OBRA LAW/DRUG ORDER REQUIREMENTS Flashcards
What does OBRA stand for?
Ominibus Budget Reconciliation Act.
Name the objective of OBRA.
Save taxpayers money by funding prescriptions using taxpayer dollars.
What requirement of the state Medicaid programs must be conducted after the dispensing of a drug according to OBRA?
Retrospective Drug Utilization Review.
What is the abbreviation for Drug Utilization Review?
DUR.
Name the objective of a retrospective DUR.
Identify inappropriate use of drugs.
Generate cost saving by making corrections.
True or False
In a Retrospective DUR, prescription problems can be corrected before they happen.
False.
In a Retrospective DUR, prescriptions that have been sent out are reviewed for errors.
A Retrospective DUR is conducted by doing which of the following:
a) Reviewing prescribing patterns of patients.
b) Reviewing prescribing patterns of practitioners.
c) Monitoring scripts that fall inside of the normal DUR guidelines.
d) Monitoring scripts that fall outside the normal DUR guidelines.
b) Reviewing prescribing patterns of practitioners. and
d) Monitoring scripts that fall outside the normal DUR guidelines.
True or False
In a Prospective DUR, prescriptions are reviewed for errors after they have been dispensed.
False.
In a Prospective DUR, a pharmacist reviews prescription prior to being dispensed to prevent future problems.
What are the phases of Prospective DUR?
Review/correct patient profile issues.
Provide prescription counsel for each Medicaid patient.
In which OBRA process is the pharmacist involved?
a) Prospective DUR
b) Retrospective DUR
a) Prospective DUR
Name the problems to watch for during the Prospective DUR of the OBRA process.
Clinical abuse or misuse. Script duplication. Incorrect dosage or usage duration. Drug-drug interactions. Drug-disease & Drug-allergy contraindications.
Who is allowed to counsel patients in the pharmacy?
The pharmacist.
True or False
If a technician has been authorized by the state to request pharmacist counseling services for a patient and the patient accepts, the pharmacist can ultimately decline this request.
False
Only the patient can refuse the right, the pharmacist cannot deny the obligation.
OBRA requires which of the following documents to be easily retrievable upon request:
a) pharmacist’s comments relevant to individual’s drug therapy
b) pharmacist’s comments relevant to individual’s dog therapy
c) patient’s name, address, phone, DOB, & race
d) patient’s name, address, phone, DOB & gender
e) minor history of diseases, allergies, drug reactions, concurrent medications
f) significant history of diseases, allergies, drug reactions, concurrent medications
a) pharmacist’s comments relevant to individual’s drug therapy
d) patient’s name, address, phone, DOB & gender
f) significant history of diseases, allergies, drug reactions, concurrent medications
Name the information that must be written on the face of a controlled substance.
Patient’s full name and address.
Prescriber’s full name and office address.
Prescriber’s DEA #.
Date and Qty. written out.
What two dates must be written on a Medicare prescription?
Date the script is generated.
Date the script is signed.
True or False
If the dates written on a Medicare prescription are the same, you aren’t required to write them twice on the prescription.
False.
Both dates are required to be written regardless.
What are the requirements that must be included on a Medicare prescription?
Patient’s full name and address.
Prescriber’s full name and office address.
Date and qty written out.
Disease code of product used.
Exact directions and product name.
Prescriber’s NPI #
Prescriber’s handwritten signature and date signed next to each other.
Why was the IPLEDGE Registry established?
To prevent use of isotretinoin during pregnancy.
True or False
The IPLEDGE Registry requires the patient, prescriber, and the pharmacist all receive specialized training about the drug.
True.
All must be registered in the program before participating.
True or False
The Clozapine Registry requires the patient and pharmacist be registered in the program.
False.
It requires the pharmacy and the pharmacist to be registered.
What is the objective of the Clozapine Registry?
Track the blood tests and results of patients who have tested with an abnormal blood test while using Clozapine.
Name the four main components involved in the e-Prescribe system.
Prescriber
Transaction Hub
Pharmacy Benefit Manager (PBM)
Pharmacy
Name the major advantage the e-Prescribe system has over using prescription blanks.
It eliminates the problem of trying to read the prescriber’s handwriting.
Describe how the prescriber utilizes the e-Prescribe system.
Sign in using identity verification process.
Identify/Review the patient record and medical history.
D/C, modify, or initiate new drug therapy.
Enter new script info to transmit to T-Hub.
What is the purpose of the e-Prescribe Transaction Hub.
Link the prescriber, pharmacy, and patient’s pharmacy benefit manager.
Describe Transaction Hub e-Prescribe process.
Script received from prescriber.
Insurance Adjud. request sent to PBM.
PBM verifies coverage and payment info.
Sends back to T. Hub, which sends back to prescriber.
Describe the next step of the prescriber after an e-script has gone through the T. Hub.
E-signs script -> transmits to pharmacy via fax or -> print hard copy for patient.
True or False
Most e-prescribe systems do not allow the pharmacy to electronically contact the prescriber for refill authorization.
False
Most e-prescribe systems allow this.
Which of the following are true when a pharmacy receives a prescription by an alternate method?
a) A hard copy of the script must be generated.
b) The script generated becomes the official script.
c) Telephone scripts must be immediately reduced to writing by the pharmacist.
d) Printing out a faxed or e-transmitted script does not make it an official script.
a) A hard copy of the script must be generated.
b) The script generated becomes the official script.
c) Telephone scripts must be immediately reduced to writing by the pharmacist.
Name the three exceptions for which the DEA allows filling a faxed or telephoned schedule 2 script.
Scripts for a C2 narc compound to be directly administered parenterally.
Scripts for LTC residents.
Scripts for hospice enrolled patients.
What constitutes an emergency schedule 2 e-script usage?
CS usage needed immediately for intended user.
No alternative treatment.
Impossible to receive written order prior to dispensing.
What if a pharmacist does not receive a written script for an emergency C2 e-script at the end of 7 days?
Pharmacist must notify the nearest DEA admin office.
What if a pharmacist does not receive a written script for an emergency S2 e-script at the end of 7 days?
Pharmacist must notify the nearest DEA admin office.
What does NPI stand for and what is it’s purpose?
National Provider Identifier
Identifies every member of the healthcare system.
For a script to qualify as tamper-resistant, it must contain three features. They prevent:
Unauthorized copying of complete/blank script.
Erasure or modification of info written.
Counterfeit script forms.
Name the 4 industry recognized features designed to prevent Unauthorized copying of a complete blank or script.
Anti-Copy Watermark
UV Fiber Security
Hidden Messages
Anti-Erasure Background
Name the 3 industry recognized features designed to prevent Erasure or modification of info written on the script by the practitioner.
Anti-Erasure Background
Secure Rub
Toner Bond Security
Name the 5 industry recognized features designed to prevent Usage of counterfeit script forms.
Anti-Copy Watermark UV Fiber Security Secure Rub Unique Production Batch # Security Warning Band
Which of the following is an industry recognized feature designed to prevent erasure or modification of info written on the script by the practitioner?
a) Anti-Copy Watermark
b) Anti-Erasure Background
c) Secure Rub
d) Toner Bond Security
b) Anti-Erasure Background
c) Secure Rub
d) Toner Bond Security
Which of the following is an industry recognized feature designed to prevent unauthorized copying of a complete blank or script?
a) Toner Bond Security
b) Anti-Erasure Background
c) Anti-Copy Watermark
d) Secure Rub
b) Anti-Erasure Background
c) Anti-Copy Watermark
Which of the following is an industry recognized feature designed to prevent usage of counterfeit script forms?
a) Security Warning Band
b) Secure Rub
c) Anti-Erasure Background
d) Unique Production Batch #
a) Security Warning Band
b) Secure Rub
d) Unique Production Batch #
Which of the following is an industry recognized feature designed to prevent unauthorized copying of a complete blank or script?
a) Hidden Message
b) Unique Production Batch #
c) UV Fiber Security
d) Security Warning Band
a) Hidden Message
c) UV Fiber Security
Which of the following is an industry recognized feature designed to prevent usage of counterfeit script forms?
a) Anti-Erasure Background
b) Anti-Copy Watermark
c) Hidden Message
d) UV Fiber Security
b) Anti-Copy Watermark
d) UV Fiber Security
What info is included in the Header of a prescription?
Dr.’s name, address, phone, license type and DEA #.
Patient’s full name and address.
Date written.
What info is included in the Body of a prescription?
Drug name, strength, dosage, form, and qty.
Instruction for use (sig).
Refill info.
What info is included in the Signature of a prescription?
Dr.’s signature written in ink.
Which of the following is incorrect regarding a schedule 2 script?
a) It may be filled/dispensed pursuant to a written script
b) It may be filled/dispensed pursuant to a telephoned script in an emergency situation
c) It may be filled/dispensed pursuant to a faxed script
d) all of the above are correct
d) all of the above are correct
Which piece of information is not required on a hospital schedule 2 drug order?
a) The prescribing practitioners DEA #
b) The patient’s room #
c) The patient’s hospital billing #
d) all of the above are required
a) The prescribing practitioners DEA #
