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PRACTICE QUESTIONS

Q. When may a pharmacist decline to fill a prescription?
A.

A pharmacist may decline to fill a prescription if the pharmacist, in his or her professional judgment, believes that:

  • Filling the prescription would be unlawful;
  • Filling the prescription would be potentially harmful to the medical health of the patient;
  • The prescription is fraudulent; or
  • The prescription is not for a legitimate medical purpose.

Before declining to fill a prescription, the pharmacist must contact the prescriber to discuss the pharmacist’s concerns regarding the prescription.  Before speaking with the prescriber, the pharmacist may:

  • Keep the prescription and not return it to the patient;
  • Return the prescription to the patient;
  • Make a copy of the prescription and return the prescription to the patient;
  • Dispense no more than a three-day supply of the drug while trying to reach the prescriber [NOTE: a pharmacist may not dispense any CII until he or she speaks with the prescriber].
     

Authority:  NAC 639.753

 
Q. What should a pharmacist do if he or she determines that a prescription is unlawful, fraudulent, or not for a legitimate purpose?
 
A. If a pharmacist determines that a prescription is unlawful, fraudulent, or not for a legitimate purpose, the pharmacist shall not fill the prescription, shall retain the prescription, and may not return it to the patient.
 

Authority:  NAC 639.753(4)

 
Q. How long is a pharmacy required to keep prescription records?
 
A. The Board of Pharmacy requires that all pharmacy records, including prescriptions, be retained on file for at least two years.
 

Authority:  NAC 639.236(1)

 
Q. Can a pharmacist accept a faxed CII prescription?
A.

A CII prescription can be faxed by a practitioner to a pharmacy only when:
 

  • The controlled substance will be compounded for the direct administration to a patient by parenteral, intravenous, intramuscular, subcutaneous or intraspinal infusion;
  • The controlled substance is issued to a resident of a facility for long-term care; OR
  • The controlled substance is issued to a patient enrolled in a licensed program that provides hospice care.
     

Authority:  NAC 639.711(1)(a),(b), and (c)

 
Q.

How many Pharmaceutical Technicians are allowed for each pharmacist on duty?
 

A. The ratio of pharmaceutical technicians to pharmacists cannot exceed three to one.  Pharmaceutical technicians-in-training count against this ratio, but interns do not.
 

Authority:  NAC 639.1371

 
Q.

How do I get a patient profile from the Controlled Substances Task Force?
 

A. The Prescription Controlled Substance Abuse Prevention Task Force is the ONLY agency with access to patient drug utilization. Please contact them at (775) 687-5694 or fax the Task Force a request at (775) 687-5161. DO NOT refer anyone to the Board of Pharmacy, as the Board does not have access to patient information.
 

Authority: 

 
Q.

Where can I complain if I have problems or concerns with the way an insurance company has acted, including delays with processing or denials for pharmacy claims?
 

A.

The Nevada Insurance Commissioner has invited complaints regarding pharmacy claims to be sent to her office. Click here for the Insurance Complaint Form
 

Authority: 

 
Q.

Does a prescription for Accutane (Isotretinoin) need an I-PLEDGE sticker?
 

A. No, a prescription for Accutane does not need an I-PLEDGE sticker in order to fill it. Since the sticker is not required, phone in prescriptions of Accutane are also allowed. If you have more questions, please visit the FAQ page on the I-PLEDGE website or call their toll free hotline at 1-866-495-0654 for more information.
 

Authority: 

   
Q.

Is the Board of Pharmacy involved in the process of licensing and regulating medical marijuana?
 

A. The Board of Pharmacy has no jurisdiction over the medical use of marijuana. Please contact the Department of Agriculture at (775) 688-1880 for further information.
 

Authority: 

   
Q.

What is the National Provider Identifier (NPI) number?
 

A. All pharmacists must have an individual NPI number by May 23, 2007. Applications to obtain an NPI began on May 23, 2005. The National Provider Identifier (NPI) number is a unique, government-issued, standard identification number for individual health care providers and provider organizations like clinics, hospitals, schools and group practices. The government has contracted with an external company for processing applications and developing these random 10-digit numbers for applicants. If you need an NPI number you can apply at the NPPES website. Please refer to the FAQ website and use NPI numbers for your search term to find answers to more of your questions.
  

Authority: 

   
Q.

Are partial fills of CIII and CIV prescriptions considered refills under Nevada law?
 

A. No, under Nevada law a partial fill of CIII and CIV prescriptions are not considered to be refills. A complete filling of a prescription or a complete filling of a refill of a prescription does not occur until all the drug authorized by the practitioner has been provided. Thus, a prescription authorizing 30 dosage units is not deemed a complete filling or refilling until 30 dosage units have been dispensed, whether dispensed in one filling of 30 or in three partial fills of 10 each.
 

Authority:  21 CFR §1306.22(a) & NAC 453.460

   
Q.

When is a positive ID required?
 

A.

The general rule is that for the first filling of any controlled substances prescription for a patient, a pharmacy must obtain from the patient a current and valid form of identification issued by a federal, state, or local governmental agency that contains a photograph of the patient.   A positive ID is not required when:

  • The prescription is paid for, in whole or in part, by an insurer;
  • A prescription is for a patient who has had a prescription for the same controlled substance previously filled by the pharmacy; OR
  • The pharmacy is a part of a health care facility where the patient is being treated.
     
NOTE:  When the pharmacy obtains the identification, it must make a copy of the identification and keep the copy with the prescription OR enter the identification number on the prescription, the refill log, the counseling log, or a computer record regarding the patient.
 

Authority:  NAC 639.748

   


 

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