How do pharmacists lose their license?

[ldiot]

Obviously drug diversion/drug abuse/insurance fraud/fatal errors... but is it common for pharmacists to lose their license or get into trouble over other reasons?

I understand that a lot of this is state specific but I see some pharmacists who really make their life a lot harder than it needs to be by calling on stupid things such as switching inhalers, switching 2 25mg tabs for 1 50mg tab... etc. I'm just kind of torn by the different "styles"...heck I've even seen ppl switch scripts from 30 to 90 days.

Sure... it's stupid to have to call on some of this stuff but I think when I graduate I'd be more hesitant to do some of this

---

Members don't see this ad.

 

[rph3664]

A fatal error is not necessarily a reason for a license revocation, or even a censure, as long as there was no malicious intent and the pharmacist was not the only person involved.

The kinds of calls you describe are at the pharmacist's discretion. In short, when in doubt, call.

 

[genesis09]

In Wisconsin, the most common reason for license issues is due to drug diversion or abuse. All other issues are probably less than 10% of discipline cases.

 

[Wickett]

Obviously drug diversion/drug abuse/insurance fraud/fatal errors... but is it common for pharmacists to lose their license or get into trouble over other reasons?

I understand that a lot of this is state specific but I see some pharmacists who really make their life a lot harder than it needs to be by calling on stupid things such as switching inhalers, switching 2 25mg tabs for 1 50mg tab... etc. I'm just kind of torn by the different "styles"...heck I've even seen ppl switch scripts from 30 to 90 days.

Sure... it's stupid to have to call on some of this stuff but I think when I graduate I'd be more hesitant to do some of this

Like others said, the vast majority of licenses being taken away are for drug diversion. You can look up cases on your state board to get an idea. Now, fines/marks on your record can be due to other things.

The key is following hipaa guidelines and the laws on counseling. Most common fines I have seen involve some privacy issue or lack of counseling. COUNSEL ALL NEW MEDS. I have known several people that have been fined because their techs asked if someone had a question on a new script and just sold it if a patient said no.

Make sure techs just automatically grab you if a script is marked new. Other instances of license suspension or loss have occurred when a PIC shows a pattern of some sort of repeated negligence or bad record keeping on board inspections/multiple warnings.

Bottom line: don't steal meds or kill someone, and you will usually be fine with basic good judgement. At worst, you may get some fine for a one off mistake, like the counseling one.

 

[wagrxm2000]

COUNSEL ALL NEW MEDS. I have known several people that have been fined because their techs asked if someone had a question on a new script and just sold it if a patient said no.

Make sure techs just automatically grab you if a script is marked new.

Curious, what exactly does your state law say about counseling?

 

[boriqua]

there's a website to check the enforcement actions against healthcare professionals in NY. I'm looking at the site right now for pharmacists that lost their license last month. 3 people got caught on a DUI, 1 person commited a class C felony ( grand larceny), 1 person forgot to do enough CE credits to renew license and let it expire, and 1 person changed the number of refills on a controlled stubstance

 

[farmadiazepine]

You lose our license when you harm a patient intentionally.

You lose it for fraud. You lose it for diversion.

Everything else, as long as you are acting in the best interest of the patient and do everything for their safety, it's no big deal.

I don't know how some states have mandatory counseling on all new prescriptions. How do you even have time to do that? Are insurance companies paying you $15 per prescription? NO! I feel like states that mandate counseling by a pharmacist for all new prescriptions should put mandatory fees paid to the pharmacist as well. I'm sick and tired of running in 5 directions to make a penny.

 

[ABCPharmD]

I don't know how some states have mandatory counseling on all new prescriptions. How do you even have time to do that? Are insurance companies paying you $15 per prescription? NO! I feel like states that mandate counseling by a pharmacist for all new prescriptions should put mandatory fees paid to the pharmacist as well. I'm sick and tired of running in 5 directions to make a penny.

Try mandatory counseling on all prescriptions like we have in Wisconsin.

 

[Sine Cura]

If your state really has mandatory counseling as required by state regulation (i.e., techs cannot offer, and the pharmacist must acknowledge refusal to counsel), you either go overboard (Walmart) or just eat the fines as the cost of doing business (CVS).

 

[gwarm01]

Try mandatory counseling on all prescriptions like we have in Wisconsin.

Even refills?! Hah! Just goes to show how out of touch the legislature is with current practice.

Mam, I really must speak to you about this maintenance medication you have been taking for 20 years.

 

[farmadiazepine]

I know a guy who lost his CT and NJ licenses. He was caught for Medicare and Medicaid fraud. He had to surrender his pharmacist licenses, went to federal prison for 14 months, had to pay back about $350,000, and had to go through some psychiatric evaluations. The crazy part is, after he initially lost his license, he continued to practice as a pharmacist, and while doing that, he was caught selling OxyContin to people without prescriptions, knowing it would be sold on the streets. The charges on that were dropped. He's now on the federal OIG list.

How does he still own 3 pharmacies? He just opened up a new one a little less than a year ago and is planning to open another one. I think he is using his wife's name on all the legal paper work. It's screwed up..

 

[ldiot]

In my state asking "do you have any questions" fulfills the legal requirement to offer counsel.

It's still a legal requirement to counsel on all NEW meds but I've literally never seen it done in my 3 years working in a pharmacy unless the customer asks questions.

What if the state board writes up the pharmacy for not keeping proper records or signing certain forms? Does the staff pharmacist hold any liability or is it all on the PIC? What if it's the staff pharmacist who forgets to sign a narc... does it go against both of their records/just PIC/just the responsible pharmacist if this is caught by a state board audit? Again this may depend on the state but a generalization would at least be nice.

Do most states have a system in which marks on your record expire?

From the information that I've gathered the advise posted here seems true: don't steal/divert/abuse drugs or intentionally commit fraud and you will be okay.

 

[Wickett]

In my state asking "do you have any questions" fulfills the legal requirement to offer counsel.

It's still a legal requirement to counsel on all NEW meds but I've literally never seen it done in my 3 years working in a pharmacy unless the customer asks questions.

What if the state board writes up the pharmacy for not keeping proper records or signing certain forms? Does the staff pharmacist hold any liability or is it all on the PIC? What if it's the staff pharmacist who forgets to sign a narc... does it go against both of their records/just PIC/just the responsible pharmacist if this is caught by a state board audit? Again this may depend on the state but a generalization would at least be nice.

Do most states have a system in which marks on your record expire?

From the information that I've gathered the advise posted here seems true: don't steal/divert/abuse drugs or intentionally commit fraud and you will be okay.

Here in Texas, the pharmacist must offer the counseling/a tech cannot ask if are any questions, but simply get the pharmacist. Regardless of the state, I always recommend training techs to just grab you and you offer the counseling.

https://www.pharmacy.texas.gov/abo/phy/24763.pdf

 

[ldiot]

Here in Texas, the pharmacist must offer the counseling/a tech cannot ask if are any questions, but simply get the pharmacist. Regardless of the state, I always recommend training techs to just grab you and you offer the counseling.

https://www.pharmacy.texas.gov/abo/phy/24763.pdf

I think CVS is rolling out a new thing where when a new fill is rung up in the register, the patient name/med/key counseling points will drop into the QV and the tech is supposed to deliver the meds to the pharmacist after they are paid for and send the customer to consultation. This will essentially force the pharmacist to counsel.

 

[lord999]

Administrative Suspension/Revocation:
Failure to pay child support (most states have some law that a court can order the professional board to do that). Settled upon paying up. If it happens repeatedly, this could be made permanent.

With a grain of salt as with a good reputation and pleading, it's not always that severe. This is my general list of revocation worthy behavior from off the top of my head (some of this could be suspension in the circumstance, but the board would have a debate on revocation authority on these matters):

Revocation And The Board Never Wants That Person To Apply Again:

• Perjury On Your Initial Application For Licensure (No statute of limitations)
• Egregious lack of regard for human life (Knowingly selling someone a method for suicide with intent without following state medical assisted suicide procedures falls under here too)
• Patient Abandonment
• Felony fraud against a healthcare entity or such that it is seen to cause patient care issues (Jerome Erland).
• FDA Involvement On Adulteration/Misbranding (Very, very rare before those idiots in Boston made it a bigger issue)
• Major Trafficking (DEA Involvement)
• Schedule I Issues (DEA Involvement)
• NRC-MUL Revocation (If the pharmacist is that stupid with radiopharmaceuticals...)
• International Issues (Drug Smuggling/Supply Chain Tampering/Precursor Business Outside Department of State/Department of Justice Authority)
• Felony With A Capital Sentence (Murder, Rape, Child Porn, etc.)
• Felony Involving Cocaine/Crack (It's penalized a lot more heavily even though it's Schedule II)
• Felony That Has Public Trust Revocation as part of the sentence
• Felony Involving ATF Issues as pharmacists have greater privileges than the public with the purchasing, sale, and distribution of those regulated matters.
• Felony Involving Pharmaceuticals In Criminal Behavior (The Desperate Housewives pharmacist)
• Impersonating a physician or unauthorized use of a physician's/other clinician's authority (Even if the Board of Pharmacy is willing to forgive you later, the Board of Medical Examiners probably won't!)
• Impersonating another pharmacist (My friend had someone's RPh license revoked for doing that on transfers using her name and license number when she wasn't even in the state.)
• Revocation from another state with the issues above.

Revocation And Possibly Reconsider After Reapplication In Five-Ten Years:

• Felonies that are not the above.
• Diversion that is not of the above matters.
• Criminal possession of a controlled substance (it could be suspension)
• Practicing under the influence including alcohol (it could be suspension but in AZ/MN, it's definitely a revocation/stayed revocation in treatment)
• Egregious negligent behavior (as in, you didn't make just a mistake, and you didn't just override warnings, you were directly told it was wrong, and proceeded to do so anyway.)
• Manufacturing Without FDA Authorization (Not Compounding, but Manufacturing without the proper GMPs, approvals, etc.)
• Facilitating another person's addiction (or yours).
• Gross misdemeanors that embarrass the profession
• Practicing pharmacy in a location where you are not licensed or have authority (Practicing in CA with an AZ license and not CA's, the CA BoP will call the AZ one to revoke your AZ license)
• Inappropriate relations in a training context (This has been revocable in AZ and MN as preceptors may not have 'unprofessional' relationships with currently assigned interns. Preceptor's license is considered to be at fault. After assignment, no one cares...)
• Ignore A Personally Directed Board Order (So, if the board already had an order sent down on some behavior of the pharmacists and there is another violation in the same category...)
• Revocation from another state from another state with the issues above.