PURPOSE: This rule establishes licensure guidelines for nonresident pharmacies.

1. (1) Nonresident pharmacies shall not ship, mail or deliver prescription drugs into Missouri without first obtaining a pharmacy license from the Missouri Board of Pharmacy. An exemption to licensure is allowed when a nonresident pharmacy provides a prescription drug in an emergency situation or supplies lawful refills to a patient from a prescription that was originally filled and delivered to a patient within the state in which the nonresident pharmacy is located or provides medications upon receipt of a prescription or physician order for patients in institutional settings and the nonresident pharmacy is not recognized as a primary provider.

2. (2) To obtain a license as a pharmacy, a nonresident pharmacy must comply with each of the following:

   1. (A) Maintain a license in good standing from the state in which the nonresident pharmacy is located;
   2. (B) Submit an application as provided by the Missouri Board of Pharmacy for licensure in compliance with 4 CSR 220-2.020(2) and (3);
   3. (C) Pay all appropriate licensing fees;
   4. (D) Submit a copy of the state pharmacy 20 CSR 2220-2

license from the state in which the nonresident pharmacy is located; and

1. (E) Submit a copy of the state and federal controlled substance registrations from the state in which it is located, if controlled substances are to be shipped into Missouri.

1. (3) When requested to do so by the Missouri Board of Pharmacy, each nonresident pharmacy shall supply any inspection reports, warning notices, notice of deficiency reports or any other related reports from the state in which it is located concerning the operation of a nonresident pharmacy for review of compliance with state and federal drug laws.
2. (4) The Missouri Board of Pharmacy will extend reciprocal cooperation to any state that licenses and regulates nonresident pharmacies for the purpose of investigating complaints against pharmacies located in Missouri or the sharing of information and investigative reports, as long as the other state will extend the same reciprocal cooperation to the Missouri Board of Pharmacy.

AUTHORITY: sections 338.140 and 338.280, RSMo 2000 and 338.220, RSMo Supp. 2001.* This rule originally filed as 4 CSR 220-2.025. Original rule filed Jan. 16, 1990, effective May 11, 1990. Amended: Filed June 28, 2002, effective Jan. 30, 2003. Moved to 20 CSR 2220-2.025, effective Aug. 28, 2006.

*Original authority: 338.140, RSMo 1939, amended 1981, 1989, 1997; 338.220, RSMo 1951, amended 1969, 1981, 1989, 1997, 1999, 2001; and 338.280, RSMo 1951, amended 1971, 1981.