Arizona State Regulatory Update April 2019
HB 2075: E-Prescribing CS and Physician Assistant Prescriptive Authority
Covers e-prescribing, exceptions, and deadlines. It is an emergency measure made retroactive to December 31, 2018. HB 2075 delays e-prescribing requirements for all counties until January 1, 2020.
Additionally, the bill immediately reinstates a Board-certified physician assistant's ability to issue a 30-day prescription for Schedule II, III, IV, and V controlled substances (CS) that are opioids and benzodiazepines.
Pharmacy Technician Trainee Licenses: Extensions
Pharmacy technician trainees with licenses that have expiration dates on or before July 31, 2019, are eligible to reapply for a two-year extension of their licenses, up to 60 days before their licenses expire. Note: No applications that reapply for extensions will be accepted after July 31, 2019. Pharmacy technician trainees with licenses expiring after July 31, 2019, are not eligible to reapply for extensions. Reapplying for an extension is not available for a technician trainee whose license has already expired or has already been extended. An extension is only allowed one time. Technician trainees who are granted reapply extensions will receive a one-time, two-year extension of their licenses. If the technician trainee license expires, the technician trainee may not work until he or she receives a technician license.
What does this mean for pharmacists practicing in the state of Arizona?
- Mandatory e-prescribing has been delayed; pharmacists may still accept written and called in prescriptions for controlled substances through January 1, 2020 (current CS laws still apply). Pharmacies must use this time to prepare and train their staff on the proper use of e-prescribing for controlled substance prescriptions to prepare for the upcoming requirement.
- Pharmacy managers must educate their technician staff on the new licensure requirements for work, and routinely inspect that all technicians on staff are appropriately licensed to work.
Arizona State Regulatory Summary- July 2018
The following is a summary of recent pharmacy practice bills passed in the state of Arizona:
Senate Bill (SB) 1001: Controlled substance; regulation; appropriation.
- Prohibits some healthcare from dispensing Schedule II controlled substances (CS) that are opioids.
- Limits an initial prescription for a Schedule II CS that is an opioid to a five-day supply and permits a 14-day supply for initial prescriptions following a surgical procedure.
- Prohibits a health professional who is authorized to prescribe CS from issuing a new prescription order for a Schedule II CS that is an opioid and that exceeds 90 morphine milligram equivalents (MMEs) unless the prescription meets specific exemption criteria.
- Requires that a health professional additionally prescribe naloxone or another opioid antagonist to a patient who is prescribed more than 90 MMEs per day.
- Requires that a nonemergency prescription order for a Schedule II opioid dispensed directly by a pharmacist must have a red cap and warning label.
- Requires an electronic prescription to a pharmacy for a Schedule II drug that is an opioid.
SB 2149: Remote dispensing pharmacies.
Allows for a certified licensed technician to operate a pharmacy that is supervised by a pharmacist remotely.
House Bill (HB) 2633: Pharmacist; controlled substances.
Pharmacist is not required to verify with the prescriber whether the initial prescription meets exemption requirements.
HB 2107: Pharmacies; practices; pharmacy benefits managers.
Prohibits pharmacy benefits managers (PBMs) from prohibiting a pharmacy or pharmacist from providing information regarding the amount of the patient's cost share for a prescription drug and discussing alternative treatment.
HB 2548: Health professionals; continuing education; opioids.
A prescriber or dispenser shall complete a minimum of three hours of opioid-related continuing medical education each license renewal cycle.
HB 2040: Pharmacy board; definitions; reporting.
Defines satellite pharmacy and remote pharmacy kiosks into regulation.
HB 2041: Pharmacy board; licenses; permits.
Aligns the language on renewal processes.
HB 2549: Controlled substance; dosage limit.
Exempts opioid prescriptions that are issued following surgical procedures and that are limited to a 14-day supply from the 90 MME limitation.
Permits a health professional to issue a prescription that exceeds the 90 MME limitations under certain parameters.
What do these new regulations mean for pharmacists practicing within the state of Arizona?
- Pharmacists must be aware of who can prescribe opioid prescriptions by law, and the limitations of opioid prescribing, to help educate health care providers. Pharmacists are not required to verify all prescriptions that are written outside of required limitations and can assume that the patient meets one of the allowable exemptions but must also use their professional judgement during all opioid dispensing.
- Pharmacists must be prepared to accept electronic prescription for all opioids by the set deadlines; begin to create awareness with your pain management patients, and local physicians to avoid delays in treatment later.
- All healthcare providers must plan to include pain management or opioid continuing education beginning with their next license renewal, per new requirements.
- Pharmacists can now provide information to their patients around cost effective alternatives, including generic options and therapeutic interchanges, to promote adherence and improved health outcomes of their patients. Include this discussion as part of your patient counseling discussions.
For more information, visit the Arizona Division of Professional Licensing