Reading 15 Flashcards
Where in the Indiana Code are health professions’ standards of practice discussed?
Professions and Occupations (Title 25)
According to IC 25-1-9-2, “practitioner” mean an individual who holds what (5 lines)?
- an unlimited license, certification, or registration;
- a limited or probationary license, certificate, or registration;
- a temporary license, certificate, registration, or permit;
- an intern permit; or
- a provisional license;
issued by the board regulating the profession in question, including a certificate of registration issued under IC 25-20.
IC 25-0.5-11 lists ___ boards or committees for which the term “practitioner” can apply to
18
True or false: in Indiana, you are only under the purview of your given board if you are actively practicing.
false; if you have a license, you are still under purview of the board (regardless of actual practice status)
What are the 15 general actions a practitioner can be disciplined for?
Just a warning that I am trying to simplify, these are NOT the complete descriptions
- fraud/deception (either in obtaining a license, during the course of services, or related to billing)
- convicted of a crime with direct bearing on ability to practice or is harmful to the public
- knowingly violating federal/state laws and rules regulating the profession
- practicing even though incompetent
- lewd/immoral conduct in delivery of public services
- allowing your name/license to be used by some unqualified
- disciplinary action taken against you in another state/jurisdiction
- drug/device diversion
- knowingly giving narcotics/dangerous drugs to an addict
- non-compliance with an order imposing a sanction (i.e., working on a suspended license)
- sexual contact with a patient
- knowingly collecting/attempting to collect payment from a patient that an HMO should pay
- assisting in an act that is grounds for disciplinary sanctions
- failing to report child abuse
- failing to provide information on suspected human trafficking and/or failure to provide correct information requested by IPLA
Pharmacists’ licenses are considered to be ______________, meaning they cannot be taken away without due process.
property rights
If you are called for a hearing in front of the Board of Pharmacy, you have the right to request a ______________ before having a contested hearing before the board to potentially resolve the situation.
settlement conference
True or false: the Board of Pharmacy does not have to grant a settlement during a settlement conference.
true
True or false: information on sanctions and complaints is available to the public.
true; unless the hearing is closed, all information can be heard by attendees at the board meeting and is included in the meeting minutes
All complaints and final orders can be found on the _____________________ website.
Indiana license litigation
True or false: if the Board of Pharmacy decides to revoke your license, this is only temporary.
false; it is taken away permanently
You can apply for a new license ___ years from the date of revocation.
7
True or false: when applying for a new license after revocation, you do not need to worry about re-taking your exams.
false; all exams must be re-taken since a new license is being issued with a new number
In general, your license is suspended _____________.
indefinitely
In addition to a standard suspension, the board can also summarily suspend a practitioner’s license for __ days.
90
True or false: a pharmacist can be summarily suspended for an incidence that occurred in the past.
false; must be a current or imminent danger to the public (i.e. only for active issues that may impact your ability to practice)
Summary suspensions, also called emergency suspensions, can be renewed for up to __ days if necessary while waiting for a hearing or appeal.
90
Which practitioners must be notified about the allegations and the summary suspension hearing before an emergency suspension can be done?
- physicians
- veterinarians
- physician assistants
True or false: a practitioner whose license is placed on probation cannot practice.
false; can still practice, but must meet their probation conditions
What is a letter of reprimand?
a written record indicating a license has been disciplined and what precisely the board found inappropriate
What is a censure?
a verbal expression of disapproval (i.e. you appear in front of the board and they tell you what you did wrong)
The board may assess fines of up to $_______ for listed violations in IC 25-1-9-4, except for physical or mental disability.
1000
What can happen if a practitioner fails to pay a board fine within the set time?
the board can suspend their license without a hearing (however, they can’t suspend due to inability to pay)
True or false: the board must hand out similar sanctions for similar conduct.
mostly true; the board is allowed to significantly depart from previous decisions so long as their findings are explained
Instead of going in for a hearing, a practitioner may _______ their license.
surrender
True or false: the board may refuse to accept a license’s surrender and require a hearing instead.
true; additionally, a practitioner must petition the board for surrender without knowing what conditions the board may impose on the surrender
Which 5 conditions may be imposed when the board issues a probationary license?
- Report regularly to the board upon the matters that are the basis of the discipline of the other state or jurisdiction
- Limit practice to those areas prescribed by the board
- Continue or renew professional education
- Engage in community restitution or service without compensation for a number of hours specified by the board
- Perform or refrain from performing an act that the board considers appropriate to the public interest or to the rehabilitation or treatment of the applicant
True or false: the board may require an applicant for licensure to appear before the board before issuing a license.
true; IC-25-1-9-17
What conditions may be imposed on a probationary license?
- regularly report to the board
- limit areas of practice
- continue or renew professional education
- engage in community restitution or services without pay
- perform or refrain from performing an act that the board considers appropriate
How must all prescriptions for controlled substances be issued in Indiana?
electronically
Which prescriber types are not included in the electronic prescribing requirement for controlled substances in Indiana?
veterinarians and medical residents
True or false: there are no exceptions to a controlled prescription being electronic…if it’s not, it’s invalid in Indiana.
false; there are exceptions because there will be times when a prescriber can’t reasonably be expected to provide an electronic prescription for a patient
In what 7 situations may a non-electronic controlled substance prescription be warranted in the state of Indiana?
- prescriber is unable to transmit an electronic prescription due to either technological/electronic failure or inability of the dispenser to receive/process an electronic prescription
- prescriber issues a prescription to be dispensed by a pharmacy outside Indiana
- prescriber and pharmacist are the same entity
- the prescriber issues a prescription that meets any of the following:
- elements not supported by the technical standards developed by the NCPDP
- FDA requires the prescription to contain certain elements that cannot be supported in an e-script
- the prescription is non-patient specific in response to a public health emergency or another instance allowable under state law and that requires a non-patient specific standing order
- the prescription is issued under a research protocol
- prescriber has a waiver or renewal of a previously received waiver from the board in accordance with rules under section 9
- the board has determined that an e-script would be impractical and cause delay, adversely impacting the patient
- prescriber reasonably determines that it would be impractical for the patient to obtain an e-script in a timely matter and that the delay would adversely impact the patient’s medical condition
In which document can you find information about emergency waivers for controlled substance electronic prescribing?
document #20-628(E) in the Indiana Register
How can we verify a prescriber’s e-prescribing waiver status?
Indiana’s license search and verify function
True or false: prescribers are not required to write their waiver number on their prescription or indicate that a waiver has been applied for.
false; they must do this AND write their DEA number and CSR on the prescription
The term “telemedicine” does not include a healthcare service provided by what entities?
- an employee of a practitioner; or
- an individual who is employed by the same entity that employs the practitioner; who is performing a health care service listed in section 2.5(2), 2.5(3), or 2.5(4) of this chapter under the direction and that is customarily within the specific area of practice of the practitioner
True or false: having a patient fill out an internet questionnaire is considered telemedicine.
true
What drug(s) cannot be prescribed by telemedicine if a patient has not been previously examined by the prescriber in person?
opioids (unless it’s a partial agonist used to treat/manage opioid dependence) and abortion-inducing drugs
Can a pharmacist be held responsible for filling an opioid prescription they did not know was done via telemedicine?
nope (and we often have no way of knowing)
What is required for a provider located outside of Indiana to be able to issue prescribe for an Indiana patient via telemedicine?
they and their employer or contractor have to certify in writing to IPLA that they agree to be subject to Indiana courts and laws (AKA “certification”)
When does a prescriber need to renew their certification? What about the employer/contractor?
prescriber: when they renew their license
employer: only at the time of initial certification
Which individuals are limited to a 7-day opioid supply in Indiana?
- first-timers from that prescriber
- individuals under 18
- animals
When does Indiana’s 7-day opioid provision NOT apply?
when issued for cancer, palliative care, treatment for substance use disorder, a condition exempted by the medical licensing board, or if in the prescriber’s professional judgement the patient needs more than a 7-day supply
If a prescriber determines an opiate is the only appropriate medication and issues a prescription for more than a 7 day supply using one of the previously listed reasons, they must document this in the patient’s ____________.
medical record
When issuing prescriptions, prescribers are required to write for a _______ quantity than they initially intended, if requested by the patient, personal or legal patient representative, or patient guardian.
lesser
If a patient receiving an opioid prescription, a personal or legal patient representative, or a patient guardian asks a pharmacy to dispense less than the amount the prescription was written for, the pharmacist is required to dispense the _______ amount.
lesser
True or false: pharmacists do not need to document partial opioid fills.
false
For CIIs, if a prescription is initially partially filled on a patient or representative’s request, the remaining portions can be provided within __ days of the date the prescription was written.
30
For C-IIs, Indiana law only specifies partial filling for ___________.
opioids
Which practitioners are allowed prescribe through telemedicine?
- physicians
- PAs
- APRNs
- optometrists
- podiatrists
What are the 6 primary sanctions available to the Board of Pharmacy?
- revocation
- suspension
- probation
- letter of reprimand
- censure (verbal reprimand)
- fine
What can be prescribed via telemedicine?
- legend drugs
- partial opioid agonists (buprenorphine), usually buprenorphine/naloxone combination
- medical devices (can do ophthalmic devices)
- controls
What types of C-IIs can be partially refilled?
opioids (NOT Vyvanse or Adderall)
