We are currently handling one such federal criminal case for a pharmacist and it is something our client never thought he would ever face in his career. Cases like this are being charged across the country. The theory being used in this case and other cases is that the pharmacist deliberately ignored red flags on questionable prescriptions -- not that they "knew" is was not legitimate.
The federal regulation for "corresponding responsibility" means that the pharmacist who fills the prescription has the same duty as the physician to determine legitimate medical need for a Schedule II prescription. Thus, pharmacists in today's world need to go far beyond determining that the prescription is valid, that a physician issued it and that the prescription has not been tampered with at all, or that the patient is obtaining prescriptions from multiple physicians. Pharmacists need to look at any red flags and document follow up on anything suspicious as well as confirm diagnoses that support the medication being dispensed and show that he or she exercised sound professional judgment.
The California Board of Pharmacy is holding a joint training with the DEA on Pharmacist's Corresponding Responsibility and California's CURES program. It will be held on July 25, 2013 in Downey, California and pharmacists and pharmacy technicians can register online. If you cannot attend that seminar, I recommend watching some of the other Pharmacy Board online seminars that have been posted.
Physicians and the California Medical Association are concerned about the aggressiveness of the DEA and Pharmacy Board in having pharmacists challenge medical necessity for pain medications that are controlled substances. They are asking physicians to contact them if and when they cannot fill medically necessary prescriptions.
Pharmacies such as Walgreens (who just paid the U.S. a $80 million fine for not having its pharmacists meet their corresponding responsibilities) are asking for information on diagnosis, ICD-9 codes, expected length of therapy and medications previously tried and failed. However, what does the pharmacist do if the information provided is not accurate? How far does the pharmacist need to go?
Posted by Tracy Green, an experienced health care and pharmacist attorney.
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