MPJE Review Session Flashcards
describe the membership for the pharmacy commission
-10 pharmacists (licensed in WA for at least 5 years, geographically representative, and representing various areas of practice)
-4 public members, not affiliated with any aspect of pharmacy
-1 pharmacy technician
how long is a term for a pharmacy commission member
4 year terms
what is the practice of pharmacy from RCW 18.64.011
-interpreting prescription orders
-compounding, dispensing, labeling, administering and distributing of drugs and devices
-monitoring of drug therapy and use
-initiating or modifying drug therapy in accordance with written protocols approved for his or her practice by a practitioner authorized to prescribe
-participating in DUR and drug product selection
-proper and safe storage, distribution, record keeping
-providing of info on legend drugs
what is considered monitoring of therapy from WAC 246-945-355
review of drug therapy regimen by a pharmacist for the purpose of evaluating or rendering advice to the prescribing practitioner or patient regarding the patients’ drug therapy
what can a pharmacist edit on a script
- change qty if: prescribed qty or pack size isn’t commercially available, change is relating to dosage form, change is intended to dispense up to the total amount authorized by the prescriber including refills, change extends a maintenance drug for the limited qty necessary to coordinate a patient’s refills in a med sync program
- change dosage form
- complete missing info
- documentation *** must document changes in the patient’s record
what is the required training during the first year of licensure as an rph
suicide prevention training
when do you need to do the CE requirement for heath equity
at least once every 4 years
do techs licensed in WA need to pass a national exam
yes, either the PTCE or ExCPT
how many hours of CE do techs need to perform
20 hours relating to pharmacy practice and directed to technicians
do techs need to do certain CE
yes, 2 hours must be in pharmacy law and 1 hour must be in patient safety
how many days may be included in the checked cassettes of unit-dose checking (tech-check-tech)
48 hours
is there a pharmacist to technician ratio
not anymore as of 9/2019. the ratio is to be determined by the responsible pharmacy manager, and the responsible pharmacy manager will ensure that the number of pharmacy techs on duty can be safely supported by the pharmacist on duty
how many times can you retake a failed exam in WA
up to 3 times within 3 years
who are considered federal pharmacists
indian health service, PHS, armed forces, VA
do WA licensed federal pharmacists who are on active duty or in the PHS pay fees or submit CE
no
what is the requirement for Nuclear pharmacists in WA
- be certified by a specialty certification board or
- complete 200 hours in a structured educational program meeting requirements set in WAC 246-240-075(2), to obtain a written attestation to such successful completion from a preceptor-authorized nuclear pharmacist
how much CE is required to renew a pharmacist license
30 hours every 2 years
what is the DEA form to apply for a new pharmacy and when do you need to have it done by
DEA form 224, 30 days prior to commission meeting
what are the pharmacy owner responsibilities
-place a pharmacist in charge
-pay license fee
-file a statement of ownership and location
-maintain records of prescriptions and dispensing for a min of 2 years
-maintain CSA records for a min of 2 years
if there is a change in responsible pharmacy manager, when should you notify of the change
within 30 days
community/outpatient label requirements
-drug qty
-number of refills
-unless a vet rx “warning: state or federal law prohibits transfer of this drug to any person other than the person for whom it was prescribed”
-name of facility if the “patient” is a facility or entity
-compounds meet USP
-exp date: take into account the nature of drug, container from manufacturer, patient’s container, expected shortage conditions, expected length of therapy
-vet meds: name and species of patient
WA facility standard
-Constructed and equipped for adequate security
-Properly equipped to ensure safe, clean, and sanitary conditions
-Staffed sufficiently to allow appropriate supervision, operate safely, and remain
open during posted hours
-Adequately stocked to maintain at all times a representative assortment of drugs to
meet needs of patients (WAC 246-945-415)
-Designate a RPM by opening and within 30 days of vacancy
-Create P&Ps
-DUR required before dispensing/delivery UNLESS emergency
what schedule of drugs must be kept in a separate file than c3-5 or legend drugs
c2
when does a pharmacy do a self inspection
annually in march
when does the board give the inspection report
within 10 business days
what are non-resident pharmacies
sell or ship drugs to patients in WA
who do non-resident pharmacies need to register with
WA pharmacy commission
what are the requirements for inpatient hospital prescription labeling
-drug name
-strength
-compounded product must meet USP chapter labeling requirements
when can verbal orders be used in hospital and LTC facilities
only in emergencies
when can a patient use their meds brought from home in a hospital
a written policy must be in place, and can only be administered if properly ordered
when can a patient self administer medication in hospital/rehab/LTC
may be done under a policy and approved protocols in a program of self care or rehab and the policy must be developed by hospital RPM and be approved by the admin/medical/nursing staff
when do you do a controlled substance inventory
-every 2 years
-within 30 days of new RPM
-addition of new substance to the schedule
what are the labeling requirements for prepacked meds in extended care facilities (skilled nursing facilities)
-drug name
-strength
-exp date
-manufacturer name
-lot #
-identity of pharmacist/provider responsible for prepacking
what are the labeling requirements for unit dose packaging
-individual storage unit for each patient, clearly labeled with resident name
-individual package must have:
-name of drug
-strength
-lot #
-exp date
-CSA schedule
can a pharmacy repackage and reuse unused drugs returned by a long-term care facility or hospice program to the pharmacy in per-use blister packaging (whether in unit dose or modified unit dose form) *except where prohibited by federal law
yes
what are the labeling requirements for non-prescription drugs
-date of receipt by facility
-patient’s name
-manufacturer or pharmacy label
-doesn’t apply to selected bulk drugs used by the facility
OBRA requirements for LTC facilities
-pharmacist must be involved in care of patient
-development of comprehensive care plan for each resident
-resident’s therapy must be free of unnecessary drugs (duplicate therapy, excessive duration, inadequate monitoring, inadequate indications for use, use of drugs in presence of ADRs)
-comprehensive reviews of psychotropic drugs and plan to reduce in each patient
-drug regimen review by pharmacist every 30 days
where is the list of contents on an emergency kit
on the outside of the kit
what is the process where a pharmacy can outsource for LTC or hospice program residents
-Obtain approval from LTC/hospice
-Provide copy of prescription or chart order to pharmacy providing shared
pharmacy services
-Supplying pharmacy retains copy of prescription, dispensing record, and
notifies outsourcing pharmacy of service & quantity provided
-Only transfers one fill or partial fill to another pharmacy to meet needs of
patient
who is responsible for storage, security, and accountability of LTC supplemental dose kits
Pharmacy and PSC
who determines the contents for LTC supplemental dose kits
PSC
who can stock the ADDD (automatic drug dispensing devices)
pharmacist, intern, or technician (under pharmacist supervision)
who makes the list of emergency meds which are subject to retrieval without prospective pharmacist DUR
determined by PSC or P&T committee
in what situations can a pharmacist NOT perform a prospective DUR
-subsequent dose from previously reviewed order
-prescriber in immediate vicinity and controls drug dispensing process
-system is used for emergency meds (pharmacist retrospective review within 24 hours)
what can a medicare-approved dialysis center or facility operating a medicare-approved home dialysis program may sell/deliver/posses/dispense directly to its home dialysis patients in cases or full shelf package lots if prescribed:
-sterile heparin 1000 u/ml in vials
-sterile KCl 2 mEq/ml for injection
-commercially available dialysate
-sterile sodium chloride 0.9% for injection in containers of not less than 150ml
what usp do nuclear pharmacies follow
usp 825
when should you notify the commission prior to closing a pharmacy (regardless of setting)
at least 30 days prior
what do you put in a commission notice of pharmacy closure
-intended date of closing
-names and addresses of persons who shall have custody of pharmacy’s records
-names and addresses of persons who will acquire any of the legend drugs of CSAs (if known)
within 15 days after closing the pharmacy, what must be supplied to the commission
-The pharmacy license (voided)
-Written confirmation of:
-Proper transfer or destruction of legend drugs, including names and addresses of transferees
-Proper transfer of any CSAs and names and addresses of transferees
-Return of DEA registration and unused forms to DEA
-Destruction of pharmacy labels and prescription blanks
-Removal of all signs and symbols indicating the presence of pharmacy
when you’re closing a pharmacy, what do you tell the patients and how
-direct mail or newspaper ad and posting a sign near the pharmacy
-intended date of closing
-name and address of pharmacy to which prescriptions will be transferred
-instructions on how patients can arrange for transfer of their prescriptions to a pharmacy of their choice, and the last day a transfer may be initiated
how do shopkeepers register to sell otc drugs
register via Master License application system
in what situation does a pharmacy not need to register as a wholesaler
if they sell to another pharmacy or practitioner for an emergency medical reason
pharmacy selling to another pharmacy or provider: what constitutes an emergency
when a patient requires the specific medication, with no alternative therapy,
and the other entity has no way of obtaining the medication from a licensed wholesaler to
meet the need. Additionally, it is not feasible for the patient to travel to the pharmacy with
the stock to get the medication.
drugs may not be introduced into commerce unless
proven safe (1938) and effective (1962) for intended use
from the Wiley Act: what is adulteration
Impurities
Added injurious substances
Failure to meet compendial standards
Stored improperly or in unsanitary conditions
from the Wiley Act: what is misbranding
In 1906, this meant false and fraudulent statements on the label
Now, means any false or misleading statements on the labeling (which
includes label and other statements made about the product by the
manufacturer)
what is the difference between a medguide and a patient package insert
-medguides are required for those drugs that pose the most serious and significant public health concern
-PPI (patient package inserts) are generally no considered by the FDA to carry the same serious and significant public health concerns
what may be included with REMS requirements
Assessments at 18 months, 3 yrs, and 7 yrs post marketing
MedGuide or PPI development
Communication plan to health professionals
Plans:
Limit prescribing to physicians with special training
Limit dispensing to certified providers
Limit administration to certain settings
Limit distribution to patients with documentation of safe-use conditions, such as lab
tests
Monitoring for each patient using the drug Enrollment of each patient in a registry
what changed on package inserts in 2006 when the FDA revised the format
PIs now follow a specified layout, with a “highlights” section which must be the first section of the insert
what are the requirements of a 7 point OTC label
-name of product
-name and address of manufacturer/packager/distributor
-net contents
-active ingredients and quantity of certain other ingredients
-name of any habit-forming drugs
-cautions and warnings
-adequate directions for use
what act requires child-resistant containers on all rx drugs
poison prevention packaging act
do all over the counter meds require child resistant packaging
no
what otc meds require child resistant packing
Aspirin Acetaminophen NSAIDs Iron preparations > 250 mg elemental
iron/pkg Diphenhydramine > 66 mg/pkg Fluoride > 50 mg/pkg Lidocaine, Dibucaine Loperamide Minoxidil
Methacrylic acid Methyl salicylate Ethylene glycol Methyl alcohol Hydrocarbons and solvents NaOH, KOH, H2SO4 Permanent Wave Neutralizers Drugs switched to OTC status after 2001
what legend drugs do not require child resistant packaging
Nitroglycerine SL SL, chewable isosorbide <= 10 mg NaF <= 110 mg/pkg Cholestyramine and colestipol
powder Oral corticosteroids in doses <=105
mg of prednisone equiv. Mebendazole <= 600 mg/pkg
K+ supplements <= 50 mEq/dose EES granules <= 8 g/pkg, tabs <= 16 g Aerosols for inhalation Pancrelipase OCs in memory aid containers;
MPG; other hormones
information required on label of dispensed legend drug (federal law)
-name and address of dispenser
-serial (prescription) number
-date of the prescription or of its filling
-name of the prescriber
-if stated in the prescription, name of the patient
-the directions for use and cautionary statements, if any, contained in such prescription
-side effects statement
what is the side effects statement
call your doctor for medical advice about side effects. you may report side effects to FDA at 1-800-FDA-1088
does the side effects statement need to be included on the label?
no
where can the side effects statement be printed
-on a sticker attached to package (or label)
-on preprinted vial cap
-on separate sheet of paper
-in consumer med info
-in FDA-approved medguide containing the statement
what info is required on label of legend drug
Complete directions for use (“UD” not valid)
Expiration date
Quantity dispensed
Number of refills remaining, if any
Name and strength of drug
Initials of pharmacist (can be in computer system)
“Warning: State or federal law prohibits transfer of this medication to any person
other than the person for whom it is prescribed.”
what are the only controlled substances that a naturopath can prescribe
codeine and testosterone products only
what practitioners do not have prescriptive authority in WA
Naturopath, optometrist
pharmacist, midwife
can you accept any script from BC
only legend drugs unless they’re registered with the DEA
can PT or OT prescribe? what can they do
no, may order and use certain legend drugs (from a wholesaler and for office use). only can administer drugs appropriate to physical or occupational therapy
do prescriptions “die” with the prescriber
not in WA but best practice is to encourage patient to find new prescriber
when receiving a transferred Rx – what must you ask the transferring pharmacist
if the original was written on a tamper-resistant pad
what are the requirements for electronic prescribing in WA
-must meet standards for security and integrity
-must be approved by the commission
-staff must sign and adhere to security and integrity policy and procedures
-must allow for communicating preferences for substitution
-C2 are allowed via electronic prescribing as long as the prescriber and pharmacy are in compliance with regulations required by the DEA
all legend drugs expire after how long in WA
1 year
the full qty of the prescription refill may be dispensed up to what day
last day before the rx expires
for non-CSA drugs, an emergency supply for what may be given once in 6 months
up to 30 days or most recent fill (which ever is less)
can prescribers delegate refill auth to a nurse or staff under protocol
no
can you sell syringes/needles in WA
yes a retailer may sell needles/syringes if he/she is satisfied that the device will be used for the legal use intended
how old do you need to be to purchase needles/syringes otc
persons > 18 years old
do retailers need to sell syringes/needles to public
NO not required
what did the drug quality and security act of 2013 do
new compounding standards resulting from improper oversight at NECC
- outlines steps to build an electronic, interoperable system by 11/27/13 which will identify and trace certain prescription drugs as they are distributed within the US (will enhance the FDA’s ability to help protect US consumers by improving detection and removal of potentially dangerous products from the pharmaceutical supply chain)
what are the prohibited products for compounding
Prohibited Products May not compound products that are listed by FDA as having been
removed from market due to lack of safety or efficacy May not compound “regularly or in an inordinate amount”
products that are essentially copies of commercially available drug
products. May not compound products that are listed by FDA as having
demonstrable difficulties in compounding.
what does WA consider to not be “manufacturing”
“Manufacturing” does NOT include: Office Use – Compounded by a pharmacy on order of licensed practitioner for
use in practitioner’s professional practice for administration to patients; Limited repackaging – Repackaging of commercially available medication in
“small, reasonable quantities” for office use by a practitioner; Centralized compounding – Distribution of a compounded product to other
appropriately licensed entities under the ownership or control of the facility in
which the compounding takes place; or Delivery - Delivery of finished and appropriately compounded products
dispensed pursuant to a prescription to “alternative delivery locations, other
than the patient’s residence, when requested by the patient, or the prescriber to
administer to the patient, or to another licensed pharmacy to dispense to the
patient.
what does the USP 795 apply to
non sterile preparations
when do non-aqueous liquids and solids expire according to 795
6 months or 25% of mfr label if made from manufactured product
*not greater than 6 months if USP of NF ingredient is source
aqueous expiration date according to 795
14 days, stored in cold place
all other (not non-aqueous liquids/solids or aqueous preparations) expiration date
30 days or intended duration of therapy
what does USP 797 apply to
sterile products and responsibilities of pharmacy personnel in their preparation
what does the USP 800 apply to
handling of hazardous drugs
what group requires hazard communication program
OSHA
when must you assess USP 800 job function
every 12 months
what are the types of exposure of hazardous drugs
dermal, mucosal, inhalation, ingestion, injection
groups of HDs determined by NIOSH
1-antineoplastic drugs
2-non-antineoplastic drugs
3-drugs that primarily pose reproductive risks to those actively trying to conceive and women who are pregnant or breast feeding
USP labeling standards for compounded products
-name of preparation
-internal identification number
-beyond use date
-initials of compounder
-storage requirements
-other items required by state law
is certification from the pharmacy compounding accreditation board mandatory
no but may be required by insurance companies for sterile compounding
what is the new WA definition from 2021 for compounding
“Compounding” means the act of combining two or more ingredients in the
preparation of a prescription. Reconstitution and mixing of (a) sterile
products according to federal food and drug administration-approved
labeling does not constitute compounding if prepared pursuant to a
prescription and administered immediately or in accordance with package
labeling, and (b) nonsterile products according to federal food and drug
administration-approved labeling does not constitute compounding if
prepared pursuant to a prescription.
who can receive prescription drug samples
ONLY prescribers or to hospitals at request of prescribers
what kind of clinic may possess and distribute drug samples
free
in what instance can retail pharmacies have drug samples
only when part of a drug donation program
should you repack legend drugs while transferring between pharmacies
no
what is the definition of a class 1 recall
likelihood of injury or death from use of product; may include public warning
what is the definition of a class 2 recall
temporary or reversible health problems from use of product
what is the definition of a class 3 recall
use of product NOT likely to cause health problems
when would a drug be withdrawn from the market
minor health risk or minor FDA violation
what does the federal controlled substances act establish
a closed system of inventory and accounting for distribution of controlled substances
out of the schedules, 1-7, which are considered controleld
1-5
washington law allows naloxone scripts to be filled for who in case of accidental overdose
caregiver or friend of opiate user
terminally ill (death expected within how many months) competent adult WA residents may request a script they may take to end their life
6
how many physicians must certify the terminally ill patient is competent
2
what does the terminally ill patient need to do to actually request the prescription to end their life
make an oral and written request to the physician
how long must the terminally ill patient wait between the oral and written request for a prescription to end their life
15 days
how many witnesses does the written request for a med to end life need
2; 1 of which may not be related to the patient, be entitled to share the patient’s real estate, or be employed by the institution providing care
how much time must elapse between the second oral request for a med to end life and issuance of the prescription
48 hours
what are the restrictions for prescriptions under the DWDA
-must be for a drug the patient can ingest by him/herself (no injections)
-physician may dispense drug directly to patient or with pt permission can contact willing pharmacist and explain nature of script
What are the individual provider rights within the DWDA
-no rph or physician may be compelled to participate in aid-in-dying
-no rph or physician may be disciplined or otherwise adversely treated for participating in aid-in-dying
what other registration do internet pharmacies need to dispense controlled substances
registered under Ryan Haight Online Pharmacy Consumer Protection Act of 2008
what are the optometrist WA CSA prescribing limits
-no C2
-no more than 7 days supply of CSA
-no more than 30 dosage units of 3 or 4
-single dose BZDs for pre-procedure use
which employee of hospital may use hospital DEA number with permission in the course of his/her duties if otherwise authorized to prescribe
any
do public health service or bureau of prisons employees need a DEA #
no, use social security number as DEA #
do military practitioners need a DEA to prescribe CSA on base
no, but they need if prescribing off base
for physical CSA inventories, when do you need to actually count C3-5
if container have > 1000 doses and has been opened
what does a completed CSA rx need
Completed CSA Rx
Patient name
Patient address
Date written
Drug, Quantity, Directions
Physician Address
Physician DEA Number
Physician Signature or Name
Other information required by state
Pharmacies must have on file diagnosis for use of amphetamines
ICD10 code for opioids from episodic care prescriber
WA Commission has indicated that a pharmacist may add any missing information after
consultation with prescriber, may add DEA number without consultation if it is already known
with certainty. (changing the drug or patient is not allowed)
according to the DEA, can you use a faxed request for refills of CSA as need rx?
no: prescriber must generate new Rx, sign it and fax that to the pharmacy
in WA, when do C2 scripts expire
6 months
when do you need a confirming/covering Rx from a Emergency C2 phoned/faxed script by
postmarked or received at pharmacy within 7 days
if you don’t receive a covering rx for an emergency c2 script what are the next steps
must notify BOP and/or DEA
in what situations can you use a faxed c2 script as an original
-LTC facilities
-home infusion practices (only injectables)
-hospice patients
what can an RPh change in a C2 rx after consult with the prescriber
-dosage form
-drug strength
-drug qty
-directions for use
-issue date
what can an RPh not change on a C2 rx
patients name (other than spelling) or the controlled substance prescribed (other than brand/generic)
what can the RPh change without prescriber consult
patients address after verification and DEA number if known
When can you partial fill a controlled substance
IF
1. requested by either prescriber or patient
2. not prohibited by state law
3. total dispensed in partial fillings doesn’t
what is the transfer warning for CSA prescriptions in WA vs Federal
Federal; “caution: federal law prohibits transfer of this medication to any person other than the person for whom it was prescribed”
WA; “Caution: State or Federal Law prohibits transfer of this medication to any person other than the person for whom it was prescribed”
Does WA require the transfer warning on only CSA scripts
no – on all
where should all non cancer patients should receive scripts from …
1 practitioner and 1 pharmacy whenever possible
when should periodic reviews happen for narcotics in non-cancer pain
every 6 months
in what situation would periodic reviews happen for narcotics in non-cancer pain happen annually
stable chronic non-cancer pain involving non-escalating daily doses of 40 mg MED or less
what is necessary for a provider to write for long-acting opioids (like methadone)
completed at least 1 CME of 4 contact hours on the safe use of long acting opioids
what are the requirements for opioid prescriptions written by episodic care practitioners
include indications for use or the ICD10 code and shall be written to require photo ID of the person picking up the script in order to fill
when is counseling mandatory for narcotics for non-cancer pain
patient reaches or exceeds 120mg MED
when are prescribers exempted from the mandatory counseling if pt is taking MED > 120mg
if they are pain management specialists, or have completed 12 category 1 CME hours on chronic pain management with at least 2 hours devoted to long-acting opioids within the prior 2 years
in what scenarios are controlled substance scripts not entered into the PMP
inpatient scripts or drugs dispensed in correctional facilities (except for substances dispensed to inmates at time of release)
what schedule of controlled substance MUST be filed by itself in WA
C2
what are the acceptable indications for non-narcotic stimulants in WA
-narcolepsy
-hyperkinesis
-epilepsy
-differential psychiatric diagnosis of depression
-multiple sclerosis
-moderate to severe binge eating disorder in adults
what are the acceptable non-narcotic stimulants in WA
-amphetamine salts and combinations
-dextroamphetamine salts and combinations
-phenmetrazine (preludin)
-methylphenidate (ritalin)
what qualifies as a practitioners e signature
verified by 2/3:
-biometric
-knowledge factor
-a device separate from the computer
how long must your keep log book for methamphetamine precursor sales
2 years
how old do you need to be to buy sudafed in WA
18
what is the sudafed daily limit in WA
3.6g
what is the sudafed monthly limit in WA
9g
what is the electronic system to track pseudoephedrine sales in WA
national precursor log exchange (NPLEx)
what is the exception for methadone prescribing at NTP site
if methadone is being used for pain
what are the hospital schedule 2 requirements in WA
-Perpetual inventory of C-IIs in pharmacy
-Record of drugs distributed to other units of hospital
-Records of administration or disposal of C-IIs, usually done in the MAR
-Wastage of unused CIIs must be witnessed -Policies maintained on destruction (see DEA form 41 requirements)
-Monitoring to assure chart records are correct
-Use of multiple dose vials of a controlled substance is discouraged
-Physical counts of C-II or C-III drugs stored as floor stock required at each shift change
in a hospital and the full amount of a CSA isn’t used, how many people must observe the wastage
2 individuals who are licensed to administer
who is responsible for creating and maintaining policies on the proper destruction of C2s in a hospital
the director of pharmacy
what are the non unit dose system nursing home CSA rules
Non-unit dose systems
C-II stored separately under lock C-III stored separately from other drugs but may be stored
with C-II
Bound log book for all C-II or C-III drugs
Physical prescription counts q 24 h for C-II and weekly for C-III
Community pharmacies serving LTC facilities will be able to provide a collection receptacle for the disposal of residents’ discontinued or outdated controlled substances
what are the unit dose requirements for CSAs in nursing homes
Unit dose – may follow above rules or develop alternative system with equivalent record keeping
C-III unit dose may be stored with other UD drugs
Discontinued unit dose drugs other than C-II may be returned to pharmacy
all other drugs than c2s must be destroyed within …..
90 days
what is WRAPP
established in 1983 by WSPA and WSSHP with goals of protecting health and safety of the public and to provide a health resource and rehab support for the impaired pharmacist
if a pharmacist self reports to WRAPP do they make a notification to the commission
no and details are kept confidential
when would the commission be notified in an involuntary WRAPP referral
if a drug theft is linked to the discovery of an individual’s impairment
in what instances is patient counseling required
-upon initial fill for a new or change of therapy
-when the pharmacist using professional judgement determines it is necessary
-does not apply when meds are administered by licensed health professional
does WA require documentation of counseling
no
when is the deadline to obtain an NPI after licensure (or an update of information)
30 days
when you deidentify information, what do you remove
-name
-address
-ZIP
-city
-DOB
-admission date
-discharge date
-age
-telephone number
-fax number
-electronic mail address
-social security number
-medical record numbers
-vehicle identification numbers
-pictures
what is the time limit for records retrieval in WA
ASAP with 15 day limit for initial response and a 21 day max
what is the time limit for amendment of records in WA
10 days for response; 21 days max
WA regulation restricts communication of PHI with ….
family who are not obvious agents or caregivers
in what instances are minors treated like adults in WA
emancipated minors or minors married to a person who is not a minor are treated as adults
what is the age limit for minors ability to consent to treatment for STDs in WA
14 and over
what is the age limit for minors ability to consent to contraceptives or pregnancy termination services
any age
what is the age limit for minors ability to consent to inpatient or outpatient mental health treatment
13 and over
what is the age limit for minors ability to consent to outpatient chemical dependency treatment
13 and over
before you self report — even WRAPP — what should you do
get an attorney
