Obtaining CII meds at local pharmacies questions

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Specializes in Med Surg, Hospice, Home Health.

I work for a for profit company. They have tried going from one compounding pharmacy delivering medications to

patients' families obtaining medications in the past ( to save money) , and starting SATURDAY they are instituting this policy once more.

My manager tells me that there is a "law" where local pharmacies must accept a faxed prescription for hospice patients,

as long as the fax says "terminally ill". I've checked with a local pharmacy and yes, they will accept a faxed prescription

and will dispense a 3 day supply, but they must receive the ORIGINAL within 3 business days. Also, that faxed prescription

MUST have a physicians signature, quantity to dispense and DEA number. My problem is we only have our medical director in the office once every 14 days for IDT meetings, and then for just that meeting.

WHAT IS A NURSE TO DO???

We use a system called EHO, which is essentially a billing service for medications (they aren't like hospice pharmacia who will generate a prescription with a prescription number and physicians DEA number for physician to sign). All EHO does is profile the medication, and if you try to have a script refilled more than 2 days early, it is denied.

For this patient, I've faxed the current MAR and information for billing purposes printed out of EHO and a face sheet for the patient. I spoke with the lead pharmacist (at a local pharmacy my patient has chosen) and he is "looking the eho" system over. He said he doesn't routinely fill for hospice patients, but he has in the past (and it is not a compounding pharmacy)...

SO, here is the upcoming situation. Patient had CII meds last filled on 2/2/09, they are not up to be refilled until 2/17/09 (tuesday). I can't get the CII filled before SUNDAY, and medical director won't be in the office until THURSDAY 2/19/09...Patient will be out of meds on 2/18/09......AND I don't even know if this pharmacy can handle this patients medications...Morphine sulfate 45mg po qid, and liquid roxinol 20mg/ml.

Anyone else have to jump through hoops? Any input is greatly appreciated.

linda

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Specializes in psych, addictions, hospice, education.

Can the doctor's office fax a prescription tomorrow that says to fill it on the day you need to have it filled (if he's in the office tomorrow, of course)?

My hospice had a person who went to doctors' offices to get the originals and delivered them. She picked them up on Tuesdays and Thursdays.

Or the family could pick up the original and take it to the pharmacy or have it ready for the delivery person, if the pharmacy delivers. Logistics of this boggle the mind, don't they?

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Specializes in Med Surg, Hospice, Home Health.

YES!!! Thank the good LORD!!! There is a law that allows pharmacies to dispense with a faxed prescription. Also, we are able to use our previous compounding pharmacy and they will deliver, for free, to our local inpatient unit (so at least meds are available by the next day). So, this is better than it was.

linda

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Specializes in HOSPICE,MED-SURG, ONCOLOGY,ORTHOPAEDICS.

Jimminy, the pitfalls of being a hospice nurse and getting what we need in a timely manner for our patients. I think the pharm laws vary state by state. In our state, the pharmacy has to have a hardcopy script on hand within 5 days (some of our local pahrmacies have a policy stating three days so that they are well within the range). Any of our pharmacies will take a schedule 2 order by phone from our hospice nurses. Our contracted pharmacies will meet us 24 hours a day to fill for us, even if the pharmacy is closed so that we can get the meds we need for our patients. One of our pharmacies is a compounding pharmacy and will even compound 24 hours a day for us. The pharmacies deal with obtaining the scripts, we just deal with taking care of the patients, getting the doctors order and calling it into the pharmacy. :yeah:

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