I think my store is breaking the law

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SevenPharmacyCalls

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At my store in California, we have a high customer base that is from Mexico. California requires that any person picking up a controlled prescription identify themself. The law does not say how. In the CVS system, a government issue id is prompted for and says "foreign or US" (indicating that a foreign id is acceptable.) My PIC refuses to accept Mexico forms of ID (or any foreign id) and I am worried that I am putting my license at risk by refusing valid ids. In California, we cannot refuse to fill any valid prescription and when we have to return the prescription just because they have a Mexico id, I think we are violating this law. Does anyone have advice?
 
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I should add that I have contacted other CVSs all of which accept Mexico ids. We have also had multiple patients accuse us of discrimination and transfer elsewhere. They usually transfer to WAGS where Mexico ids are accepted.
 
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If I call the ethics line do I risk putting myself at risk since I engaged in this also (was forced to by PIC)? Should I just start accepting them and let the PIC get in trouble when someone calls the BOP which is just a matter of time until that happens?
 
OP, I assume you are a tech or intern? If so, the legality falls on the pharmacist, you can't legally fill a prescription, if the pharmacist tells you not to.
 
Right now I am grad intern, but Cali runs a little different. Everyone that violates law is held accountable. We had a tech get fined 1000k because she didn't offer counseling. In addition the pharmacist was also fined 1000k for the technicians mistake.
 
SevenPharmacyCalls said:
If I call the ethics line do I risk putting myself at risk since I engaged in this also (was forced to by PIC)? Should I just start accepting them and let the PIC get in trouble when someone calls the BOP which is just a matter of time until that happens?
Click to expand...

You won’t get into trouble for calling Ethics. You had a concern and that’s why you called to clarify. You won’t be at fault.

I would say talk to your pharmacy supervisor first though. Just ask him/ her that this is how it’s being done, and is that correct? If they say no then tell them to clarify it with the pic and leave your name out of it if you don’t feel comfortable.

“ I received a complaint from a patient rather than this person brought it to my attention”
 
BidingMyTime said:
OP, I assume you are a tech or intern? If so, the legality falls on the pharmacist, you can't legally fill a prescription, if the pharmacist tells you not to.
Click to expand...

Off topic and I know it is immoral to advocate this but I have not been to a place that doesn't do questionable stuff one way or the other. If I'm lucky then it is something in the "gray area" and not downright dangerous or illegal.

Maybe I'm just a shame to the profession after all, but the biggest "real world" lesson for me is to know how many bosses there are that I need to please, where the line is, what I have to ignore and what I must act on. But then I'm just a miserable retail pharmacist so it is just my experience.
 
Sabril said:
Off topic and I know it is immoral to advocate this but I have not been to a place that doesn't do questionable stuff one way or the other. If I'm lucky then it is something in the "gray area" and not downright dangerous or illegal.

Maybe I'm just a shame to the profession after all, but the biggest "real world" lesson for me is to know how many bosses there are that I need to please, where the line is, what I have to ignore and what I must act on. But then I'm just a miserable retail pharmacist so it is just my experience.
Click to expand...

Learning to pick your battles is a critical skill.
 
SevenPharmacyCalls said:
If I call the ethics line do I risk putting myself at risk since I engaged in this also (was forced to by PIC)? Should I just start accepting them and let the PIC get in trouble when someone calls the BOP which is just a matter of time until that happens?
Click to expand...
No. If you choose to identify yourself to the ethics line and state the illegal act, they will bend over backwards to avoid pissing you off.
 
Just take the ID?

What is the PIC going to do? You will be a pharmacist soon anyways.
 
I am somewhat conflicted. On one hand I think ratting out your boss is kind of a ****ty thing to do. On the other hand, this is not a subjective matter - either you are right or they are. If you are right, this could easily be construed to be a racist policy. Following racist policies seems less than ideal from a human being prospective.

Let me frame it this way for you. What do you hope to get out of reporting your boss? Just getting him to start accepting Mexico IDs? Why does that matter to you? What is in it for you? I mean if you are a crusader for justice so be it, I am just asking you to introspect what your intentions are. You will be a pharmacist and then you can follow whatever policies you want so why does it matter to you so much what this other pharmacist does?

From my perspective I see no up side to you for doing this, except possibly some kind of nebulous karma points for being a decent human being or maybe being able to sleep soundly at night. The potential downside is being labeled a trouble maker or your boss just being straight up pissed at you for ratting them out which can manifest in countless ways directly and indirectly. It's up to you to balance your priorities and decide what matters most to you.

FWIW, I almost certainly would not report this.
 
wagrxm2000 said:
Just take the ID?

What is the PIC going to do? You will be a pharmacist soon anyways.
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What would you do if you caught an intern do something you told them was illegal? Just let it go since they will be a pharmacist soon anyway?
 
From https://www.pharmacy.ca.gov/laws_regs/lawbook.pdf:

4075. Proof of Identity Required – Oral or Electronic Prescription No prescription for a controlled substance transmitted by means of an oral or electronically transmitted order shall be furnished to any person unknown and unable to properly establish his or her identity. The board may by regulation establish procedures to prevent unauthorized persons from receiving prescription drugs furnished to a patient or a representative of the patient.

Op, I'm not sure that this is illegal. I'll use a French passport example. A patient shows up in CVS and needs a prescription for Phenobarbital. It's written for Pierre Mec. Pierre Mec shows up as a pharmacy and present a French passport while you're not a Department of State worker that can recognize passports by sight, does establish identity good enough to dispense. I don't see on what grounds you would refuse dispense unless you don't accept that document to establish identity (and if you don't, well, that's actually a federal matter).

Going back to your example though, the question comes down to, does a Mexican Consulate ID establish identity according to the State of California (not the federal in this case). I would answer yes:


The MCAS is not going to for federal identification (meaning a Real ID), but it is valid to establish identity for the state of California.

-----------------------------------------------

None of the above or the below is legal advice, but I would say something else. The regulation does not say HOW you establish identity, just that you do. Your corporation may have more stringent requirements, but I used to sell prescriptions to people that I knew on sight as my memory is good enough for identity (and that has been tested multiple times in CA with alcohol sale law). If the person presented an MCAS to me, that would be enough for me to have a clean conscience to sell this person the med, as there is no citizenship or even residency requirement for me to sell prescriptions to them.
 
owlegrad said:
What would you do if you caught an intern do something you told them was illegal? Just let it go since they will be a pharmacist soon anyway?
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It isn't illegal though so the intern isn't doing anything wrong.

Maybe I missed it but I didn't think the intern said it was illegal just that the PIC said not to.
 
wagrxm2000 said:
It isn't illegal though so the intern isn't doing anything wrong.

Maybe I missed it but I didn't think the intern said it was illegal just that the PIC said not to.
Click to expand...

You are right, I assumed the pharmacist said it was illegal - facts not in evidence. I don’t know what other pretense the pharmacist would use though - against company policy? Straight up racism? Because I said so?

I will modify my question though - if an intern did something in your pharmacy that you told them not to, you would be cool with that?
 
owlegrad said:
You are right, I assumed the pharmacist said it was illegal - facts not in evidence. I don’t know what other pretense the pharmacist would use though - against company policy? Straight up racism? Because I said so?

I will modify my question though - if an intern did something in your pharmacy that you told them not to, you would be cool with that?
Click to expand...

I actually tell my interns if they ever learn anything law related that I'm not aware of to let me know.

They are actively learning while I graduated many, many years ago.
 
I would imagine it would turn into a PR nightmare if they reported discrimination to the news station and guess what corporate will tell your PIC to do.
 
SevenPharmacyCalls said:
If I call the ethics line do I risk putting myself at risk since I engaged in this also (was forced to by PIC)? Should I just start accepting them and let the PIC get in trouble when someone calls the BOP which is just a matter of time until that happens?
Click to expand...

My goodness.... you could just have a direct conversation with the PIC and get it straightened out in house.

When I was a retail PIC I was almost perfect... but just shy of perfect. I creates an environment where if the staff pharmacists thought I was wrong we would talk about it and figure out exactly what the right answer was.

I think that would be super shi**y of you to call the ethics hotline or anything like that. What ever happened to people directly communicating and learning from each other?
 
Just have a talk to the PIC.
What was the point of having identification.
You want to ensure the medication is going to the right user. Also, he/she will use the medication to properly treat him/herself.
Not someone using a fake ID, trying to score some control substance with street value. (We definitely don't want the drug abuse going into the streets)
 
SevenPharmacyCalls said:
Right now I am grad intern, but Cali runs a little different. Everyone that violates law is held accountable. We had a tech get fined 1000k because she didn't offer counseling. In addition the pharmacist was also fined 1000k for the technicians mistake.
Click to expand...

These things aren't the same as your situation. And what Cali does is pretty much the same that happens with any state that licenses techs. Techs are accountable for their job responsibilities, so since offering counseling is legally required by the technician or pharmacists, then a technician that doesn't do this can get in trouble. Pharmacists are responsible for everything technicians do under their watch, so yes, if a technician gets in trouble, the pharmacist and/or pharmacist manager will also get in trouble.

None of this correlates with the licensed pharmacist telling you that you can't fill a prescription. It would be illegal for you to fill a prescription that the pharmacist told you not to, so I don't see how you would be in any trouble if the BOP came in (unless CA has some requirement to report, but since the other commenters are saying that what the manager is doing is not illegal, then this wouldn't be a concern either.)

I agree with Owl, I'd let this go until you are a pharmacist, and then you can fill all those prescriptions. While I suspect your bosses boss might not be happy at these prescriptions not being filled, I wouldn't rock the boat until you are a licensed, employed pharmacist (and then it won't matter, because you can do things properly.)
 
What the manager is doing is violating BPC 733.

If the CA BOP fines pharmacies for not getting refill authorizations (LOLLLLLLLLLLLL) they sure as hell could fine for refusing to dispense because of Mexican ID
 
What about for pseudophed? I was told a couple different thing so I'm confused. Foreign passports are acceptable?
 
Unless there is more to meets it eye.
If there is a Narc being smuggled down across border under an guise of fake pain, getting narcs, bring it back down?

Then again, I'm not there. I can't see the situation. Wonder why would he/she not allowed them to use their form of ID.
 
Not sure if you already mentioned this but are you an intern? pharmacist? tech?
If you're a pharmacist, just remember that you have your own license to protect and no one is really forcing you to do anything if you believe something is unlawful...
 
SevenPharmacyCalls said:
At my store in California, we have a high customer base that is from Mexico. California requires that any person picking up a controlled prescription identify themself. The law does not say how. In the CVS system, a government issue id is prompted for and says "foreign or US" (indicating that a foreign id is acceptable.) My PIC refuses to accept Mexico forms of ID (or any foreign id) and I am worried that I am putting my license at risk by refusing valid ids. In California, we cannot refuse to fill any valid prescription and when we have to return the prescription just because they have a Mexico id, I think we are violating this law. Does anyone have advice?
Click to expand...
lmao. California is hilarious.
SevenPharmacyCalls said:
Right now I am grad intern, but Cali runs a little different. Everyone that violates law is held accountable. We had a tech get fined 1000k because she didn't offer counseling. In addition the pharmacist was also fined 1000k for the technicians mistake.
Click to expand...
I've had it out with California Board of Pharmacy investigators and they are not the sharpest or most competent.

You're fine.
Choose your battles.
For example, choose to talk to the pic.
 
Sine Cura said:
What the manager is doing is violating BPC 733.

If the CA BOP fines pharmacies for not getting refill authorizations (LOLLLLLLLLLLLL) they sure as hell could fine for refusing to dispense because of Mexican ID
Click to expand...

Whoa you got a link to a disciplinary report about that?
 
Optum Rx mail order - both Optum and PIC fined for obstructing prescription orders and unprofessional conduct.


1) Atripla requested on Mar 19, promised time Mar 21, delivered on March 25
2) Zetia requested to be sent to alternative address, but was sent to default address. Refill initiated Aug 19, delivered Sept 16
3) Lipitor refill authorization requested by customer on Jan 30, new Rx received Feb 27 after multiple attempts to reach prescriber. The allegation claimed the pharmacy did not send a refill request to the prescriber at least once
4) Feb 9 order for Singulair not delivered until February 23.


Imagine getting fined because some of these terrible low-income clinics don't respond to phone, to fax, to e-requests, to the word of God
 
Why you will never see me in California let alone practicing pharmacy there. Overcrowded, polluted, poorly governed no wonder people are leaving that state. Medicaid for illegal immigrants. I have heard of one other state that fined pharmacist for failure to counsel- Nevada. Working in these busy stores which you have no control over workload just to be fined $1000 when your tech does not offer counseling? I hope you plan on practicing in another state when you graduate.

OP did you ask your law professor at school?
 
johnpharm01 said:
Why you will never see me in California let alone practicing pharmacy there. Overcrowded, polluted, poorly governed no wonder people are leaving that state. Medicaid for illegal immigrants. I have heard of one other state that fined pharmacist for failure to counsel- Nevada. Working in these busy stores which you have no control over workload just to be fined $1000 when your tech does not offer counseling? I hope you plan on practicing in another state when you graduate.

OP did you ask your law professor at school?
Click to expand...

Wait I thought California was considered the perfect state?
 
johnpharm01 said:
Why you will never see me in California let alone practicing pharmacy there. Overcrowded, polluted, poorly governed no wonder people are leaving that state. Medicaid for illegal immigrants. I have heard of one other state that fined pharmacist for failure to counsel- Nevada. Working in these busy stores which you have no control over workload just to be fined $1000 when your tech does not offer counseling? I hope you plan on practicing in another state when you graduate.

OP did you ask your law professor at school?
Click to expand...

I thought the fine was $1000k?
 
rxkrafted said:
Not sure if you already mentioned this but are you an intern? pharmacist? tech?
If you're a pharmacist, just remember that you have your own license to protect and no one is really forcing you to do anything if you believe something is unlawful...
Click to expand...

Yes, he already did mention this, he is an intern. So, no he can not get in trouble for not filling a prescription that the pharmacist on duty told him he couldn't fill. Quite the opposite in fact, if he filled a prescription without the pharmacist's authorization, that would get him in trouble.
 
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