Health Law Monitor
WVBOP COVID-19 Updates
March 24, 2020
By: Briana Cunningham Breault and Alaina N. Crislip
As the COVID-19 crisis intensifies, the West Virginia Board of Pharmacy (WVBOP) issued a new temporary rule and a multitude of waivers. While these waivers will cease to be in effect when the WV State if Emergency related to COVID-19 pandemic ends, WVBOP adopted the following guidance:1
Chloroquine and Hydroxychloroquine. Because these drugs are thought to be helpful in the treatment of COVID-19, some prescribers began writing prescriptions for family and friends. The is leading to a shortage of the drug. Therefore, no prescription for chloroquine or hydroxychloroquine may be dispensed except if:
- The prescription bears a written diagnosis;
- The prescription is limited to no more than 30 tablets;
- No refills are permitted.2
Remote Processing of Prescriptions for Social Distancing. Pharmacy professionals are permitted to process prescriptions for a West Virginia pharmacy from a location other than the physically licensed pharmacy. Remote processing is permitted so long as the pharmacies or pharmacists have computer software and hardware capable of performing the desired task, ensure safeguarding protected health information, and notify WVBOP.
- For Pharmacists: Remote processing does not include the dispensing of a drug, but may include receiving, interpreting, evaluating, clarifying, and approval of medication orders and prescriptions, as well as order entry, other data entry, performing prospective drug utilization review, interpreting clinical data, insurance processing, performing therapeutic interventions, providing drug information services, and authorizing release of medication for administration. Pharmacists at all settings must hold the physical product in hand to do the physical product final check.
- For Pharmacy Technicians and Pharmacy Interns/Trainees: Remote processing does not include the dispensing of a drug, but may include prescription or order entry, other data entry, insurance processing, and clarifying prescriptions and medication orders.
Signature for Received Prescriptions. Signatures are only required to pick up controlled medications and with the purchase of pseudoephedrine (PSE) products and all over-the-counter controls. While signatures are no longer required for the purchase of PSE or OTC controls, the PSE reporting requirements are still in effect. Optum, ExpressScripts, and CMS have indicated that they are willing to waive patient signatures so long as the reason is noted. Pharmacists must check with other PBM contracts for further instruction and are urged to utilize gloves, hand sanitizer, and other protective measures to minimize contact and ensure safety.
Early Refills for Controls. By law, a pharmacist may not refill a controlled substance any earlier than 3 days prior to the current script having ended; however, WVBOP’s new waivers permit a pharmacist to dispense a refill on a controlled substance using his or her professional judgement as long as the pharmacist documents the reason for early refill. This waiver allows for at-risk patients to obtain refills without unnecessary exposure.
Pharmacy Technician to Pharmacists Ratios. The statutory ratio of 4 to 1 may be exceeded only if the ratio is exceeded due to an actual impact of COVID-19. If the ratio will be exceeded for more than 2 days, WVBOP must be notified at email@example.com. The ratio does not include pharmacy interns.
Out of State Pharmacy Staffing. WVBOP will allow pharmacy professionals to work in WV with a temporary permit. More information regarding temporary permits is available on WVBOP’s website.
Conserving PPE/Sterile Compounding. Pharmacists may implement a process for reusing masks in a manner that does not compromise the microbial state of control in cleanrooms. Products to be reused should be visibly inspected and discarded if there are concerns.3
Pharmacy Preparedness. Pharmacies and pharmacists should:
- Have handouts containing information pertaining to refill requests, emergency supplies, and other prescription medication information;
- Develop processes to care for high risk populations, such line-free prescription pickup, senior hours, curb-side and mail delivery;
- Implement infection control measures:
- Maintain social distance;
- Clean/disinfect counters and other spaces every hour or every 10 patients; and
- Place alcohol-based hand sanitizer or gloves next to the checkout area;
- Consider utilizing only drive-thru or curb-side drop-off and pick-up to minimize exposure; and
- Develop an Emergency Response Plan.4
Controlled Substance Monitoring Program Reporting. WVBOP waived the requirement to submit reports of “zero” if there was no dispensings when the pharmacy is closed due to COVID-19.
Immunizations. Pharmacists and pharmacy interns are not permitted to administer immunizations without gloves and proper hand hygiene. Masks and gowns are not required.
PPE for immunizations. Immunizations should not be given to patients displaying or reporting symptoms of respiratory illness, including, fever, cough, or shortness of breath.
CPE. Pharmacists missing the 6 hours of live CPE and the 3 hours of drug diversion requirements are granted an additional 90 days after the end of the WV State of Emergency to complete necessary licensure requirements.
WVBOP continues to update their website as this situation rapidly develops. Jackson Kelly will continue to keep you updated as more information becomes available.
1 See https://www.wvbop.com/article.asp?id=40 and https://www.wvbop.com/article.asp?id=45.
2 See W.Va. Code § 15-1-26; https://www.wvbop.com/article.asp?id=45.
3 For more information regarding the conservation of PPE, please visit https://www.wvbop.com/article.asp?id=40, https://www.cdc.gov/coronavirus/2019-ncov/hcp/healthcare-supply-ppe-index.html, and https://www.fda.gov/medical-devices/letters-health-care-providers/surgical-mask-and-gown-conservation-strategies-letter-healthcare-providers.
4 See https://www.wvbop.com/article.asp?id=37.