CII Drugs- Emergency Declaration

RESOLUTION

Whereas, the Mississippi Board of Pharmacy is charged with the protection of the public health as it relates to patient safety, patient health, patient access, and patient services, and

Whereas, Governor Tate Reeves declared a state of emergency on March 14, 2020, concerning the coronavirus and the potential spread of COVID-19; and

Whereas, in the best interest of protecting the public health, the delivery of healthcare services is being facilitated through telemedicine rather than face-to-face examinations; and

Whereas, the Mississippi Board of Pharmacy regulations restrict the prescriptions of Schedule II controlled substances under emergency conditions to a quantity of medication that does not exceed a forty-eight (48) hour supply when the prescription is issued orally; and

Whereas, to facilitate access by the public to drugs that are vital and necessary to maintaining each individual’s health, now therefore;

Be it resolved, that for the duration of the Governor’s declaration of emergency, Article XIX of the Mississippi Board of Pharmacy Regulations shall be suspended with respect to the quantity of Schedule II controlled substances prescribed orally. The Board shall allow a quantity of medication necessary for a thirty (30) day supply for a patient to be dispensed pursuant to an oral prescription for a Schedule II controlled substance during the declaration of emergency.

Be it further resolved, that all other provisions of Article XIX shall remain in effect and all pharmacies permitted by the Mississippi Board of Pharmacy are encouraged to be familiar with the provisions of Article XIX and CFR §1306.11(d).

__________________________

Resolved through an emergency, telephonic meeting of the Mississippi Board of Pharmacy this day, March 18, 2020, at 4:45 o’clock P.M.

​​In response to the Governor’s State of Emergency declaration and potential issues with CII prescriptions, the Board of Pharmacy had an emergency phone in meeting yesterday. Below is the decision that was made.

Please be advised on the following regulations surrounding CII prescriptions-

1. Call in prescriptions for CII drugs are allowed at this time.

2. The normal 48-hour rule has been waived and is now up to a 30-day limit.

3. Pharmacists will need to receive a hard copy of the prescription within 7 days of the called in prescription.

4. This rule is only in effect during the Governor’s Declaration of the State of Emergency.

5. It is recommended that this should only be used in an absolute emergency when a written or electronic prescription may not be obtained. Because of the strict requirement of the 7-day hard copy prescription, there could be major issues with the DEA if this is not followed.

6. Pharmacists are expected to use professional judgment. There is NO requirement to fill any prescription that you determine should not be filled.

***If you have not received the hard copy within the 7-day time period, it is your responsibility to contact the local DEA to report the prescriber or the prescription will be considered an invalid prescription by the DEA. Failure to do so can affect any audit or investigation the DEA performs on you and your facility. ***

Language from the DEA Pharmacist’s Manual:

Emergency Dispensing

An "emergency prescription" in this context, is defined to mean that the immediate administration of the drug is necessary for proper treatment of the intended ultimate user, that no alternative treatment is available (including a drug which is not a schedule II controlled substance), and it is not possible for the prescribing practitioner to provide a written prescription for the drug at that time. In a bona fide emergency, a practitioner may telephone a schedule II prescription to the pharmacist who may then dispense the prescription. The prescribing practitioner must provide a written and signed prescription to the pharmacy within seven days and meet the below requirements:

1. The drug prescribed and dispensed must be limited to the amount needed to treat the patient during the emergency period. Prescribing or dispensing beyond the emergency period must be pursuant to a written prescription order.

2. The prescription order must be immediately reduced to writing by the pharmacist and must contain all information, except for the prescribing practitioner's signature.

3. If the prescribing individual practitioner is not known to the pharmacist, he/she must make a reasonable effort to determine that the oral authorization came from a registered individual practitioner, which may include a call back to the prescribing individual practitioner using his or her telephone number as listed in the telephone directory and/or other good faith efforts to insure his or her identity.

4. Within seven days after authorizing an emergency telephone prescription, the prescribing practitioner must furnish the pharmacist a written, signed prescription for the controlled substance prescribed. The prescription must have written on its face "Authorization for Emergency Dispensing" and the date of the oral order. The written prescription may be delivered to the pharmacist in person or by mail, but if delivered by mail, it must be postmarked within the seven day period. Upon receipt, the dispensing pharmacist must attach this written prescription to the oral emergency prescription which had earlier been reduced to writing by the pharmacist. By regulation, the pharmacist must notify the local DEA Diversion Field Office (Visit www.DEAdiversion.usdoj.gov for current addresses and telephone numbers) if the prescriber fails to provide a written prescription within seven days. Failure of the pharmacist to do so will void the authority conferred on the pharmacy to dispense the controlled substance without a written prescription of a prescribing practitioner.