Current through February 26, 2024
(1) The board
may review dispensing data, monitored prescription drug history reports, PDMP
data, and data compiled pursuant to s.
CSB
4.12 to determine whether circumstances indicate
suspicious or critically dangerous conduct or practices of a pharmacist,
pharmacy, practitioner, or patient.
(2) The board may include any of the
following factors when determining whether circumstances indicate suspicious or
critically dangerous conduct or practices of a pharmacist or pharmacy:
(a) The pharmacist or pharmacy's monitored
prescription drug dispensing practices deviate from accepted pharmacist or
pharmacy practices.
(b) There are
unusual patterns in the payment methodology used by patients to whom monitored
prescription drugs are dispensed by the pharmacist or pharmacy.
(c) The history of actions taken against the
pharmacist or pharmacy by other state agencies, agencies of another state, or
law enforcement.
(d) The type and
number of monitored prescription drugs dispensed by the pharmacist or at the
pharmacy.
(e) The pharmacist or
pharmacy has dispensed forged prescription orders for a monitored prescription
drug.
(f) The distance patients
travel to have monitored prescription drugs dispensed at the
pharmacy.
(g) The number of
patients dispensed monitored prescription drugs at the pharmacy or by the
pharmacist who satisfy any of the criteria identified in sub. (4).
(3) The board may include any of
the following factors when determining whether circumstances indicate
suspicious or critically dangerous conduct or practices of a practitioner:
(a) The practitioner's monitored prescription
drug prescribing practices deviate from accepted prescribing
practices.
(b) The practitioner
prescribes potentially dangerous combinations of monitored prescription drugs
to the same patient.
(c) The type
and number of monitored prescription drugs prescribed by the
practitioner.
(d) The history of
actions taken against the practitioner by other state agencies, agencies of
another state, or law enforcement.
(e) The distance patients travel to obtain
monitored prescription drug prescriptions from the practitioner.
(f) The number of patients to whom the
practitioner prescribed a monitored prescription who satisfy any of the
criteria identified in sub. (4).
(4) The board may include any of the
following factors when determining whether circumstances indicate suspicious or
critically dangerous conduct or practices of a patient:
(a) The number of practitioners from whom the
patient has obtained a prescription for a monitored prescription
drug.
(b) The number of pharmacies
from where the patient was dispensed a monitored prescription drug.
(c) The number of prescriptions for a
monitored prescription drug obtained by the patient.
(d) The number of monitored prescription drug
doses dispensed to the patient.
(e)
Whether the monitored prescription drugs dispensed to the patient include
dangerous levels of any drug.
(f)
The number of times the patient is prescribed or dispensed a monitored
prescription drug before the previously dispensed amount of the same or a
similar monitored prescription drug would be expected to end.
(g) The payment methodology used by the
patient to obtain controlled substances at a pharmacy.
(5) Upon determining that circumstances
indicate suspicious or critically dangerous conduct or practices of a pharmacy,
practitioner, or patient, the Board may disclose monitored prescription drug
history reports, audit trails, and PDMP data to any of the following:
(a) A relevant patient.
(b) A relevant pharmacist or
practitioner.
(c) A relevant state
board or agency.
(d) A relevant
agency of another state.
(e) A
relevant law enforcement agency.
(6) Upon determining that a criminal
violation may have occurred, the board may refer a pharmacist, pharmacy, or
practitioner to the appropriate law enforcement agency for investigation and
possible prosecution. The board may disclose monitored prescription drug
history reports, audit trails, and PDMP data to the law enforcement agency as
part of the referral.
