NMBOP: 16.19.06 PHARMACIES Flashcards
Define
“Contracted”
means having a written agreement (to include business associate agreements as required by federal law) between parties to ensure the authenticity and prescribing authority of each prescriber transmitting prescriptions, sufficient security to prevent the fraudulent creation or alteration of prescriptions by unauthorized parties, and assurance that network vendors or electronic prescription transmission intermediaries involved in the transmission and formatting of the prescription can provide documentation of chain of trust of who has had access to prescription content. Electronic prescription transmissions by non-contracted parties will be invalid.
Define
“Drug utilization review” (DUR)
means evaluating or reviewing the patient record in order to determine the appropriateness of the drug therapy for a patient and which includes the prospective drug review in 16.19.4 NMAC and the verification of data entries including the correct interpretation and input of written prescriptions and the drug regimen review (Subsection L of Section 61-11-2 NMSA 1978) as required by the board.
Define
“Electronically transmitted prescriptions”
means communication of original prescriptions, refill authorizations, or drug orders, including controlled substances to the extent permitted by federal law, from an authorized licensed prescribing practitioner or his or her authorized agent directly or indirectly through one or more contracted parties to the pharmacy of the patient’s choice by electronic means including, but not limited to, telephone, fax machine, routers, computer, computer modem or any other electronic device or authorized means.
Define
“Electronic signature”
means an electronic sound, symbol or process attached to or logically associated with a prescription record.
Define
“Network vendor”
means prescription transmission intermediary contracted by business associate agreements with appropriate parties involved, including point of care vendors, pharmacy computer vendors, pharmacies, to transmit the prescription information only having access to the prescription content to make format modification to facilitate secure and accurate data transmission in a format that can be received and deciphered by the pharmacy.
Define
“Point of care vendor”
means an entity contracted with a prescriber to generate or transmit electronic prescriptions authorized by a practitioner directly to a pharmacy or to a contracted intermediary or network vendor, who will ultimately transmit the prescription order to a patient’s pharmacy of choice. Vendor must provide an unbiased listing of provider pharmacies and not use pop-ups or other paid advertisements to influence the prescriber’s choice of therapy or to interfere with patient’s freedom of choice of pharmacy. Presentation of drug formulary information, including preferred and non-preferred drugs and co-pay information if available, is allowed.
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A “point of care vendor” is a company that helps doctors send electronic prescriptions directly to a pharmacy or a service that then sends it to the pharmacy you choose. This company must show a fair list of pharmacies without using ads or pop-ups to push any particular one. They can, however, show information about drug options and costs if it’s available.
Define
“Prescriber”
means a licensed practitioner who generates a prescription order and assumes responsibility for the content of the prescription.
Define
“Remote pharmacist DUR site”
means a remote pharmacist practice site electronically linked to the New Mexico licensed pharmacy it operates through at which a pharmacist conducts drug utilization reviews. No dispensing will occur from a remote pharmacist DUR site.
PROCEDURE FOR NEW LICENSURE OF BUSINESS FOR DISTRIBUTION OF DRUGS AND FOR TRANSFER OF OWNERSHIP OF LICENSED BUSINESSES:
A. Applicant shall submit required application and fee to the board of pharmacy office.
B. The board, at its discretion, may require all persons interested in the ownership, operation or management, pursuant to the applicant, to meet with the board to determine that all persons are qualified and cognizant of the laws and regulations pertaining to the distribution of dangerous drugs.
C. After preliminary approval of the application, the applicant shall submit a request for inspection and the inspection fee, where applicable, in advance of fourteen days of the requested date for inspection. All subsequent request for inspection shall be submitted in advance of 14 days of the requested date for inspection.
D. The board shall review the license application and the inspection report at its next meeting and shall cause the license to be issued or denied.
E. The license provided for herein shall terminate upon the sale or transfer of ownership. Operation of a business subsequent to the date of such transfer or sale without a new application and approval by the board shall constitute a violation
PIC
Question: What does the term “pharmacist-in-charge” mean?
Answer: The term “pharmacist-in-charge” refers to a pharmacist licensee in New Mexico who has been designated as such pursuant to Section 61-11-15 NMSA 1978. Failure to perform the duties outlined will constitute a violation of Paragraph (1) of Subsection A of Section 61-11-20 NMSA 1978.
PIC
Question: What are the key responsibilities of the pharmacist-in-charge?
Answer: The pharmacist-in-charge is responsible for:
1. Establishing written policies and procedures for:
- Procurement, storage, compounding, and dispensing of drugs.
- Operation and security for remote pharmacist drug utilization review sites.
- Error prevention and reporting procedures as per 16.19.25.8 NMAC.
2. Supervising all professional employees and non-professional employees related to the sale and storage of drugs.
3. Establishing and supervising methods for storing and safekeeping drugs.
4. Establishing and supervising the record-keeping system for drugs.
5. Notifying the board immediately if their service as pharmacist-in-charge is terminated.
6. Informing the board in writing within 10 days of the employment or termination of any pharmacy technician, including details such as the name, location of the pharmacy, employee name, social security number, and dates of hire or termination.
7. Completing and submitting the New Mexico Board of Pharmacy self-assessment inspection form with the pharmacy renewal application.
PIC
Question: What is required for daily supervision of a licensed pharmacy?
Answer: Every licensed pharmacy must be under the continued daily supervision of a registered pharmacist who has direct control of the pharmaceutical affairs of the pharmacy.
PIC
Question: What should be done upon the termination of the pharmacist-in-charge?
Answer: Upon termination of the pharmacist-in-charge:
- The pharmacy owner must immediately designate a successor pharmacist-in-charge.
- Notify the state board of pharmacy of the designation.
- Request the license application form for the successor pharmacist-in-charge and ensure it is completed and filed with the board within 10 days.
- Failure to designate a successor and notify the board will be deemed a violation.
MINIMUM STANDARDS
Question: What are the minimum space requirements for the prescription department?
Answer: The prescription department must occupy a restricted area of not less than 240 square feet. This area should extend the full length of the prescription compounding counter and be used for compounding, dispensing, and storing dangerous or restricted drugs. It must provide proper sanitation, temperature control, light, ventilation, segregation, and security. No office, auxiliary store room, or public restroom can be included in this area.
MINIMUM STANDARDS
Question: Can additional facilities be included in or attached to the restricted area?
Answer: Yes, additional facilities may be attached to the restricted area:
1. A private restroom for pharmacy staff, which does not count as part of the restricted area’s square footage.
2. An office for the pharmacy’s exclusive use, provided no general store accounting functions are performed there. This office does not count as part of the restricted area.
3. An auxiliary storage area for the pharmacy’s exclusive use, which also does not count as part of the restricted area’s square footage. Items stored here must be directly related to pharmacy operations.
MINIMUM STANDARDS
Question: What facilities must a pharmacy provide for patient counseling?
Answer: Each pharmacy must provide facilities for a pharmacist to professionally counsel patients or their agents, ensuring the protection of privacy and confidentiality.
MINIMUM STANDARDS
Question: Under what conditions can an exception to the minimum space footage requirement be considered?
Answer: Exceptions may be considered by the board on an individual basis, considering factors such as:
1. Location in a rural area with a small population.
2. No other pharmacy within the same geographical area.
3. No prescription area of less than 120 square feet will be acceptable.
4. Special waivers will be reviewed annually for reconsideration.
MINIMUM STANDARDS
Question: What are the space requirements for the prescription compounding counter?
Answer: The compounding counter must provide:
- A minimum of 16 square feet of unobstructed space for one pharmacist.
- A minimum of 24 square feet for two or more pharmacists working concurrently.
- The counter must be at least 36 inches high, and if necessary, at least one work station must comply with the Americans with Disabilities Act.
MINIMUM STANDARDS
Question: What is the requirement for unobstructed floor space in the restricted area?
Answer: The restricted floor area must be unobstructed for a minimum width of 30 inches from the prescription compounding center.
MINIMUM STANDARDS
Question: What facilities must be included in the restricted area?
Answer: The restricted area must include:
- An adequate sink with hot and cold water.
- A refrigerator capable of maintaining the appropriate temperature.
MINIMUM STANDARDS
Question: What are the requirements for separating and securing the restricted area?
Answer: The restricted area must be separated from the merchandising area by a barrier that is tall and deep enough to keep dangerous drugs inaccessible to unauthorized persons. All windows, doors, and gates must have secure locks, and the restricted area must be locked when a pharmacist is not present.
MINIMUM STANDARDS
Question: How should a restricted area be separated if it is part of a business other than a retail drug store?
Answer: In a retail pharmacy established in conjunction with another business, the restricted area must be separated from the other business’s merchandising area by a permanent barrier or partition from floor to roof. Entry doors must be securely locked when a pharmacist is not on duty.
Question: What minimum equipment must a pharmacy have?
Answer: A pharmacy must have the necessary equipment for:
- Safe and appropriate storage, compounding, packaging, labeling, dispensing, and preparation of drugs and parenteral products.
- Equipment must be suitable to the scope of pharmaceutical services provided.
Question: What reference sources are required in the pharmacy?
Answer: The pharmacy must have:
- An updated reference source, either electronic or paper version, appropriate to the practice site.
- One copy of the most recently published New Mexico pharmacy laws, rules, and regulations, including available revisions, either electronic or paper version.
NOTICE OF EMPLOYEE CHANGE: Proprietors of pharmacies must report on the annual application for renewal of pharmacy license the names and registry numbers of all registered pharmacist employees and registered interns and shall notify the secretary of the board of pharmacy within _________________, in writing, of any change in personnel.
10 days
Question: What must be conspicuously displayed in a pharmacy or place of business?
Answer: The following must be displayed in full view of patrons:
- Pharmacy license
- Prohibition of the return of drugs sign
- Current board of pharmacy inspection report
- Current controlled substance registration
- “Patient’s Bill of Rights” as approved by the board
Question: What identification is required for pharmacists while on duty?
Answer: All pharmacists must wear name tags that include their job title and the designation “R.Ph.” while on duty.
Question: What are the requirements for notifying about the permanent closure of a pharmacy?
Answer: Pharmacies permanently closing must:
- Notify the public and the board of pharmacy at least 30 days prior to the final day of service.
- Include the last date of service, and the name, address, and phone number of the location where patient records will be transferred and/or stored.
- Provide notice through one of the following methods: newspaper notice, radio broadcast, or other method approved by the executive director of the board.
Question: What is the policy regarding the return or exchange of drugs, medicines, sickroom supplies, and items of personal hygiene?
Answer: Drugs, medicines, sickroom supplies, and items of personal hygiene cannot be accepted for return or exchange by any pharmacist or pharmacy once they have been taken from the premises where sold or distributed.
Question: What must a pharmacy include in its record of prescriptions returned to stock?
Answer: The record must include:
- Patient name
- Date filled
- Prescription number
- Drug name
- Drug strength
- Drug quantity
Additional Information: The record must be retrievable within 72 hours.
Question: What is required before any inventory of dangerous drugs or controlled substances can be sold, transferred, disposed of, or otherwise removed from the premises?
Answer: Permission must be obtained in writing from the board, after inspection. All sales are subject to the laws of the state.
Question: What is required for a pharmacy to collect and dispose of unwanted or expired patient dispensed legend and OTC medications?
Answer: The pharmacy must submit a protocol or subsequent changes to the board or the board’s agent for approval. Once approved, the pharmacy is authorized to collect pharmaceuticals for destruction. The protocol must include:
- Secure Collection Unit: A secure and enclosed collection unit that does not allow for unauthorized access.
- Dedicated Area Description: A description of the dedicated area for the collection unit inside the pharmacy, within sight of authorized pharmacy staff.
- Direction of Collection: Safe and secure disposition directions.
- Disposal Company Information: Name of the contracted disposal company that is licensed for pharmaceutical destruction.
- Frequency of Collection: Frequency of collection and destruction by the disposal company.
- Records of Collection: Records of collection and destruction supplied by the disposal company.
Question: What items are accepted at a take back site?
Answer:
- Dangerous drugs (prescription drugs)
- Controlled substances if authorized under federal law or rule
- Over-the-counter medications
- Veterinary medications
- Medicated ointments and lotions
- Liquid medication in glass or leak-proof containers
Question: What items are not accepted at a take back site?
Answer:
- Needles
- Thermometers
- Bloody or infectious waste
- Personal care products
- Controlled substances (unless authorized by federal law)
- Hydrogen peroxide
- Empty containers
- Business waste
Take Back Day Question: Can collected medications be re-dispensed?
No
Question: What must be posted on the collection unit for patient take back?
Answer: Directions for take back for patients and a list of accepted and non-accepted products must be posted on the collection unit.
Question: What happens if a pharmacy violates the approved protocol for collecting and disposing of pharmaceuticals?
Answer: The pharmacy’s authority to collect and dispose of dispensed pharmaceuticals will be suspended. The pharmacy may petition the board for the removal of that suspension.
Question: What should a pharmacy do if it is involved in a robbery, burglary, fire, flood, or any unusual event affecting dangerous drugs?
Answer: The owner must immediately file a signed statement with the board detailing the circumstances of the occurrence and provide evidence that local authorities were notified, if applicable.
Question: What happens when a business is sold or ownership is transferred, and a new license application is submitted?
Answer: The board may require an examination of any stock that may be adulterated, deteriorated, or of questionable quality. Merchandise deemed unfit for sale may be embargoed if the owner does not voluntarily consent to destruction. If drugs are embargoed, the owner must bear the expense of assay to prove purity, strength, and product quality.
SIGNS TO BE REMOVED WHEN PHARMACY DISCONTINUES OPERATION
Question: What must be done when a pharmacy discontinues operation?
Answer: The permit issued by the board must be immediately surrendered to the board office. All drug signs and symbols, either within or outside the premises, must be removed. All drugs, devices, and poisons must be removed or destroyed.
SIGNS TO BE REMOVED WHEN PHARMACY DISCONTINUES OPERATION
Question: What are the requirements regarding signs for a business that is not licensed as a pharmacy?
Answer: Any store or place of business with signs or words like “pharmacist,” “pharmaceutical chemist,” “druggist,” “pharmacy,” “drug store,” “drugs,” “drug sundries,” “prescriptions,” or similar terms must obtain a license from the board of pharmacy. If not licensed, the business must remove any such signs or words.
SIGNS TO BE REMOVED WHEN PHARMACY DISCONTINUES OPERATION
Question: Can a business obtain a waiver for the requirement to remove drug-related signs?
Answer: Yes, the board may grant a waiver upon petition. The petition must include:
1. Name of the party
2. Address of the business
3. Type of business
4. Reason for the waiver request
5. Supporting documents
6. Photographs of the business showing the use of the sign or words in question
SIGNS TO BE REMOVED WHEN PHARMACY DISCONTINUES OPERATION
Question: Can pharmacists advertise their professional services?
Answer: Yes, pharmacists registered in New Mexico may advertise their professional services, but such advertisements must not solicit prescription drug sales unless done in conjunction with a licensed pharmacy.
SIGNS TO BE REMOVED WHEN PHARMACY DISCONTINUES OPERATION
Question: What are the rules for using pharmacy-related names in advertising?
Answer: An advertiser can use names like “pharmacy,” “drug store,” or similar terms only if:
1. The advertiser is or has a licensed pharmacy in New Mexico, or
2. The advertiser is or has a non-resident pharmacy licensed in New Mexico, or
3. The advertisement includes a clear statement such as “the advertiser is not a licensed pharmacy and does not fill prescriptions or practice pharmacy,” and
4. The advertisement discloses the name of the licensed pharmacy where prescriptions are filled for New Mexico residents, and
5. Any confidential information is obtained by authorized persons.
LABELING OR TO LABEL
Question: What does “labeling” or “to label” mean under the Pharmacy Act, Section 61-11-2 NMAC 1978?
Answer: “Labeling” or “to label” means the act of affixing, applying, or attaching written, printed, or graphic matter on or in the immediate container of any human use drug, repackaged or dispensed on a practitioner’s order. This function is restricted to registered pharmacists and registered pharmacist interns as required by the Pharmacy Act, Section 61-11-21 NMSA 1978, except as specified in board Regulation Article 15.
LABELING OR TO LABEL
Question: How is “label” or “labeling” defined under the Drug and Cosmetic Act Section 26-1-11 NMSA 1978?
Answer: Under the Drug and Cosmetic Act, “label” or “labeling” refers to the manufacturer or repackager’s label required on the commercial container when the substance is offered for sale or distributed by the manufacturer or repackager.
LABELING OR TO LABEL
Question: What are the prescription drug dispensing container requirements for manufacturers and pharmacists?
Answer: Both pharmacists and drug manufacturers are responsible for packaging drug products according to the monographs for drug products recognized in the official compendium. After August 27, 1978, drug products must provide information for the pharmacist to maintain the identity, strength, quality, and purity of the product. Standards for proper dispensing containers, effective April 1, 1977, apply to both manufacturers’ containers and pharmacists’ dispensing containers. Manufacturers of non-compendia drug products must use terminology from an official compendium to describe suitable containers, including standards for tightness of seal, light resistance, moisture permeability, and special instructions like “keep in a cold place” or “avoid exposure to excessive heat.”
LABELING OR TO LABEL
Question: What information must be included on a dispensing container label?
Answer: The label must identify the contents by generic or trade name. For compounded prescriptions containing more than three drugs or trade name products, the label may state “Compound” at the pharmacist’s or prescribing physician’s discretion. The label must also include the expiration date, per USP/NF guidelines, and the quantity dispensed, as required by the Drug and Cosmetic Act, Subsection B of Section 26-1-16 NMSA 1978, unless the prescribing practitioner specifically requests that such information be omitted from the label.
Question: What are the requirements and fees for changing the location or physical dimensions of a licensed pharmacy?
Answer: Before changing its location or physical dimensions, a licensed pharmacy must submit a new application to the board detailing the changes. After approval, the pharmacy must request an inspection from the chief inspector. There is no charge for the new application, but the inspection will incur the same fee as for a new pharmacy inspection.
TRANSFER OF OWNERSHIP: A transfer of ownership occurs upon.
A. The sale of the pharmacy to another individual or individuals by the present owner.
B. The addition or deletion of one or more partners in a partnership.
C. The death of a singular or sole owner.
D. The change of ownership of thirty percent or more of the voting stock of a corporation since the issuance of the license or last renewal application. A new license application will be required to be filed in each of the above circumstances. As stated in the Pharmacy Act, Subsection I of Section 61-11-14 NMSA 1978, licenses are not transferable, and shall expire on December 31 of each year unless renewed.