Federal and State Regulations Flashcards
7 cards from real CCP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Federal and State Regulations flashcards as text
Under Medicare Part D regulations, a Medication Therapy Management (MTM) program must target beneficiaries who have at minimum how many chronic diseases?
Answer: Three
CMS requires Part D MTM programs to target beneficiaries with multiple chronic diseases, using a minimum threshold of 3 chronic diseases.
A consultant pharmacist discovers that a skilled nursing facility is routinely using PRN antipsychotic orders as a chemical restraint without documented clinical indication. This practice violates:
Answer: Federal Nursing Home Reform Act (OBRA '87) F-tag 758
OBRA '87 (F-tag 758) prohibits unnecessary drug use in LTC facilities, including the use of psychotropic drugs without a valid clinical indication.
Under the Ryan Haight Online Pharmacy Consumer Protection Act, a physician may prescribe a controlled substance via telemedicine without an in-person examination only if:
Answer: The patient is in a DEA-registered hospital or clinic
The Ryan Haight Act allows telemedicine prescribing of controlled substances without a prior in-person exam when the patient is being treated by a DEA-registered hospital or clinic.
Under state pharmacy practice acts, which action typically requires a consultant pharmacist to notify the state board of pharmacy?
Answer: Changing a patient's therapy without prescriber authorization
Changing a patient's drug therapy without prescriber authorization constitutes unauthorized prescribing and is a reportable violation under most state pharmacy practice acts.
Which federal law requires long-term care facilities to have a written agreement with a licensed pharmacist to provide consultant pharmacy services?
Answer: Omnibus Budget Reconciliation Act (OBRA '87)
OBRA '87 (42 CFR Part 483) requires skilled nursing facilities to have a licensed pharmacist review each resident's drug regimen and mandates a written agreement for these services.
A pharmacist receives a prescription for a non-patient-specific, office-use compounded product. Under USP and state law, this practice is:
Answer: Permitted in limited quantities when there is an established prescriber-patient-pharmacist relationship
Office-use compounding is permitted in limited quantities without a patient-specific prescription when a bona fide prescriber-patient relationship exists and state law allows it.
Under the Health Care Fraud and Abuse Control Program (HCFAC), a consultant pharmacist who knowingly submits a false claim to Medicare may face penalties under:
Answer: Both the FCA and the Civil Monetary Penalties Law (CMPL)
False claims to Medicare can trigger liability under both the FCA (qui tam provisions, treble damages) and the CMPL (up to $10,000 per false claim plus treble damages).