Law question??

[killingbill]

in the state of new jersey, if someone comes in with a script for a C2, say percocet, with a quantity of 90. , take 1 tablet three times a day. say the insurance covers only 30 at a time. if the patient wanted only what the insurance covers, is a new script required as this would be considered a partial fill, or can just 30 be dispensed then the script is dead?

---

Members don't see this ad.

 

[FAMUPharmD09]

in the state of new jersey, if someone comes in with a script for a C2, say percocet, with a quantity of 90. , take 1 tablet three times a day. say the insurance covers only 30 at a time. if the patient wanted only what the insurance covers, is a new script required as this would be considered a partial fill, or can just 30 be dispensed then the script is dead?

Only speaking from my experience in FL, I would say yes a new Rx is required because technically it is considered a refill. To my understanding, partial filling of C-II is allowed if the pharmacist cannot dispense the entire prescription (i.e Rx calls for 90, you only have 30), however pt must pick up the remainder within 72 hours (Don't know of any pharmacists who would feel comfortable doing this, most will send them to another store that has the full qty). The pharmacist can not partial fill a C-II at the request of the patient. Also you can partial fill C-II if the patient is a hospice pt and the MD must explicitly note that this the case. In which case the Rx is good for 60 days from written date.

Of course in NJ it may be different. Hope this helps

 

[Farmercyst]

Same story, if insurance pays #30/30 days, then a new rx will be required.

 

[Old Timer]

State laws may differ but most states do not consider partial fills of any kind to be a refill. So for example if you do not have the full quantity of a C-II drug on hand, you may dispense the partial and then dispense the balance with 72 hours and that does not constitute a refill. The same with hypnotics. If a physician prescribes 30 Ambien 10 mg 1 hs with 5 refills and the insurance plan allows only 14 at a time, they are not limited to 6 fills of 14 tablets as the partial required for insurance billing does not constitute a refill.

In the same vein, if you dispense a partial on the insurance and a partial cash, it is not considered a refill. If you work for a chain store, try it out and you will see it will go through.

DO NOT equate the way your computer system handles something with the reality of the situation......

 

[acetyl]

State laws may differ but most states do not consider partial fills of any kind to be a refill. So for example if you do not have the full quantity of a C-II drug on hand, you may dispense the partial and then dispense the balance with 72 hours and that does not constitute a refill.

How many times in your career have you partial filled a CII you didn't have, ordered it, then got the rest to the patient within the 3 day window?

 

[Doctor M]

How many times in your career have you partial filled a CII you didn't have, ordered it, then got the rest to the patient within the 3 day window?

Ive done it numerous times for regular patients. I feel comfortable doing it as long as I know i will get the order next day.

 

[Old Timer]

How many times in your career have you partial filled a CII you didn't have, ordered it, then got the rest to the patient within the 3 day window?

Many times.... You can get a C-II order within 1 business day. Give the order to the driver on Tuesday and as long as you faxed the 222 form in advance, you get the order on Wednesday.....

 

[farmist]

Here either the board or the DEA weighed in on this, I don't remember which. Basically, If insurance covers 30 and the Rx is written for 90. They can get 30 with no refills through insurance or they can get 90 pay cash and take it up with their insurance company. However, they cannot get 30 through insurance then pay cash for 60 as a refill though even if it is filled the same day.

 

[MountainPharmD]

How many times in your career have you partial filled a CII you didn't have, ordered it, then got the rest to the patient within the 3 day window?

More times than I can count or remember thanks.

 

[MountainPharmD]

Do a search. This questions has been asked and argued about 4 times that I can remember in the last several years.

The Pharmacist Manual published by the DEA is quite clear.

Each state will have thier own little differences so you will have to consult your state law book.

 

[genesis09]

In Illinois, you can do a partial fill of a C-II. You must receive and dispense the remaining quanity within 72 hours.

 

[Old Timer]

Here either the board or the DEA weighed in on this, I don't remember which. Basically, If insurance covers 30 and the Rx is written for 90. They can get 30 with no refills through insurance or they can get 90 pay cash and take it up with their insurance company. However, they cannot get 30 through insurance then pay cash for 60 as a refill though even if it is filled the same day.

Proof please. This is clearly permitted by the law. It does not limit the reason for not being able to fill the prescriptions to out of stock situations. Further, the DEA has already ruled in relation to CIII-CV drugs that partial fills DO NOT constitute a refill.

Code of Federal Regulations​

_________________________________________________________________________

Section 1306.13 Partial filling of prescriptions.

(a) The partial filling of a prescription for a controlled substance listed in Schedule II is permissible, if the pharmacist is unable to supply the full quantity called for in a written or emergency oral prescription and he makes a notation of the quantity supplied on the face of the written prescription (or written record of the emergency oral prescription). The remaining portion of the prescription may be filled within 72 hours of the first partial filling; however, if the remaining portion is not or cannot be filled within the 72-hour period, the pharmacist shall so notify the prescribing individual practitioner. No further quantity may be supplied beyond 72 hours without a new prescription.
http://www.deadiversion.usdoj.gov/21cfr/cfr/1306/1306_13.htm


Please note it does not mention out of stock. The Pharmacist letter states:

Partial Filling. If a pharmacist is unable to supply the full quantity of drug called for on a C-II prescription for any reason, the prescription may be partially filled. The quantity supplied must be written on the front of the prescription, and the remaining portion must be filled within 72 hours. If this is not possible, the original prescription is void and the prescriber must be contacted by the pharmacist.2

http://www.pharmacistsletter.com/(S(nvjkfa55nvpuruqmf4hwrj45))/pl/ArticleDD.aspx?nidchk=1&cs=CVS&s=PL&pt=6&fpt=31&dd=240101&pb=PL&searchid=14373489

 

[rxforlife2004]

in the state of new jersey, if someone comes in with a script for a C2, say percocet, with a quantity of 90. , take 1 tablet three times a day. say the insurance covers only 30 at a time. if the patient wanted only what the insurance covers, is a new script required as this would be considered a partial fill, or can just 30 be dispensed then the script is dead?

never heard of partial fill of C-II !!! I am in California, btw

 

[Old Timer]

never heard of partial fill of C-II !!! I am in California, btw

This has only become an issue recently as insurance companies have clamped down on claims.....

 

[ItsOverZyvox]

I know nothing about this topic. I'm not sure I want to know...

 

[SpirivaSunrise]

I know nothing about this topic. I'm not sure I want to know...

Hope you don't intend to license reciprocate to any other state any time soon!!!

 

[ItsOverZyvox]

Hope you don't intend to license reciprocate to any other state any time soon!!!

why do I need to reciprocate... I already have 3 licenses to the states that actually matter.

 

[ItsOverZyvox]

And the next license I would've wanted, I need to take the NAPLEX again... No thanks. Keep your swamps and your large flesh eating reptiles!!!

 

[SpirivaSunrise]

And the next license I would've wanted, I need to take the NAPLEX again... No thanks. Keep your swamps and your large flesh eating reptiles!!!

What's wrong??? Afraid you'd faillll??


Posted via Mobile BlackBerry Device

 

[ItsOverZyvox]

What's wrong??? Afraid you'd faillll??


Posted via Mobile BlackBerry Device

Hmmm...haven't thought about that...

That's right..not only is it pain in the ass to take the NAPLEX, to pay good money to do it and with the the possibility of failing, it makes no sense. Heck..it gets cold in Orlando..I froze my ass off playing golf there.

 

[SpirivaSunrise]

Hmmm...haven't thought about that...

That's right..not only is it pain in the ass to take the NAPLEX, to pay good money to do it and with the the possibility of failing, it makes no sense. Heck..it gets cold in Orlando..I froze my ass off playing golf there.

Nahhh...you've got to go further south. I'll send you a copy of the beach house key. Along with my realtor's business card, since you'll be sold. Take the fam for a weekend.

Better start studying!!!


Posted via Mobile BlackBerry Device

 

[Vitamin K]

Proof please. This is clearly permitted by the law. It does not limit the reason for not being able to fill the prescriptions to out of stock situations. Further, the DEA has already ruled in relation to CIII-CV drugs that partial fills DO NOT constitute a refill.

Code of Federal Regulations​

_________________________________________________________________________

Section 1306.13 Partial filling of prescriptions.

(a) The partial filling of a prescription for a controlled substance listed in Schedule II is permissible, if the pharmacist is unable to supply the full quantity called for in a written or emergency oral prescription and he makes a notation of the quantity supplied on the face of the written prescription (or written record of the emergency oral prescription). The remaining portion of the prescription may be filled within 72 hours of the first partial filling; however, if the remaining portion is not or cannot be filled within the 72-hour period, the pharmacist shall so notify the prescribing individual practitioner. No further quantity may be supplied beyond 72 hours without a new prescription.
http://www.deadiversion.usdoj.gov/21cfr/cfr/1306/1306_13.htm


Please note it does not mention out of stock. The Pharmacist letter states:
http://www.pharmacistsletter.com/(S(nvjkfa55nvpuruqmf4hwrj45))/pl/ArticleDD.aspx?nidchk=1&cs=CVS&s=PL&pt=6&fpt=31&dd=240101&pb=PL&searchid=14373489

I see where you're coming from, but I interpret this a little differently. Here's my take on it:

In the state of Washington, the law limits C3-C4 drugs to "6 months or 5 refills". Some insurance will only cover 14 ambien per 23 days or 10 per 30 days, etc. We've had patients who come in, get the 14 from their insurance and then pay cash for the remaining 16 in order to get 30 per month. I've called the state board regarding whether that #16 fill counts as a "partial" or an additional fill. They have told me that it counts as a FILL, so that a 6 month prescription of Ambien filled this way will only be double-filled for 3 months before a new prescription is required.

Not the exact same situation, but if you translate this to the C2 law, then that extra part they're filling constitutes an additional fill, not a partial. The patient's insurance not wanting to pay isn't the same as the pharmacist being "unable to fill" the prescription.

Just my interpretation.

 

[genesis09]

In Illinois, partial fills of C-3s-C-5s do not count towards the 5 refill maximum per 6 month rule.

 

[Vitamin K]

In Illinois, partial fills of C-3s-C-5s do not count towards the 5 refill maximum per 6 month rule.

Right, and a true "partial" (i.e. we're out and have to get the rest to you later) doesn't count. But filling through the insurance and then filling again for cash isn't counted as a partial. It's counted as an additional fill. I called and asked for clarification because I think it's ridiculous, but that's the verdict here.

 

[MountainPharmD]

Right, and a true "partial" (i.e. we're out and have to get the rest to you later) doesn't count. But filling through the insurance and then filling again for cash isn't counted as a partial. It's counted as an additional fill. I called and asked for clarification because I think it's ridiculous, but that's the verdict here.

So who did you call? If it was the state board did they give you the specific state regulation that says you cannot do it? What we are discussing here is federal law. Not someones opinion at the state board.

Stop interpreting the law and just read exactly what it says. It is quite clear. What you and so many others do is try to read between the lines and add stuff that is not there.

Again, this has been discussed ad nauseum on here over the last few years.
OldTimers explanation as well as his references to the law are exactly correct. Unless your state SPECIFICALLY by way of a written regulation prohibits it then it is legal under the federal law.

Seriously, its not that hard. Listen to the pharmacists who are actually out there practicing and who deal with this on a daily basis.

 

[Vitamin K]

So who did you call? If it was the state board did they give you the specific state regulation that says you cannot do it? What we are discussing here is federal law. Not someones opinion at the state board.

Stop interpreting the law and just read exactly what it says. It is quite clear. What you and so many others do is try to read between the lines and add stuff that is not there.

Again, this has been discussed ad nauseum on here over the last few years.
OldTimers explanation as well as his references to the law are exactly correct. Unless your state SPECIFICALLY by way of a written regulation prohibits it then it is legal under the federal law.

Seriously, its not that hard. Listen to the pharmacists who are actually out there practicing and who deal with this on a daily basis.

I'm not saying that Old Timer is wrong, I'm saying that I view the statements differently. I did read "exactly what it says". It says that you can do this if "the pharmacist is unable to fill the full prescription" and it does NOT talk about part-insurance/part-cash fills. The law just isn't that detailed, so it IS open to some interpretation. For the record, I'm not a pharmacist (I graduate in 4 weeks), but I AM "out there practicing" and I DO "deal with this on a daily basis". Since 2nd year pharmacy school, I've worked between 20 and 42 hours/week WHILE in class, so I've dealt a lot with legal issues and otherwise. Feel free to step down from your high-horse.

 

[ItsOverZyvox]

OldTimers explanation as well as his references to the law are exactly correct.

 

[aboveliquidice]

I was under the impression that if your pharmacy only has 60 pills for the Rx - despite it being written for 90 - the patient would have to make a choice. Get only 60, or keep the Rx and decide to try another pharmacy.

This may have been simply a store policy - Because the 222 & the 72 hour window is not always possible.

 

[Vitamin K]

I was under the impression that if your pharmacy only has 60 pills for the Rx - despite it being written for 90 - the patient would have to make a choice. Get only 60, or keep the Rx and decide to try another pharmacy.

This may have been simply a store policy - Because the 222 & the 72 hour window is not always possible.

Definitely a store policy. Not all pharmacies will partial fill even if it's allowed because, if they don't get their C2s in time, they're either in violation of the law or they don't dispense the other half and end up with a pissed off patient.

 

[Old Timer]

You crack me up. That truly brought a smile to my face. Lunch is on me the next time your in town....