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The New York State Education Department (“SED”) Office of the Professions (“OP”)
is alerting everyone to a vishing scam that has been brought to our attention.
Phishing—or “vishing”—scams impersonate SED employees or websites attempting to
collect licensure and personal information from the licensee. If you receive an
inquiry which you believe to be suspicious do not provide any information. To
verify if the inquiry was from OP, contact OP directly using the following
contact information. You may report suspicious calls or emails to the Federal
Trade Commission(link is external).
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QUESTIONS AND ANSWERS FOR PHARMACISTS AND PHARMACIES JULY 10, 2003




BREADCRUMB

 1. Home
 2. New York State Licensed Professions
 3. Pharmacist
 4. Frequently Asked Questions
 5. Questions and Answers for Pharmacists and Pharmacies July 10, 2003


PHARMACISTS

Laws, Rules & Regulations Consumer Information Contact Information License
Statistics License Requirements License Application Forms Professional Practice
Administration of Immunizations Collaborative Drug Therapy Management Nuclear
Pharmacist Certification Purple Book: Lists of Licensed Biological Products with
Reference Product Exclusivity and Biosimilarity or Interchangeability
Evaluations(link is external) Electronic Prescribing Practice Issues Frequently
Asked Questions Continuing Education Board Meetings

The New York State Education Department and the State Board of Pharmacy are
pleased to provide you with guidance to support sound practice and provide for
greater public protection.

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REGISTRATION OF OUT-OF-STATE ESTABLISHMENTS

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1. ARE ALL PHARMACY ESTABLISHMENTS LOCATED IN OTHER STATES REQUIRED TO REGISTER
TO DO BUSINESS IN NEW YORK STATE?

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Yes. Any establishment that routinely ships or delivers prescription drugs to
professionals or patients in New York State must register with the Education
Department through the State Board of Pharmacy. This includes manufacturers and
wholesalers of drugs and registered pharmacies.

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2. DO THE NEW LAW AND REGULATIONS APPLY TO MAIL ORDER AND "INTERNET" PHARMACIES?

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Yes.

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3. ARE THERE ANY EXCEPTIONS TO THIS REQUIREMENT?

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Yes, when transactions are isolated, the registration requirement may be waived.
Regulations define isolated transactions as fewer than 600 prescriptions per
year for pharmacies or sales that total less than $10,000 at wholesale, per
calendar year. The Board of Pharmacy may also waive the registration requirement
in an emergency.

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4. IS THERE A WAY TO CONFIRM THAT OUT-OF-STATE ESTABLISHMENTS, INCLUDING
"INTERNET" PHARMACIES ARE PROPERLY REGISTERED?

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Yes. You can search for manufacturers, wholesalers and pharmacies by name or
registration number on our Web site. You can search for establishments located
within New York State as well as those located elsewhere. You can also verify
that a pharmacy establishment is registered by calling 518-474-3817.

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5. WHAT SHOULD I DO IF AN OUT-OF-STATE FIRM THAT ROUTINELY SHIPS OR DELIVERS
PRESCRIPTION DRUGS TO PROFESSIONALS OR PATIENTS IN NEW YORK STATE IS NOT LISTED
AMONG REGISTERED FIRMS ON THE WEB SITE?

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Please notify the Office of the State Board of Pharmacy by phone at 518-474-3817
ext. 130 or by e-mail at pharmbd@nysed.gov(link sends email).

PROFESSIONAL OBLIGATIONS

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6. IS THERE ANY GUIDANCE REGARDING THE PROFESSIONAL OBLIGATIONS OF NEW YORK
STATE LICENSED PHARMACISTS WITH RESPECT TO PROVIDING SERVICES TO WHICH THEY MAY
BE RELIGIOUSLY, MORALLY, OR ETHICALLY OPPOSED TO?

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Answer: Yes, the Department, in conjunction with the New York State Board of
Pharmacy, has the following guidance with respect to pharmacists providing such
services.

Please note that this guidance memorandum is not intended to supersede relevant
laws, rules or regulations. Further, we recognize that professional judgment is
often based upon specific sets of facts that require a particular analysis and
cannot be answered with general guidance. Nonetheless, it is important that we
share the information that forms the basis of our general analysis.

Pharmacists have a professional responsibility to ensure that their patients
obtain properly ordered and therapeutically appropriate medications in a timely
manner with appropriate counseling from a pharmacist. Licensees have a
responsibility to practice competently and to protect against abandoning or
neglecting a patient in need of immediate care without making adequate
arrangements. Additionally, it is professional misconduct to be found to have
refused to provide professional services based upon a person's race, creed,
color or national origin. When a pharmacist recognizes that their religious,
moral or ethical belief, or any other factor, will result in the refusal to fill
a prescription that is otherwise available in a pharmacy, the pharmacist has a
professional obligation to take appropriate steps to avoid the possibility of
abandoning or neglecting a patient.

When a pharmacist begins practice in a professional setting, they should take
steps that may include notifying the owner and supervising pharmacist if their
beliefs will limit the drug products they will dispense. If a pharmacy employs a
pharmacist that has identified circumstances that would preclude the filling of
prescriptions for particular products, the owner and supervising pharmacist
should devise, within reason, accommodations that will respect the pharmacist's
choice while assuring delivery of services to patients in need. This may include
special attention to scheduling of professionals to allow a pharmacist who has a
religious, moral or ethical objection to practice simultaneously with another
pharmacist who will fill the requested prescription, entering into collaborative
arrangements with pharmacies in close proximity, or other accommodations
designed to protect the public.

Where a pharmacist has a religious, moral or ethical objection to filling a
prescription, they should not interfere with another pharmacist responding to
the professional needs of a patient. The pharmacist should refrain from engaging
in non-health related judgmental or confrontational activities with the patient.
Please remember that verbal abuse or other harassment of a patient will
constitute unprofessional conduct for professionals under existing rules and
regulations. We hope this information is helpful. If you have questions or
concerns regarding this or any pharmacy practice matter, please feel free to
contact the Pharmacy Board Office directly at Pharmbd@nysed.gov(link sends
email).

PATIENT COUNSELING

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7. WHEN IS A PHARMACIST OR REGISTERED PHARMACY INTERN REQUIRED TO COUNSEL A
PATIENT?

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A pharmacist or pharmacy intern provide patient education (counseling):

 * Before dispensing a medication to a new patient of the pharmacy;
 * Before filling a new prescription for an existing patient of the pharmacy;
   and
 * If the dose, strength, route of administration, or directions for use has
   changed for an existing prescription previously dispensed to an existing
   patient of the pharmacy.

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8. ARE NEW YORK STATE REGISTERED MAIL ORDER AND "INTERNET" PHARMACIES REQUIRED
TO PROVIDE COUNSELING TO PATIENTS?

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Yes. Registered pharmacies that conduct business through the mail or by common
carrier must include written notification that counseling is available and
provide a toll-free number where the pharmacist or pharmacy intern can be
readily reached. A pharmacist or pharmacy intern must be available to provide
counseling.

If the pharmacist or pharmacy intern determines that there are potential drug
therapy problems that could endanger the health of the patient, including but
not limited to: therapeutic duplication, drug-drug interactions and drug-allergy
interactions, the patient must be contacted prior to filling the prescription.
Alternatively, the pharmacist or pharmacy intern may contact the prescriber and
obtain permission to dispense an alternative drug.

If a prescriber gives approval for the dispensing of an alternative drug, the
pharmacist must include a notice of the change with the order and make two
documented attempts to telephone and inform the patient of the change within 48
hours of mailing or delivery. A telephone call is not required for generic
substitution.

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9. IS A REFILL AUTHORIZATION OR A NEW PRESCRIPTION FOR A DRUG A PATIENT HAS
RECENTLY BEEN TREATED WITH CONSIDERED A NEW PRESCRIPTION?

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No.

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10. IF A PATIENT IS HAVING A PRESCRIPTION REFILLED OR HAVING A PRESCRIPTION
FILLED FOR MEDICATIONS PREVIOUSLY RECEIVED, ARE WE STILL REQUIRED TO OFFER TO
PROVIDE COUNSELING?

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Yes. An to provide counseling must be made every time a patient has a
prescription re-filled or has a prescription filled for a medication therapy
that has been re-authorized by a prescriber. Any member of the pharmacy staff
can make the offer to counsel on behalf of a pharmacist, including pharmacy
interns, clerks, registered pharmacy technicians, etc. If a patient requests to
be counseled, a pharmacist or pharmacy intern must be available to provide
counseling.

If prescription drugs have been ordered through a registered pharmacy by mail or
on the Web, the pharmacist must provide the patient with a written offer to
counsel and a toll-free number where the pharmacist or pharmacy intern can be
readily reached.

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11. WHEN A PHARMACIST OR PHARMACY INTERN PROVIDES COUNSELING, WHAT ASPECTS OF
MEDICATION THERAPY SHOULD BE COVERED?

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A pharmacist or pharmacy intern should use his/her professional judgment when
deciding what to discuss with a patient during counseling. Depending on the
situation, you may choose to discuss items such as the following:

 * the name and description of the medication and known indications;
 * dosage form, dosage, route of administration and duration of drug therapy;
 * special directions and precautions for preparation, administration and use by
   the patient;
 * common severe side or adverse effects or interactions and therapeutic
   contraindications that may be encountered, including their avoidance, and the
   action required if they occur;
 * techniques for self-monitoring drug therapy;
 * proper storage;
 * prescription refill information; and
 * action to be taken in the event of a missed dose.

Pharmacists, pharmacy interns and all health care practitioners are required to
provide patient education in a confidential manner.

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12. CAN I DISPENSE A PRESCRIPTION TO A PATIENT IF THE PATIENT DECLINES
COUNSELING OR SIMPLY REFUSES TO BE COUNSELED?

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Yes, but you must document the patient's decision to decline or refuse
counseling in your pharmacy's records.

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13. HOW WILL COUNSELING REQUIREMENTS BE MONITORED AND ENFORCED?

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The Education Department and the Board of Pharmacy appreciate the vital role
pharmacists play in the health care system. Counseling provides an opportunity
for pharmacists to provide consumers with information necessary to comply with
medication regimens or avoid potentially harmful interactions. Good patient
counseling also helps to reduce prescription and medication errors. The
Department will enforce this provision by incorporating observation of
counseling in our routine inspections of pharmacies. We will also review
counseling procedures whenever a prescription error is brought to our attention.

ASSISTANCE BY UNLICENSED PERSONNEL

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14. IS THERE A LIMIT TO THE NUMBER OF UNLICENSED PERSONNEL THAT MAY ASSIST A
PHARMACIST?

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Yes. Up to four unlicensed persons may assist a pharmacist with filling
prescriptions. Staff involved in other duties not directly related to the
filling of prescriptions are NOT counted in the 4:1 ratio.

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15. ARE REGISTERED PHARMACY INTERNS INCLUDED IN THE 4:1 RATIO?

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No.

RETAIL DRUG PRICE LIST

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16. WHAT IS THE DRUG RETAIL PRICE LIST?

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The drug retail price list List is list of the 150 most frequently prescribed
drugs, in the most common quantities. The list of 150 drugs is updated annually
by the State Board of Pharmacy and posted on the Department's website.

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17. HOW WILL WE RECEIVE A COPY OF THE DRUG RETAIL PRICE LIST?

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The State Education Department will post the drug retail price list on its
website for pharmacies to download and print paper copies for their
establishment to utilize.

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18. ARE NEW YORK STATE REGISTERED PHARMACIES REQUIRED TO MAKE THEIR DRUG RETAIL
PRICE LIST AVAILABLE TO CONSUMERS?

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Yes. Every pharmacy that sells drugs at retail must make drug retail price lists
available with prices of the 150 most frequently prescribed drugs. The pharmacy
must also display a sign in bold, block letters at least one inch in height that
states "Drug Retail Price List Available Upon Request." Consumers may request a
computer-generated list to take with them when they leave the pharmacy.

Pharmacies offering to dispense prescription drugs to consumers in New York
State through the Internet are required to post a notice of availability of the
drug retail price list and a toll-free number to obtain the list on your Web
site. Pharmacies offering to dispense prescription drugs to consumers in New
York State through mail order are required to include a printed notice with each
delivery of a prescription drug informing the consumer of the availability of
the list and a toll-free telephone number to obtain it.

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19. DOES THE DRUG RETAIL PRICE LIST REPLACE THE PRESCRIPTION PRICE POSTER?

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Yes.

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20. HOW OFTEN IS A PHARMACY REQUIRED TO UPDATE THE SELLING PRICE OF THE DRUGS ON
THE LIST?

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You must update the list at least weekly.

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21. IF OUR SELLING PRICE CHANGES DURING THE WEEK, CAN WE LEGALLY CHARGE THE NEW
PRICE?

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Yes.

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22. ARE WE ALLOWED TO QUOTE PRESCRIPTION PRICES OVER THE PHONE?

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Yes, but you are not required to do so.

CONTINUING EDUCATION REQUIREMENTS

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23. ARE NEW YORK STATE LICENSED PHARMACISTS REQUIRED TO COMPLETE FORMAL
CONTINUING EDUCATION ON MEDICATION SAFETY?

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Yes. During each three-year registration period, you must complete at least
three hours of formal continuing education on strategies and techniques to
reduce medication and prescription errors.

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24. WILL I BE REQUIRED TO COMPLETE THE THREE HOURS OF CONTINUING EDUCATION ON
MEDICATION SAFETY IN ADDITION TO THE EXISTING 45-HOUR MANDATORY CONTINUING
EDUCATION REQUIREMENT?

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No. Coursework on reducing medication and prescription errors can be applied to
the 45 hours of continuing education each pharmacist must complete every three
years.

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25. DO I HAVE TO COMPLETE COURSEWORK IN THIS AREA THROUGH "LIVE" PROGRAMMING?

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No. You can take either "live" or "home study" courses.

FURTHER INFORMATION

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26. WHO DO I CONTACT IF I HAVE ADDITIONAL QUESTIONS OR NEED MORE INFORMATION?

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Please contact the State Board of Pharmacy by phone at (518) 474-3817 ext. 130;
fax at (518) 473-6995; or by e-mail at pharmbd@nysed.gov(link sends email).



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