TBLs and Lectures Flashcards
can a licensed PA write a standing order in NYS for pharmacists to immunize (for anyone)
No, only MD or NP. If it is for one patient, then PA can also write it
Which vaccine can a pharmacist NOT give in NYS
- influenza to 6 yo
- pneumo for 58 yo
- rabies for 19 yo
- hepatitis to 22 yo
- all are allowed
no rabies!
can a pharm tech vaccinate an 11 yo for covid
nope
immunization records must be kept for _______ years per NYS law
5 years, medicaid is 6 years, medicare is 10 years
when can a pharm tech compound a med
in outpatient pharmacy owned by hospital
what is the NYS ratio of registered pharm techs : pharmacist
4:1
registered pharm techs must be _______ years old
18
can a certified pharm tech reconstitute an antibiotic in a community pharmacy
NO
which are hipaa violations if you need more information for a script
1. announcing a patient needs to come back to pharmacy for their rx over speakers
2. if you have phone #, then you can call them to come back to the pharmacy for the rx or leave a msg in their voicemail
both!
if a person comes in to pick up for their neighbor who lives alone w no phone # and cannot leave the house, what can you do
1. counsel neighbor?
2. only give patient the rx?
3. only give to neighbor if they show ID
you can fill the rx AND counsel the neighbor
can u look up shakiras profile at the hospital
no! do not shake those hips unless she gives you permission!
SPongebob is head of household for his wife sandy and their squirrel sponge kids. Can you give the kids under 18 and sandys med lists to spongebob
no, you can mail them tho to address on record
erie county DOH gives u a ring and asks for all covid and flu shots given so far. How do u hand over the info? (consider emergency)
you can hand over information you either identified or de-identified, if not emergency, then need warrant
the administrator for a nursing home you jusut signed a contract with wants a silly little discount on pharmacy MERCH. Is this ok? If not what does it violate
NO, violates medicaid section 515.2 and u shall not oblige!`
Which are NYS False Claims Act violations
1. billing for non-existent RX
2. rph makes up patients njury to bill NYS compensaton claim
3. billing medicaid for first shingles shot when they have not received the second
4. offering same employee discount to employees of a nursing home you vendor
1,2,4
lets play, is it fraud?
- rx for crestor #30, you only have #20 (no!), you tell patient you will have balance in 3 days and bill medicaid tonight
- rx for lipitor 20mg #30, 5 RF. Pt requests 60 bc theyre going to ur moms house on vacay, you bill medicaid for 30 today and for 30 27 days later
3.medicaid underpays a pharmacy and it is not self-disclosed to the Office of NYS Inspsector General - ONYSrx for #30 lipitor 20mg, yo bill medicaid for #10 at a time
- FRAUDDD
- 10000% fraud
- not fraud, only have to report if medicaid OVERPAYS you
- F R A U D
define qui tam
in hiring a lawyer, an employee of yours acts as a whistleblowerrrrrrr against you for false claims act (basically whistleblowing)
Case: a case is brought against your employer, james bond, for coding up claims for patients in a nursing home, booooo. What acts are associated with this case?
1. Federal False Claims Act
2. Lanham Act
3. NYS false Claims Act
4. Social Security Act
5. Medicare Part D
all except Lanham which protects the owner of a federally registered mark against the use of similar marks if such use is likely to result in consumer confusion (the little TM we see next to brands essentially)
wind blows dumpster open and paperwork is lost into the woods. What do yo do
We dont know how many patients it is for and you report it to HHS within 60 days of the incident and show it on public news at the same time
dumpster blows over and it is for <500
send letter to people within 60 days and report to HHS within 60 days of the end of the year
registered vs certified pharm tech?
certified = passes the exam (CPTB or NHA) registered techs are one step further and are registered to NYS = work in hospital or pharmacies owned by hospital
What is EPT, is it covered?
expedited partner treatment for chlamydia gonorrhea and trich. It goes under patients name but can be under partners insurance. If under partners insurance, needs to go under partners name and isnt anonymous
false claims act
combats healthcare fraud, mainly medicare and medicaid billing fraud
fraud enforcement and recovery act
increases funding for federal financial fraud enforcement and expands liability under false claims act
affordable care act
tough rules and sentencing for criminals, enhanced screening, new resources to slow spending in medicare and medicaid. Gives states an additional 10% of damages recovered
deficit reduction act
establish liability to the state for false or fraudulent claims and awards qui tam
Marijuana regulation and taxation act
allows people to grow weed in their home
what is the one FDA approved CBD product
epidiolex
cannabinoid limit in food/beverage
25mg per individually packaged product, no more than 75mg per individual serving
age and plants per person if growing at home
> 21 and 6 plants per person, max of 12 plants total regardless of # people in house
what is tax % on medical marijuana
7%
