Tuesday, May 24, 2011

Florida Pharmacists Under Fire

Once again, due to the actions of a few, the responsible pharmacists have to suffer.

The State of Florida, which many consider the epicenter of prescription drug abuse, has recently taken drastic measures to curb being known as the "pill mill" state.

Florida Pill Mills

Unfortunately, those measures include costly and punitive legislation for Florida pharmacists. According to a summary of Florida House Bill 7095 which takes effect on July 11th -
Community pharmacies must be re-licensed under the provisions of this act and rules adopted thereunder by July 1, 2012. Additional licensure requirements are intended to prevent felons and other nefarious persons from owning or operating pharmacies. In addition, pharmacies will be required to develop policies and procedures to minimize dispensing based on fraudulent representations or invalid practitioner-patient relationships.

A pharmacist must report to a local law enforcement officer any person who obtains or attempts to obtain a controlled substance through fraudulent methods or representations. The failure to report is a misdemeanor of the first degree. (my bold)

Principals associated with a pharmacy must undergo annual criminal background screening. The department must forward the results to wholesale distributors permitted under ch. 499, F.S., for purposes of complying with the requirements related to due diligence of purchasers.

The amendment includes additional requirements and disciplinary action related to activities in pharmacies and by pharmacists.

But, this is just a summary of the new laws. The finer details are still be worked out and could negatively-impact innocent and responsible pharmacists even further. According to an article in PNJ.com, one independent pharmacist is concerned about the ability of the profession to remain self-regulating.

And rightly so too. Who's to decide whether or not a pharmacist knew if a prescription was fraudulent? Would you rather have a board of your peers decide that, or someone else not familiar with how a pharmacy operates?

Not to mention that you could also be held criminally liable for your mistake. A first-degree misdemeanor in the State of Florida is a crime punishable by no more than one year in jail, one-year probation, and a $1,000 fine.

4 comments:

  1. I'm interpreting it a little differently. To me it looks like they are mandating the reporting of the fradulent Rx. I know in my state it is not written in the pharmacy statute and I know from talking to various colleuges not every fake rx gets called into the police. I myself had a situation I did not feel comfortable reporting.

    My tech was handed a script for Vicodin ES #90 tid, not very uncommon where I practice. The Rx was perfect, it must have been a computer copy of a real one, had all the right info. I was checking it and about to hit enter when I double checked the DOB. Now 90 Vic for an adult would not have phased me, but it was a 16 year old (I don't know how I missed it the first time I must have just checked the numbers against hardcopy for a match and comp doesn't flag 16 as pediatric dosing obviously). Anywho that was fishy to me, maybe 20 or 30 pushing it, but 90 for a 16 year old with no rx history. I asked my tech what she thought because she interacted with pt and she didn't say anything because she figured I would catch it right away because kid was nervous. Remind your techs if they have a suspicion to tell you! (I know we are smart but I was at the other end how was I supposed to know he was shaking when he gave it to her and would not make eye contact).

    Sorry for rambling so, at this point the boy is back at the counter wondering how much longer . I TOLD him I need to call Dr to check dose have a seat. He SAT down. It took me 30 min to get conf it was fake (dr off) and he sat their the whole time. If he had been sitting there all smug and arrogant, for sure I would have called police. He was really scared.
    I asked him to follow me to talk in private. I said you have a choice you can give me your mom's number, she must come into store and pick you up and you admit right now what you have done or we go with option 2. He looked like he was going to melt into the floor, immediately confessed and apologized and we called his mom. She came (ended up being an ARNP), I copied the rxf for her, we explained the seriousness to her son of what he did. I have no doubt the next day that boy at a minimum was enrolled in some heavy duty counseling (she was talking in patient rehab if he failed a drug test).
    In that situation, I don't know if police would have been best option? He was going to be punished at home. Drug charges at 16 you lose financil aid for college, he could have been charged as an adult. Yes he broke the law, but what would it do to his future. It was painfully obviously his 1st time because an experienced forger would have taken off the second I said I'm calling Dr.

    RPh in Fl lose that discretion. And so now everytime you are forced to report you have to go to court. Do any of the companies pay or is that on your own time because that would upset me.

    Sorry for the long comment, up with a little guy right now and not much to do!

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  2. Thanks for stopping by and reading my diatribe. No need to apologize for the long comment, people can speak their minds here.

    The problem that I see with this new law is what would have happened if you weren't aware that the prescription was fake and "did" fill that fake Rx?

    In most States, whenever a pharmacist makes a reported mistake, the board of pharmacy investigates it and the board determines what should be done to prevent that mistake from happening again.

    With the new laws in Florida, it seems to me that the pharmacist doesn't answer to the board of pharmacy now in this aspect, you answer directly to law enforcement. That one (or more) power over our own profession has now been legislated out of existence.

    So now, if you mistakenly filled an "excellent" fake prescription like you described, the board doesn't investigate it as a mistake, the "non-pharmacist" police investigate it as a crime. In essence, that "nice" 16 y/o boy that you described just made you an accomplice in his crime.

    It doesn't matter if you were mistakenly duped by some sorry-ass POS drug seeker, the police can hold you immediately criminally liable for your mistake and may even throw you in jail if you get fooled more than once.

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  3. I think Jesse Vivian's article entitled, The Prescription Defense in this month's issue of U.S. Pharmacist describes best what can happen when we hand over the power to regulate ourselves to law enforcement.

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  4. Just to clarify this new law a little. From the Ackerman Practice Update: Pharmacy Practice Impacted by the Pill Mill Bill - House Bill 7095 -

    When a pharmacist knows a person obtained or attempted to obtain a controlled substance through fraudulent means, the pharmacist must report the incident to a law enforcement agency of the county in which the pharmacy is located. This must be done within 24 hours of learning of the incident or at the close of business on the next business day, whichever is later. The failure to report is a first-degree misdemeanor.

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