Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 30 - Division of Regulation and Licensure › Chapter 1 - Controlled Substances › Section 19 CSR 30-1.064 - Partial Filling of Controlled Substance Prescriptions

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment updates Missouri's partial
				  filling of controlled substances prescriptions regulation to be consistent with
				  federal law and recently promulgated federal regulations regarding the partial
				  filling of controlled substances listed in Schedule II.
PURPOSE: This rule sets requirements for the partial
				  filling of controlled substance prescriptions.
(1) The partial filling of a controlled
				substance listed in Schedule II is permitted as provided in this rule and
				federal regulations.
(A) Insufficient supply
				on hand. The partial filling of a prescription for a controlled substance
				listed in Schedule II is permissible, if the pharmacist is unable to supply the
				full quantity called for in a written or emergency oral prescription, and s/he
				makes a notation of the quantity supplied on the face of the written
				prescription (or written record of the emergency oral prescription), or in the
				electronic record. The remaining portion of the prescription may be filled
				within seventy-two (72) hours of the first partial filling; however, if the
				remaining portion is not or cannot be filled within the seventy-two- (72-) hour
				period, the pharmacist shall so notify the prescribing individual practitioner.
				No further quantity may be supplied beyond seventy-two (72) hours without a new
				prescription.
(B) Long-term care or
				terminally ill patient. A prescription for a Schedule II controlled substance
				written for a patient in a long-term care facility (LTCF) or for a patient with
				a medical diagnosis documenting a terminal illness may be filled in partial
				quantities to include individual dosage units. If there is any question whether
				a patient may be classified as having a terminal illness, the pharmacist must
				contact the practitioner prior to partially filling the prescription. Both the
				pharmacist and the prescribing practitioner have a corresponding responsibility
				to assure that the controlled substance is for a terminally ill patient. The
				pharmacist must record on the prescription whether the patient is "terminally
				ill" or an "LTCF patient." A prescription that is partially filled and does not
				contain the notation "terminally ill" or "LTCF patient" shall be deemed to have
				been filled in violation of Chapter 195, RSMo. For each partial filling, the
				dispensing pharmacist shall record on the back of the prescription (or on
				another appropriate record, uniformly maintained and readily retrievable) the
				date of the partial filling, quantity dispensed, remaining quantity authorized
				to be dispensed, and the identification of the dispensing pharmacist. The total
				quantity of Schedule II controlled substances dispensed in all partial fillings
				must not exceed the total quantity prescribed. Schedule II prescriptions for
				patients in a LTCF or patients with a medical diagnosis documenting a terminal
				illness shall be valid for a period not to exceed sixty (60) days from the
				issue date unless sooner terminated by the discontinuance of
				medication.
(C) Patient or
				prescriber request. For a patient who is not terminally ill or a patient in a
				long-term care facility, the partial filling of a prescription for a controlled
				substance listed in Schedule II may occur at the request of a patient or it may
				be directed by the prescriber in the manner established by applicable federal
				regulations. The dispensing of a partial filling under this subsection shall
				not occur beyond thirty (30) days from the date of the issuance of the
				prescription.