PURPOSE: This rule establishes procedures and requirements for the performance of nondispensing activities outside of a pharmacy.

1. (1) Pursuant to section 338.220, RSMo, a pharmacist may perform the following nondispensing activities outside of a licensed pharmacy:

   1. (A) Patient counseling/education, as authorized by Missouri law, provided the pharmacist shall be obligated to comply with 20 CSR 2220-2.190, when applicable;
   2. (B) Obtain patient history/information;
   3. (C) Review patient records/medical histories;
   4. (D) Patient assessment/evaluation, as authorized by Missouri law;
   5. (E) Billing and insurance claim submissions/review;
   6. (F) Drug utilization review;
   7. (G) Assess health plan and medication eligibility/coverage;
   8. (H) Pharmacy compliance audits/evaluations;
   9. (I) Administer drugs, vaccines, or biologicals, as authorized by law and the rules of the board;
   10. (J) Peer review/peer consultations;
   11. (K) Review, select, and develop formularies or plan/practice guidelines;
   12. (L) Review compliance with benefit guidelines;
   13. (M) Manage inventory, including purchasing and ordering;
   14. (N) Manage/review information systems;
   15. (O) Patient medication review;
   16. (P) Consultation with other health care professionals;
   17. (Q) Patient referrals;
   18. (R) Prescription order entry/review, provided that a pharmacist shall only be authorized to accept a prescription on the premises of a Missouri licensed pharmacy, as required by section 338.095.5, RSMo; and
   19. (S) Medication therapy management, pursuant to and as authorized by Chapter 338, RSMo, and the rules of the board.
2. (2) Confidentiality. A pharmacist performing non-dispensing activities pursuant to this rule shall comply with all applicable state and federal confidentiality laws and regulations and shall provide sufficient storage and security for confidential documents and electronic data processing hardware. In addition, data processing systems must utilize sufficient security software to ensure confidentiality and prevent unauthorized access. Any breach in the security or confidentiality of the data processing systems or confidential documents shall be documented and reported to the board in writing within seven (7) days of the breach.
3. (3) Notwithstanding any other provision of this rule, a pharmacist shall not meet with patients in the pharmacist’s residence or living quarters.
4. (4) A pharmacist performing non-dispensing activities pursuant to this rule shall ensure compliance with Chapter 338, RSMo, and the rules of the board at all times. Nothing in this rule shall be construed to eliminate or otherwise exempt any pharmacist from the record-keeping, confidentiality, or security requirements otherwise imposed by Chapter 338, RSMo, or the rules of the board. Violations of this section shall constitute grounds for discipline.
5. (5) This rule shall not be construed to authorize a pharmacist to conduct the unauthorized practice of medicine or to conduct any activity for which a license is required pursuant to Chapters 330, 331, 332, 334, or 337, RSMo.
6. (6) A pharmacy permit shall be required for performing non-dispensing activities if the pharmacist is using a pharmacy technician to assist in the practice of pharmacy at the location where non-dispensing activities are being performed, provided that a pharmacy permit shall not be required for sites used solely by the pharmacist for administering vaccines as authorized by Chapter 338, RSMo, and the rules of the board. Pharmacy technicians shall only be authorized to work under the direct supervision of a pharmacist as provided by section 338.013, RSMo, and 20 CSR 2220-2.700. AUTHORITY: sections 338.010 and 338.220, RSMo Supp. 2009 and 338.140, RSMo 2000.* Emergency rule filed Oct. 23, 2009, effective Nov. 2, 2009, expired April 30, 2010. Original rule filed Oct. 22, 2009, effective June 30, 2010. *Original authority: 338.010, RSMo 1939, amended 1951, 1989, 1990, 2007, 2009; 338.140, RSMo 1939, amended 1981, 1989, 1997; and 338.220, RSMo 1951, amended 1969, 1981, 1989, 1997, 1999, 2001, 2004, 2007, 2009.