In California, can OOS C-II scripts be filled?

[eddie269]

I've asked 5 different pharmacists at work and have gotten mixed results.

For example, we get a script for Concerta from Oregon (office is in Portland, OR) written by an Oregon MD. It is dated, signed, has all the proper items on the script. But is it legal to fill in California?

Some say yes as long as it's on a California approved security rx pad.

Some say no because only a California licensed prescriber can write for C-II.

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[daabc]

I've asked 5 different pharmacists at work and have gotten mixed results.

For example, we get a script for Concerta from Oregon (office is in Portland, OR) written by an Oregon MD. It is dated, signed, has all the proper items on the script. But is it legal to fill in California?

Some say yes as long as it's on a California approved security rx pad.

Some say no because only a California licensed prescriber can write for C-II.

Don't know the answer, but I do know the pharmacists at work will not fill a C-II that is out of state.

Although all the out of state C-II I have seen do not meet the requirements in California. Its always missing a few things, since the md mainly have what his state requires on his rx pad.

 

[Blago]

OOS CII prescriptions can be filled if and only if it's from a CA licensed physician, written on a security script that satisfies the CA CII requirements.

Technically a MD can be licensed in both Oregon and California, but if he/she practices in the summer in Oregon then he/she can write a CII script provided that she/he has a valid DEA and California license number.

It makes total sense when you think about "Drug diversion prevention". It's just a way for state to track a MD's CII count.

 

[meister]

Out-of-state CII prescriptions can be filled in California. State law is explicit about this.

http://www.pharmacy.ca.gov/licensing/prescribe_dispense.shtml

Can a California pharmacy fill a controlled substance prescription from an out of state prescriber for a patient in California?

California Code of Regulations section 1717(d), in accordance with Business and Professions Code section 4005(b), allows written and oral prescriptions from out-of-state prescribers. Pharmacies must verify the prescription. The pharmacist should use his or her best professional judgment when filling out-of-state prescriptions.

(b) Notwithstanding any provision of this chapter to the contrary,
the board may adopt regulations permitting the dispensing of drugs
or devices in emergency situations, and permitting dispensing of
drugs or devices pursuant to a prescription of a person licensed to
prescribe in a state other than California where the person, if
licensed in California in the same licensure classification would,
under California law, be permitted to prescribe drugs or devices and
where the pharmacist has first interviewed the patient to determine
the authenticity of the prescription.

(d) A pharmacist may furnish a drug or device pursuant to a written or oral order from a prescriber licensed in a State other than California in accordance with Business and Professions Code Section 4005.

It's perfectly legal as long as the pharmacist talks to the patient to verify its authenticity and exercises professional judgment. In other words most over-worked stressed out wimpy RPhs will use it as an excuse to tell them they can't fill it.

 

[meister]

...

 

[StevePerry]

I've asked 5 different pharmacists at work and have gotten mixed results.

For example, we get a script for Concerta from Oregon (office is in Portland, OR) written by an Oregon MD. It is dated, signed, has all the proper items on the script. But is it legal to fill in California?

Some say yes as long as it's on a California approved security rx pad.

Some say no because only a California licensed prescriber can write for C-II.

Listen to the pre-pharmer...

 

[Momus]

CII.. don't listen to meister.. CIII-V ok as long as you verify it

pre-pharm is right

 

[meister]

CII.. don't listen to meister.. CIII-V ok as long as you verify it

pre-pharm is right

I'm quoting the law book and the CA code of regulations which are both non-specific with respect to "controlled substances," do you have a source that states CII is treated differently in this matter?

 

[Ilikechemicals]

Can a California pharmacy fill a prescription for a Schedule II controlled substance that was written by an out-of-state prescriber for an out-of-state patient? What about Schedule III thru V controlled substances?

Yes, so long as the prescription conforms to the requirements for controlled substance prescriptions in the state in which the controlled substance was prescribed. The prescription must be delivered to the patient in the other state. Prescriptions for Schedule II controlled substances must be reported to CURES and effective January 1, 2005, prescriptions for both Schedule II and III must be reported to CURES.


http://www.pharmacy.ca.gov/licensing/prescribe_dispense.shtml#sb151

 

[meister]

Can a California pharmacy fill a prescription for a Schedule II controlled substance that was written by an out-of-state prescriber for an out-of-state patient? What about Schedule III thru V controlled substances?

Yes, so long as the prescription conforms to the requirements for controlled substance prescriptions in the state in which the controlled substance was prescribed. The prescription must be delivered to the patient in the other state. Prescriptions for Schedule II controlled substances must be reported to CURES and effective January 1, 2005, prescriptions for both Schedule II and III must be reported to CURES.


http://www.pharmacy.ca.gov/licensing/prescribe_dispense.shtml#sb151

I knew there was a more specific answer about this but I thought maybe they had changed the regulation since I was last in a pharmacy in CA.

Federalism can be really dumb sometimes.

 

[eddie269]

Can a California pharmacy fill a prescription for a Schedule II controlled substance that was written by an out-of-state prescriber for an out-of-state patient? What about Schedule III thru V controlled substances?

Yes, so long as the prescription conforms to the requirements for controlled substance prescriptions in the state in which the controlled substance was prescribed. The prescription must be delivered to the patient in the other state. Prescriptions for Schedule II controlled substances must be reported to CURES and effective January 1, 2005, prescriptions for both Schedule II and III must be reported to CURES.


http://www.pharmacy.ca.gov/licensing/prescribe_dispense.shtml#sb151

ok so i emailed a Cali inspector and he basically told me the same thing.

OOS rx complies with that OOS CII security rules and is filled for a patient from that same state (i.e. visiting cali but from oregon) then it's ok.

 

[kbv]

OP, you should have talked to your pharmacy manager or better, your pharmacy supervisor. Blago is right; meister is wrong.

 

[Marcus X]

OP, you should have talked to your pharmacy manager or better, your pharmacy supervisor. Blago is right; meister is wrong.

This guy's awesome.

 

[meister]

People will use any excuse to not fill a script it seems. The entire premise behind the Controlled Substances Act is ******ed and it's a shame people don't get the meds they need because of ass-backwards state regulations.

 

[NLTV07]

Hello Eddie
According to Dr. Weissman law book...the only one exception you can fill CII rx in CA from OOS is that is an OOS patient, who wish to have their scripts filled by out-of-state mail order operation...In other word, patient A is living in Oregan and MD is in Oregan but she/he can mail to mail order pharmacy in CA and mail order in CA fills this script and mail back to patient in Oregan.... Unless, patient is terminall ill patient. It may be different requirement...
If you want to clarify this...look :" A Guide to California Community Pharmacy Law" 7th Edition by Dr. Fred Weissman---page 301
I hope this help

 

[Farmercyst]

Now, I'm willing to be wrong, but my understanding is that you could fill an OOS CII for a pt in CA if:
The MD would be able to write CII's if they were licensed in CA

4005. Adoption of Rules and Regulations
(b) Notwithstanding any provision of this chapter to the contrary, the board may adopt regulations permitting the dispensing of drugs or devices in emergency situations, and permitting dispensing of drugs or devices pursuant to a prescription of a person licensed to prescribe in a state other than California where the person, if licensed in California in the same licensure classification would, under California law, be permitted to prescribe drugs or devices and where the pharmacist has first interviewed the patient to determine the authenticity of the prescription.(c) The adoption, amendment, or repeal by the board of these or any other board rules or regulations shall be in accordance with Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.

And the RX in question met the requirements of CA controlled substance RX and was printed by a company authorized by the state to do so.

 

[olddoctor65]

Actually the exception is if a calfornia resident receives an out of state rx for a c2 while seeing an out of state physician in the state where that physician practices as long as the rx is written on rx pad that meets that states requirement a "diligent" pharmacist may fill the rx. California residents are treated better than the visitors.

 

[Sine Cura]

The out-of-state provision where California controlled substance prescription forms need not be used refers to "delivery to a patient in another state," i.e., mail order, independent of whether the patient is a California resident.

California regulation does not allow pharmacies to dispense directly to patients any written prescriptions for controlled substances prepared on forms that do not conform to the California controlled substance prescription form requirement (Section 11164 of the Health and Safety Code). It doesn't matter if it's CII, CIII, CIV, or CV. There is nothing I have seen that explicitly prohibits out-of-state prescribers from ordering these forms though, but security printers probably want a California license in order to issue them.

This has been addressed multiple times by the CA BOP, including their newsletter:

http://www.pharmacy.ca.gov/publications/10_sep_script.pdf

Q. Can I fill a controlled substance prescription written by a prescriber in another state if it is written on a California security prescription form? Can I fill it if it is not written on a California security prescription form?

A. The answer to the first question is yes, but the answer to the second question is not so simple. If it is not written on a California security prescription form, H&SC section 11164.1 directs that the prescription must conform to the laws of the state where the prescription was written. California pharmacists may dispense Schedule III-V controlled substances pursuant to a prescription issued by a prescriber in another state, but prescriptions for Schedule II medications may be dispensed only for delivery to a patient in another state. In other words, the pharmacist cannot dispense a Schedule II controlled substance directly to the patient in California if the prescription is not on a California security prescription form.

What this really means is that pharmacies cannot legally dispense directly written Schedule III-V prescriptions that do not conform to the security requirements regardless of whether the prescriber is out-of-state (11164.1(a) refers solely to the "mail-order" or delivery context, 11164.1(b) refers to direct dispensing of prescriptions from out-of-state prescribers), but they are allowed to dispense oral prescriptions (not facsimile) regardless of whether the prescriber is out-of-state, so you can verify the non-compliant CIII-CV written Rx orally and treat it as an oral prescription, but you can't do the same with a CII.


See below for relevant sections:

Title 16, Section 1717 (California Code of Regulations)
(d) A pharmacist may furnish a drug or device pursuant to a written or oral order from a prescriber licensed in a State other than California in accordance with Business and Professions Code Section 4005.

4005. Adoption of Rules and Regulations (Business and Professions Code)
(b) Notwithstanding any provision of this chapter to the contrary, the board may adopt regulations permitting the dispensing of drugs or devices in emergency situations, and permitting dispensing of drugs or devices pursuant to a prescription of a person licensed to prescribe in a state other than California where the person, if licensed in California in the same licensure classification would, under California law, be permitted to prescribe drugs or devices and where the pharmacist has first interviewed the patient to determine the authenticity of the prescription.

11164. (Health and Safety Code)
Except as provided in Section 11167, no person shall prescribe a controlled substance, nor shall any person fill, compound, or dispense a prescription for a controlled substance, unless it complies with the requirements of this section.
(a) Each prescription for a controlled substance classified in Schedule II, III, IV, or V, except as authorized by subdivision (b), shall be made on a controlled substance prescription form as specified in Section 11162.1 and shall meet the following requirements:
(1) The prescription shall be signed and dated by the prescriber in ink and shall contain the prescriber's address and telephone number; the name of the ultimate user or research subject, or contact information as determined by the Secretary of the United States Department of Health and Human Services; refill information, such as the number of refills ordered and whether the prescription is a first-time request or a refill; and the name, quantity, strength, and directions for use of the controlled substance prescribed. (2) The prescription shall also contain the address of the person for whom the controlled substance is prescribed. If the prescriber does not specify this address on the prescription, the pharmacist filling the prescription or an employee acting under the direction of the pharmacist shall write or type the address on the prescription or maintain this information in a readily retrievable form in the pharmacy.

11164.1. (Health and Safety Code)
(a) (1) Notwithstanding any other provision of law, a prescription for a controlled substance issued by a prescriber in another state for delivery to a patient in another state may be dispensed by a California pharmacy, if the prescription conforms with the requirements for controlled substance prescriptions in the state in which the controlled substance was prescribed.
(2) All prescriptions for Schedule II, Schedule III, and Schedule IV controlled substances dispensed pursuant to this subdivision shall be reported by the dispensing pharmacy to the Department of Justice in the manner prescribed by subdivision (d) of Section 11165.
(b) Pharmacies may dispense prescriptions for Schedule III, Schedule IV, and Schedule V controlled substances from out-of-state prescribers pursuant to Section 4005 of the Business and Professions Code and Section 1717 of Title 16 of the California Code of Regulations.

 

[mikejones123]

People will use any excuse to not fill a script it seems. The entire premise behind the Controlled Substances Act is ******ed and it's a shame people don't get the meds they need because of ass-backwards state regulations.

don't listen to anything meister says......he seems to be a drug addicted troll

 

[farmadiazepine]

The quick answer is on the bottom, but read the information from the 3 sources below.

____________________________________________________________________________

http://www.pharmacy.ca.gov/licensing/prescribe_dispense.shtml

MORE SB 151 QUESTIONS AND ANSWERS
Can a California pharmacy fill a controlled substance prescription written by an out of state prescriber for a patient that is a California resident?

California Code of Regulations section 1717(d), in accordance with Business and Professions Code section 4005(b), in general, allows written and oral prescriptions from out-of-state prescribers. Health and Safety Code 11164.1 allows Schedule CIII-V written by an out of state prescriber to be dispensed, but CII may not unless delivered to the California resident while out of state. Written controlled substance prescriptions must be on a form that meets the requirements for controlled substance prescriptions in the state in which it was prescribed. Pharmacies must verify the prescription. The pharmacist should use his or her best professional judgment when filling out-of-state prescriptions.

Updated 12/19/13

Can a California pharmacy fill a controlled substance prescription written by an out of state prescriber for a patient that resides out of state?

Health and Safety Code 11164.1 allows a California pharmacy to deliver the controlled substance to the patient in another state. The prescription must conform with controlled substance prescription form requirements of the state in which it was written. Schedule III, IV, and V controlled substances may be dispensed pursuant to Health and Safety Code 11164.1(b) but Schedule II must be delivered to the patient in another state per Health and Safety Code 11164.1(a)(1).

Updated 12/19/13

______________________________________________________________________________

http://www.leginfo.ca.gov/cgi-bin/displaycode?section=hsc&group=11001-12000&file=11150-11180

http://codes.findlaw.com/ca/health-and-safety-code/hsc-sect-11164-1.html

Health and Safety Code 11164.1

(a)(1)  Notwithstanding any other provision of law, a prescription for a controlled substance issued by a prescriber in another state for delivery to a patient in another state may be dispensed by a California pharmacy, if the prescription conforms with the requirements for controlled substance prescriptions in the state in which the controlled substance was prescribed.

(2) All prescriptions for Schedule II and Schedule III controlled substances dispensed pursuant to this subdivision shall be reported by the dispensing pharmacy to the Department of Justice in the manner prescribed by subdivision (d) of Section 11165.

(b) Pharmacies may dispense prescriptions for Schedule III, Schedule IV, and Schedule V controlled substances from out-of-state prescribers pursuant to Section 4005 of the Business and Professions Code and Section 1717 of Title 16 of the California Code of Regulations.

(c) This section shall become operative on January 1, 2005.
______________________________________________________________________________

http://www.pharmacy.ca.gov/laws_regs/lawbook.pdf

2015 LAWBOOK FOR PHARMACY
Excerpts from the California Uniform Controlled Substances Act

DIVISION 10. UNIFORM CONTROLLED SUBSTANCE ACT
CHAPTER 1. GENERAL PROVISIONS AND DEFINITIONS

11010. Dispense Defined
"Dispense" means to deliver a controlled substance to an ultimate user or research subject by or
pursuant to the lawful order of a practitioner, including the prescribing, furnishing, packaging,
labeling, or compounding necessary to prepare the substance for that delivery.

______________________________________________________________________________

It seems as if people don't know how to interpret the law, and that's the problem here. The definitions of words also have to be taken into account. The word dispense in the Uniform Controlled Substance Act does not simply means to give a prescription directly to a person, but it means to deliver a controlled substance to an ultimate user pursuant to the lawful order of a practitioner.

The answer is yes, you can fill an out of state prescription for a schedule II drug for an out of state resident as long as the prescription meets the requirements of a scheduled II substance prescription in that respective state. It is the duty of the California pharmacist to verify that all requirements are met for that particular state. No, the schedule II prescription does not have to be issued by a California practitioner, nor does it have to be on a California triplicate, nor does it have to be only for a California resident.

 

[Sine Cura]

Again, the only conditions that permit a non-compliant out-of-state CII written Rx to be filled are that

1) the dispensed prescription is "for delivery to a patient in another state" ("A prescription for a controlled substance issued by a prescriber in another state for delivery to a patient in another state may be dispensed by a California pharmacy..."). This is understood to be "mail order"
2) "the prescription conforms with the requirements for controlled substance prescriptions in the state in which the controlled substance was prescribed" given that it is delivered to a patient in another state, not in general

By "non-compliant" I am referring to non-compliance to the California security prescription requirements.

So if you are saying the California Board of Pharmacy does not know how to interpret the law, there is no point in arguing further.

Q. Can I fill a controlled substance prescription written by a prescriber in another state if it is written on a California security prescription form? Can I fill it if it is not written on a California security prescription form?

A. The answer to the first question is yes, but the answer to the second question is not so simple. If it is not written on a California security prescription form, H&SC section 11164.1 directs that the prescription must conform to the laws of the state where the prescription was written. California pharmacists may dispense Schedule III-V controlled substances pursuant to a prescription issued by a prescriber in another state, but prescriptions for Schedule II medications may be dispensed only for delivery to a patient in another state. In other words, the pharmacist cannot dispense a Schedule II controlled substance directly to the patient in California if the prescription is not on a California security prescription form.

http://www.pharmacy.ca.gov/publications/10_sep_script.pdf

 

[farmadiazepine]

Here is the definition of deliver or delivery

11009. Deliver or Delivery Defined
"Deliver" or "delivery" means the actual, constructive, or attempted transfer from one person to
another of a controlled substance, whether or not there is an agency relationship.

http://www.pharmacy.ca.gov/laws_regs/lawbook.pdf

 

[maria1oh]

The pharmacies on college campuses are where I saw a lot of out of state c2s for ADHD.

 

[HelpfulPharmer1]

A second supporting view regarding comments of this poster who wrote:

1) the dispensed prescription is "for delivery to a patient in another state" ("A prescription for a controlled substance issued by a prescriber in another state for delivery to a patient in another state may be dispensed by a California pharmacy..."). This is understood to be "mail order"
http://www.pharmacy.ca.gov/publications/10_sep_script.pdf

I found:
Source 2: Retrieved 11-07-2015 from link: http://www.pharmacy.ca.gov/licensing/prescribe_dispense.shtml
"Can a California pharmacy fill a controlled substance prescription written by an out of state prescriber for a patient that is a California resident?
California Code of Regulations section 1717(d), in accordance with Business and Professions Code section 4005(b), in general, allows written and oral prescriptions from out-of-state prescribers. Health and Safety Code 11164.1 allows Schedule CIII-V written by an out of state prescriber to be dispensed, but CII may not unless delivered to the California resident while out of state."

Based on the discussion here and law quotations emphasizing delivery to out of state, my decision at retail pharmacy will be like this:
Patient is at my counter with paper for C2. Paper was written on Oregon paper, by Oregon doctor.
I am sorry, the law does not allow me to give you this medication at this counter. I can only mail this to you but chain pharmacy does not mail. My pharmacist friends and I discussed about this and the way to help you now is to take this paper to any pharmacy that can mail. Pharmacist will mail to your family in your state. Your family in your state will mail to California for you. 1 day to your state. 1 more day to California. You get your med in 2 days.

If I am wrong, please kindly share your reasons and supporting law reference. Thank you very much in advance.

Possible answers from patient.
Are you out of your mind? I was born in California, my parents were born in California. I have lived in California for the past 65 years and paid tax until now. I went to a Cancer doctor in Oregon and got this paper. Now you tell me I have to wait for family in Oregon to mail to me?

I will have this law reference ready for this special case.

In summary, I am very very sorry but my hands are tied by the law, you live in California, doctor wrote on Oregon paper, pharmacist can only mail to Oregon. And here is the law reference. Please forgive me...

Source 2: Retrieved 11-07-2015 from link: http://www.pharmacy.ca.gov/licensing/prescribe_dispense.shtml