Partial Filling C2 Unable to Fill Remainder Within 72 hours

[rxlol]

A C2 was partially filled due to limited stock, and an order was put out for the remainder. However, the order will arrive after the 72 hours. The C2 script was ran through insurance as the full quantity since that's how the software is setup. I don't think it has partial fill options on it.

What should the pharmacist do in this scenario? According to the law, should the pharmacist call the doctor to void the old script and get a new C2 script? The old C2 script was used for a partial fill and the patient received some of the drugs. The script was billed as the full quantity written on the script. Any new script will result in insurance issues. Should the old script be reversed and the quantity changed to the actual filled quantity?

Note: Software allows filling less than quantity written (ex: 30 days supply instead of written 90). I suppose this can be considered "partial"

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[browneyes021]

A C2 was partially filled due to limited stock, and an order was put out for the remainder. However, the order will arrive after the 72 hours. The C2 script was ran through insurance as the full quantity since that's how the software is setup. I don't think it has partial fill options on it.

What should the pharmacist do in this scenario? According to the law, should the pharmacist call the doctor to void the old script and get a new C2 script? The old C2 script was used for a partial fill and the patient received some of the drugs. The script was billed as the full quantity written on the script. Any new script will result in insurance issues. Should the old script be reversed and the quantity changed to the actual filled quantity?

I've never been in that situation before, but it seems like the right thing to do is to reverse the rx and bill the insurance with the actual amount the patient received. Otherwise, you've overcharged the patient and the insurance company for a product the patient never got. After that, get a new prescription and fill it as it is written. That's how I would do it. But honestly, I never do partial fills because of this situation, unless I know the C-II order comes in the next day with that drug amount in enough to cover them and others as well. The Rph should've told the patient they'd lose the remaining amount or let them go elsewhere to get their script filled.

 

[SoylentGreen]

+1 for not doing partials on CII's in the first place. I tell them they can have what we have and forfeit the rest, wait for the whole order to come in, or go elsewhere.

 

[BenJammin]

+1 for not doing partials on CII's in the first place. I tell them they can have what we have and forfeit the rest, wait for the whole order to come in, or go elsewhere.

Surely you're still contacting the doctor telling them what you did, right? If not, you're breaking federal law. Section 1306.13 of the Controlled Substances Act.

 

[Rx MPLS]

Surely you're still contacting the doctor telling them what you did, right? If not, you're breaking federal law. Section 1306.13 of the Controlled Substances Act.

That's really interesting. I don't think many pharmacists I've worked with know that's illegal.

 

[Kwiz]

Ideally, what you should have done (according to NYS law?) was call the doctor and let him or her know that it was partialled and that the remaining pills would need a new rx, and that it was due to a supply issue. Also technically, 72 hours is subject to debate because I've spoke with multiple pharmacists in this exact situation and there's some disagreement/differences because some pharmacists dispense in these situations with the assumption that 72 hours refers to business hours (3 business days). I would like to hear what you find out if anything.

 

[Ackj]

72 hours is subject to debate because I've spoke with multiple pharmacists in this exact situation and there's some disagreement/differences because some pharmacists dispense in these situations with the assumption that 72 hours refers to business hours (3 business days)

I have heard this as well, but I'd hate to stand in a court and find out the real meaning. Probably safest to notify and get a new RX.

 

[Old Timer]

Also technically, 72 hours is subject to debate because I've spoke with multiple pharmacists in this exact situation and there's some disagreement/differences because some pharmacists dispense in these situations with the assumption that 72 hours refers to business hours (3 business days). I would like to hear what you find out if anything.

There is no technically anything. The law says 72 hours. That means 72 hours. It doesn't mean dog hours or business hours, it says hours and that is what it means.

 

[Kwiz]

Technically = according to the facts or exact meaning of something. I've heard RPhs quote PharmD/JDs on both side of this, have heard district managers argue on each of these two sides, as well as one DEA agent.

So point one, realize that I used the word technically correctly, and that "technically" does equal the technicality of something.

Point 2, I never said I am disputing the technicality of what is written in the legislation.

Point 3, to think that what is written in a piece of legislation is set in stone is stupid. Why would judges exist? ...because these sort of things are open to interpretation.

I didn't state my opinion or my interpretation, because I'm not going to try to influence how others practice pharmacy or law. You shouldn't either unless you want a gavel coming down on you. Now if you would like to dispute these people's (the people i mentioned) claims in regard to their interpretations being incorrect, go for it. Don't go all ad hominem on me just because I made you stop and question it for a split second. I'm the messenger stating REAL WORLD interpretations, whether it be correct or not, it is a good thing for me to mention it, because it brings about recognizing difference in opinion. If you don't learn from differences in opinions, then GTFO bc this is SDN, not Hardass Consultant Attorney PLLC. I want opinions, not a crackheaded stickupmyass legal advice from someone who did nothing more than regurgitate to me exactly what is written. Get an original opinion, accept that there's people above you that think the same and others that think differently, wipe the tears, and realize that perhaps, if what you're saying is correct, and that I am not in prison, that perhaps my opinion is similar to yours, but most importantly, that it is just that, an opinion.

PS - remove the stick and I might reply again

 

[g40631]

There is no technically anything. The law says 72 hours. That means 72 hours. It doesn't mean dog hours or business hours, it says hours and that is what it means.

This. It has to be dispensed within 72 hours from the date and time the partial was given. The DEA does not have leniency on this.

That being said...does the patient have to have the remaining balance picked up in 72 hours, or does it need to just be ready for pickup within 72 hours?

 

[g40631]

Technically = according to the facts or exact meaning of something. I've heard RPhs quote PharmD/JDs on both side of this, have heard district managers argue on each of these two sides, as well as one DEA agent.

So point one, realize that I used the word technically correctly, and that "technically" does equal the technicality of something.

Point 2, I never said I am disputing the technicality of what is written in the legislation.

Point 3, to think that what is written in a piece of legislation is set in stone is stupid. Why would judges exist? ...because these sort of things are open to interpretation.

I didn't state my opinion or my interpretation, because I'm not going to try to influence how others practice pharmacy or law. You shouldn't either unless you want a gavel coming down on you. Now if you would like to dispute these people's (the people i mentioned) claims in regard to their interpretations being incorrect, go for it. Don't go all ad hominem on me just because I made you stop and question it for a split second. I'm the messenger stating REAL WORLD interpretations, whether it be correct or not, it is a good thing for me to mention it, because it brings about recognizing difference in opinion. If you don't learn from differences in opinions, then GTFO bc this is SDN, not Hardass Consultant Attorney PLLC. I want opinions, not a crackheaded stickupmyass legal advice from someone who did nothing more than regurgitate to me exactly what is written. Get an original opinion, accept that there's people above you that think the same and others that think differently, wipe the tears, and realize that perhaps, if what you're saying is correct, and that I am not in prison, that perhaps my opinion is similar to yours, but most importantly, that it is just that, an opinion.

PS - remove the stick and I might reply again

A tad harsh but you bring up a good point. That being said, yes laws are open for interpretation. But are you willing to let a judge decide whether or not what you did was correct (dispensing on Tuesday after partial given on Friday because you feel it is 72 business hours?). Better to just stick to 72 hours as stated by the DEA and not ever have to worry about a judge deciding on your behalf, correct?

 

[BenJammin]

Also technically, 72 hours is subject to debate because I've spoke with multiple pharmacists in this exact situation and there's some disagreement/differences because some pharmacists dispense in these situations with the assumption that 72 hours refers to business hours (3 business days).

What those pharmacies believe/think/do is completely irrelevant. Are you going to listen to hearsay or are you going to follow the law? If it is Friday at 6 pm then you have until Monday at 6 pm to fill it. If you don't fill for the remaining amount then you must contact the doctor. The DEA is going to rip you a new one if you try to deviate from this law.

 

[owlegrad]

I don't see how this is a matter of opinion. How is it anyone's 'opinion' what 'hour' means? Three days would be more unclear than 72 hours. 72 hours really doesn't leave anything to the imagination.

And I would say 'picked up in 72 hours'. That's the way I read it anyway.

 

[Kwiz]

Like I said, assuming the conservatives are correct, and since I'm not in prison, then it's probably safe to say that I personally do not practice the more liberal interpretation. Allow me to dumb it down since it didnt work the first time: I practice 72 hours = 72 hours. Some people do not. People can do whatever they want, so yes it is a matter of opinion. That opinion might wind them up with soap on a rope and a 20 year residence in a 6'x8', but there's lots of people out that there that say F the law. I know this might surprise some people, so I'll let you in on a secret...they're called criminals.

 

[owlegrad]

I am not sure you understand what an opinion is. I agree that people break the law, that doesn't make it an opinion...

 

[Kwiz]

Opinion is shorter than writing "one's interpretation of a written law". Since I was referring to NYS (New York State, for those playing at home), here's some exceptions for you weenies:

http://w3.health.state.ny.us/dbspac...25652c006f1189?OpenDocument&Highlight=0,80.73

 

[Kwiz]

People have opinions about laws and the interpretation thereof. I know this might be news for some people, but that's the purpose of voting. I know what you're thinking, "I always thought it was so i could get the 'I voted today' sticker." A common misconception.

 

[owlegrad]

People have opinions about laws and the interpretation thereof. I know this might be news for some people, but that's the purpose of voting. I know what you're thinking, "I always thought it was so i could get the 'I voted today' sticker." A common misconception.

You can have an opinion about a law. For example you may think the law is stupid or pointless. But how can you have an opinion that 72 hours means something besides 72 hours? 😕

That is not a matter if opinion, at least not by my understanding of the English language. I *guess* you could argue that it is a matter of interpretation, but even then I don't know how you can 'interpret' a law to mean something other than what it explicitly states.

 

[Kwiz]

I don't. Others do. ^^

 

[eagles22]

You can have an opinion about a law. For example you may think the law is stupid or pointless. But how can you have an opinion that 72 hours means something besides 72 hours? 😕

That is not a matter if opinion, at least not by my understanding of the English language. I *guess* you could argue that it is a matter of interpretation, but even then I don't know how you can 'interpret' a law to mean something other than what it explicitly states.

Didn't Bill Clinton ask what the definition of "is" was? You can debate the meaning of everything legally. That's why we don't know what a law actually means until there's a judicial ruling on it. Judge very well can say 72 hours means business hours.

 

[Rockinacoustic]

Is this the pre-law forums or something?

I have never seen a CII partial. If we don't have the full amount, I ask the patient if they have enough until we get the order in- we're rarely short on opioids for breakthrough pain, and those who need their long-acting opioid are usually good in bringing in their rx before they've exhausted their supply.

And when the above doesn't apply, I either tell them we can give them what we have but the remaining balance will be voided (in which case they should ask their doctor for a new prescription sooner), but usually insist on referring them to another pharmacy that has the full amount.

I can only reason partialling a CII in the event you're the only pharmacy for like 50 miles (or whatever distance inconveniences you non-city folk).

 

[Kwiz]

Didn't Bill Clinton ask what the definition of "is" was? You can debate the meaning of everything legally. That's why we don't know what a law actually means until there's a judicial ruling on it. Judge very well can say 72 hours means business hours.

Thank you, that was exactly the point I was trying to make was that some pharmacists have claimed to me that there has been a ruling on 72 hours meaning business hours. I have never been able to find such a case, and I sort of think its bs, but in the event that they're right, I wanted to find any info about that if anyone knew it. Thank you for having an original thought. I am personally strict when it comes to the law however, although I still feel that it is at the very least a feasible claim if true.