Why are pharmacists asking for diagnoses and treatment plans if pharmacists’ only responsibility
under DEA regulations is to ensure that a prescription is legitimate?
Pharmacists are not just required to ensure that a prescription for a controlled substance is legitimately
written. According to 21 C.F.R.1306.04, pharmacists are required to ensure that prescriptions for
controlled substances are issued for a legitimate medical purpose. The regulation states, in pertinent
part,the following:
“The responsibility for the proper prescribing and dispensing of controlled substances is upon the
prescribing practitioner, but a corresponding responsibility rests with the pharmacist who fills the
prescription. An order purporting to be a prescription issued not in the usual course of professional
treatment or in legitimate and authorized research is not a prescription within the meaning and intent
of section 309 of the Act (21 U.S.C. 829) and the person knowingly filling such a purported
prescription,as well as the person issuing it, shall be subject to the penalties provided for violations of the provisions
of law relating to controlled substances. ”
Any time that a Walgreens pharmacist asks for a diagnosis or a treatment plan, that pharmacist is
requesting the information to ensure that the prescription for a controlled substance has been
prescribed for a legitimate medical purpose.
Can pharmacists ask for patient information protected under HIPAA?
Pharmacies and pharmacists are covered under HIPAA as “health
care providers , ” which includes entities
who sell or “dispense a drug, device, equipment
or other item in accordance with a prescription.” (45
CFR 160.103 par (3))
Therefore, by law, pharmacists are granted access to protected health information
necessary for them to perform their responsibilities. Every prescription on file for our patients is
protected health information, which Walgreens has always held as confidential information and
protected under federal law (HIPAA).
Each and every medical condition or allergy of our patients is
similarly held as confidential and used only to ensure the proper dispensing of medications.
Is Walgreens ’ policy designed to “limit” the quantity of pain medication that can be dispensed to
patients?
No.
A prescription for a large quantity of narcotics may draw increased scrutiny, but a physician’s
prescriptions are not denied solely because of the quantity of tablets prescribed.
Similarly, Walgreens does not want to inconvenience our patients by making them go to multiple
pharmacies. If one Walgreens pharmacist refuses a specific prescription for an opioid
for a patient, that prescription will be refused at all Walgreen pharmacies, as it has been entered
in our system as “refused
.”
Each patient should be given this information to avoid travelling to multiple Walgreens pharmacies in order to fill a prescription.
While Walgreens ’ policy is not designed to limit our patients’ access to needed pain medication, we as
health care providers must understand that the prescribing and dispensing of opioids
is changing and must continue to change in order to stop diversion and unnecessary “accidental” deaths by overdose.
