Page 30 - FPGEE Management Q&A Book

www.pharmacyexam.com Krisman

If there is any question whether a patient may be a more detailed response and are therefore more
classified as having a terminal illness, the appropriate to build successful patient-practitioner
pharmacist must contact the practitioner prior to relationship.
partially filling the prescription.
For example: Closed-ended question: “Have you
Both the pharmacist and the prescribing ever had a low blood sugar reaction?”
practitioner have a corresponding responsibility to
assure that the controlled substance is for a Open-ended question: “How do you feel when you
terminally ill patient. have a low blood sugar reaction?”

The pharmacist must record on the prescription 29. (a) Pre-contracted community pharmacy
whether the patient is "terminally ill" or an "LTCF provider networks have the highest reimbursement
patient." A prescription that is partially filled and rates and program costs among all the other
does not contain the notation "terminally ill" or choices. There are four types of community
"LTCF patient" shall be deemed to have been filled pharmacy networks:
in violation of the Act. For each partial filling, the
dispensing pharmacist shall record on the back of 1. Open, pre-contracted or shelf network
the prescription (or on another appropriate record, 2. Restricted, preferred or customized network
uniformly maintained, and readily retrievable) the 3. Exclusive or closed network
date of the partial filling, quantity dispensed, 4. Specialized network.
remaining quantity authorized to be dispensed, and
the identification of the dispensing pharmacist. The 1. Open, pre-contracted or shelf network:
total quantity of Schedule II controlled substances
dispensed in all partial fillings must not exceed the This type of network usually enrolls any pharmacy
total quantity prescribed. in the network if the pharmacy agrees with the
terms and conditions of the provider.
Schedule II prescriptions for patients in an LTCF or
patients with a medical diagnosis documenting a This network also gives the advantage to plan
terminal illness shall be valid for a period not to members by providing the broadest access. Since
exceed 60 days from the issue date unless sooner the base reimbursement rate is inversely
terminated by the discontinuance of medication. proportional to the size of the network, open
networks usually have the highest reimbursement
27.(b) Forgetfulness is the most stated reason for rates and program costs.
noncompliance.
2. Restricted, preferred or customized network:
Statements % of Total
In this type, fewer pharmacies are available within a
Forgetfulness 39.6% network compared to open networks, and
Side effects 17.7% therefore the reimbursement cost and plan
Drug perceived as not necessary 12.5% member cost is less compared to open network
Confusion 11.5% systems.
Cost 10.4%
3. Exclusive or closed network:
28.(c) This type of question is classified as a closed-
ended question. Open-ended questions usually It locks out any pharmacy not enrolled in the
encourage discussion more effectively than closed- network. It offers very limited access to plan
ended questions. Closed-ended questions can be members for prescription services and therefore it
answered yes or no; open-ended questions require has the lowest reimbursement rate and plan cost.

75