January 2015 Florida Pharmacy Journal by Florida Pharmacy Today

The Official Publication Of The Florida Pharmacy Association JAN. 2015

UNDERSTANDING THE PHARMACIST’S DECISION NOT TO FILL A CONTROLLED SUBSTANCE PRESCRIPTION

Board of Pharmacy Licensure Disciplinary Proceedings Compounding Violations, Pharmacy Audit Disputes Mergers and Acquisitions Commercial, Civil and Criminal Proceedings KAHAN ◆ HEIMBERG, PLC

Pharmacist Attorney Brian A. Kahan, R.Ph., J.D. Licensed Florida Pharmacist and Attorney

STATEWIDE REPRESENTATION 561-392-9000 bkahan@kahanlaw.com 2300 N.W. Corporate Blvd., Suite 123 Boca Raton, FL 33431 The hiring of a lawyer is an important decision that should not be based solely upon advertisements. Before you decide, ask us to send you free written information about our qualifications and experience.

e bl i la 7 va / A 24

A Pharmacist And A Lawyer PHARMACY CONSULTING & STAFFING SOLUTIONS Pharmacist & Technician Staffing Pharmacy Management Temporary & Vacation Coverage

Open a Pharmacy (Retail & Compounding) Licensing for All States Medicaid & BOP Inspection Preparation Assistance with Insurances Policy & Procedures Buy/Sell a Pharmacy WE ARE PROVEN TO BE THE MOST RELIABLE AND TRUSTED STAFFING & CONSULTING FIRM EPC is Pharmacist Owned and Operated www.epcepc.com (855) 374-1029

Work Smarter Independent…But Not Alone. PPSC is Your Partner for Success For more on how PPSC can maximize the potential of your independent pharmacy, visit www.ppsconline.com or call toll-free 888-778-9909.

2 |

FLORIDA PHARMACY TODAY

PPSC can help your independent pharmacy become more efficient and productive through its innovative Work Smarter programs and services. PPSC can help you: ENHANCE operational workflows AUTOMATE dispensing, product returns and Part B billing REDUCE claim resubmissions INCREASE your profits

florida PHARMACY TODAY Departments 4 Calendar 4 Advertisers 5 President’s Viewpoint 7 Executive Insight 18 Member Profile 28 Buyer’s Guide

VOL. 78 | NO. 1 JANUARY 2015 THE OFFICIAL PUBLICATION OF THE FLORIDA PHARMACY ASSOCIATION

Features

9 15 21 22

How Deep Is The Rabbit Hole? Understanding the Pharmacist’s Decision Not to Fill a Controlled Substance Prescription

Pharmacists’ Patient Care Process: Consistency is Critical Changes in Publishing for Florida Pharmacy Today

Call for FPA Award Nominations

JANUARY 2015

FPA Calendar 2014-2015

JANUARY 31

FPA election ballots due FEBRUARY

10-11 Florida Board of Pharmacy Meeting Gainesville 28

Awards nominations due MARCH

Legislative session begins

Continuing Education Tallahassee

9-10

Pharmacist Legislative Days and Health Fair Tallahassee

21-22 FPA Committee and Council Meetings 25-26 RxImpact Day Washington DC 27-30 APhA Annual Meeting San Diego, California

APRIL 3

Good Friday, FPA Office Closed

18-19 FPA Regulatory and Law Conference - Tampa Airport Marriott Tampa 24

Last day to submit resolutions MAY

10-12 Pharmacist Mutual Leadership Conference Rockville, Maryland 12-13 NCPA Legislative Conference Arlington, VA 16-17 FPA Clinical Conference Jacksonville 25

Memorial Day, FPA Office Closed JUNE

24-28 125th Annual Meeting and Convention St. Augustine

For a complete calendar of events go to www.pharmview.com Events calendar subject to change CE CREDITS (CE cycle) The Florida Board of Pharmacy requires 10 hours LIVE Continuing Education as part of the required 30 hours general education needed every license renewal period. Pharmacists should have satisfied all continuing education requirements for this biennial period by September 30, 2015 or prior to licensure renewal. Consultant pharmacists and technicians will need to review their licenses and registrations by December 31, 2014. For Pharmacy Technician Certification Board Application, Exam Information and Study materials, please contact the FPA office. For More Information on CE Programs or Events: Contact the Florida Pharmacy Association at (850) 222-2400 or visit our Web site at www.pharmview.com

Mission Statements: of the Florida Pharmacy Today Journal

The Florida Pharmacy Today Journal is a peer reviewed journal which serves as a medium through which the Florida Pharmacy Association can communicate with the profession on advances in the sciences of pharmacy, socio-economic issues bearing on pharmacy and newsworthy items of interest to the profession. As a self-supported journal, it solicits and accepts advertising congruent with its expressed mission.

of the Florida Pharmacy Today Board of Directors

The mission of the Florida Pharmacy Today Board of Directors is to serve in an advisory capacity to the managing editor and executive editor of the Florida Pharmacy Today Journal in the establishment and interpretation of the Journal’s policies and the management of the Journal’s fiscal responsibilities. The Board of Directors also serves to motivate the Florida Pharmacy Association members to secure appropriate advertising to assist the Journal in its goal of self-support.

Advertisers EPC........................................................................ 2 THE HEALTH LAW FIRM.............................. 21 KAHAN HEIMBERG, PLC................................ 2 PPSC...................................................................... 2 PHARMACISTS MUTUAL............................. 14 Rx OWNERSHIP............................................... 29

CONTACTS FPA — Michael Jackson (850) 222-2400 FSHP — Tamekia Bennett (850) 906-9333 U/F — Art Wharton (352) 273-6240 FAMU — Leola Cleveland (850) 599-3301 NSU — Carsten Evans (954) 262-1300 DISCLAIMER Articles in this publication are designed to provide accurate and authoritative information with respect to the subject matter covered. This information is provided with the understanding that neither Florida Pharmacy Today nor the Florida Pharmacy Association are engaged in rendering legal or other professional services through this publication. If expert assistance or legal advice is required, the services of a competent professional should be sought. The use of all medications or other pharmaceutical products should be used according to the recommendations of the manufacturers. Information provided by the maker of the product should always be consulted before use.

4 |

FLORIDA PHARMACY TODAY

E-MAIL YOUR SUGGESTIONS/IDEAS TO dave@fiorecommunications.com

The President’s Viewpoint SUZANNE KELLEY, FPA PRESIDENT

Leading in Pharmacy

re you a leader? Do you see yourself as a leader? Prior to asking this question, you need to know the definition. What is a leader? According to the dictionary, a leader is a person or thing that leads. A leader is the guiding or directing head of an army, movement or political group. Can you be a leader at work? Can a pharmacist be a leader? Is it possible for a student to be a leader? What about a technician? The answer to all of these questions is YES. I am sure that you can give a few names of leaders you know. On Saturday, January 10, 2015, I attended the FPA Emerging Leaders in Pharmacy Conference. I found myself awed by the excitement of the students who came. They were all well-dressed from head to toe. To top this off, they all had smiles. These students came from most of the Florida Colleges of Pharmacy and from all classes, P1 to P4. Others who attended were seasoned pharmacists. What do I mean by “seasoned pharmacists?” I am referring to those who have been practicing for some years. We also had technicians who came and participated. All who participated left having learned quite a bit about leadership. As you can see, basically anyone can be a leader. An effective leader is one who has good skills. This conference was filled with tools to help you become an effective leader. First, it is important to identify your own personal leadership style. According to the conference, there are four styles: (1) Problem-Solving Leader; (2) Consistent Leader; (3) Visionary Leader; and (4) Team Catalyst. The room was set up in tables and they worked in groups consisting of students as well as pharmacists. Their interaction was stimulating

and thought provoking. If you search for the word “leadership” on the internet, you will find many sites that are filled with information. Definitions, characteristics and

John C. Maxwell says that there are 21 indispensable qualities of a leader which are: character, charisma, commitment, communication, competence, courage, discernment, focus, generosity, initiative, listening, passion, positive attitude, problem solving, relationships, responsibility, security, selfdiscipline, servanthood, teachability and vision. skills of effective leaders can be found everywhere. John C. Maxwell says that there are 21 indispensable qualities of a leader which are: character, charisma, commitment, communication, competence, courage, discernment, focus, generosity, initiative, listening, passion, positive attitude, problem solving, relationships, responsibility, security, selfdiscipline, servanthood, teachability and vision. Forbes states that the top 10 qualities that make a great leader are honesty, the ability to delegate, communication, a sense of humor, confidence, commitment, a positive attitude, creativity, intuition and the ability to inspire. These are some key qualities that every good

Suzanne Kelley 2014-2015 FPA President

leader should possess and learn to emphasize. Remember that your business and its employees or your association and its members are a reflection of yourself. What a BIG responsibility to have. Leadership is a learned behavior that with time becomes unconscious and automatic. Experiences and encounters, which are accumulated, affect decision-making. The most successful leaders tend to be instinctual when making those decisions. Remember that leadership is a process. A good leader is one who influences and motivates others to be involved in the accomplishment of a particular task. Effective leaders lead people into new eras, new lands, a more modern world or a different phase. If you look back into history, you will find some great leaders. The qualities that made them effective leaders back then are still appropriate in today’s world. Some of the greatest leaders were Mahatma Gandhi, George WashingJANUARY 2015

2014 FPA Board of Directors The Florida Pharmacy Association gratefully acknowledges the hard work and dedication of the following members of the FPA leadership who work diligently all year long on behalf of our members.

Terry Gubbins.......................................................................... Chairman of the Board Suzanne Kelly...............................................................................................FPA President Tim Rogers................................................................................................... President Elect Alexander Pytlarz................................................................................................Treasurer Bob Parrado................................................Speaker of the House of Delegates Jackie Donovan...........................Vice Speaker of the House of Delegates Jennifer Raquipo..............................................................Interim Director, Region 1 Michael Hebb........................................................................................ Director, Region 2 Stephen Grabowski........................................................................ Director, Region 3 Linda Lazuka........................................................................................ Director, Region 4 Jason Beattie...................................................................................... Director, Region 5 Luther Laite IV.................................................................................... Director, Region 6 Kimberly Jones................................................................Interim Director, Region 7 Humberto Martinez......................................................................., Director, Region 8 Mitchell Fingerhut......................................................... Interim Director, Region 9 Christine Gegeckas............................................................................. President FSHP Michael Jackson........................................Executive Vice President and CEO

Florida Pharmacy Today Journal Board Chair.............................................................. Carol Motycka, motycka@cop.ufl.edu Vice Chair...........................................Jennifer Pytlarz, jlc_rxdoc@hotmail.com Treasurer....................Stephen Grabowski, sgrabowski@seniormmc.com Secretary.............. Verender Gail Brown, brownvgrx4304@hotmail.com Member.................................................Joseph Koptowsky, docjik1215@aol.com Member........................Rebecca Poston, rebecca_poston@doh.state.fl.us Member........................................................Cristina Medina, cmmedina@cvs.com Member................................................................Norman Tomaka, FLRX9@aol.com Member........................................................................Stuart Ulrich, Stuarx@aol.com Member............................................................. Don Bergemann, don@bceinfo.com Executive Editor................Michael Jackson, mjackson@pharmview.com Managing Editor...................Dave Fiore, dave@fiorecommunications.com Journal Reviewer....................... Dr. Melissa Ruble, mruble@health.usf.edu Journal Reviewer....................................Dr. Angela Hill, ahill2@health.usf.edu

6 |

FLORIDA PHARMACY TODAY

ton, Abraham Lincoln, Nelson Mandela, Julius Caesar, Winston Churchill, Fidel Castro, Mao Zedong, Adolf Hitler and Muhammad. Whether you believe in their philosophy is a different matter. All of them had their own style and had many followers. Each one achieved their specific goal or goals. It may or may not have been good for their people or country, but each was an effective leader. You can probably name other great leaders. In order to be a great leader, you first must have the desire and passion to be a leader. Generally, leaders help themselves as well as others to the right things. They build on a dream or create something brand new. Leaders map out a direction where they need to go to succeed as an organization. Often, they must use management skills to guide their people to reach the desired destination. Leadership means different things to different people around the world, and different things in different situations. As you know, leadership could be related to community, religion, politics and any other situation where there are groups of people. Do you have the desire to be a leader? What about wanting to learn more about yourself and how to lead others effectively? If you weren’t at this leadership conference or have never attended one before, join us at the next FPA Leadership Conference. It’s exciting to be part of this great journey, and I urge you to be a part of it! So when I think about my leadership of FPA thus far, I hope that the membership realizes that all I want is the best for our organization. I do not believe that I am selfish as my desire is only to be a good leader. My dream is for the Florida Pharmacy Association to be a successful and thriving organization that is “United to Advance Health Care and Pharmacy Practice.” n

Executive Insight BY MICHAEL JACKSON, RPH MICHAEL JACKSON, BPHARM, EVP & CEO, FLORIDA PHARMACY ASSOCIATION

125th Annual Meeting Will Be a Blast

he signature event for pharmacy has traditionally been the annual meetings of professional organizations. Over the years, I have found a tremendous amount of interdisciplinary networking going on with a lot of problem solving and skills development. Pharmacists, pharmacy technicians and students attending this meeting have found the educational sessions stimulating and brimming with new practice tools. Of course, don’t take my word for it. You have to experience this for yourself. There is something for everyone at the annual meeting, with educational sessions covering a variety of topics. Some of these topics include indepth analysis of pulmonary management, nutrition, pharmacogenomics, pain management and pharmacy business management. We are also including a special student track along with a host of other functions and activities. House of Delegates The Florida Pharmacy Association convention is more than just a venue for continuing education and professional development for technicians, pharmacists and pharmacy students. It is a forum where member stakeholders assemble to discuss emerging issues that affect the practice. Members often wonder how issues are placed and prioritized on the task list for the Association. It actually starts within the House of Delegates, chaired this year by Speaker Bob Parrado. The House Vice Speaker is Jackie Donovan. Members and affiliated organizations can submit resolutions or proposed policy statements for the FPA to consider by the April 24, 2015 deadline. For example, in 2000, the FPA House of Delegates approved a policy

statement that started the transition of Florida from a state that prohibited licensure transfer, to a state that allows licensure transfer by endorsement. This created a way for pharmacists in this state to become licensed in other states, and pharmacists in other states to get licensed in Florida without having to retake the NAPLEX examination. This is one of the more important meetings because it allows grassroots pharmacists, pharmacy technicians and students to have input on where the Association should focus its energy and resources. Some of our members believe that a phone call or email to the FPA office triggers action on issues. It may in some cases if the issue is an FPA-adopted policy and Association staff has been granted authority to address it. Unfortunately, the FPA does have finite resources that are governed by the Board of Directors. Issues are prioritized by your elected leadership with outcomes reported at each Annual Meeting. Florida Pharmacist Political Committee The FPA has a dedicated membership group that has been working hard to support our political advocacy efforts. The Florida Pharmacist Political Committee (FPPC) meets annually during the convention to formulate fundraising plans designed to support members of the Florida House and Senate who are sensitive to pharmacy issues. Also, we’ve scheduled a special convention event that will raise awareness of the FPPC’s work and encourage member participation. New this year will be an open invitation for convention participants. There will be no registration fees, but you will need to RSVP to at-

Michael Jackson, B.Pharm

tend. This event will be an exciting, charged-up political rally and may involve special guests. University Alumni Gatherings Each year, several pharmacy schools facilitate a welcome reception at the FPA Annual Meeting. Even if you don’t plan to attend the Annual Meeting, drop in on these events to network with your former classmates. Friendships are renewed at these events. You will also get to see the new and innovative things that are going on at your alma mater. Student Activities The FPA Annual Meeting is jampacked with student functions and activities that range from educational sessions and poster presentations, to patient counseling competitions and learning-focused game shows. Our student colleagues have found that the AnJANUARY 2015 |

FPA STAFF Executive Vice President/CEO Michael Jackson (850) 222-2400, ext. 200

Director of Continuing Education Tian Merren-Owens, ext. 120 Controller Wanda Hall, ext. 211

Educational Services Office Assistant Stacey Brooks, ext. 210 Coordinator of Membership Christopher Heil, ext. 110

FLORIDA PHARMACY TODAY BOARD Chair..................................... Carol Motycka, St. Augustine Vice Chair.........................Jennifer Pytlarz, Herndon, Va. Treasurer...............................Stephen Grabowski, Tampa Secretary.........................Verender Gail Brown, Orlando Member..................................... Joseph Koptowsky, Miami Member..............................Rebecca Poston, Tallahassee Member....................................Cristina Medina, Hollywood Member................................. Norman Tomaka, Melbourne Member..............................Stuart Ulrich, Boynton Beach Member.......................Don Bergemann, Tarpon Springs Executive Editor.........Michael Jackson, Tallahassee Managing Editor.........................Dave Fiore, Tallahassee

This is a peer reviewed publication. ©2015, FLORIDA PHARMACY JOURNAL, INC. ARTICLE ACCEPTANCE: The Florida Pharmacy Today is a publication that welcomes articles that have a direct pertinence to the current practice of pharmacy. All articles are subject to review by the Publication Review Committee, editors and other outside referees. Submitted articles are received with the understanding that they are not being considered by another publication. All articles become the property of the Florida Pharmacy Today and may not be published without written permission from both the author and the Florida Pharmacy Today. The Florida Pharmacy Association assumes no responsibility for the statements and opinions made by the authors to the Florida Pharmacy Today. The Journal of the Florida Pharmacy Association does not accept for publication articles or letters concerning religion, politics or any other subject the editors/ publishers deem unsuitable for the readership of this journal. In addition, The Journal does not accept advertising material from persons who are running for office in the association. The editors reserve the right to edit all materials submitted for publication. Letters and materials submitted for consideration for publication may be subject to review by the Editorial Review Board. FLORIDA PHARMACY TODAY, Annual subscription - United States and foreign, Individual $36; Institution $70/year; $5.00 single copies. Florida residents add 7% sales tax. FLORIDA PHARMACY ASSOCIATION

610 N. Adams St. • Tallahassee, FL 32301 850/222-2400 • FAX 850/561-6758 Web 8 Address: | F L O Rhttp://www.pharmview.com IDA PHARMACY TODAY

Get a taste for previous FPA meetings by taking a peek at this video.

nual Meeting is special and gives them an opportunity for collaborative discussion across campuses. Special student awards recognizing the volunteer work of our student members will be presented. Do You Like Golf? This year’s Annual Meeting and Convention will be at the Renaissance Resort at World Golf Village. If you love the game, you will savor the history of walking through the Hall of Fame where the legends of the sport are enshrined. Walk the grounds where the world’s greatest players competed and find room in your schedule to play in the golf outing that will be arranged. Slots will be limited, so when the registration opens on pharmview.com, sign up early. Installation of FPA Officers Members of the FPA Board of Directors include the officers of the Association, regional directors and the FSHP president. They are all installed during the Annual Meeting at the Presidents Breakfast, which this year takes place on Sunday, June 28. It is at this function that you will hear firsthand what our efforts for 2015-2016 will concentrate on. These volunteer leaders will declare their commitment to the Associa-

tion and to representing your interests to the best of their ability. Awards Event What is a convention without an awards event? Many of our volunteers are doing great things in their communities that need to be recognized. For many years, the FPA has presented awards to individuals within our industry who have made a difference to the profession and to the quality of health care. It is through their passion that the Association makes a declaration to the public about their personal accomplishments and achievements. Come to the Annual Meeting and help us recognize our profession’s trailblazers. The 125th (quasquicentennial) Annual Meeting is going to be a special event. The first 300 full convention registrants will receive a commemorative gift. FPA staff and leadership is working hard to make this year’s convention very special for you. If you have never been to an Annual Meeting, 2015 should be the year that you remove that to-do item from your bucket list. It is at conferences like this one where we are confident that you will find your passion for pharmacy. n

How Deep Is The Rabbit Hole?

Understanding the Pharmacist’s Decision Not to Fill a Controlled Substance Prescription Joseph Scuro LD, D.C., Pharm.D. This article is the opinion of the author and does not necessarily represent the views of the Association or its members. Today, a pharmacist is being presented with prescriptions by an established local patient written by an out-of-town physician for 180 tablets of OxyContin (80mg) and 240 tablets of Oxycodone (30mg) and she ponders, “Are they legitimate? Are they reasonable? Are they in the best interest of my patient? Am I obligated to fill them? Does the patient look like they are in that much pain? What would that much pain even look like? Is the physician’s office too far from the pharmacy? Is this typical of the physician’s practice? Do I have the time to call the physician to verify? What if the doctor’s office is closed or the office will only take messages? If I refuse, will the patient cause a scene and call corporate to file a complaint?” Does this sound all too familiar? Do you use this or some similar confusing analysis when deciding whether or not to fill your patients’ controlled prescriptions? Or is your plan simply to say, “I don’t have the medication in stock today” and avoid the rabbit hole all together? In an attempt to prevent controlled substance misuse and diversion, con-

fusion has crept into this once-exacting profession and many pharmacists find themselves unsure and uncomfortable when deciding to fill their patients’ controlled substance prescriptions. Pharmacists and pharmacies now openly express fear and concern that filling controlled prescriptions can put them and their practice at risk for reg-

“Are they legitimate? Are they reasonable? Are they in the best interest of my patient? Am I obligated to fill them? Does the patient look like they are in that much pain?”

ulatory action, civil fines and possible criminal arrest. As a result, a new and dangerous growing trend of “Do not fill” controlled medications has arisen in the pharmacy profession as the confusion over corresponding responsibility, duty, obligation and the increasing DEA reports of pharmacy and pharmacist criminal involvement continue

to drive fear. The unfortunate effect of this confusion is that patients who are truly in need of pain relief are far too often being turned away or delayed for days from receiving their pain medications. Patients find themselves traveling from one pharmacy to another in search of a pharmacist willing to admit that the controlled medications are in stock and, more importantly, who are willing to take the risk and fill the pain medications without multiple delays, excuses and completing the company’s legal department checklist. No pharmacist wants to lie to their patients, but all this fear has created a sense of confusion and a growing belief that refusing to fill controlled prescriptions is acceptable, reasonable and rapidly becoming the new standard of pharmacy practice. No one wants to be identified as the pharmacist in town who has controlled medications in stock and is willing to fill prescriptions for fear that, once the word gets out, patients seeking controlled medications will be lined up around the corner with their prescriptions in hand, and so will suspicion, inspection and accusation. The question then arises - how can a pharmacist know when they should be concerned about filling a controlled substance prescription? What concerns are based in fact, which are false and which have just simply become convenient in today’s busy pharmacy practice? The intention herein is to filJANUARY 2015

ter the rumors, beliefs and horror stories into an understandable and usable plan of action - a process that summarizes the actual actions taken by pharmacists that are most often targeted by drug enforcement agencies and accepted within the judicial system as the “WARNING SIGNS” of controlled medication abuse and diversion. The hope is that, once armed with a clear understanding of the pharmacist’s actions drug enforcement agencies have identified as leading to drug abuse and diversion, pharmacists will regain some level of confidence, perform the necessary review and limit the unnecessary patient delays and refusals of care. Over the last several years, the controlled substance abuse epidemic has forced the DEA, as well as other national, state and local law enforcement authorities, to focus more resources into controlled substance prescription drug investigations. This heightened focus on reducing controlled substance

FLORIDA PHARMACY TODAY

abuse extends throughout the entire drug supply chain — the DEA today is fulfilling its responsibility to protect the public. The practices used by those seeking to illegally obtain controlled medications are constantly adapting around drug enforcement efforts. As the investigations uncover one method of diversion or abuse, another pops up in its place, and as a result the drug enforcement “WARNING SIGNS” change yet again. Today’s pharmacist must remain ever-diligent and informed with the changes in medication use and discoveries among the ever-growing list of control medications now available. They must also remain just as aware of the new practices and identified “WARNING SIGNS” suggestive of possible drug misuse and diversion. OK, first let us deal with the obvious — no one from the DEA, or other national, state or local law authority has ever directed, suggested or prevented a

pharmacist from filling a patient’s controlled medication. No one from the DEA or other national, state or local authority has been without cause when seeking to take a pharmacist’s license or closing a pharmacy practice. No one from the DEA or other national, state or local authority is preventing the ordering or the receiving of controlled medications into pharmacies. So, let’s first all agree to stop using drug enforcement efforts as an excuse we give to patients for why their controlled prescriptions can’t be filled today. However, a pharmacist’s apprehension to fill a controlled prescription is in fact real and often fueled by corporate legal policy seeking to limit corporate exposure, stories of pharmacy fines, armed pharmacy raids and closures, pharmacists charged with criminal actions and an overall lack of any uniform pharmacy profession response to the confusion. Today, pharmacists report that drug enforcement agents are regularly visiting pharmacies ask-

ing to inspect prescriptions. As expected, the agents are focused on opioids and poly-controlled medication prescribing. Additionally, they are looking for “WARNING SIGNS” of abuse and diversion. As the role of a pharmacist continually expands, so does the pharmacist’s professional and legal duty. Today, pharmacists find themselves as the last line of defense in the controlled medication delivery highway. In this role, the pharmacist is legally charged with a Corresponding Responsibility to do their best in preventing controlled medication misuse and diversion. The Corresponding Responsibility duty reads in part: “[A] pharmacist shall not dispense a controlled substance(s) when t he pharmacist KNEW or SHOULD HAVE KNOWN that the controlled substance(s) prescribed by the physician were excessive and inappropriate, were not written for a legitimate medical purpose and were likely to be diverted.” Pharmacists’ duties are summarized as follows: 1. Determine if the amount of medications prescribed are excessive. 2. Determine if the medications prescribed are inappropriate. 3. Determine if the prescriptions are written for a legitimate purpose. 4. Determine if the medications are likely to be diverted. Upon the plain reading of the Pharmacist Corresponding Responsibility duties, unless the pharmacist works weekends as a mind reader, this appears to be a fairly impossible duty to live up to. The key to understanding the Pharmacist Corresponding Responsibility duties is not found in the tasks themselves as set forth, but rather in understanding the pharmacist’s state of mind when filling the controlled substance prescription. If the pharmacist knew at the time of filling the controlled substance prescription that it was excessive, inappropriate, not written for a legitimate propose and/or likely to be diverted, then the pharmacist did knowingly choose to break his professional standards and the law. In these cases, drug enforcement should and must determine wrongdoing and levy professional and

criminal action against the pharmacist. The actions were knowingly taken and the results are without question. The overwhelming majority of all drug enforcement actions taken against pharmacists as related to controlled substance prescriptions, unfortunately fall within this category. The pharmacist knowingly and willfully choosing to violate his professional standards by filling and delivering excessive, in-

As the role of a pharmacist continually expands, so does the pharmacist’s professional and legal duty. Today, pharmacists find themselves as the last line of defense in the controlled medication delivery highway. appropriate, not written for a legitimate propose or likely to be diverted controlled substance medications. The good news is that the vast majority of pharmacists never knowingly choose to go down this path for personal gain. Then what does the Corresponding Responsibility duty language mean when referring to the pharmacist’s state of mind when filling a controlled prescription as, “The pharmacist should have known that the controlled substance(s) prescribed by the physician were excessive, were inappropriate, were not written for a legitimate medical purpose or were likely to be diverted?” Well, it does not mean the pharmacist has to prove the prescriber is providing the right therapy. The pharmacist is not licensed to provide a second

medical opinion as to the prescriber’s therapeutic decision in treatment of the patient’s condition. However, it does mean that pharmacists must confirm the authenticity of the prescription before dispensing. Pharmacists must confirm that each prescription has been issued “for a legitimate medical purpose by a licensed practitioner acting in the usual course of professional practice.” Pharmacists must use their professional judgment in this effort to formulate an opinion as to whether the controlled prescription written is excessive and/or is likely to be abused or diverted, or if it is appropriate and appears to have a logical link to a legitimate medical purpose. What sources of information can pharmacists rely on to reach the decision of whether to fill a controlled prescription? First, the patient’s medication history, which is accessible through the pharmacy’s patient profile or by reaching out to the prescribing physician for background to answer your concerns. Second, you can use the state-sponsored Prescription Drug Monitoring Program. This can be a valuable resource to assist in determining both the excessive use and legitimacy of the controlled prescription. Use this PDMP resource every time you are evaluating a controlled substance prescription, and always document all of your due-diligence efforts onto the prescription itself or in your system’s record. Documentation is important. If it is not documented, it did not happen! The excuse of being too busy or not having enough staff to document each controlled prescription review has never been accepted as a legal defense. It is when the pharmacist consciously disregards the controlled prescription review process that results in the dispensing of controlled medications that are excessive, inappropriate, not written for a legitimate medical purpose or likely to be diverted, that the pharmacist fails the “should have known” or stated another way “failed to take reasonable steps to discover” duty. By choosing not to perform a controlled substance prescription review, the pharmacist then violates his duty JANUARY 2015 |

by omission and commits a substantial gross deviation from his professional standard of care. It is the pharmacist’s duty to refuse to fill any prescription if professional judgment suggests filling it would be contrary to law, be against the best interest of the patient, aid or abet an addiction or habit, or be contrary to the health and safety of the patient. The good news is that it is OK to be wrong. The law does not demand that the pharmacist be perfect, only that the pharmacist go through a review process on a routine basis before coming to a decision to fill a controlled prescription. Let’s review this point: It’s OK to be wrong as long as you documented a reasonable effort to uncover the “WARNING SIGNS” of abuse and diversion. I have compiled a list of the practices either performed or willfully omitted that drug enforcement officials have most often identified as the common “WARNING SIGNS” suggesting drug abuse and diversion. The presented Warning Signs of Abuse and Diversion Checklist represents a summation of current drug enforcement key questions and observations used during an investigation and prosecution. Therefore, every reasonable pharmacist should include and document these questions within their individual decision tree. I suggest you consider keeping the list in hand, update it as needed and add to it in order to fit your individual practice needs. My hope

is that it will provide a sense of confidence and control over the confusion surrounding the filling of controlled prescriptions. If after completing a reasonable review of the controlled prescription, you conclude that you will not fill the controlled medication, first document your decision tree into the record-keeping system, then without being dishonest, simply be professional and explain to the patient “that in your professional judgment you are not going to be able to fill their controlled prescription today.” Explain that, based on the pharmacist’s professional judgment, it is your responsibility and duty not to fill a controlled prescription that fails to meet your review. This is never easy, but pharmacists have always been and will forever be respected as the most trusted profession for one important reason - pharmacists always act with integrity and honesty in the best interest of their patients’ health. Pharmacists are medication experts and are expected to know the health risks associated with the abuse of controlled medications. Addiction crosses all economic boundaries. While it takes courage, confidence and conviction, it can be rewarding to privately approach a patient about addiction and direct them to drug abuse treatment. Today’s practicing pharmacists must remain well informed and become active participants in the battle to reduce controlled medication abuse throughout our communities. Updates, ques-

It is the pharmacist’s duty to refuse to fill any prescription if professional judgment suggests filling it would be contrary to law, be against the best interest of the patient, aid or abet an addiction or habit, or be contrary to the health and safety of the patient. 12

FLORIDA PHARMACY TODAY

tions and comments can be received at RxLawDoc@gmail.com. This article discusses general principles of law and risk management. This discussion is not intended to represent legal advice. Specific legal questions should be referred to local legal counsel. Opinions expressed reflect those of the presenter and should be confirmed within your pharmacy jurisdiction.

Joseph Scuro, JD, DC, RPh HealthForce Consultant Group, llc Jacksonville, FL Joseph Scuro, is president of HealthForce Consultant Group providing pharma-legal education, research and consultation. A graduate of the Northwestern College of Law, Northwestern College of Chiropractic Medicine and Palm Beach Atlantic School of Pharmacy, he practiced in each area developing an interest in regulatory compliance, health service delivery, error prevention and outcome analytics. He serves as an effective liaison between the healthcare delivery team, government regulators and the community to improve cost-effective service delivery, usage and outcomes.

WARNING SIGNS OF ABUSE AND DIVERSION PRESCRIPTION HARD COPY REVIEW

The identified top 10 controlled medication of concern: Hydrocodone, Oxycodone/OxyContin® , Oxymorphone/ Opana®, Xanax®/Alprazolam, Methadone, Fentanyl, Adderall®, Carisoprodol/Soma®, Hydromorphone, Suboxone/Subutex RX complies with all Federal and State controlled prescription requirements Ink and handwriting differences; Misspelling key words and/or names on controlled prescription Directions differ from the quantity of controlled medication written Failing to contact other pharmacists to inquire why they refused to fill the controlled prescription issued by a particular physician

PHARMACY-PATIENTPHYSICIAN LOCATION REVIEW

Is the physician’s office and/or the patient’s physical address within a reasonable distance away from pharmacy? Defined as: distances that cannot be explained. Note: this does not suggest limiting your service area to only the pharmacy’s county geographical area.

PATIENT REVIEW

Valid government-issued photo ID information written legible for the individual dropping off and picking up the controlled prescription Arriving in pharmacy 15 minutes to closing time; Unduly anxious; Threatening retaliation Patient and/or physician often request early refills; Often reported to be stolen, lost and/or patient frequently leaving town; Patient refers to drugs using street slang (xanies, bars, purple drank)

PHYSICIAN’S REVIEW

Is there a patient-physician relationship? Physician prescribes controlled medication for themselves or for family; Controlled substance prescriptions that are inconsistent with physician’s area of practice (fentanyl from dentist) Internal pharmacy data reflects that a large portion of prescriptions for controlled medication are written by a single physician’s office; No individualized dosing: prescription for the strongest dose

REVIEW PATIENT’S No patient history at your pharmacy: Call physician’s office to verify controlled prescription, physician’s DEA MEDICATION HISTORY registration number, office address and telephone number; Patient profile clearly reveals that patient is receiving controlled medication from multiple prescribers REVIEW PRESCRIPTION DRUG MONITORING PROGRAM

Report reveals multiple physicians, multiple pharmacies and/or multiple fills of controlled prescription; Extensive patient controlled medication history. Patient commonly receives control drug cocktail: an opiate, a benzodiazepine and carisopridol

PHARMACY PROCEDURES

Only one pharmacy staff member orders and/or check-ins the majority of drug orders No controlled medication verification process used involving other pharmacy staff members. No random controlled medication verification of perpetual inventory. High volume controlled medication(s) inventory not frequently checked No orderly controlled medication record-keeping system JANUARY 2015

www.phmic.com 800.247.5930

announcing

Pharmacists Mutual your single source for insurance protection

Seth Swanson

•

Company founded in 1909 by pharmacists, for pharmacists.

•

A true mutual company, with members who elect the Board of Directors and have had dividends returned each year since 1909.*

•

Local ﬁeld representatives and a home ofﬁce staff with specialized knowledge of pharmacy risks and needs.

•

A tradition of courteous, fast and fair service.

•

Financially secure company, with an uninterrupted A (Excellent) rating or higher from A.M. Best Company for more than 90 years.

•

Endorsed by state and national pharmacy associations.**

•

Supports the profession of pharmacy by providing:

Serves Florida

850.688.3675

seth.swanson@phmic.com

A. B. C. D. E. F.

Chuck Neyland

Scholarships to students at pharmacy schools. Lectures on pharmacy law to pharmacy students. C.E. speakers at conventions. Legislative support of pharmacy bills. Financial support through Pharmacy Marketing Group and the state associations. Sponsorship of the Distinguished Young Pharmacist Award nationwide.

Serves the Florida Panhandle

251.656.7219

chuck.neyland@phmic.com

Not licensed to sell all products in all states. *Dividends cannot be guaranteed. **Compensated endorsement.

Find us on Social Media: 14

FLORIDA PHARMACY TODAY

Professional Liability | Business Protection Workers Compensation

Pharmacists’ Patient Care Process: Consistency is Critical Recognizing the need for a consistent process in the delivery of patient care across the profession, the Joint Commission of Pharmacy Practitioners (JCPP)1 recently released the Pharmacists’ Patient Care Process. The process is applicable to any practice setting where pharmacists provide patient care and for any patient care service provided by pharmacists. This article describes the development of the Pharmacists’ Patient Care Process, what the process is, why it’s important and initial implementation steps. The Foundation JCPP’s vision statement for the pharmacy profession and strategic plan for reaching this vision were revised in July 2013 as part of a strategic planning retreat t hat included thought leaders from inside and outside the profession. The newly adopted vision, “Patients achieve optimal health and medication outcomes with pharmacists as essential and accountable providers within patient-centered, team-based health care,” reflects the need for pharmacists to be patient-centered and accountable for patient outcomes while working collaboratively with other members of the health care team. Key drivers to achieving the JCPP vision identified by pharmacy thought leaders include: 1) a widely-adopted

and consistently delivered pharmacist patient care process, 2) quality measures to measure the value of pharmacists’ services, 3) robust health information technology to support patient care and 4) payment for pharmacists’ services. The need for pharmacists to use a consistent approach to patient care

delivery has always been important. However, with the increasing movement to outcomes-based payment models in the health care system, this need is becoming more urgent. Payment models are starting to emerge where

The need for pharmacists to use a consistent approach to patient care delivery has always been important.

health care professionals are paid for achieving desired outcomes for their patients (e.g., patients’ blood pressure at goal) instead of by the number of patient visits they complete. To measure the outcomes of pharmacists’ services in a meaningful way, a consistent process of care must be used to deliver the services. That way an “apples to apples” comparison can be made for the collective value that pharmacists provide within the health care system. The Pharmacists’ Patient Care Process was developed by a group of national pharmacy organizations working under the direction of JCPP. The foundation for the process is embedded within the pharmaceutical care model developed by Hepler and Strand in the 1990s and was developed by examining a number of key source documents on pharmaceutical care and medication therapy management. These key documents were cataloged and compared to create a patient care process consistent with best practice models in pharmacy. The patient care process is articulated in a manner aligned with the patient care processes of other health care professionals while at the same time detailing the unique medication-related aspects of pharmacists’ training. The development process included organizational comment periods and testing with clinicians to create the document approved by JCPP on May 29, 2014. What is the Pharmacists’ Patient Care Process? The Pharmacists’ Patient Care Process uses a patient-centered approach that depends first and foremost on the pharmacist having an established relationship with the patient. This relationship supports engagement and JANUARY 2015

PHARMACISTS’ PATIENT CARE PROCESS Using principles of evidence-based practice, pharmacists:

Collect The pharmacist assures the collection of necessary subjective and objective information about the patient in order to understand the relevant medical/medication history and clinical status of the patient. Information may be gathered and verified from multiple sources, including existing patient records, the patient and other health care professionals. This process includes collecting: ■■ A current medication list and medication use history for prescription and nonprescription medications, herbal products and other dietary supplements; ■■ Relevant health data that may include medical history, health and wellness information, biometric test results and physical assessment findings; and ■■ Patient lifestyle habits, preferences and beliefs, health and functional goals and socioeconomic factors that affect access to medications and other aspects of care.

effective communication with the patient, family members and caregivers throughout the process. The process also involves the pharmacist working with prescribers and other practitioners to optimize patient health and medication outcomes (see sidebar). The follow-up step signals that the patient care process is repeated with each and every patient encounter, and the frequency of follow-up depends on the acuity of the patient and the nature of their care. The level of intensity for each step will vary with the service provided, but the process should

Assess The pharmacist assesses the information collected and analyzes the clinical effects of the patient’s therapy in the context of the patient’s overall health goals in order to identify and prioritize problems and achieve optimal care. This process includes assessing: ■■ Each medication for appropriateness, effectiveness, safety and patient adherence; ■■ Health and functional status, risk factors, health data, cultural factors, health literacy and access to medications or other aspects of care; and ■■ Immunization status and the need for preventive care and other health care services, where appropriate.

not vary. The process is intended to be used in all patient care settings, and while one pharmacist might be responsible for all the steps in some settings, in other settings, there may be more than one pharmacist involved at different stages of the process. Pharmacist Involvement National pharmacy associations are currently working to facilitate implementation of the process across the profession, including developing case examples for different practice settings. The Accreditation Council for Pharma-

Plan The pharmacist develops an individualized patient-centered care plan in collaboration with other health care professionals and the patient or caregiver that is evidence-based and cost effective. This process includes establishing a care plan that: ■■ Addresses medication-related problems and optimizes medication therapy; ■■ Sets goals of therapy for achieving clinical outcomes in the context of the patient’s overall health care goals and access to care; ■■ Engages the patient through education, empowerment and self-management; and ■■ Supports care continuity, including follow-up and transitions of care as appropriate.

cy Education (ACPE) has incorporated the Pharmacists’ Patient Care Process into the Draft Standards 2016 revision for the Doctor of Pharmacy curriculum. These Standards were considered for final approval at the January 2015 ACPE Board meeting and will be distributed profession-wide shortly thereafter. With the ACPE Standards revision, schools and colleges of pharmacy will be working to incorporate the process into the curriculum. ACPE-accredited continuing-education providers will also be encouraged to incorporate the process into continuing-education

National pharmacy associations are currently working to facilitate implementation of the process across the profession, including developing case examples for different practice settings. 16

FLORIDA PHARMACY TODAY

Implement The pharmacist implements the care plan in collaboration with other health care professionals and the patient or caregiver. During the process of implementing the care plan, the pharmacist: ■■ Addresses medication- and health-related problems and engages in preventive care strategies, including vaccine administration; ■■ Initiates, modifies, discontinues or administers medication therapy as authorized; ■■ Provides education and self-management training to the patient or caregiver; ■■ Contributes to coordination of care, including the referral or transition of the patient to another health care professional; and ■■ Schedules follow-up care as needed to achieve goals of therapy.

programming for pharmacists. You can play an important role in the adoption of this process. Start by reviewing the process and thinking about how closely the patient care process used in your practice mirrors this process. Talk to other pharmacists in your practice to make them aware of the process and to discuss how the practice as a whole can adopt a consistent process of care. Consider how pharmacy technicians can be incorporated into aspects of the process, such as data collection, to improve the efficiency of the process. Share the process with other health care practitioners you work with to make them aware of it. Practice using the process and reflect on how effectively the process facilitated patient care. Share your experiences with other pharmacists in your practice, your colleagues and at professional meetings. Incorporate the process into the teach-

Follow-up: Monitor and Evaluate The pharmacist monitors and evaluates the effectiveness of the care plan and modifies the plan in collaboration with other health care professionals and the patient or caregiver as needed. This process includes the continuous monitoring and evaluation of: ■■ Medication appropriateness, effectiveness, and safety and patient adherence through available health data, biometric test results and patient feedback; ■■ Clinical endpoints that contribute to the patient’s overall health; and ■■ Outcomes of care including progress toward or the achievement of goals of therapy.

ing materials for students you precept on IPPEs, APPEs and internships. Make sure that students have the opportunity to practice using the process in their patient care encounters. Students will be asking about the process, so if you are a preceptor, it’s important to be prepared. Finally, watch for additional resources to assist you in the implementation and assessment of the Pharmacists’ Patient Care Process. Pharmacists are often called upon to describe the value they bring to the health care system. A unified, consistent patient care process is critical to measuring pharmacists’ value and advancing the profession as a whole in the evolving health system. 1

of Colleges of Pharmacy, American College of Apothecaries, American College of Clinical Pharmacy, American Pharmacists Association, American Society of Consultant Pharmacists, American Society of Health-System Pharmacists, National Association of Boards of Pharmacy, National Alliance of State Pharmacy Associations, and the National Community Pharmacists Association.

The Joint Commission of Pharmacy Practitioners (JCPP) includes the following organizations: Academy of Managed Care Pharmacy, Accreditation Council for Pharmacy Education, American Association JANUARY 2015

FPA Member Profile Dan Fucarino, B Pharm

THE STATS Hometown: Tampa, Florida Employer: Owner, Carrollwood Pharmacy

What do you value most about your FPA membership?

What got you interested in pharmacy in the first place?

There are several things, but a few things, in order of importance, include: legislative and Board representation, excellent continuing education and the ability to get the heartbeat of my profession.

I wanted to be able to help people by not only providing them with medication, but by educating them on ways to stay healthy and why we are a crucial health team member.

What are some thoughts that you have on pharmacy as a profession right now?

What do you think your patients would say about you and your practice?

In many ways I have worried about the direction of pharmacy because of the recent influx of additional pharmacy schools. This could adversely drive down the demand for pharmacists. Overall, I feel the profession is healthy, but we need to be vigilant to keep it that way. We must get our most recent graduates very involved in their future.

What are you the most excited about regarding the future of pharmacy? I am most excited about the emerging technology and additional responsibilities that will make us more valued health team members. New innovative practice settings will continue to flourish and social media will allow us to get our fellow pharmacists more involved.

What do you wish everybody knew about pharmacy? We truly care about our patients’ outcomes. When it seems we are denying service, we are actually protecting our patients from harm.

FLORIDA PHARMACY TODAY

We take their health seriously. We are the place to come to get good, clear, honest health advice.

What is the funniest thing that ever happened to you? Because we are a compounding pharmacy and we have always advertised that we do human and pet prescriptions, some people think that I am an expert on veterinary matters. Twenty years ago, a very upset mother and her young child came into the pharmacy with a hamster that had been on an exercise wheel. The axle of the wheel had been rolled into the hamsters’ skin and it appeared that the hamster had been impaled by the axle of the wheel. I recognized that it was simply rolled into the skin and had not impaled the pet and slowly unwound the skin from the wheel. The mother and daughter were so relieved. Now 20 plus years later, the daughter, now a mother herself, reminds me of my “heroic” act every time she comes into the pharmacy. My wife asks me all the time, “Why do people ask you questions that have nothing to do with pharmacy or medicine?” My answer is always, “Because we pharmacists are the most trusted profession.” I hope we never lose that.

CALL FOR RESOLUTIONS TO THE 2015 HOUSE OF DELEGATES The House of Delegates Board of Directors will meet in May 2015 to review and approve resolutions for the Annual Meeting. The deadline for submitting resolutions is April 24, 2015! PLEASE NOTE THIS DEADLINE. The following information will be needed when submitting resolutions: 1. Name of Organization: The name of the organization submitting the resolutions(s); 2. Name and Telephone Number of Individuals: A contact in the event clarification or further information is needed; 3. Problem: A statement of the problem addressed by the resolution; 4. Intent: A statement of what passage of the resolution will accomplish; 5. Resolution Format: Please type and use double spacing. TITLE OF RESOLUTION NAME OF ORGANIZATION WHEREAS , AND

WHEREAS :

THEREFORE BE IT RESOLVED (THAT THE FPA OR SUBDIVISION OF FPA)

CONTACT NAME AND PHONE #: PROBLEM: INTENT:

Return this form to: Membership Coordinator, Florida Pharmacy Association, 610 North Adams Street, Tallahassee, Florida 32301 or fax (850) 561-6758

JANUARY 2015

THE WALKWAY OF RECOGNITION

FPA OFFICE

YOUR NAME HERE

Have you been searching for just the right gift or thought of placing your name in perpetuity? If so, then consider purchasing an engraved brick for you or someone else. The main sidewalk at the Florida Pharmacy Association needs replacing. The Florida Pharmacy Foundation has undertaken the project to repair and beautify the sidewalk with engraved personal bricks purchased by pharmacists or friends of pharmacy. Engraved 4x8 bricks can be purchased for $250.00 each with the donor’s name engraved (3 lines available) or you could also purchase an engraved brick for someone you feel should be honored or remembered. The monies earned from this project will be used to fulfill the goals and future of the Foundation. There are a limited number of bricks available – so, it is first come first served.

ORDER FORM

The Walkway of Recognition

❑ YES, I want to order _______ concrete brick/s at $250.00 each. (Please copy form for additional inscriptions). PL E A S E P R INT I NSC RIP TION

The concrete bricks are 4x8 and can be engraved with up to 14 characters per line, three lines available, spaces and punctuation count as one character. Please find enclosed my check for $_________ for _________ bricks. PLEASE PRINT: Please charge my

❑ Master Card

CARD #

Contributions to the Florida Pharmacy Foundation are tax deductible as a charitable contribution for federal income tax purposes. Consult your CPA for complete details. Fed Emp. I.D. #59-2190074

❑ Visa EXP. DATE

AUTHORIZED SIGNATURE NAME ADDRESS CITY

STATE

PHONE (W)

(H)

Send to Florida Pharmacy Foundation, 610 N. Adams St., Tallahassee, FL 32301, or fax to (850) 561-6758.

ZIP

A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE 1-800-435-7352 WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL OR RECOMMENDATION BY THE STATE.

125

FLORIDA PHARMACY ASSOCIATION 125TH ANNUAL MEETING AND CONVENTION Renaissance Resort at World Golf Village St. Augustine, Florida

SAVE THE DATE: June 24- 28, 2015 Changes in Publishing for Florida Pharmacy Today The Florida Pharmacy Today is now an online-only publication. The Journal Board announced this month that due to budget changes, monthly issues will be available to members online, but will no longer be printed and mailed. Online journals will be available through pharmview.com and members will receive an email notice each month when the latest issue has been posted. Although this will be a significant change, the online version offers many advantages including space for longer articles, links to other resources, embedded videos and more opportunities to engage directly with readers. The Florida Pharmacy Today is a peer-reviewed journal that serves as a medium through which the Florida Pharmacy Association can communicate with the profession on advances in the sciences of pharmacy, socio-economic issues bearing on pharmacy and newsworthy items of interest to the profession. Archived copies of the Pharmacy Today Journal are also available on the FPA website.

Representing Pharmacists, Pharmacies and Health Providers throughout Florida & the U.S. • • • • • • • •

DEA Hearings Contract Review DOH Investigations Disciplinary Matters Sale of Pharmacy Administrative Hearings Licensure Problems Forfeiture Defense

• • • • • • • •

Investigations NPDB Reports Board Hearings Civil Litigation Corporate Work DEA Defense Medicaid Audits Medicare Defense

George F. Indest III, J.D., M.P.A., LL.M. Retired JAGG officer, licensed in Florida, Louisiana, and Washington, D.C., Board Certified by the Florida Bar 30+ Years of experience, LL.M. from G.W.U.

The healTh law Firm

Main Office: 1101 Douglas Ave., Altamonte Springs, FL 32714 Phone: (407) 331-6620 • Fax: (407) 331-3030 Website: www.TheHealthLawFirm.com Branch Offices in Orlando and Pensacola We accept HPSO insurance. JANUARY 2015

C A L L APhA Foundation and NASPA Bowl of Hygeia Awarded to a pharmacist for outstanding community service above and beyond professional duties. The use of the following selection criteria is required: ■■ The recipient must be a Florida licensed pharmacist and a member of FPA. ■■           ■■ T recipient has not previously received the award. ■■               two  on its award committee or an officer of the association in other than an ex officio capacity. ■■   has compiled an outstanding record of community service, which, apart from his/her specific identification as a pharmacist, reflects well on the profession. James H. Beal Award Awarded to the "Pharmacist of the Year." The criteria established for this award is that the recipient be a Florida registered pharmacist and a member of FPA, who has rendered outstanding service to pharmacy within the past five years. Criteria: ■■   must be a Florida registered pharmacist and a member of the FPA. ■■   has rendered outstanding service to pharmacy within the past five years. Technician of the Year Award Awarded annually to a Florida pharmacy technician who is recognized for his/her outstanding performance and achievement during his/her career. Criteria: ■■ Candidate must be a member of the Florida Pharmacy Association for at least two years. ■■ Candidate must have demonstrated contributions and dedication to the advancement of pharmacy technician practice.

FLORIDA PHARMACY TODAY

F O R

N O M I N A T I O N S

■■ Candidate must have demonstrated

contributions to the Florida Pharmacy Association and/or other pharmacy organizations. ■■ Candidate must have demonstrated commitment to community service. ■■ Candidate is not a past recipient of this award. R.Q. Richards Award This award is based on outstanding achievement in the field of pharmaceutical public relations in Florida. Criteria: ■■  recipient must be a Florida registered pharmacist and a member of the FPA. ■■   has displayed outstanding achievement in the field of pharmaceutical public relations in Florida. Frank Toback/AZO Consultant Pharmacist Award Criteria: ■■ Candidate must be an FPA member, registered with the Florida Board of Pharmacy as a consultant pharmacist in good standing. ■■ Candidate should be selected based on their outstanding achievements in the field of consultant pharmacy. DCPA Sidney Simkowitz Pharmacy Involvement Award Presented annually to a Florida pharmacist who has been active at the local and state pharmacy association level in advancement of the profession of pharmacy in Florida. Criteria: ■■ A minimum of five years of active involvement in and contributions to the local association and FPA. ■■ Candidate must have held office at local level pharmacy association. ■■ Member in good standing for a period of at least five years in the FPA and must have served as a member or chairman of a committee of the association. ■■ Candidate must have been actively involved in a project that has or could potentially be of benefit to members of the profession.

Pharmacists Mutual Companies Distinguished Young Pharmacist Award Awarded to a young pharmacist for their involvement and dedication to the practice of pharmacy. Criteria: ■■ Licensed to practice for nine years or less. ■■ Licensed to practice in the state in which selected. ■■ Participation in national pharmacy association, professional programs, and/or community service. IPA Roman Maximo Corrons Inspiration & Motivation Award Interamerican Pharmacists Association created this award to honor the memory of Roman M. Corrons who inspired and motivated countless pharmacists to participate actively and aspire to take on leadership roles in their profession. Roman was always there with guidance and support that motivated pharmacists and encouraged visionary leadership, approachable active membership and succession planning. This award recognizes the motivators among us who inspire others to continue to advance the profession. Criteria: ■■ The recipient must be a Florida Licensed Pharmacist and a member of the FPA. ■■ Candidate should motivate others to excel within the profession by encouraging them to be leaders. ■■ Candidate is not necessarily an association officer, but guides, supports and/or inspires others. A brief description on the candidate’s motivational/inspirational skills must accompany the nomination. The Jean Lamberti Mentorship Award The Jean Lamberti Mentorship Award was established in 1998 to honor those pharmacists who have taken time to share their knowledge and experience with pharmacist candidates. The award is named in honor of long time FPA member Jean Lamberti for her effort in working with pharmacy students.

F P A

A W A R D S

Criteria: ■■ The recipient must be an FPA member. ■■ The recipient must serve as a role model for the profession of pharmacy. Upsher Smith Excellence in Innovation Award Awarded to honor practicing pharmacists who have demonstrated innovation in pharmacy practice that has resulted in improved patient care. Criteria: ■■ The recipient has demonstrated innovative pharmacy practice resulting in improved patient care. ■■ The recipient should be a practicing pharmacist within the geographic area represented by the presenting Association. Qualified Nominee: A pharmacist practicing within the geographic area represented by the presenting Association.

2 0 1 4 - 2 0 1 5

Cardinal Generation Rx Award The Cardinal Health Generation Rx Champions Award recognizes a pharmacist who has demonstrated excellence in community-based prescription drug abuse prevention. The award is intended to recognize outstanding efforts within the pharmacy community to raise awareness of this serious public health problem. It is also intended to encourage educational prevention efforts aimed at patients, youth and other members of the community. The nominee must be a pharmacist who is a member of the state association. Self-nominations are allowed. Applications will be evaluated based upon the following criteria: ■■ Commitment to community-based educational prevention efforts aimed

■■

■■ ■■

at prescription drug abuse Involvement of other community groups in the planning and implementation of prevention programs Innovation and creativity in the creation and implementation of prevention activities Scope/magnitude of prescription drug abuse efforts Demonstrated impact of prescription drug abuse prevention efforts

DEADLINE FOR NOMINATIONS: FEBRUARY 28, 2015 FPA AWARDS NOMINATION FORM I AM PLEASED TO SUBMIT THE FOLLOWING NOMINATION:

NOMINATED BY:

Name:

Address:

Date Submitted:

FOR THE FOLLOWING AWARD: (Nomination Deadline February 28, 2015)  APhA Foundation and NASPA Bowl of Hygeia  James H. Beal Award  Technician of the Year Award

Signature: Please describe briefly below the nominee's accomplishments, indicating why you feel he or she should receive this award. (Attach additional sheets if necessary.)

 R.Q. Richards Award  Frank Toback/AZO Consultant Pharmacist Award  DCPA Sydney Simkowitz Award  Pharmacists Mutual Co. Distinguished Young Pharmacist Award  IPA Roman Maximo Corrons Inspiration & Motivation Award  The Jean Lamberti Mentorship Award  Upsher Smith Excellence in Innovation Award  Cardinal Generation Rx Award

MAIL NOMINATONS TO: Annual Awards, Florida Pharmacy Association, 610 N. Adams St., Tallahassee, FL 32301 (850) 222-2400 FAX (850) 561-6758 DEADLINE FOR NOMINATIONS IS FEBRUARY 28, 2015

JANUARY 2015

S AV E

T H E D AT E â&#x20AC;&#x201D; J U N E

24-28, 2015

125th Annual Meeting and Convention of the Florida Pharmacy Association Renaissance World Golf Village Resort

500 South Legacy Trail St. Augustine, Florida 32092 For room reservations call (800) 468-3571

JUNE 24-28, 2015 Florida Pharmacy Association 610 North Adams Street Tallahassee, Florida 32301

Phone: (850) 222-2400 Fax: (561) 6758 www.pharmview.com

FLORIDA PHARMACY TODAY

NETWORK WITH COLLEAGUES

The Florida Pharmacy Association (FPA) is accredited by the Accreditation Council of Pharmacy Education as a provider of continuing education. The FPA is also a Florida Department of Health approved provider of continuing education and reports to CEBroker

Florida Pharmacy Association’s 125Florida ANNUAL MEETING AND CONVENTION Pharmacy Association’s Renaissance World Golf Village St. Augustine, FL 125th ANNUAL MEETING ANDResort, CONVENTION 24-28, 2015 Renaissance World GolfJune Village Resort, St. Augustine, FL th

Room Rates: $129 single/double occupancy for24-28, standard 2015 deluxe room. The room reservation deadline is Monday, June 1, June 2015 or when room block is full. Thereafter, reservations may be taken on a space available or rate available basis. Room Rates: single/double occupancy for standard deluxegroup room.rate. The All room reservation deadline is Monday, June 1, night Please be $129 sure to ask for the Florida Pharmacy Association reservations must be accompanied by a first 2015room or when room block is full. Thereafter, reservations may be taken on a space available or rate available basis. deposit or guaranteed with a major credit card. A deposit is refundable only if Hotel receives cancellation at least 72 Please be sure for the Florida Pharmacy rate. Alltime reservations accompanied by can a first hours priortotoask arrival. The check-in time is Association 4:00pm andgroup the checkout is 11:00 must am. be Room reservations benight made by roomcalling deposit or guaranteed a major credit is card. A deposit isValet refundable if Hotel receives cancellation at least 72 (800) 266-9432. with Guest self parking complimentary. parkingonly is $10 per day/night. hours prior to arrival. The check-in time is 4:00pm and the checkout time is 11:00 am. Room reservations can be made by calling (800) 266-9432. Guest self parking is complimentary. Valet parking is $10 per day/night. General Education Track

Thursday - Sunday Track The general education track will offer General courses Education designed to educate pharmacists on a wide variety of important topics Thursday - Sunday pertaining to the profession of pharmacy practice. Specific courses being offered are Reducing Medication Errors, HIV/AIDS, The and general education trackoffering will offer coursesLegislative designed Update. to educate pharmacists a wide variety of course important topics the always-popular of Florida There will also beona New Drug Update which focuses pertaining to the profession of pharmacy practice. Specific courses being offered are Reducing Medication Errors, HIV/AIDS, on the most recently FDA approved drugs introduced into the market. and the always-popular offering of Florida Legislative Update. There will also be a New Drug Update course which focuses on the most recently FDA approved drugs introduced into theEducation market. Track Consultant Thursday- Saturday Consultant Education The consultant education track will provide pharmacists withTrack the most current information available on various topics that pharmacists encounter in the profession of Thursdaypharmacy.Saturday The specific topics being offered include Nutrition, Pain Management The consultant education track will provide pharmacists with the most current information available on various topics that and Autoimmune Disorders. There are 15 hours available for consultant pharmacists. pharmacists encounter in the profession of pharmacy. The specific topics being offered include Nutrition, Pain Management and Autoimmune Disorders. There are 15 hours available for consultant pharmacists. Student and Technician Track Thursday – Sunday Student Technician Students and Technicians will benefit fromand interacting withTrack practicing pharmacists and attending student and technician Thursday – Sunday focused continuing education programs. The technician track offers several hours of continuing education on a variety of Students and Technicians will benefit fromfor interacting with practicing pharmacists and Medication attending student technician topics, including the required courses Florida registration and PTCB renewal: Errors, and Pharmacy Law and focused continuing education programs. The technician track offers several hours of continuing education on a varietysuch of as HIV/AIDS for initial renewal. The student track consists of several hours of fun and exciting continuing education, topics, including required courses for Florida registration and PTCB Errors, The Career the Forum and the NASPA/NMA Game Show. Students willrenewal: also haveMedication an opportunity to Pharmacy participate Law in theand Patient HIV/AIDS for initial renewal. and Theshowcase student track of several hours of fun and exciting continuing education, such as Counseling Competition theirconsists Poster Presentations. The Career Forum and the NASPA/NMA Game Show. Students will also have an opportunity to participate in the Patient Counseling Competition and showcase their Poster Presentations.Education Pre-Convention Wednesday Only Pre-Convention Education Our traditional Wednesday program will focus on Pulmonary Disorders. Pulmonary disease affects all age groups. Wednesday Only Pharmacists play a vital role in the management and patient education of pulmonary disorders. The hands on program will Our traditional Wednesday program will focus on Pulmonary Disorders. Pulmonary disease affects allwill age groups. focus on the most current information evolving in the area of pulmonary disorders. The program offer 6 hours of live Pharmacists play a vital continuing role in the management andRegister patient education of pulmonary disorders. Theaway handswith on valuable program knowledge will general/consultant education credit. for this outstanding program and walk focusfor onyou the and mostyour current information evolving disorders. in the areaAofseparate pulmonary disorders. The program willfor offer hours of live patients with pulmonary registration fee is required the6 pre-convention general/consultant continuing education credit. Register for this outstanding program and walk away with valuable knowledge program. for you and your patients with pulmonary disorders. A separate registration fee is required for the pre-convention program. Special Events Exhibits: Participate in our grand opening reception in the exhibit hall! Poster Presentations: Browse submissions from Special Events if you would like to submit a poster presentation. Awards pharmacy students. Contact the FPA office for more information Exhibits: Participate in our grand reception in the exhibit Posterpresentation. Presentations: Browse submissions from the Ceremony Reception: Honoropening outstanding practitioners during hall! the awards President’s Breakfast: Attend pharmacy students. Contact the FPA office for more information if you would like to submit a poster presentation. Awards Sunday morning installation of new officers. Receptions: Enjoy catching up with your colleagues as the Universities Ceremony Reception: Honor the awards Breakfast: Attend theBe a entertain their alumni andoutstanding friends, andpractitioners as the FPAduring Foundation host presentation. its Speedway President’s Tailgater. House of Delegates: Sunday morning installation newhow officers. Receptions: Enjoy catching up direction with yourofcolleagues as the Student Universities delegate or observer andofsee important member participation is to the the Association. Events: entertain their alumni and friends, and Mentor as the Social. FPA Foundation host its Speedway Tailgater. of pharmacists, Delegates: Be a Participate in the Adopt-A-Student Students will benefit from interacting with House practicing attending delegate or observer see how important memberand participation is tohand the direction of FPA the Association. Student Events: student focused and continuing education programs learning first about the and how involvement can improve Participate in the Adopt-A-Student Mentor Students benefit interacting withFPPC practicing pharmacists, their chosen profession. Call the FPA Social. office and offer towill mentor or from sponsor a student. Reception: Attendattending this reception student focused continuing education programs and learning first hand about the FPA and how involvement can improve to support your Political Action Committee. 5K FUN RUN/WALK: Exercise is good for the soul. Incorporate health and their fitness chosen while profession. FPA office and mentor Join or sponsor a student. this reception at theCall FPAthe convention. FPAoffer Golfto Event: us Friday for theFPPC FPA Reception: Golf Event. Attend Please register early to to support your reserve yourPolitical space. Action Committee. 5K FUN RUN/WALK: Exercise is good for the soul. Incorporate health and fitness while at the FPA convention. FPA Golf Event: Join us Friday for the FPA Golf Event. Please register early to reserve your space. FPA 125h ANNUAL MEETING & CONVENTION June 24-28, 2015 INFO (850) 222-2400

FPA 125h ANNUAL MEETING & CONVENTION June 24-28, 2015 INFO (850) 222-2400

JANUARY 2015

FPA 125th Annual Meeting and Convention June 24-28, 2015  St. Augustine, FL

5 Pre Convention -

Participant Participant Information Information

Name: _____________________________________________________ Name: _______________________________________________ Mailing Address: _____________________________________ Badge Name: _______________________________________________ City, State, Zip: _______________________________________ Mailing Address: ____________________________________________ Phone: (W)Zip: _____________________________________________ __(H)___________________ City, State, Email: _____________________________________________ (H)_______________________ Phone: (W) License: PS______________ PU _____________RPT_________ Fax: ______________________________________________________ NABP License:e-profile#____________________ PS________________ PU_________DOB Other(MM/DD)_______ State___________

Full____________________________________________________ Package Registration—Excludes Box 5 2Email: Full package registration includes Educational Programs (ThursExhibit Hall, Awards Reception and President’s Breakfast. 2 Sun), Handbooks are not included in full package registration.

Handouts will be available on our website, www.pharmview.com, the week of June 22, 2015. Before May 29 After May 29 Amount_ $_______

Wednesday, June 24, 2015

PULMONARY DISORDERS

Before May 29 � FPA Member with Full Registration $75 � FPA Member $140 � Non Member with Full Registration $100 � Non Member $190

After May 29 $95 $160 $120 $210

Pulmonary disease affects all age groups. Pharmacists play a vital role in the management and patient education of pulmonary disorders. The hands on program will focus on the most current information evolving in the area of pulmonary disorders. Total Amount: $__________

Special Events Registration

The events listed below must be purchased individually and are not included in any other registration packages.

House of Delegates

(Non-convention registrants)

Quantity

Price

Amount

_________

@ $25

$_______

Reception _________ Special Events Registration 6FPPC (Complimentary event, indicate if attending)

@ N/C

FPA Member

$320

$405

Non Member

$500

$585

$_______

The events listed below must be purchased individually and are not Golf Event in any other registration _________ $_______ included packages. @ $150

Pharmacist BEST Value

$515

$600

$_______

Christian RPh Breakfast

Quantity _________

Price @ $40

Amount $_______

Member Technician

$145

$180

$_______

PharmPACCE Luncheon Student Luncheon

_________

@@$60 $45

$_______ $_______

Non Member Technician

$165

$200

$_______

Technician BEST Value

$175

$210

$_______

Student

$135

$_______

Guest (no CE)

$150

$_______

$40

N/A

$_______

Guest Name: Handbooks

3(BEST Value includes Registration & Membership) indicate below which functions you will attend. These 3 Please functions are included in the Full Package. If no boxes are

selected, we will assume you will not attend any of the events listed below. Full registration package includes one ticket to each of these events. Please see box 7 for additional tickets.



House of Delegates (Thursday)



Exhibit Hall (Friday and/or Saturday)

Awards Reception (Saturday)



4

#_______

Before After President’s Breakfast (Sunday) June 27 June 27  I will not attend any of these functions. FPA Member $140 $150

# Amount

Non MemberEducation Daily

$_______

$195 $225 Registration

________

Total Amount: $

_____

Additional Tickets

The following events ARE included in the Full Registration Package. However, you must purchase additional tickets for guests who are NOT registered. Quantity Price Amount

Additional Tickets 7Exhibit Hall

@ $30 $_______ The following events ARE included in the Full Registration Package. Awards Ceremony @for $80 However, you must purchase additional tickets guests who$_______ are NOT registered.Breakfast President’s @ $50 $_______ Quantity Price A_______ Total Amount: $_______ _____

Contributions (Make

Foundation).

check payable to FL Pharmacy



Adopt-A-Student Program



Foundation

8 9

$_______

Daily registration include admittance$60 to functions or Member Technician does not $40 $_______ handbooks. Handouts will be posted on our website June 22. Non Member Technician $55 $75 $_______ Before After May 29 May 29 Amount Handouts $30 N/A $_______ Please select the day(s) you will attend: FPA Member $165 $185 $_______ Thursday Friday Saturday Sunday Non Member $220 $240 $_______

___________

Amount: $_______ Total Amount: $

Convention Polo Shirt (Deadline is May 29, 2015) Quantity



Yes

Price

______ @ $35

Payment  Payment Check (To: FPA)

Amount: $_______

 Discover

M/F

______

Size

______

Amount $_______

Total Enclosed: $______ Enclosed:$Visa Total MasterCard

 Check#(To: FPA)  MasterCard  Visa  AMEX  Discover Account _______________________________________________ Account # ________________________________________________ Security Code _________________ Expiration Date ______________

Member Technician

$85

$105

$_______

SecurityAddress Code _________________ Expiration Date _______________ Billing ___________________________________________

Non Member Technician

$100

$120

$_______

Billing Address _____________________________________________ Signature _______________________________________________

Handbooks

$40

N/A

$_______

Please select the day(s) you will attend: Friday Saturday Thursday

FLORIDA PHARMACY TODAY

Sunday

Four Ways to Register

Mail: FPA, 610 North Adams Street, Tallahassee, FL 32301 Phone: 850-222-2400 Fax: 850-561-6758 Web: www.pharmview.com

CALL FOR ABSTRACTS FOR POSTER PRESENTATIONS For Florida Pharmacy Students

FLORIDA PHARMACY ASSOCIATION 125th ANNUAL MEETING AND CONVENTION

June 24-28, 2015 Renaissance World Golf Village Resort ♦ St. Augustine, Florida Poster Session: Friday, June 26, 2015 ♦ 11:00AM-1:00PM

The FPA Poster Presentations are open to PHARMACY STUDENTS ONLY. Complete and submit this COVERSHEET for each abstract submission. Submissions must be received no later than Friday, May 1, 2015. Abstracts will NOT be accepted after this date. Mail or E-mail this application along with the abstract submission to: Tian Merren Owens, MS, PharmD, Director of Continuing Education Florida Pharmacy Association 610 N. Adams Street Tallahassee, FL 32301 tmerren@pharmview.com

PLEASE TYPE

Contact Information: Presenter's Name (MUST BE A STUDENT):________________________________________________________________

□Entry Level Pharm.D. □ Post B.S. Pharm.D. Address: ________________________________________________________________________________________

City, State, Zip: ___________________________________________________________________________________ Telephone No: _____________________E-Mail Address: _________________________________________________ Abstract Title: ____________________________________________________________________________________ Poster Type:

□Clinical Research □Basic Science Research □Translational Research (Basic Science and Clinical Research)

Primary Author: __________________________________________________________________________________ (Students must be listed first to be considered for the Award. Presenter will be notified by mail of acceptance). Co-Author(s): _________________________________________________________ Student

□YES □NO

Awards:

Posters will be eligible for 1st, 2nd, and 3rd place prizes to be presented at Convention. (Only one prize is given for each winning poster)

Free Registration:

Three entry level students from each Florida College of Pharmacy will be eligible for a complimentary Florida Pharmacy Association Convention Student registration. (Student Registration does not include CE or hotel accommodations) I am interested in being considered for this registration:

College:

□YES

□NO

_____________________________________________________________________________

ABSTRACT FORMAT The abstract form submitted should be the equivalent of one page. The abstract should include: Title (Include authors’ names and name of College of Pharmacy), Purpose, Methods, Results, and Conclusions. Abstracts will not be accepted if it is not in this format. Do not include figures or graphs.

Please direct all questions and concerns to:

Tian Merren Owens ♦ (850) 222-2400 ext. 120 ♦ tmerren@pharmview.com DEADLINE DATE: FRIDAY, MAY 1, 2015 JANUARY 2015

florida BUYER’S GUIDE PHARMACY TODAY

ADVERTISERS: This is a special section designed to give your company more exposure and to act as an easy reference for the pharmacist.

PHARMACY RESOURCES Abbott Diabetes Care Hernan Castellon (305) 220-0414 PPSC Retail Pharmacy Purchasing Program (888) 778-9909

LEGAL ASSISTANCE Kahan ◆ Heimberg, PLC Brian A. Kahan, R.Ph., Attorney at Law 561-392-9000 Fried Law Office, P.A. Dennis A. Fried, M.D., J.D. (407) 476-1427 The Health Law Firm George F. Indest III, J.D., M.P.A., LL.M. (407) 331-6620

PHARMACEUTICAL WHOLESALER

PHARMACY CONSULTANTS HCC Pharmacy Business Solutions Bob Miller, BPharm, CPH (800) 642-1652 Empire Pharmacy Consultants Michael Chen PharmD., CPH President (855) 374-1029

TEMPORARY PHARMACISTS – STAFFING HealthCare Consultants Pharmacy Staffing Bob Miller (800) 642-1652 Empire Pharmacy Consultants Michael Chen PharmD., CPH President (855) 374-1029 Rx Relief (800) RXRELIEF

McKesson Drug Company Jim Springer (800) 804-4590 FAX: (863) 616-2953

Advertising in Florida Pharmacy Today Display Advertising: please call (850) 264-5111 for a media kit and rate sheet. Buyers’ Guide: A signed insertion of at least 3X per year, 1/3 page or larger display ad, earns a placement in the Buyers’ Guide. A screened ad is furnished at additional cost to the advertiser. Professional Referral Ads: FPA Members: $50 per 50 words; Non‑members: $100 per 50 words; No discounts for advertising agencies. All Professional Referral ads must be paid in advance, at the time of ad receipt. 28

FLORIDA PHARMACY TODAY

FREQUENTLY CALLED NUMBERS AHCA MEDICAID PHARMACY SERVICES 2727 Mahan Drive Tallahassee, FL 32308 (850) 412-4166 www.fdhc.state.fl.us/medicaid/ pharmacy AMERICAN PHARMACISTS ASSOCIATION (APhA) Washington, D.C. (800) 237-2742 www.pharmacist.com AMERICAN SOCIETY OF HEALTH SYSTEM PHARMACISTS Bethesda, MD (301) 657-3000 www.ashp.com/main.htm DRUG INFORMATION CENTER Palm Beach Atlantic University (561) 803-2728 druginfocenter@pba.edu FLORIDA BOARD OF PHARMACY 4052 Bald Cypress Way Bin #C04 Tallahassee, FL 32399-3254 (850) 245-4292 www.doh.state.fl.us/mqa FLORIDA POISON INFORMATION CENTER NETWORK (800) 222-1222 www.fpicn.org NATIONAL COMMUNITY PHARMACISTS ASSOCIATION 100 Daingerfield Road Alexandria, VA 22314 703.683.8200 703.683.3619 fax info@ncpanet.org RECOVERING PHARMACISTS NETWORK OF FLORIDA (407) 257-6606 “Pharmacists Helping Pharmacists”

Buying, Selling or Starting a Pharmacy? We can help you practice pharmacy your way. Our dedicated and experienced ownership consultants can help you achieve your goals. From planning and financing to site selection and product mix, we deliver answers you can trust. Set your pharmacy-ownership goals and point your future in the right direction with the help of RxOwnership. Visit RxOwnership.com or call 800.266.6781 today!

RxOwnership.com