Arkansas State Regulatory Update April 2019
SB 174: To Require Mandatory Electronic Prescribing for Controlled Substances
A practitioner shall not issue a prescription for a controlled substance included in Schedule II through Schedule VI unless the prescription is made by electronic prescription from the practitioner issuing the prescription to a pharmacy.
A practitioner may issue a prescription for a controlled substance included in Schedule II through Schedule VI by written, oral, or faxed method only if issued by:
- A veterinarian;
- a practitioner to be dispensed by a pharmacy located outside of the state;
- For a controlled substance which requires the prescription to contain certain elements that are not captured through electronic prescribing methods;
- for the dispensing of a nonpatient specific prescription under a standing order, approved protocol for drug therapy, collaborative drug management or comprehensive medication management, or in response to a public health emergency or other circumstances in which the practitioner may issue a nonpatient specific prescription; for a controlled substance under a research protocol;
- who has received a waiver;
- other exceptional circumstances demonstrated by the practitioner.
This act is effective on and after the later of: January 1, 2021; or the certification by the Attorney General that the United States Department of Health and Human Services requires mandatory electronic prescribing.
Regulation 5 Nursing Home Consulting Changes that became effective on August 1, 2018.
- Updated language regarding the destruction of unused drugs for long-term care facilities to remove outdated language.
Regulation 7 General Regulations Regarding Prescriptions Changes that became effective on January 1, 2019.
- Reduced regulatory burdens when transferring prescriptions between pharmacies by allowing for transfers to be "communicated directly between two licensed or registered individuals where one of the two must be a pharmacist," meaning that interns and technicians can take part in the transfer of prescriptions under supervision.
- This change also states, "Pharmacies transferring prescriptions may utilize facsimile or other electronic means to communicate information for transfers," which will be a useful tool for non-controlled substances (CS). Drug Enforcement Administration (DEA) regulations state that the transfer of CS refills, "must be communicated directly between two licensed pharmacists."
- Added language to specify that a pharmacist cannot dispense more of a Schedule II narcotic medication than a prescriber can prescribe as required by Act 820 of 2017.
- Also clarified partial filling of Schedule II prescriptions.
Regulation 8 Wholesale Distribution Changes that became effective on August 1, 2018.
- Allowed an outsourcing facility to operate under a single permit if it does not provide medications directly to patients.
Regulation 9 Pharmaceutical Care/Patient Counseling Changes that became effective on December 1, 2017.
- Matched updated statutes to delete language for the Medications Administration Advisory Committee.
- Matched updated statutes to remove the limitations on the list of medications that can be administered by pharmacists.
- Deleted a reference that CPR courses must be accredited by the American Heart Association, which does not accredit such courses.
What does this mean to pharmacists practicing in the state of Arkansas?
- Pharmacists must ensure that their pharmacy is equipped to receive prescription orders for controlled substances by the effective date and begin to educate their pharmacy staff on the requirement and allowed exceptions. Now is a good time to also educate their pain management patients on these new requirements to avoid delays or interruptions in therapy.
- Train your staff on the clarification of transfer prescription regulations; use these clarifications to provide improved service and operational efficiency to the pharmacist's day. Check with your employer to ensure that operational policies and SOP's allow for this activity.
Arkansas State Regulatory Updates 2017 Session
Administration changes:
- Influenza vaccines may be administered to a person seven (7) years of age and older under a general written protocol.
- Immunizations other than influenza vaccines and influenza immunizations may be administered to a person from seven (7) years of age to eighteen (18) years of age under a patient-specific order or prescription and subject to reporting of the administration to the prescribing physician together with any other reporting.
- Vaccines and immunizations other than influenza vaccines and influenza immunizations may be administered to a person eighteen (18) years of age or older under a general written protocol. Prescriptions must be written by a physician licensed by the Arkansas State Medical Board and practicing in Arkansas or within fifty (50) miles of the Arkansas border.
- Pursuant to a statewide protocol, a pharmacist may initiate therapy and administer or dispense, or both, naloxone.
Requirements for administering and dispensing under a statewide protocol. When initiating therapy and administering or dispensing, or both, under a statewide protocol, a pharmacist shall:
- Notify the primary care provider of any drug or device furnished to the patient.
- Provide the patient with a written record of the drugs or devices furnished and advise the patient to consult a physician of the patient's choice, if the patient does not have a primary care provider; and
- Make a standardized fact sheet available to the recipient of the drug or device.
What do these new regulations mean for pharmacists practicing within the state of Arkansas?
The amended Pharmacy Practice Act regulation marks many positive steps in the way the state views the pharmacist's contributions to healthcare, including:
- Recognition of the pharmacist as an individual healthcare provider,
- Allows pharmacists to administer expanded immunizations other than influenza, to patients 18 years and older pursuant to an approved general written protocol,
- Allows pharmacists to provide naloxone to patients pursuant to a statewide protocol.
- Pharmacists can now provide these services to the community. Establish proper training and standard operational procedures for pharmacy teams to ensure that these new services are in accordance to state law, including the use of approved protocols for each service.
For more information, visit the Arkansas Board of Pharmacy
