Tenn. Comp. R. & Regs. 0940-05-36-.10

Current through June 10, 2024

Section 0940-05-36-.10 - PREREQUISITES TO ISSUING PRESCRIPTIONS OR DISPENSING MEDICATIONS

(1) Prior to writing a prescription or medication order, an OBOT Plus provider shall comply with Rule 0940-05-35 and Rule 0880-02-.14(2).

(2) Buprenorphine dispensed by an OBOT Plus may only be filled and labeled by:

(a) An authorized provider; or

(b) By a designated agent of the authorized provider, if:

1. The filling and labeling is done in the physical presence of the authorized provider at the OBOT plus;

2. The authorized provider acts as the final check in the dispensing process, and is responsible for the dispensing process in its entirety; and

3. The authorized provider documents that he or she has completed a final verification of the dispensing.

(3) Authorized providers may dispense an initial prescription only after checking the CSMD and central registry.

(4) Authorized providers must check the CSMD for every prescription dispensed.

(5) When a patient is first seen at a Facility and the patient has previously been dispensed buprenorphine, the authorized provider shall make a reasonable effort to contact the patient's previous dispenser and obtain dosing information.

(6) Authorized providers dispensing buprenorphine pursuant to Rule 0940-05-36-.10(2) above, must comply with medication counseling requirements pursuant to Rule 1140-03-.01 and Rule 0940-05-35.

(a) Upon the initial receipt of a prescription or medication order and following a review of the patient's record, the authorized provider shall personally counsel the patient or authorized caregiver "face-to-face" if the patient or authorized caregiver is present. If the patient or authorized caregiver is not present, an authorized provider shall make a reasonable effort to counsel through alternative means.

(b) The authorized provider must document the counseling or document the reasonable efforts taken to provide counseling. If the patient or authorized caregiver refuses counseling, the authorized provider must document this refusal.

(c) Patient counseling shall cover matters as defined in Rule 1140-03-.01, which in the exercise of the authorized provider's professional judgement, the authorized provider deems significant. This shall include, but is not limited to, the following:

1. The name and description of the medication;

2. The dosage form, dose, route of administration, and duration of drug therapy;

3. Special directions and precautions for preparation, administration, and use by the patient;

4. Common side effects or adverse effects or interactions and therapeutic contraindications that may be encountered, including their avoidance, and the action required if they occur;

5. Techniques for self-monitoring drug therapy;

6. Proper storage; and

7. Action to be taken in the event of a missed dose.

(d) Upon a subsequent dispensing of a buprenorphine product, the authorized provider, or a person designated by the authorized provider, shall offer for the authorized provider to personally counsel the patient or caregiver about the medication.

(7) An OBOT Plus shall not require that a patient's buprenorphine be dispensed from that OBOT Plus. An OBOT Plus shall provide patients with a list of alternative locations where buprenorphine is dispensed should the patient choose to fill his or her prescription at another location.

Tenn. Comp. R. & Regs. 0940-05-36-.10

Original rules filed March 29, 2019; effective 6/27/2019.

Authority: T.C.A. §§ 4-3-1601, 4-4-103, 33-1-302, 33-1-305, 33-1-309, 33-2-301, 33-2-302, 33-2-402, 33-2-403, 33-2-404, 33-2-407, and Chapter 978 of the Public Acts of 2018.