding for direct administration to a patient
• Patients residing in a long-term care facility
• Patients residing in hospice care certified by Medicare

Question 7

Walters is a pharmacist dispensing a refill of a Schedule IV controlled substance. What information must be recorded on the reverse side of the written prescription? Select all that apply:

Answer 7

• date of dispensing
• quantity dispensed
• dispensing pharmacist
• signature must be recorded

Question 8

To issue prescriptions for controlled substances, a practitioner must possess a…

Answer 8

DEA registration #

Question 9

PRN refills not allowed for controls in NY…

Answer 9

interpret as 0.

Question 10

In NY state, refills can never be issued for certain categories of medication. What are those?

Answer 10

Schedule II controls and benzodiazepines (includes chlordiazepoxide and ethyl loflazepate)

Question 11

As of March 2016, New York law requires all Rxs to be issued electronically*.

Question 12

Exceptions to electronic prescribing:

Answer 12

• Rxs written by veterinarians
• Temporary technological failure
• Prescribers who have a wavier or renewal of a wavier (waivers valid for 1 year)
• No more than a 5-day supply of medications in situations where the prescriber determines e-prescribing is impractical and would adversely impact the patient’s medical condition (controlled substances)
• The Rx will be dispensed by an out-of-state pharmacy
• Prescribers who certify to the NYDOH that they will not issue more than 25 prescriptions per 12 months (includes controls and non-controls)

Question 13

*Effective July 2016, a prescriber cannot initially prescribe more than a…

Answer 13

7-day supply of opioid medication for acute pain. This is done to reduce overprescribing of opioids

Question 14

What specific information must be included on all Rxs for controlled substances?

Answer 14

• Patient’s full name, address, age, and gender
• Prescriber’s name, address, DEA #, and phone #
• Drug name, strength, and form
• Quantity prescribed (in # and written form)
• Directions for use (at minimum, must include the dose, frequency, and max daily dose)
• # of refills authorized (also in # and written form)
• Prescriber’s handwritten signature (or electronic for E-Rx)
• Date written

Question 15

What information from controlled substance prescriptions must be electronically transmitted to the NYDOH/BNE, (Prescription Monitoring Program)?

Answer 15

• Rx # assigned by the pharmacy
• NPI # of the pharmacy
• Patient name, address, DOB, and gender
• Date filled
• NDC # of drug dispensed
• Metric quantity dispensed
• Days’ supply
• Prescriber’s DEA #
• Date written
• Serial # on the official Rx form
• Payment method
• # of refills authorized and refill # (if applicable)
• species code and name of animal, if applicable

Question 16

When should information from controlled substance prescriptions must be elecctronically transmitted?

Answer 16

No later than the 15th day of the next month following the month in which the controlled substance was dispensed.

Question 17

Except in certain circumstances, prescriptions for controls cannot be written in quantities exceeding a 30-day supply.

Answer 17

True

Question 18

For which conditions can a prescriber write for a 3-month supply or (6-month supply for anabolic steroids)? *Must write name of condition on front of Rx

Answer 18

Code A: Panic disorder. “A” for anxiety Code B: Attention deficit disorder (ADD) “B” for boy Code C: chronic, debilitating neurological conditions. “C” for “Ceizures” Code D: relief of pain caused by chronic or incurable disease. “D” for disease Code E: NarcolEpsy Code F: male hormone deficiency, gynecologic conditions responsive to treatment with anabolic steroids or chorionic gonadoptropin, metastatic breast cancer, anemia, and angioedema. Day limits: 180 days for steroids; 90 days for HCG

Question 19

How many refills may be issued for a C-III, C-IV (non-benzo), or C-V controlled substance?

Answer 19

Up to 5 refills (when the Rx is for more than a 30-day supply, then only one refill may be issued)

Question 20

A prescription for a C-III, C-IV (non-benzo), or C-V controlled substance is valid for…

Answer 20

6 months after the date the Rx was signed by the prescriber.

Question 21

Additional prescriptions for the same controlled substance cannot be issued to the same patient within 30 days of the date the previous Rx was issued, unless the patient has exhausted all but a…

Answer 21

7-day supply provided by the previously issued Rx.

Question 22

Can a pharmacy ever accept a CII or benzodiazepine Rx via facsimile?

Answer 22

Yes, but only if the following criteria are met:

• The faxed image shows the Rx was written on an official NY state Rx form
• The medication is to be compounded for infusion, or if it is for a patient enrolled in a hospice program or Residential Health Care Facility (RHCF) that is contracted with the pharmacy
• The prescriber write “hospice patient” or “RHCF patient” on the face of the the Rx (not required for Rxs to be compounded for infusion)
• Prescriber furnishes the pharmacy with the original official NY state prescription within 72 hours (attach to the faxed copy and file in control substance records)

Question 23

If you receive a controlled substance Rx that is missing information, what do you do?

Answer 23

Obtain the missing information orally from the prescriber, and enter it on the Rx along with your signature and the date.

Question 24

Some information on a controlled substance Rx cannot be added orally by the prescriber, including:

Answer 24

• Prescriber’s signature
• Date written/signed
• Medication name
• Quantity to be dispensed (but can change* quantity with permission)
• Patient’s name

Question 25

What information can be added to a controlled substance Rx by a pharmacist without contacting the prescriber?

Answer 25

Patient’s address, age, and/or gender

Question 26

What information can be added to a controlled substance Rx by a pharmacist with practitioner authorization?

Answer 26

• Practitioner DEA #
• Institutitoinal DEA #/suffix
• Directions
• Code
• MDD
• Strength

Question 27

What information can be changed on a controlled substance Rx by a pharmacist with practitioner authorization?

Answer 27

• Practitioner DEA #
• Institutitional DEA #suffix
• Directions
• Code
• Quantity
• MDD
• Strength
• Dosage Form

Question 28

What information can never be changed on a controlled substance Rx by a pharmacist?

Answer 28

• Patient Name
• Practitioner Signature
• Date written
• Drug Name

Question 29

Can a prescriber orally authorize changes to a C-II or benzo Rx?

Answer 29

Yes, indicate the changes on the Rx and write your initials next to each change;

However, you still cannot change the prescriber’s signature, the date written/signed, the drug name, or the patient’s name. *Also, record the reason for the changes, sign, and date the Rx.