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Wagner Murray Dingell Bill To provide comprehensive health care delivery under Social Security system
1945 – President Harry Truman Made direct appeal for a national health program By 1950’s – National health insurance was a dead issue
Medical Assistance Act (Kerr Mills Act) in 1960 Was enacted as a compromise to the 1957 bill by Forand Federal grants to states to extend health services to low income elderly Controversial – Source of humiliation to elderly Program declared ineffective in 3 years 90% went to 5 states
1957 – Bill in Congress by Aime Forand To include necessary nursing home and hospital care as an extension of Social Security benefits AMA – Massive campaign to oppose
Durham and Humphry act 1951 Pharmacists cannot dispense without a prescription
1965 – President Lyndon Johnson introduced Health insurance for aged – Medicare Health insurance for poor - Medicaid AMA – strong opposition
Medicare - Provide publicly financed health insurance to all elderly regardless of their income Part A Medicare – Use Social security funds to finance hospital & nursing home coverage Part B Medicare – Cover physician’s bills through government subsidized insurance
1992 - President Bill Clinton Reintroduced the idea of national health insurance plan and was a big failure
2003 – Medicare Modernization Act was introduced by President Bush Also known as Medicare Part D Went into effect in 2006 To cover the prescription costs for the elderly
2010 – Patient Protection and Affordable Care Act was introduced by President Obama To provide preventive care—including family planning and related services—more accessible and affordable for many Americans Still rolling into effect
Jonathan Roberts First hospital pharmacist – Pennsylvania hospital (1752 - 1755) Hospital received a large shipment of drugs from London and wanted someone to assort them
John Morgan (1755 – 1765 Proposed the separation of medicine and pharmacy
By the end of the period Apothecary was no more a luxury, but a necessity Medical schools began to train doctors & they started prescribing Physicians started appointing apothecaries Development of specialty shops such as shoe shops
Era of flexner report Educational, i.Medical school admission require, at a high school diploma and at a least 2 years of university study. iI medical school should be 4 years iii.Proprietary medical schools should close or be incorporated into existing universities
Hill Burton act era expansion, Money was designated to the states to achieve 4.5 beds per 1,000 people.
Health Believe model Patients making a rational appraisal between the benefits and barriers of taking medication
elixir sulfamanide tradgedy led to food drug and cosmetic act.
Medicare D CPT, and billable for mtm
When no refills are specified on a prescription on a control substance, it means you cannot refill. T
No refills of a controlled substance may be issued until 80% of the prescription is consumed in accordance with the prescriber's instruction T
When can a faxed script be used as the original Hospice care certified by medicare and state.and long term care facility
A controlled substance prescription must have specific instructions on when and how its used. T
Regarding Verbally ordered CII prescription Moose
Amount verb ordered doesnt exceed 72 hour supply T
There is a prescriber-patient relationship in place T
A written order must come in within 7 business days T
Techs cannot Receive verbal prescriptions or medication order. They cannot perform drug utilizations/clarify prescription orders
All pharmacy staff having contact with patients must wear identification with their name and position. T
When communicating by any means pharmacy staff must identify themselves as to their license classification. T
Dispense means interpretation and evaluation and implementation of a prescription/nonprescription drug or device
Practice of pharmacy means -not prescribing the drug to patients, -Providing pharma care -collaborative pharma practice in accordance with the collaborative pharma practice act -Supervising the pharmacist supportive personnel, pharma interns and techs
Rewenal 2 years (may change to 1 year)
Under Utah law a secure email address must be established by the PIC in accordance to DOPL T
Utah board of pharmacy consists of 5 pharmacists, 1 tech and 1 member of the general public
Each CII prescription may contain 3 meds on the same form False 3 max but different forms
Each CII prescription cannot exceed a 30 day supply T
Each CII prescription must be filled within 30 days of the script or within 30 days of the dispensing date T
Each CII prescription maybe refilled up to 5 times per instruction of the provider F, cannot be refilled need new script
Actual physical count must be taken for CIIs on hand T
Actual physical count must be taken for all prescriptions on hand F CII only
All completed controlled substances inventory must be delivered by mail to DEA F
For CIII-C5 substances (in a container) an actual physical count must be made if the container is opened and there is over 1000 units in that container T
A licensure with DOPL is required if a person place or business does Prescribes, Distributes, Manufactures, Produces
A schedule II prescription maybe refilled _ times 0
A schedule III-IV prescription expires _ months and and maybe refilled no more than _ times 6 months and 5 times
A schedule V prescription expires _ months after issuance 12 months
An annual inventory is not required F
For class B pharmacies a perpetual inventory must be maintained T
Under Utah controlled substance act controlled substance records must be maintained for _ years 5
Diversion suspending disciplinary action for unprofessional/unlawful conduct if the person decides to participate in a education/rehab (diversion program)
DOPL and administrative inspections Can make you do a self audit (cant falsify info what a surprise) and can come and do an inspection (during regular business hours)
If a PIC is changing the DOPL email address, a new one must be sent withing 10 business days F, its 7 business days
You may have more than 1 dopl email address per pharmacy F, only one is allowed
State board of pharmacy can serve a 4 year term and no more than 2 consecutive terms T
Dispensing medical practitioner clinical pharmacy isnt a license like A B C D E pharms F
Who is responsible for all activities of the pharmacy PIC and owner
A pharmacy can only have 1 supervising pharmacist F, only 1 PIC
Requirements for continuing education 2 years, 30 CE hours every two years, atleast 1 hour must be in ethics and law
A new license requires a Criminal Background check True
Prescription files excluding refill orders must be maintained for 5 years F including refill orders
CS general rule, CS prescription may only be transferred one time T
CII verbal orders need to be promptly reduced to writing by a tech/intern/pharmacist F, tech cannot do it w/o supervised by pharmacist
Omnibus Budget Reconciliation act Led to the counseling of pharmacists in medicare
When well diversified large employers assume the risk of medical bills by medical claims it is known as? Self-insurance, not group insurance or individual private insurance
A prescription for a CS must be written or authorized by: a practitioner authorized to prescribe drugs and medicine under the laws of this state or under the laws of another state having similar standards; and licensed under this chapter or under the laws of another state having similar standards
A prescription for a CS must be written unless, not required under the federal CSA: •Verbal order for emergency CII (reduced immediately to writing) •Verbal orders for CIII-CV (reduced promptly to writing) •Facsimile (faxed) (reduced promptly to writing)
A prescription for a CS must be signed by prescriber in ink or indelible pencil or signed by electronic signature, as authorized by division rules, and must include” •Name, address, and registry number of prescriber •Name, address, and age of patient •Date of issuance of prescription •Name, quantity, and specific directions for use
CII prescriptions: •Not refillable •Cannot exceed a 30-day supply per the directions on the prescription •Must be filled within 30 days of the prescription’s issue date, or within 30 days of the dispensing date if the dispensing date is different than the issue date
CIII-CIV prescriptions: •No more than 5 refills •Must be filled within 6 months of the prescription’s issue date
CV prescriptions: •In Utah prescription is required •Must be filled within 12 months of the prescription’s issue date •May be refilled as prescriber directs
More than one prescription at the same time for the same CII if: (A) no more than 3 prescriptions for same CII may be issued at same time; (B) no one prescription may exceed a 30-day supply;
(C) a 2nd or 3rd prescription shall include the date of issuance and the date for dispensing (earliest date it can be filled); (D) unless the practitioner determines there is a valid medical reason to the contrary, the date for dispensing a 2nd or 3rd prescription may not be fewer than 30 days from the dispensing date of the previous prescription.
Some Prescription Requirements: •No refills indicated means no refills authorized
•No refill may be dispensed until such time has passed since the date of the last dispensing that 80% of the medication in the previous dispensing should have been consumed if taken according to the prescriber's instructions •CS prescription must have specific instructions from the prescriber on how and when the drug is to be used
Prescriber may give emergency verbal order for CII if: •Quantity to cover emergency period – but not over 72 hours •A written prescription for the CS delivered to pharmacist within 7 days
(Goes with last) Prescriber-patient relationship: Prescriber has seen patient within past 30 days or under continuing care for chronic condition, or Covering prescriber has knowledge of patient’s condition
Prescriber may dispense the CII if: •The amount verbally ordered not over 72 hour supply •Pharmacist reasonably believes practitioner licensed to prescribe the CS or makes reasonable effort to find out
Records of disposal shall be maintained for? 5 years
CS Database. Allowable purposes - pharmacists: for pharmacists having authority to dispense a CS to the extent the information is sought for the purpose of: •dispensing or considering dispensing any controlled substance; or •determining whether a person: is attempting to fraudulently obtain a controlled substance from the pharmacist; or has fraudulently obtained, or attempted to fraudulently obtain
Allows the Pharmacist-in-charge (PIC) of a pharmacy to designate up to three (3) pharmacy employees to have access to the database on behalf of a licensed pharmacist employed by the pharmacy for the above allowable purposes PIC must provide written notice to DOPL of the identify of each of the employee(s) and DOPL grants employees access PIC must provide each employee with a password that is unique to that employee to access the database
Created by: 13754597



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