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Dear ,

While you may thnk your posting needed clarification, I understoond

it quite well. Thank you for your expertise in advisement.

Respectfully,

Jeanetta Mastron CPhT BS Chem

Founder/Owner PTCB Study Group!

> Hi everyone,

> It was my understanding here in Texas,not just Medicaid, that ALL

new

> prescriptions

> have counseling given. The bag stuffer simply did not " do away "

> with the act of counseling.

> Also, I want to clarify something I said about the signature log.

> When Obra went in to effect, the signature log was developed to

> insure the patients right to counsel and to sign whether they

> accepted counseling or if they didn't want to receive it.

>

> Then the insurance giants decided they would practice medicine

> without a license and then they started playing a role in the

> signature log.

> If a pharmacy gets audited, and I have been through it before, the

> insurance company in all probability ask for the signature log to

> verify the patient or their designated agent picked up the

med.Since

> reimbursement is so low from the insurance companies, retailers and

> other healthcare providing pharmacies neccessitate keeping the

> logs, " for insurance purposes " .

>

> Now if memory serves me correctly, and depending on what format is

> used to print the logs, usually there is the signature line for the

> patient's " Hancock " , and a spot that says (wording may vary),

> accepted_________/refused____________, and either of those lines

> would be checked indicating counseling preference.

>

> Just thought I would clarify yesterdays post by me.

> Thanks,

>

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Dear Dora,

You never cease to amaze me! What great questions not only for

of NJ but for all techs of all states.

I think you are hitting the nail on the head with the confidentiality

issue and HIPPA!!!

Looking forward to this hot topic continuing.

Respectfully,

Jeanetta Mastron

Another reason Dora is the Group Moderator!

> > Hi Jeanetta and Everyone,

> >

> > The federal law has not changed. OBRA '90 as it is known is U.S.

> legislation which requires pharmacists to offer to provide

counseling

> services to all Medicaid patients. Variations of this law are in

> effect in each state. In some states, the pharmacist must

physically

> make the offer to counsel. In others the technician or cashier may

> make the offer. I would like to add that the offer to counsel

> applies to all prescriptions filled - new or refills.

> > Speaking now specifically for the state of New Jersey, the

person

> finalizing the prescription the sale is the person responsible for

> making the offer to counsel. That person must specifically say " Do

> you have any questions about this medication for the pharmacist? "

> Depending on how the patient answers, they are then asked to sign a

> log book with 2 columns. The left hand column states they were

asked

> but had no questions. The right and column states they were asked

> and DID have questions and were counseled. There is also a column

> for the person making the offer to counsel to enter their initials

> and column for the pharmacist who did the counseling to sign. I

say

> this because several pharmacies in my area were fined by the

pharmacy

> board for improperly executing the law. Here, one cannot simply

> say " Do you have any questions? " or place the rx # on the log book

> and say " Sign here for your prescription. " Many patients are under

> the incorrect assumption that the log book is for insurance

purposes,

> for legal purposes about who actually picked up the prescription or

> just for store records. And while I mention it, if someone other

> than the patient picks up the prescription, we have what we

> call " OBRA bag stuffers " which are just little notes that state our

> pharmacist is always available to answer questions about this or

any

> medication you have followed by the pharmacy phone number (the

> message is written in English, Spanish and I think Portuguese.)

> > Again the latter part of this applies to New Jersey only.

> >

> >

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Dear and all,

I appreciate your input on this subject.

For anyone who is not aware:

Any time the RX number and the patients name are connceted on the

same paper (including to but not limited to the label) there is a

confidentiality issue. So if someone is in line and you see them on

could not determing they are there to pick up a specific med for

themselves or for a neighbor. How ever the second that they pick up

a drug and it has a Rx number next to it then that is a

confidentiality issue. So I am asking is the Rx number also on the

sign off list?

Thank you all in advance,

Jeanetta

> > > Hi Jeanetta and Everyone,

> >

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Dear ,

Okay NOW you are hitting on my last entry!

ANYTIME THE PATIENT'S NAME AND RX NUMBE ARE TOGETHER on the same

paper or screen of a computer that is a confidentiality issue!

I wonder if this will be changed in the near future!

Respectfully,

Jeanetta Mastron

> > Hi Jeanetta and Everyone,

> >

> > The federal law has not changed. OBRA '90 as it is known is

U.S.

> legislation which requires pharmacists to offer to provide

counseling

> services to all Medicaid patients. Variations of this law are in

> effect in each state. In some states, the pharmacist must

physically

> make the offer to counsel. In others the technician or cashier

may

> make the offer. I would like to add that the offer to counsel

> applies to all prescriptions filled - new or refills.

> > Speaking now specifically for the state of New Jersey, the

person

> finalizing the prescription the sale is the person responsible for

> making the offer to counsel. That person must specifically

say " Do

> you have any questions about this medication for the pharmacist? "

> Depending on how the patient answers, they are then asked to sign

a

> log book with 2 columns. The left hand column states they were

asked

> but had no questions. The right and column states they were asked

> and DID have questions and were counseled. There is also a column

> for the person making the offer to counsel to enter their initials

> and column for the pharmacist who did the counseling to sign. I

say

> this because several pharmacies in my area were fined by the

pharmacy

> board for improperly executing the law. Here, one cannot simply

> say " Do you have any questions? " or place the rx # on the log book

> and say " Sign here for your prescription. " Many patients are

under

> the incorrect assumption that the log book is for insurance

purposes,

> for legal purposes about who actually picked up the prescription

or

> just for store records. And while I mention it, if someone other

> than the patient picks up the prescription, we have what we

> call " OBRA bag stuffers " which are just little notes that state

our

> pharmacist is always available to answer questions about this or

any

> medication you have followed by the pharmacy phone number (the

> message is written in English, Spanish and I think Portuguese.)

> > Again the latter part of this applies to New Jersey only.

> >

> >

>

>

>

>

>

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Hi Jeanetta,

NJ - CVS: The Rx # and the date are on the sticker which is placed on the log,

the patient or representative sign either to the left (refused counseling) or

the right (accepted counseling) of the sticker.

****SIDE NOTE: The reason I always place NJ - CVS in connection with this issue

is that I got I blasted on another site for some assumptions I made - namely, I

thought anyone could offer the counseling to the patient but only the RPh would

do actual counseling. Wrong - some states (If you are out there please let us

know who you are!) require that the RPh make the offer to counsel and do the

counseling. So in an effort to avoid a conflict here I would like to express my

opinions as those of the state of NJ and CVS pharmacy.

Thanks

Re: patient counseling

Dear and all,

I appreciate your input on this subject.

For anyone who is not aware:

Any time the RX number and the patients name are connceted on the

same paper (including to but not limited to the label) there is a

confidentiality issue. So if someone is in line and you see them on

could not determing they are there to pick up a specific med for

themselves or for a neighbor. How ever the second that they pick up

a drug and it has a Rx number next to it then that is a

confidentiality issue. So I am asking is the Rx number also on the

sign off list?

Thank you all in advance,

Jeanetta

> > > Hi Jeanetta and Everyone,

> >

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Hi Jeanetta and All:

I never really thought about it but now that you bring it up . . . Hmmm! I

could picture several scenarios where confidentiality would be breached. This

is taking it a bit far but it could happen right. Bear with me here. I'll use

myself as an example. If I am behind someone in line who for whatever reason

makes me curious about what meds they get I can see they are signing the log

book above my name (the next space - I am the next person) I waste a few

minutes getting my money or whatever ready at the counter. Meanwhile, I

memorize the 6-digit rx # of the person in front of me (not too hard.) I call

the pharmacy back on the phone posing as the other person with some seemingly

innocent question about my prescription (Are there any refills? Etc.) The

person on the phone punches the number in the computer - OK Ms. , that's

for your valtrex right? (now I have the name of the medication) You have 2

refills after the one you got today. Thank you. Simple right?

I'm going to bring this issue up to our RHM. They are strict about how we

conduct this part of our pharmacy business and I'd hate to think this part was

glossed over. I'd also hate to think that the way we are going about this is

the bare minimum allowed by the law. I will look into to this issue in some

depth and get back to you with a better answer.

Thanks for enlightening me. I love to explore new things in ways I haven't

thought of before.

Thanks

Re: patient counseling

Dear ,

Okay NOW you are hitting on my last entry!

ANYTIME THE PATIENT'S NAME AND RX NUMBE ARE TOGETHER on the same

paper or screen of a computer that is a confidentiality issue!

I wonder if this will be changed in the near future!

Respectfully,

Jeanetta Mastron

> > Hi Jeanetta and Everyone,

> >

> > The federal law has not changed. OBRA '90 as it is known is

U.S.

> legislation which requires pharmacists to offer to provide

counseling

> services to all Medicaid patients. Variations of this law are in

> effect in each state. In some states, the pharmacist must

physically

> make the offer to counsel. In others the technician or cashier

may

> make the offer. I would like to add that the offer to counsel

> applies to all prescriptions filled - new or refills.

> > Speaking now specifically for the state of New Jersey, the

person

> finalizing the prescription the sale is the person responsible for

> making the offer to counsel. That person must specifically

say " Do

> you have any questions about this medication for the pharmacist? "

> Depending on how the patient answers, they are then asked to sign

a

> log book with 2 columns. The left hand column states they were

asked

> but had no questions. The right and column states they were asked

> and DID have questions and were counseled. There is also a column

> for the person making the offer to counsel to enter their initials

> and column for the pharmacist who did the counseling to sign. I

say

> this because several pharmacies in my area were fined by the

pharmacy

> board for improperly executing the law. Here, one cannot simply

> say " Do you have any questions? " or place the rx # on the log book

> and say " Sign here for your prescription. " Many patients are

under

> the incorrect assumption that the log book is for insurance

purposes,

> for legal purposes about who actually picked up the prescription

or

> just for store records. And while I mention it, if someone other

> than the patient picks up the prescription, we have what we

> call " OBRA bag stuffers " which are just little notes that state

our

> pharmacist is always available to answer questions about this or

any

> medication you have followed by the pharmacy phone number (the

> message is written in English, Spanish and I think Portuguese.)

> > Again the latter part of this applies to New Jersey only.

> >

> >

>

>

>

>

>

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Hi:

This sounds like CVS-Maine as well. Next time I get a prescription you can

be sure that I will check to see if the Rx number is on the log. I don't

recall it being that way, but I could be wrong. And even if it was, why is

that a confidentiality issue? How can an outsider identify the drug by a Rx

number (without access to conmputer records) ?

My experience with Maine has been that anyone can offer the counseling, but

only the pharmacist can give it. Thsi is the way it is in the CVS I go to as

well as the hospital pharmacy.

Chris

Re: patient counseling

>

> Dear and all,

>

> I appreciate your input on this subject.

>

> For anyone who is not aware:

>

> Any time the RX number and the patients name are connceted on the

> same paper (including to but not limited to the label) there is a

> confidentiality issue. So if someone is in line and you see them on

> could not determing they are there to pick up a specific med for

> themselves or for a neighbor. How ever the second that they pick up

> a drug and it has a Rx number next to it then that is a

> confidentiality issue. So I am asking is the Rx number also on the

> sign off list?

>

> Thank you all in advance,

> Jeanetta

>

>

>

>

> > > > Hi Jeanetta and Everyone,

> > >

>

>

>

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Dearest !

NOW YOUV'E GOT IT! YOU HAVE THE WHOLE CONFIDENTIALITY ISSUE IN YOUR

HIP POCKET!!!

Please get back to us!

Respectfully,

Jeanetta

> > > Hi Jeanetta and Everyone,

> > >

> > > The federal law has not changed. OBRA '90 as it is known is

> U.S.

> > legislation which requires pharmacists to offer to provide

> counseling

> > services to all Medicaid patients. Variations of this law are

in

> > effect in each state. In some states, the pharmacist must

> physically

> > make the offer to counsel. In others the technician or cashier

> may

> > make the offer. I would like to add that the offer to counsel

> > applies to all prescriptions filled - new or refills.

> > > Speaking now specifically for the state of New Jersey, the

> person

> > finalizing the prescription the sale is the person responsible

for

> > making the offer to counsel. That person must specifically

> say " Do

> > you have any questions about this medication for the

pharmacist? "

> > Depending on how the patient answers, they are then asked to

sign

> a

> > log book with 2 columns. The left hand column states they were

> asked

> > but had no questions. The right and column states they were

asked

> > and DID have questions and were counseled. There is also a

column

> > for the person making the offer to counsel to enter their

initials

> > and column for the pharmacist who did the counseling to sign.

I

> say

> > this because several pharmacies in my area were fined by the

> pharmacy

> > board for improperly executing the law. Here, one cannot

simply

> > say " Do you have any questions? " or place the rx # on the log

book

> > and say " Sign here for your prescription. " Many patients are

> under

> > the incorrect assumption that the log book is for insurance

> purposes,

> > for legal purposes about who actually picked up the prescription

> or

> > just for store records. And while I mention it, if someone

other

> > than the patient picks up the prescription, we have what we

> > call " OBRA bag stuffers " which are just little notes that state

> our

> > pharmacist is always available to answer questions about this or

> any

> > medication you have followed by the pharmacy phone number (the

> > message is written in English, Spanish and I think Portuguese.)

> > > Again the latter part of this applies to New Jersey only.

> > >

> > >

> >

> >

> >

> >

> >

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Dear

While I would have posted a confidentiality scenario regarding this I

do not have to any longer. did it for me. I knew that this

would raise some issues. But the reality is if there is to be a log

then everyone would know who is a pt or agent of a pt and who is not!

Log books may be thrownout the window with HIPPA!

To answer your question read 's scenario!

Respectfully,

Jeanetta

> > > > > Hi Jeanetta and Everyone,

> > > >

> >

> >

> >

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Hi:

But doesn't everyone see the person standing at the pharmacy counter?

Doesn't that identify them as a patient?

What is HIPPA? I'm not following your post. I thought I read 's

scenario which is what I posted on. Maybe I am not getting some posts?

Chris

Re: patient counseling

> Dear

> While I would have posted a confidentiality scenario regarding this I

> do not have to any longer. did it for me. I knew that this

> would raise some issues. But the reality is if there is to be a log

> then everyone would know who is a pt or agent of a pt and who is not!

> Log books may be thrownout the window with HIPPA!

> To answer your question read 's scenario!

>

> Respectfully,

> Jeanetta

>

>

>

> > > > > > Hi Jeanetta and Everyone,

> > > > >

> > >

> > >

> > >

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Hi Chris-

HIPAA stands for Health Insurance Portability and Accountibility Act.

The act which passed in 1996 protects the health insurance of workers

who either lose their job or move to a different job--(no waiting

period until new issurance takes effect). It also had a provision

giving congress until Aug of 1999 to pass comprehensive health

privacy legislation. Congress didn't,so the Dept of Health and Human

Services wrote and is revising the regulations. The effective date is

April 14,2003. In a nutshell, patient privacy will be protected from

outside entities--no more mailing/selling patient lists to drug

companies. Also, patient information within hospital/pharmacy will be

on a 'need to know basis' There's no reason for the ward secretary on

the orthopaedic ward to have access to the files of a patient on the

psychiatric ward. I've added a couple of HIPAA links to the bookmarks

sections.

Dora

> Hi:

>

> But doesn't everyone see the person standing at the pharmacy

counter?

> Doesn't that identify them as a patient?

>

> What is HIPPA? I'm not following your post. I thought I read

's

> scenario which is what I posted on. Maybe I am not getting some

posts?

>

> Chris

>

> >

> >

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Thanks Dora:

As it is right now, it is against hospital policy for me to view patient

records

Re: patient counseling

> Hi Chris-

> HIPAA stands for Health Insurance Portability and Accountibility Act.

> The act which passed in 1996 protects the health insurance of workers

> who either lose their job or move to a different job--(no waiting

> period until new issurance takes effect). It also had a provision

> giving congress until Aug of 1999 to pass comprehensive health

> privacy legislation. Congress didn't,so the Dept of Health and Human

> Services wrote and is revising the regulations. The effective date is

> April 14,2003. In a nutshell, patient privacy will be protected from

> outside entities--no more mailing/selling patient lists to drug

> companies. Also, patient information within hospital/pharmacy will be

> on a 'need to know basis' There's no reason for the ward secretary on

> the orthopaedic ward to have access to the files of a patient on the

> psychiatric ward. I've added a couple of HIPAA links to the bookmarks

> sections.

>

> Dora

>

>

> > Hi:

> >

> > But doesn't everyone see the person standing at the pharmacy

> counter?

> > Doesn't that identify them as a patient?

> >

> > What is HIPPA? I'm not following your post. I thought I read

> 's

> > scenario which is what I posted on. Maybe I am not getting some

> posts?

> >

> > Chris

> >

>

> > >

> > >

>

>

>

>

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Hi Dora:

The previous post of mine got sent before I could finish it. I don't know

how that happened. Sorry. I was just going to say that it is now against

hospital policy for me to view any patient records not necessary to carry

out my job. As it is, my computer code only allows me access to certain

information in a patient's record but I do need to know who is on other

floors in the case of transfers to our floor, etc. It'll be interesting to

see how it works out.

In the drugstore-I still don't see how a log violates confidentiality if it

only shows prescription number and name. The person is identifying himself

as a patient by standing in line at a pharmacy picking up a prescription.

Thanks for the information on Hippa

Chris

Re: patient counseling

> Hi Chris-

> HIPAA stands for Health Insurance Portability and Accountibility Act.

> The act which passed in 1996 protects the health insurance of workers

> who either lose their job or move to a different job--(no waiting

> period until new issurance takes effect). It also had a provision

> giving congress until Aug of 1999 to pass comprehensive health

> privacy legislation. Congress didn't,so the Dept of Health and Human

> Services wrote and is revising the regulations. The effective date is

> April 14,2003. In a nutshell, patient privacy will be protected from

> outside entities--no more mailing/selling patient lists to drug

> companies. Also, patient information within hospital/pharmacy will be

> on a 'need to know basis' There's no reason for the ward secretary on

> the orthopaedic ward to have access to the files of a patient on the

> psychiatric ward. I've added a couple of HIPAA links to the bookmarks

> sections.

>

> Dora

>

>

> > Hi:

> >

> > But doesn't everyone see the person standing at the pharmacy

> counter?

> > Doesn't that identify them as a patient?

> >

> > What is HIPPA? I'm not following your post. I thought I read

> 's

> > scenario which is what I posted on. Maybe I am not getting some

> posts?

> >

> > Chris

> >

>

> > >

> > >

>

>

>

>

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Hi Dora:

Forget what I said about the pharmacy line scenario-I must have missed

's post. I'm posting this so you don't think I don't understand- I see

it now.

Thanks,

Chris

Re: Re: patient counseling

> Hi Dora:

>

> The previous post of mine got sent before I could finish it. I don't know

> how that happened. Sorry. I was just going to say that it is now against

> hospital policy for me to view any patient records not necessary to carry

> out my job. As it is, my computer code only allows me access to certain

> information in a patient's record but I do need to know who is on other

> floors in the case of transfers to our floor, etc. It'll be interesting

to

> see how it works out.

>

> In the drugstore-I still don't see how a log violates confidentiality if

it

> only shows prescription number and name. The person is identifying himself

> as a patient by standing in line at a pharmacy picking up a prescription.

>

> Thanks for the information on Hippa

>

> Chris

>

>

>

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-> and everyone,

Here in the state of Virginia and CVS, we have a form that has to be

filled out for all patients recieving a prescription. As a part of

our Tech. training we are taught that everyone is be offered

counseling for any and all prescriptions that the customer recieves.

On this form we place a sticker that gives the rx number, the

customers 3rd party condor code we use and the date it is filled. The

technicians have to initial this form on each line and then have the

customer sign right beside each sticker for their scripts. They have

a choice on which side of the sticker they sign on. If they should

have questions for the pharmacist is regards to the medications,

then the pharmacist have to sign the log to indicate that counsel was

given. Should a patient request easy-off or flip top lids, they have

a space for that on the form as well that they have to initial.

Here in the state of Virginia, I have seen Insurance Auditors come

in and examine these logs, they have gone back as far as one year in

date.

I hope this give you some more insite on what you were looking for.

Respectfully,

Tracie Smullen,Cpht

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Dear Skywriter/Lady Tracie (one and the same)

Thank you for your input on Virgina practices.

I am a bit confused though, please clarify.

the pt and tech sign a form or sign a common logbook or both?

If a common logbook, cananyone see the previous patients names?

Respectfully,

Jeanetta

> -> and everyone,

> Here in the state of Virginia and CVS, we have a form that has to

be

> filled out for all patients recieving a prescription. As a part of

> our Tech. training we are taught that everyone is be offered

> counseling for any and all prescriptions that the customer

recieves.

> On this form we place a sticker that gives the rx number, the

> customers 3rd party condor code we use and the date it is filled.

The

> technicians have to initial this form on each line and then have

the

> customer sign right beside each sticker for their scripts. They

have

> a choice on which side of the sticker they sign on. If they should

> have questions for the pharmacist is regards to the medications,

> then the pharmacist have to sign the log to indicate that counsel

was

> given. Should a patient request easy-off or flip top lids, they

have

> a space for that on the form as well that they have to initial.

> Here in the state of Virginia, I have seen Insurance Auditors

come

> in and examine these logs, they have gone back as far as one year

in

> date.

> I hope this give you some more insite on what you were looking

for.

>

> Respectfully,

> Tracie Smullen,Cpht

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--- HIya Jeanetta,

Yes it is a common logbook that everyone signs on. This stickers

that I mentioned only have the rx number, insurance condor code taht

CVS uses in processing the claims on and the date that the Rx was

filled on. The patients name is not listed on this sticker. Yes

everyone can see the previous persons signature. But if you look at

the signatures I swear that some of these look just like a doctors

signature. If you can make them out you are doing pretty good. Is it

not right that a common log like this be used. All I know from the

very start of using the 3rd party signature logs(CVS's name for the

form) this is standard. Can you let me know.. Thanks.

Respectfully,

Tracie Smullen

In @y..., " rxjm2002 " <rxjm2002@y...> wrote:

> Dear Skywriter/Lady Tracie (one and the same)

>

> Thank you for your input on Virgina practices.

>

> I am a bit confused though, please clarify.

> the pt and tech sign a form or sign a common logbook or both?

> If a common logbook, cananyone see the previous patients names?

>

> Respectfully,

> Jeanetta

>

> > -> and everyone,

> > Here in the state of Virginia and CVS, we have a form that has

to

> be

> > filled out for all patients recieving a prescription. As a part

of

> > our Tech. training we are taught that everyone is be offered

> > counseling for any and all prescriptions that the customer

> recieves.

> > On this form we place a sticker that gives the rx number, the

> > customers 3rd party condor code we use and the date it is filled.

> The

> > technicians have to initial this form on each line and then have

> the

> > customer sign right beside each sticker for their scripts. They

> have

> > a choice on which side of the sticker they sign on. If they

should

> > have questions for the pharmacist is regards to the medications,

> > then the pharmacist have to sign the log to indicate that counsel

> was

> > given. Should a patient request easy-off or flip top lids, they

> have

> > a space for that on the form as well that they have to initial.

> > Here in the state of Virginia, I have seen Insurance Auditors

> come

> > in and examine these logs, they have gone back as far as one year

> in

> > date.

> > I hope this give you some more insite on what you were looking

> for.

> >

> > Respectfully,

> > Tracie Smullen,Cpht

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Well Tracie,

This is WHY this location and site is soooo much better than the

previous one. Although I do miss it at times.

Here on this site we have TEXPERTS! Iam going to call upon all

TEXPERTS in the field of Retail tolet us know what is required on the

logbook that they have.

My suspicion is that we will find similarities but the ultimate

decision is up to the state to uphold the OBRA 90 laws and that they

may add what ever they like but can not detract from the form.

Federal law usually states that a 'thing' " must " be done or 'must

not' be done. It usually does not outline how a state must get it

done or prevent it from being done/carry out the law. But the state

must then address the issue in its state board laws and rules and

regs. again states may be more stringent than the Federal law.

If a Federal law is specific in how a state must carry out the law

then the state must follow it to the letter. Again the state could

get more specific, or more stringent .

I am not sure what the Fed law states on this book. Does any one out

there know?

Respectfully,

Jeanetta Mastron CPhT

Owner/Founder of this site

> > > -> and everyone,

> > > Here in the state of Virginia and CVS, we have a form that has

> to

> > be

> > > filled out for all patients recieving a prescription. As a part

> of

> > > our Tech. training we are taught that everyone is be offered

> > > counseling for any and all prescriptions that the customer

> > recieves.

> > > On this form we place a sticker that gives the rx number, the

> > > customers 3rd party condor code we use and the date it is

filled.

> > The

> > > technicians have to initial this form on each line and then

have

> > the

> > > customer sign right beside each sticker for their scripts. They

> > have

> > > a choice on which side of the sticker they sign on. If they

> should

> > > have questions for the pharmacist is regards to the

medications,

> > > then the pharmacist have to sign the log to indicate that

counsel

> > was

> > > given. Should a patient request easy-off or flip top lids,

they

> > have

> > > a space for that on the form as well that they have to initial.

> > > Here in the state of Virginia, I have seen Insurance Auditors

> > come

> > > in and examine these logs, they have gone back as far as one

year

> > in

> > > date.

> > > I hope this give you some more insite on what you were

looking

> > for.

> > >

> > > Respectfully,

> > > Tracie Smullen,Cpht

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