Prospective DUR and HIPAA Overview
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Prospective DUR and HIPAA Overview

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Questions and Answers

What is the primary goal of the DUR Board's Educational Programs?

  • To generate profit for the board members
  • To improve medication use among healthcare professionals (correct)
  • To compare clinical data from various hospitals
  • To reduce the number of pharmacists in the workforce

    • Which option is not a type of Educational Program utilized by the DUR Board?

  • Symposia attended by healthcare professionals
  • Written materials delivered to healthcare providers
  • Face-to-Face visits by an expert
  • Pharmaceutical sales training sessions (correct)

    • What significant advantage does Prospective DUR provide to Pharmacists?

  • It guarantees optimal medication prices for patients
  • It replaces the need for physician consultations
  • It allows for the generation of new data on medication dispensing (correct)
  • It prevents all medication errors completely

    • What does the DUR Board review in a Retrospective Review?

    <p>Data about medication usage over a previous time period</p> Signup and view all the answers

    Who is part of the DUR Board that oversees both Prospective and Retrospective Reviews?

    <p>Both Physicians and Pharmacists</p> Signup and view all the answers

    What form must be filed to change the name on a permit?

    <p>Form DH-MQA 1227</p> Signup and view all the answers

    What is required to accompany an application for a permit?

    <p>Written policies and procedures</p> Signup and view all the answers

    What fee must be submitted for each fingerprint card required with the application?

    <p>$48</p> Signup and view all the answers

    What is the prerequisite for the issuance of a new permit?

    <p>An on-site inspection</p> Signup and view all the answers

    Which of the following applicants is exempt from submitting fingerprints with their application?

    <p>Non-Resident Pharmacy Registration applicants</p> Signup and view all the answers

    How can an applicant purchase fingerprint cards?

    <p>Online at a specified website</p> Signup and view all the answers

    What must be documented during the on-site inspection by the board inspector?

    <p>Compliance with rules and statutes</p> Signup and view all the answers

    What must be included with the application to prevent controlled substance dispensing fraud?

    <p>Applicant's written policies and procedures</p> Signup and view all the answers

    What is the primary purpose of the Health Insurance Portability and Accountability Act of 1996?

    <p>To improve health insurance coverage and prevent discrimination</p> Signup and view all the answers

    What must Medicaid prescriptions be written on according to regulations?

    <p>Tamper-resistant prescription pads</p> Signup and view all the answers

    Which aspect of health information does the HIPAA regulation NOT specifically target?

    <p>Billing procedures</p> Signup and view all the answers

    What is a requirement for covered entities under HIPAA concerning patient information?

    <p>They can implement any security measures they find suitable.</p> Signup and view all the answers

    What common privacy abuse occurred with a chain pharmacy regarding its used computers?

    <p>They sold computers with patient databases intact.</p> Signup and view all the answers

    What must a pharmacy obtain to engage in sterile compounding if it does not already hold a certain permit?

    <p>Special Sterile Compounding Permit</p> Signup and view all the answers

    What is required of applicants for a Special Sterile Compounding Permit regarding personnel?

    <p>They must designate a prescription department manager or consultant pharmacist.</p> Signup and view all the answers

    What did a retiring physician do that violated patient privacy?

    <p>Sold patient medical records to another business.</p> Signup and view all the answers

    What is the time frame in which a pharmacy must obtain the Special Sterile Compounding Permit after the amendment's effective date?

    <p>180 days</p> Signup and view all the answers

    What is one intent behind requiring a National Provider Identifier (NPI) for each provider?

    <p>To enhance cost and uniformity</p> Signup and view all the answers

    Which example illustrates a serious privacy infringement related to patient information?

    <p>A daughter jokingly calling patients about HIV.</p> Signup and view all the answers

    What notification must be provided to the board by the permittee or the designated personnel?

    <p>Change in prescription department manager or consultant pharmacist within 10 days</p> Signup and view all the answers

    Which of the following is true regarding fees for obtaining a Special Sterile Compounding Permit within the designated period?

    <p>Pharmacies obtaining the permit within 180 days are exempt from additional fees.</p> Signup and view all the answers

    What is required for every location where radioactive drugs are processed?

    <p>A Nuclear Pharmacy Permit</p> Signup and view all the answers

    Which form must be completed to apply for a Nuclear Pharmacy Permit?

    <p>Form DH-MQA 1218</p> Signup and view all the answers

    What must an applicant for a Nuclear Pharmacy Permit do regarding a nuclear pharmacist?

    <p>Designate a nuclear pharmacist of record</p> Signup and view all the answers

    When must a permittee notify the board of a change in the prescription department manager?

    <p>Within 10 days</p> Signup and view all the answers

    Special Pharmacy Permits are required for which of the following situations?

    <p>Locations compounding medicinal drugs that are not community or institutional pharmacies</p> Signup and view all the answers

    What type of pharmacy is NOT considered under Special Pharmacy Permits?

    <p>Nuclear Pharmacy</p> Signup and view all the answers

    Which of the following must be designated when applying for a Special Pharmacy Permit?

    <p>An Rx Department Manager or Consultant Pharmacist</p> Signup and view all the answers

    What is one of the businesses that does not require a Special Pharmacy Permit?

    <p>Community Pharmacy</p> Signup and view all the answers

    Study Notes

    Prospective DUR (Drug Utilization Review)

    • A DUR Board comprised of both physicians and pharmacists oversees the Retrospective Review of medication use data.
    • The board compares data against predetermined criteria, analyzing trends, and identifying potential issues.
    • Prospective DUR focuses on future drug therapy, allowing pharmacists to directly intervene and ensure proper medication use.
    • Prospective DUR generates valuable data about actual medication dispensing practices.
    • It helps identify emerging treatment patterns and potential areas for improvement.
    • The DUR Board can readily examine new data and adjust existing criteria, ensuring ongoing effective drug use management.

    HIPAA (Health Insurance Portability and Accountability Act of 1996)

    • HIPAA aims to improve the portability of health insurance coverage and prevent discrimination related to health coverage.
    • It prioritizes the privacy and security of health information, with the DHHS empowered to create regulations.
    • HIPAA addresses key aspects of health information:
      • Transaction and code sets
      • National provider identities (NPIs)
      • Security
      • Privacy
    • The standardization of NPIs aims to enhance uniformity, simplify administration, and reduce costs.
    • Covered entities are required to implement security measures that protect sensitive health information from unauthorized access, alteration, deletion, and transmission.
    • Entities are free to develop their own security protocols through policies and procedures, as long as they meet regulatory standards.
    • The privacy regulations emphasize patient rights and control over how and when their information is used.

    Pharmacy Permit Requirements (Florida)

    • Pharmacy Permit Name Change: Individuals or establishments must submit Form DH-MQA 1227 ("Pharmacy Permit Name Change Form") to the board.
    • Fingerprint Requirement: Applicants must submit fingerprints through the appropriate channels, with the exception of non-resident pharmacy registration applicants.
    • On-Site Inspection: An on-site inspection is necessary for new permits, changes in ownership, or changes of address. The inspector verifies compliance with relevant rules and statutes.
    • Fraudulent Representations: Applicants must provide written policies and procedures aiming to prevent the dispensing of controlled substances based on fraudulent representations or invalid practitioner-patient relationships.
    • Nuclear Pharmacy Permit: A Nuclear Pharmacy Permit is necessary for locations compounding, dispensing, storing, or selling radioactive drugs and chemicals. Applicants must:
      • Complete Form DH-MQA 1218 ("Nuclear Pharmacy Permit Application and Information").
      • Designate a Nuclear Pharmacist of record.
      • Notify the board within 10 days of any changes in the prescription department manager.

    Special Pharmacy Permits

    • Special Pharmacy Permits: These are required for facilities dispensing medicinal drugs that are not classified as community, institutional, nuclear, or internet pharmacies. This category includes:
      • Limited Community Pharmacy
      • Parenteral and Enteral Pharmacy
      • Closed System Pharmacy
      • End Stage Renal Disease (ESRD) Pharmacy
      • Parenteral/Enteral Extended Scope Pharmacy
      • Assisted Living Facility (ALF) Pharmacy
    • Applicants must designate a prescription department manager or consultant pharmacist.
    • They are required to notify the board within 10 days of any change in the prescription department manager.

    Special Sterile Compounding Permit

    • Special Sterile Compounding Permit: This permit is mandatory for pharmacies compounding sterile products, unless they already hold an active "Special Parenteral/Enteral" or "Special Parenteral/Enteral Extended Scope Compounding" permit.
    • Applicants must:
      • Complete Form DH-MQA 1270 ("Special Sterile Compounding Permit Application and Information").
      • Designate a prescription department manager or consultant pharmacist.
      • Notify the board within 10 days of any change in the prescription department manager or consultant pharmacist.

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    Description

    This quiz explores the concepts of Prospective Drug Utilization Review (DUR) and the Health Insurance Portability and Accountability Act (HIPAA). It covers how DUR boards analyze medication data and the significance of HIPAA in maintaining health information privacy. Test your understanding of these critical healthcare components.

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