When the powers to be won’t enforce their own laws

There was a complaint filed with the Indiana Board of Pharmacy… which was referred to the AG’s office… concerning a chain drug store refusing to fill C-II’s without a ICD9 provided by the prescriber.. Didn’t not make any difference if the pt and/or the doctor was known to the pharmacy staff, nor if the pt or the prescriber had/has any previous problems concerning overuse/abuse of C-II’s

There is the response from the AG’s office :

Our attorneys have thoroughly reviewed the information you provided for possible legal action. Unfortunately, there appears to be no violation of Indiana law under the jurisdiction of the Unit.

A short time later the following email was received.. notifying all licensed RPH’s in Indiana of a suspended license of a particular prescriber along with the legal rational why a RPH has the legal right to fill a Rx… per the pharmacy practice act.

PLA Banner 2013

Dear Pharmacists:

The Indiana Professional Licensing Agency is providing this written notice to all Indiana licensed pharmacists that on February 28, 2013, the Medical Licensing Board of Indiana temporarily suspended the following license:

IC 25-26-13-16 Pharmacist’s professional judgment; honoring and refusal to honor prescriptions; immunity
Sec. 16. (a) A pharmacist shall exercise his professional judgment in the best interest of the patient’s health when engaging in the practice of pharmacy.

(b) A pharmacist has a duty to honor all prescriptions from a practitioner or from a physician, podiatrist, dentist, or veterinarian licensed under the laws of another state. Before honoring a prescription, the pharmacist shall take reasonable steps to determine whether the prescription has been issued in compliance with the laws of the state where it originated. The pharmacist is immune from criminal prosecution or civil liability if he, in good faith, refuses to honor a prescription because, in his professional judgment, the honoring of the prescription would:

  1. be contrary to law;
  2. be against the best interest of the patient;
  3. aid or abet an addiction or habit; or
  4. be contrary to the health and safety of the patient

Apparently the Indiana Practice act does not consider the failure of the prescriber to put a ICD9 on the RX a legal right to refuse to honor (fill) a Rx… however… the AG’s office appears to consider this a violation of the practice act of too low a priority to take action. Of course, if a chronic pain pt was thrown into withdrawal and have their pain shot of the scale.. not big deal for the bureaucrats…  Doesn’t appear that they “feel their pain”..

IMO.. the state of Indiana AG’s office either is understaffed or the members of the staff are under motivated !

5 Responses

  1. Here is what I do on a rx that I don’t want to fill: “Sorry, but we are out of stock”.

    • But the question has to be asked… if you knew the pt, who had patronized your pharmacy for years… the pt had never had this drug filled before… and it was written by a prescriber in the neighborhood who was not “known” as a troublesome prescriber… would you be acting professionally and in good faith… stating that you “were out of stock” and declining to fill the Rx ?

  2. I remember the email, but I may have deleted it already, so I’m not quite sure which doc just got suspended. I do remember a particular doc in NW IN who was suspended and plead guilty to fed charges due to dispensing coupious amounts of controls from his office in addition to writing for them. When he first got suspended, I was working as a float for a small company in the area. I refused to fill any of his controlled rx’s after the suspension as did some of the other RPhs in the same company. We then got an email from the owners, we were to fill any contolled rx that were written before the suspension. Now mind you, we all had strong suspicions most of these ‘patients’ weren’t legit, but you call and verify, you get all the ‘correct answer’ that it was a legit medical need. Of course it wasn’t uncommon for me to refuse to fill and they come back later when the other guy was on duty. The BOP was absolutley no help in clarifying and so the veiled threat of losing my job many times made me feel like I lost any ethics I had when I started in pharmacy. Personally I have a back story which made the veiled threat a bit of a reality. But that would be a private conversation for another time. The IN BOP seems only to be in it to keep the corporpates happy, the heck with what goes on in the trenches.

  3. If and until state boards of pharmacy honor and recognize rights of conscience, pharmacists will always be hounded and harassed for exercising their judgment, something we were trained to do and which they have been telling us we should do for 40+ yrs. We are not pharmacist monkeys and short order fillers.

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