{"version":"0.2","updated":"2026-10-14","blueprint":"MPJE Content Outline, effective 2027-03-01","domains":[{"id":"D1","weight":30,"name":"Pharmacy and Pharmacist Practice"},{"id":"D2","weight":30,"name":"Medication Use Process"},{"id":"D3","weight":20,"name":"Regulatory Authority and Legal Obligations"},{"id":"D4","weight":20,"name":"Pharmacy Operations"}],"questions":[{"id":"D1-A-01","d":"D1","s":"1A","t":1,"q":"What does the state define as the practice of pharmacy, and what acts are reserved to a pharmacist?","a":"Definitional scope; determines everything downstream.","x":"Quote the statutory definition verbatim, then list reserved acts as bullets. Cap 200 words."},{"id":"D1-A-02","d":"D1","s":"1A","t":1,"q":"May a pharmacist prescribe independently? For which drug categories?","a":"State authority sits on top of a federal floor that is NOT zero. Note where PREP Act preemption makes a restrictive state rule unenforceable.","f":"No general federal prescribing authority for pharmacists, BUT two live exceptions. (1) The PREP Act declaration amendment (89 FR, 2024-12-11) makes a state-licensed pharmacist a 'qualified person' who may ORDER and administer COVID-19 and seasonal influenza vaccines and order/administer authorized COVID-19 therapeutics through 2029-12-31, and expressly PREEMPTS contrary state law for those. (2) Pharmacists employed by VA, IHS and PHS prescribe under federal agency scope.","fc":"PREP Act declaration, 89 FR (2024-12-11)"},{"id":"D1-A-03","d":"D1","s":"1A","t":1,"q":"May a pharmacist initiate hormonal contraception? Under what protocol, age limits, or training requirements?","a":"Post-2016 state expansion; absent from older frameworks."},{"id":"D1-A-04","d":"D1","s":"1A","t":1,"q":"May a pharmacist furnish naloxone without a patient-specific prescription? Standing order, protocol, or independent authority?","a":"All states have something; the mechanism differs."},{"id":"D1-A-05","d":"D1","s":"1A","t":1,"q":"May a pharmacist test and treat (strep, influenza, COVID-19)? What CLIA status and training are required?","a":"Major post-2020 divergence."},{"id":"D1-A-06","d":"D1","s":"1A","t":2,"q":"May a pharmacist prescribe or furnish tobacco cessation products? PrEP/PEP?","a":"A growing minority of states."},{"id":"D1-A-07","d":"D1","s":"1A","t":1,"q":"Are collaborative practice agreements permitted? With which prescriber types, for which patients, and what must the agreement contain?","a":"Permitted nearly everywhere, structured differently everywhere."},{"id":"D1-A-08","d":"D1","s":"1A","t":2,"q":"Must a collaborative practice agreement be filed with or approved by the board? Does it expire?","a":"Filing and renewal duties vary."},{"id":"D1-A-09","d":"D1","s":"1A","t":2,"q":"Under what circumstances may a pharmacist refuse to fill an otherwise lawful prescription? Is there a duty to refer or transfer?","a":"Conscience clauses and refusal duties differ sharply."},{"id":"D1-B-01","d":"D1","s":"1B1","t":1,"q":"What are the internship hour requirements, and how many may be earned before graduation or out of state?","a":"Hour counts and transfer rules vary."},{"id":"D1-B-02","d":"D1","s":"1B1","t":1,"q":"Which examinations are required, what is the passing standard, and how many retakes are allowed before remediation?","a":"Retake limits are a common test item."},{"id":"D1-B-03","d":"D1","s":"1B1","t":1,"q":"What is the license renewal cycle, and what is the renewal date?","a":"Annual vs biennial, fixed date vs birth month."},{"id":"D1-B-04","d":"D1","s":"1B4","t":1,"q":"How many CE hours are required per cycle, and how many must be live, law-specific, or opioid-specific?","a":"Totals and mandatory subject carve-outs both vary."},{"id":"D1-B-05","d":"D1","s":"1B4","t":2,"q":"How long must CE records be retained, and what happens on audit failure?","a":"Retention periods differ."},{"id":"D1-B-06","d":"D1","s":"1B1","t":2,"q":"Is licensure transfer (reciprocity) available, and what are the practice-hour or exam prerequisites?","a":"Some states require a fresh law exam or minimum hours."},{"id":"D1-B-07","d":"D1","s":"1B1","t":1,"q":"Must technicians be registered, licensed, or certified? Is national certification mandatory?","a":"Registration vs licensure vs nothing."},{"id":"D1-B-08","d":"D1","s":"1B1","t":1,"q":"What is the maximum technician-to-pharmacist ratio? Does it change by practice setting or by technician certification status?","a":"One of the most reliably tested state differences.","x":"One fact record per setting. Note separately whether certification changes the ratio."},{"id":"D1-B-09","d":"D1","s":"1B1","t":1,"q":"What tasks may a technician perform, and which are expressly prohibited?","a":"Task lists are enumerated differently.","x":"Two columns: expressly permitted, expressly prohibited. Cap 15 each. Omit anything not named in rule."},{"id":"D1-B-10","d":"D1","s":"1B1","t":1,"q":"Is tech-check-tech permitted? In which settings and under what conditions?","a":"A minority of states; conditions are narrow."},{"id":"D1-B-11","d":"D1","s":"1B1","t":2,"q":"May a technician accept a called-in prescription? Transfer a prescription? Counsel?","a":"Commonly prohibited, but not uniformly."},{"id":"D1-B-12","d":"D1","s":"1B1","t":2,"q":"What is the intern-to-pharmacist ratio, and what may an intern do that a technician may not?","a":"Intern authority varies."},{"id":"D1-B-13","d":"D1","s":"1B3","t":1,"q":"What does supervision require \u2014 physical presence, line of sight, immediate availability, or remote?","a":"The supervision standard is a frequent exam hinge."},{"id":"D1-B-14","d":"D1","s":"1B3","t":1,"q":"Must each pharmacy have a pharmacist-in-charge, what are the eligibility requirements, and may one person serve at more than one site?","a":"Multi-site service is permitted in some states only."},{"id":"D1-B-15","d":"D1","s":"1B3","t":1,"q":"What are the PIC's enumerated duties, and what is the notification deadline when the PIC changes?","a":"Deadlines range from immediate to 30 days."},{"id":"D1-B-16","d":"D1","s":"1B2","t":2,"q":"Must a pharmacist report an arrest, conviction, or discipline in another state? Within what period?","a":"Self-reporting duties and windows vary."},{"id":"D1-B-17","d":"D1","s":"1B2","t":3,"q":"Is there a mandated meal or rest break for pharmacists, and may the pharmacy remain open during it?","a":"A handful of states regulate this explicitly."},{"id":"D1-B-18","d":"D1","s":"1B4","t":2,"q":"What continuing education is required for technicians and for the pharmacist-in-charge, separately from the general pharmacist requirement?","a":"Technician CE hours are separately state-set."},{"id":"D1-C-01","d":"D1","s":"1C","t":2,"q":"What are the state's wholesale distributor and third-party logistics licensing requirements?","a":"State layers sit on top of DSCSA."},{"id":"D1-C-02","d":"D1","s":"1C","t":2,"q":"May a pharmacy sell or transfer drugs to another pharmacy? Is there a percentage cap?","a":"Any 5% rule a state applies to pharmacy-to-pharmacy transfer is a STATE artifact inherited from the NABP Model Act, not a federal number. Research the state figure directly and do not assume 5%.","f":"There is no DSCSA 5% pharmacy-to-pharmacy figure. The 5% threshold is FDA's uncodified interpretive guidance on 'minimal quantities' sold by a retail pharmacy to a LICENSED PRACTITIONER for office use (59 FR 11842 proposal; FDA declined to codify). Separately, FD&C Act 503(e)(4) / 21 USC 353(e)(4) excludes certain transfers from 'wholesale distribution,' including for emergency medical reasons.","fc":"21 USC 353(e)(4); 59 FR 11842"},{"id":"D1-C-03","d":"D1","s":"1C","t":2,"q":"What must the pharmacy do on a Class I recall, and must patients be notified directly?","a":"Direct-notification duties are state-imposed."},{"id":"D1-C-04","d":"D1","s":"2B8","t":1,"q":"May dispensed drugs be returned and restocked? Is there a donation or drug-repository program?","a":"Repository programs exist in many states with tight conditions."},{"id":"D1-C-05","d":"D1","s":"1C","t":2,"q":"What beyond-use date rules apply to repackaged and dispensed products?","a":"States adopt USP by reference at different versions."},{"id":"D1-C-06","d":"D1","s":"1C","t":1,"q":"How does state law define adulterated and misbranded drugs, and does the state have its own Food, Drug and Cosmetic Act separate from the federal statute?","a":"Most states have their own act; definitions and penalties differ."},{"id":"D1-C-07","d":"D1","s":"1C","t":2,"q":"What must a pharmacy do on identifying a suspect or counterfeit product \u2014 quarantine, notification, and to whom?","a":"DSCSA sets a federal duty; state notification recipients differ.","f":"FD&C Act 582(c)(4); 21 USC 360eee-1.","fc":"FD&C Act 582(c)(4); 21 USC 360eee-1"},{"id":"D1-C-08","d":"D1","s":"1C","t":2,"q":"Does the state have a prescription drug importation program under FD&C Act 804, and what is its current status?","a":"FL, CO, NH, NM, TX, VT and others have statutes at different stages. Named in the outline. Volatile.","f":"FD&C Act 804; 21 USC 384.","fc":"FD&C Act 804; 21 USC 384"},{"id":"D1-C-09","d":"D1","s":"1C","t":2,"q":"May a pharmacy possess, store or dispense manufacturer drug samples?","a":"PDMA governs distribution; pharmacy possession is state law and flatly prohibited in many states.","f":"Prescription Drug Marketing Act, 21 USC 353(c)-(d).","fc":"Prescription Drug Marketing Act, 21 USC 353(c)-(d)"},{"id":"D1-D-01","d":"D1","s":"1D","t":1,"q":"Has the state adopted USP <795>, <797>, and <800> by reference? At which revision, and with what effective date?","a":"Adoption status and version are both state-specific and move.","x":"One fact record per USP chapter: adopted?, revision, effective date."},{"id":"D1-D-02","d":"D1","s":"1D","t":2,"q":"Which state agency regulates pharmacy, and is it independent of the health department?","a":"Structure affects inspection and discipline questions."},{"id":"D1-E-01","d":"D1","s":"1E","t":1,"q":"What distinguishes compounding from manufacturing under state law, and is anticipatory compounding allowed?","a":"Definitions and batch limits differ."},{"id":"D1-E-02","d":"D1","s":"1E","t":1,"q":"What are the facility, training, and documentation requirements for sterile compounding? Is a separate permit required?","a":"Separate sterile permits exist in many states."},{"id":"D1-E-03","d":"D1","s":"1E","t":2,"q":"May a pharmacy compound for office use without a patient-specific prescription?","a":"Permitted in some states, prohibited in others."},{"id":"D1-E-04","d":"D1","s":"1E","t":2,"q":"What are the handling, assessment-of-risk, and PPE requirements for hazardous drugs?","a":"Tracks USP <800> where adopted; otherwise state-specific."},{"id":"D1-E-05","d":"D1","s":"1E","t":2,"q":"Must the pharmacy report compounding volume, or register as an outsourcing facility, at state level?","a":"Post-DQSA state regimes vary."},{"id":"D1-F-01","d":"D1","s":"1F","t":1,"q":"Does state law impose confidentiality duties stricter than HIPAA? For which categories (HIV, mental health, substance use, minors, reproductive health)?","a":"Heightened-protection categories are the state layer.","f":"HIPAA sets a floor; stricter state law controls.","fc":"45 CFR 160.203(b)"},{"id":"D1-F-02","d":"D1","s":"1F","t":2,"q":"May a non-custodial parent access a minor's medication record? At what age does a minor control their own record?","a":"Age of consent for records varies."},{"id":"D1-F-03","d":"D1","s":"1F","t":2,"q":"What is the state's data breach notification duty and deadline for a pharmacy?","a":"State breach statutes are separate from HIPAA."},{"id":"D2-A-01","d":"D2","s":"2A1","t":1,"q":"Which practitioner types may prescribe legend drugs, and are any limited by drug category?","a":"Prescriptive authority is defined state by state."},{"id":"D2-A-02","d":"D2","s":"2A1","t":1,"q":"Which practitioner types may prescribe controlled substances, and in which schedules?","a":"Mid-level schedule limits are a classic item."},{"id":"D2-A-03","d":"D2","s":"2A1","t":1,"q":"May a pharmacist fill a prescription written by an out-of-state prescriber? Does the rule differ for controlled substances?","a":"Out-of-state CS rules are restrictive in some states."},{"id":"D2-A-04","d":"D2","s":"2A1","t":1,"q":"May a pharmacist fill a prescription issued by a prescriber in Canada or Mexico?","a":"Expressly prohibited in some states."},{"id":"D2-A-05","d":"D2","s":"2A1","t":1,"q":"How long is a legend drug prescription valid from the date issued?","a":"One year is common but not universal."},{"id":"D2-A-06","d":"D2","s":"2A1","t":1,"q":"How long is a prescription valid for each controlled schedule (II, III, IV, V)?","a":"Schedule II expiry is state-imposed.","f":"No federal expiration date for a Schedule II prescription.","fc":"21 CFR 1306.12(a)"},{"id":"D2-A-07","d":"D2","s":"2A1","t":1,"q":"What elements must appear on a valid prescription? Any required beyond federal (patient age, sex, address, diagnosis code)?","a":"Extra required elements are high-yield."},{"id":"D2-A-08","d":"D2","s":"2A1","t":1,"q":"Is electronic prescribing mandatory? For controlled substances only, or for all prescriptions? What are the exemptions and the pharmacist's verification duty?","a":"Any pharmacist verification duty is created entirely by state law. Do not code state mandates as tightening a federal pharmacist duty that does not exist.","f":"The federal EPCS mandate runs on PRESCRIBERS only (Medicare Part D; 70% of C-II-V prescriptions electronically per measurement year). CMS states a pharmacist has NO duty to verify a prescriber's exception status and may dispense a valid written, oral or faxed prescription. The federal pharmacist duty is ZERO.","fc":"SUPPORT Act s.2003; CMS Part D EPCS guidance"},{"id":"D2-A-09","d":"D2","s":"2A1","t":2,"q":"May prescriptions be transmitted by fax? Which schedules, and what makes the fax the original?","a":"Fax rules for C-II have narrow federal exceptions states may narrow further."},{"id":"D2-A-10","d":"D2","s":"2A1","t":2,"q":"What are the requirements for a tamper-resistant or security prescription blank? Is a state-issued serialized form required?","a":"Several states mandate official forms."},{"id":"D2-A-11","d":"D2","s":"2A2","t":1,"q":"Which elements of a Schedule II prescription may a pharmacist change after consultation, and which may never be changed?","a":"State policy diverges from DEA guidance."},{"id":"D2-A-12","d":"D2","s":"2A2","t":2,"q":"May a pharmacist add or correct a missing patient address, drug strength, or dosage form without contacting the prescriber?","a":"Clarification authority varies."},{"id":"D2-A-13","d":"D2","s":"2A3","t":1,"q":"May a pharmacist dispense an emergency refill without prescriber authorization? What day supply, which drug classes are excluded, and how often?","a":"Day-supply limits range widely; CS usually excluded."},{"id":"D2-A-14","d":"D2","s":"2A3","t":2,"q":"Are there separate rules for emergency supply during a declared disaster or state of emergency?","a":"Emergency provisions were expanded post-2020."},{"id":"D2-A-15","d":"D2","s":"2A3","t":1,"q":"For an emergency oral Schedule II, how long does the prescriber have to deliver the written follow-up, and what must the pharmacist do if it does not arrive?","a":"States shorten the federal window and add reporting.","f":"21 CFR 1306.11(d)(4): the practitioner must deliver the written prescription within 7 days. If it does not arrive, the pharmacist must notify the nearest DEA office; failure to do so voids the authority to dispense without a written prescription.","fc":"21 CFR 1306.11(d)(4)"},{"id":"D2-A-16","d":"D2","s":"2B3","t":1,"q":"Is there a maximum number of refills for legend drugs, and over what period?","a":"Federal law is silent for non-controlleds; states are not."},{"id":"D2-A-17","d":"D2","s":"2B3","t":2,"q":"What refill limits apply to each controlled schedule, and do any state-specific drug classes carry zero refills?","a":"The C-III/IV rule is adopted near-verbatim nationwide. The variance is entirely in the tail: state-specific zero-refill or reduced-refill drug classes. Research the tail only.","f":"C-II: no refills (21 CFR 1306.12(a)). C-III and C-IV: maximum five refills within six months of issue (21 CFR 1306.22). C-V: NO federal numeric refill limit \u2014 refillable as authorized by the prescriber. Non-controlled legend drugs: no federal limit.","fc":"21 CFR 1306.12(a), 1306.22"},{"id":"D2-A-18","d":"D2","s":"2A1","t":1,"q":"Is there a day-supply limit on an initial opioid prescription? Who is exempt (cancer, hospice, palliative, chronic pain), and does it apply to minors differently?","a":"Nearly universal since 2016, and entirely state-defined.","f":"No federal day-supply limit.","fc":"none \u2014 no federal day-supply limit exists"},{"id":"D2-A-19","d":"D2","s":"2A1","t":2,"q":"Is a morphine milligram equivalent threshold defined that triggers a pharmacist duty?","a":"MME triggers exist in several states."},{"id":"D2-A-20","d":"D2","s":"2A1","t":2,"q":"What state requirements apply to dispensing buprenorphine for opioid use disorder, beyond the federal position after the X-waiver was eliminated?","a":"State registration and quantity rules persist."},{"id":"D2-A-21","d":"D2","s":"2A1","t":1,"q":"What makes a valid medication order in an institution \u2014 who may issue it, who may receive a verbal or telephone order, and must a pharmacist review it before the first dose?","a":"The outline names 'medication orders' explicitly; the framework otherwise covers only outpatient prescriptions."},{"id":"D2-A-22","d":"D2","s":"2A1","t":1,"q":"How does the pharmacy handle medication orders when no pharmacist is on site \u2014 after-hours access, remote review, retrospective verification?","a":"After-hours institutional practice is squarely state-regulated."},{"id":"D2-A-23","d":"D2","s":"2A1","t":1,"q":"May a practitioner issue multiple Schedule II prescriptions for sequential filling, up to what total day supply, and what earliest-fill-date notation is required?","a":"The federal rule defers to state law twice; states split into permitted-at-90-days, capped-shorter, and silent.","f":"21 CFR 1306.12(b) permits up to a 90-day supply across multiple C-II prescriptions, but only 'to the extent permissible under applicable state laws' \u2014 see (b)(1)(iv) and (b)(1)(v).","fc":"21 CFR 1306.12(b)"},{"id":"D2-A-24","d":"D2","s":"2A1","t":2,"q":"What are the rules for veterinary prescriptions \u2014 who may prescribe, animal-patient labeling, sale to a veterinarian for office use, and which agency has jurisdiction?","a":"Tested on several state MPJEs and absent from most frameworks."},{"id":"D2-B-01","d":"D2","s":"2B1","t":1,"q":"What must appear on an outpatient prescription label? Which elements exceed federal requirements?","a":"Extra label elements are a staple item."},{"id":"D2-B-02","d":"D2","s":"2B1","t":2,"q":"Must the label show the drug's physical description, the prescriber's phone, the pharmacist's initials, or a purpose-of-use statement?","a":"Each of these is required somewhere."},{"id":"D2-B-03","d":"D2","s":"2B1","t":2,"q":"Are large-print, multilingual, or accessible labels required on request?","a":"A growing requirement."},{"id":"D2-B-04","d":"D2","s":"2B1","t":2,"q":"What must be on the label of a unit-dose, inpatient, long-term care, or home-infusion product?","a":"Institutional labeling diverges from outpatient."},{"id":"D2-B-05","d":"D2","s":"2B1","t":2,"q":"What controlled substance warning must appear, and in what wording?","a":"Opioid warning labels are now state-mandated in many places."},{"id":"D2-B-06","d":"D2","s":"2B9","t":1,"q":"How does a prescriber block generic substitution, and what exact wording or format is required?","a":"'Dispense as written' mechanics differ by state."},{"id":"D2-B-07","d":"D2","s":"2B9","t":1,"q":"May the patient refuse substitution? What happens when a public payer is involved?","a":"Patient-consent rules vary."},{"id":"D2-B-08","d":"D2","s":"2B9","t":2,"q":"Must generic savings be passed to the patient, and how is the amount determined?","a":"Some states mandate a pass-through."},{"id":"D2-B-09","d":"D2","s":"2B9","t":1,"q":"What are the rules for substituting an interchangeable biosimilar, including the prescriber notification duty and its deadline?","a":"Enacted state by state between 2013 and 2019; absent from older frameworks."},{"id":"D2-B-10","d":"D2","s":"2B9","t":2,"q":"Is therapeutic interchange permitted outside an institution? Under what authority?","a":"Usually institution-only, but defined differently."},{"id":"D2-B-11","d":"D2","s":"2B9","t":2,"q":"What must be documented when a product interchange is performed, and for how long?","a":"Documentation duties vary."},{"id":"D2-B-12","d":"D2","s":"2B5","t":1,"q":"Is counseling required for all patients or Medicaid only? New prescriptions, refills, or both?","a":"The OBRA floor is exceeded in most states.","f":"OBRA '90 reaches Medicaid patients.","fc":"OBRA '90, 42 USC 1396r-8(g)(2)(A)"},{"id":"D2-B-13","d":"D2","s":"2B5","t":1,"q":"Who may make the offer to counsel, and may it be delegated to a technician?","a":"Delegation of the offer is permitted in some states only."},{"id":"D2-B-14","d":"D2","s":"2B5","t":1,"q":"Must the offer, the counseling, or the refusal be documented? In what form and for how long?","a":"Documentation of refusal is a frequent item."},{"id":"D2-B-15","d":"D2","s":"2B5","t":2,"q":"What must counseling cover at minimum, and may written material substitute?","a":"Minimum content lists differ.","x":"List required content elements only. Cap 10. Do not paraphrase into prose."},{"id":"D2-B-16","d":"D2","s":"2B5","t":2,"q":"How is counseling handled for mailed, delivered, or drive-through prescriptions?","a":"Remote counseling duties vary."},{"id":"D2-B-17","d":"D2","s":"2B5","t":2,"q":"Is a private or semi-private counseling area required? What are its specifications?","a":"Physical requirements are specified in some states."},{"id":"D2-B-18","d":"D2","s":"2B2","t":2,"q":"Is prospective drug utilization review required, what must it screen for, and must the review be documented?","a":"Screening element lists vary."},{"id":"D2-B-19","d":"D2","s":"2B2","t":2,"q":"Are patient profiles required for all patients, what must they contain, and may a patient decline to provide elements?","a":"Required contents differ."},{"id":"D2-B-20","d":"D2","s":"2B3","t":2,"q":"May a Schedule II prescription be partially filled at the patient's or prescriber's request? Within what period must the balance be dispensed?","a":"Post-2023 this field is largely federal; the state residue is thin. Research only what the state ADDS or prohibits.","f":"Two different rules with different clocks. 21 CFR 1306.13(a) \u2014 pharmacist cannot supply the full quantity: remainder within 72 HOURS of the first partial fill, else notify the prescriber and no further quantity without a new prescription. 21 CFR 1306.13(b) \u2014 partial fill at the request of patient or prescriber (CARA 2016): remainder no later than 30 DAYS AFTER THE DATE THE PRESCRIPTION WAS WRITTEN, or 72 hours after issuance for an emergency oral C-II.","fc":"21 CFR 1306.13(a), (b)"},{"id":"D2-B-21","d":"D2","s":"2B3","t":2,"q":"What are the partial fill rules for long-term care and terminally ill patients?","a":"LTC/hospice carve-outs differ."},{"id":"D2-B-22","d":"D2","s":"2B3","t":2,"q":"Is there a defined threshold for refilling a controlled substance early, and what documentation is required?","a":"Percentage thresholds exist in some states."},{"id":"D2-B-23","d":"D2","s":"2B6","t":1,"q":"May controlled substance prescriptions be transferred, how many times, and does the answer differ for electronic prescriptions?","a":"The 2023 rule expressly defers to state law, so whether a C-II e-prescription may be transferred at all is a state answer.","f":"Two separate rules. REFILL transfer, C-III-V: 21 CFR 1306.25, one transfer unless pharmacies share a real-time online database. INITIAL FILL transfer, C-II-V: 21 CFR 1306.08(e)-(h) permits a one-time transfer of an ELECTRONIC prescription between retail pharmacies at the PATIENT's request, only where state law permits (88 FR 48365, eff. 2023-08-28).","fc":"21 CFR 1306.25; 21 CFR 1306.08(e)-(h)"},{"id":"D2-B-24","d":"D2","s":"2B6","t":1,"q":"May an intern or technician perform a transfer? Must both parties be pharmacists?","a":"Who may transfer is state-defined."},{"id":"D2-B-25","d":"D2","s":"2B6","t":2,"q":"What information must the transferring and receiving pharmacies each record, and where?","a":"Record placement requirements differ."},{"id":"D2-B-26","d":"D2","s":"2B6","t":2,"q":"May commonly owned pharmacies share one database, and does that change the transfer rules?","a":"Shared-database provisions vary."},{"id":"D2-B-27","d":"D2","s":"2B7","t":1,"q":"Is PDMP registration mandatory for pharmacists? Is a query mandatory before dispensing, and for which drugs or circumstances?","a":"The single biggest post-2008 addition to state law.","f":"No federal PDMP mandate.","fc":"none \u2014 no federal PDMP mandate exists"},{"id":"D2-B-28","d":"D2","s":"2B7","t":1,"q":"How quickly must a dispensing be reported to the PDMP, and which drugs beyond controlled substances are reportable?","a":"Reporting windows range from real time to weekly."},{"id":"D2-B-29","d":"D2","s":"2B7","t":2,"q":"Who may access the PDMP, may access be delegated to a technician, and what are the penalties for misuse?","a":"Delegate access rules vary."},{"id":"D2-B-30","d":"D2","s":"2B7","t":2,"q":"What must a pharmacist do when the PDMP reveals a red flag? Is there a reporting duty?","a":"Affirmative duties exist in some states."},{"id":"D2-B-31","d":"D2","s":"2B1","t":1,"q":"What are the daily and monthly sales limits, what identification and logging are required, and is a prescription required?","a":"Some states exceed CMEA or require a prescription.","f":"CMEA retail limits: 3.6 g per purchaser per day; 9 g per purchaser per 30 days. MAIL-ORDER 30-day limit is 7.5 g, not 9 g (21 CFR 1314.100). Logbook, photo ID and employee training required.","fc":"21 CFR 1314.100; 21 USC 830(e)"},{"id":"D2-B-32","d":"D2","s":"2B1","t":2,"q":"Which products are behind-the-counter or pharmacist-only in this state?","a":"State-specific BTC lists exist."},{"id":"D2-B-33","d":"D2","s":"2B1","t":2,"q":"May syringes be sold without a prescription? Any quantity limit or logging duty?","a":"Still restricted in a few states."},{"id":"D2-B-34","d":"D2","s":"2B4","t":3,"q":"May a pharmacy repackage another pharmacy's dispensed prescription? Under what conditions?","a":"Prune if uniform."},{"id":"D2-B-35","d":"D2","s":"2B4","t":1,"q":"What are the child-resistant packaging requirements, and how is a waiver obtained \u2014 patient blanket waiver, prescriber per-prescription waiver, and must either be in writing?","a":"The PPPA sets the floor; waiver mechanics and documentation are state-specified.","f":"Poison Prevention Packaging Act, 15 USC 1471-1477; 16 CFR 1700.","fc":"Poison Prevention Packaging Act, 15 USC 1471-1477; 16 CFR 1700"},{"id":"D2-B-36","d":"D2","s":"2B4","t":2,"q":"What are the requirements for unit-dose, adherence or multi-medication blister packaging, and may a pharmacy repackage into them for a long-term care patient?","a":"Adherence packaging rules are state-built and growing."},{"id":"D2-C-01","d":"D2","s":"2C","t":1,"q":"Which vaccines may a pharmacist administer, to what minimum patient age, and under prescription, protocol, or independent authority?","a":"Age floors and vaccine lists are highly variable.","x":"One fact record per vaccine or vaccine group, each with its own minimum age."},{"id":"D2-C-02","d":"D2","s":"2C","t":1,"q":"What training, certification, and CPR requirements apply to an immunizing pharmacist?","a":"Training hour requirements differ."},{"id":"D2-C-03","d":"D2","s":"2C","t":1,"q":"Must immunizations be reported to a state registry, and within what period?","a":"Registry reporting deadlines vary."},{"id":"D2-C-04","d":"D2","s":"2C","t":2,"q":"May a technician or intern administer vaccines? Under what supervision?","a":"Expanded in many states post-2020."},{"id":"D2-C-05","d":"D2","s":"2C","t":2,"q":"Beyond vaccines, which drugs may a pharmacist administer, and by which routes?","a":"Long-acting injectables are newly permitted in many states."},{"id":"D2-C-06","d":"D2","s":"2C","t":2,"q":"What adverse events must be reported, to whom, and in what timeframe?","a":"State reporting sits alongside VAERS and MedWatch."},{"id":"D3-A-01","d":"D3","s":"3A2","t":1,"q":"How many members serve on the board, how many are pharmacists, how many are public members, who appoints them, and what are the term lengths?","a":"Pure state fact; almost always tested.","x":"One fact record per number: total, pharmacist members, public members, appointing authority, term length."},{"id":"D3-A-02","d":"D3","s":"3A2","t":2,"q":"What are the board's rulemaking, inspection, subpoena, and emergency suspension powers?","a":"Powers are enumerated differently.","x":"Cap 8 powers. Rulemaking, inspection, subpoena, emergency suspension always included if present."},{"id":"D3-A-03","d":"D3","s":"3A2","t":2,"q":"May the board inspect without notice? What must be produced, and may a pharmacy refuse entry?","a":"Inspection authority varies."},{"id":"D3-A-04","d":"D3","s":"3A2","t":1,"q":"What conduct constitutes unprofessional conduct, and what sanctions may the board impose?","a":"Enumerated lists are state-specific.","x":"List only grounds a pharmacist can trigger in daily practice. Cap 12 items, most-cited first. Cite the full list."},{"id":"D3-A-05","d":"D3","s":"3A2","t":2,"q":"What is the disciplinary process \u2014 complaint, investigation, hearing, appeal \u2014 and what are the deadlines at each step?","a":"Procedural timelines are tested."},{"id":"D3-A-06","d":"D3","s":"3A2","t":2,"q":"Is there an impaired pharmacist or recovery program, is participation confidential, and does it substitute for discipline?","a":"Program structure differs."},{"id":"D3-A-07","d":"D3","s":"3A2","t":2,"q":"What are the civil and criminal penalty ranges for practicing without a license or for a pharmacy operating without a permit?","a":"Penalty amounts are state facts."},{"id":"D3-A-08","d":"D3","s":"3A2","t":1,"q":"What has the board published on the legal authority of its newsletter, policy statements, declaratory rulings and FAQs \u2014 are they binding, advisory, or enforceable as rule?","a":"Some boards treat the newsletter as enforceable; the published position is citable, unlike a guess about what NABP tests."},{"id":"D3-A-09","d":"D3","s":"3A2","t":2,"q":"What happens if a license lapses \u2014 grace period, late fee, reinstatement requirements, and is practice during lapse a disciplinary offense?","a":"Grace periods and consequences differ."},{"id":"D3-A-10","d":"D3","s":"3A1","t":2,"q":"What does the board's candidate bulletin or practice act state about applying state versus federal law when the two conflict?","a":"Where stated, it is directly citable. Expect roughly half the states to have no published statement \u2014 record that as silence, not as absence of an answer."},{"id":"D3-B-01","d":"D3","s":"3B2","t":1,"q":"Does the state schedule any substance differently from federal, or schedule anything federal law does not?","a":"State-only scheduling (gabapentin, kratom, cannabis derivatives) is high-yield."},{"id":"D3-B-02","d":"D3","s":"3B4","t":1,"q":"Is a separate state controlled substance registration required, for whom, and on what renewal cycle?","a":"Separate state CSR exists in many states."},{"id":"D3-B-03","d":"D3","s":"3B1","t":1,"q":"How often must a controlled substance inventory be taken, on what date, and must it be filed with anyone?","a":"Annual vs biennial, with fixed dates.","f":"Biennial inventory.","fc":"21 CFR 1304.11"},{"id":"D3-B-04","d":"D3","s":"3B1","t":2,"q":"What triggers an inventory outside the regular cycle \u2014 change of PIC, change of ownership, theft, newly scheduled drug?","a":"Trigger lists differ."},{"id":"D3-B-05","d":"D3","s":"3B2","t":1,"q":"How long must controlled substance records be retained, and must they be kept on site?","a":"Two to seven years, with on-site rules.","f":"Two years.","fc":"21 CFR 1304.04"},{"id":"D3-B-06","d":"D3","s":"3B2","t":2,"q":"How must controlled substance prescriptions be filed \u2014 three-file, two-file, or state-specific \u2014 and what marking is required?","a":"Filing systems are specified by state."},{"id":"D3-B-09","d":"D3","s":"3B5","t":1,"q":"To whom must theft or significant loss be reported, within what period, and on what form?","a":"The one-business-day federal deadline is now tighter than most states'. Research what the state ADDS \u2014 a second recipient (board, state police), a different form, or a duty covering non-controlled drugs.","f":"21 CFR 1301.76(b): written notice to the DEA Field Division Office within ONE BUSINESS DAY of discovery, and a complete DEA Form 106 filed through DEA's secure network application within 45 CALENDAR DAYS of discovery. (Amended 88 FR 40712, eff. 2023-07-24.)","fc":"21 CFR 1301.76(b)"},{"id":"D3-B-10","d":"D3","s":"3B5","t":1,"q":"Does the state impose the same reporting duty for non-controlled legend or dangerous drugs?","a":"A state-only duty with no federal analogue."},{"id":"D3-B-11","d":"D3","s":"3B6","t":1,"q":"How may a pharmacy destroy expired or unwanted controlled substances, and may it act as an authorized collector?","a":"State disposal rules sit on top of the DEA take-back framework."},{"id":"D3-B-12","d":"D3","s":"3B6","t":2,"q":"What are the requirements for a drug take-back kiosk, including placement, access, and recordkeeping?","a":"Kiosk rules are state-specified."},{"id":"D3-B-13","d":"D3","s":"3B2","t":2,"q":"Must a perpetual inventory be maintained for Schedule II? In all settings?","a":"Required in a minority of states.","f":"Not required.","fc":"21 CFR 1304.04 (no perpetual inventory required)"},{"id":"D3-B-14","d":"D3","s":"3B2","t":1,"q":"May a practitioner prescribe or dispense controlled substances for themselves or an immediate family member?","a":"Expressly prohibited in some states, silent in others.","f":"No general federal prohibition.","fc":"no general federal prohibition; see 21 CFR 1306.04 (legitimate medical purpose)"},{"id":"D3-B-15","d":"D3","s":"3C","t":1,"q":"How does state law express the pharmacist's corresponding responsibility, and are specific red flags enumerated in rule?","a":"Enumerated red-flag lists exist in several states and are directly testable."},{"id":"D3-B-16","d":"D3","s":"3C","t":1,"q":"What must a pharmacist do on receiving a forged, altered, or suspicious controlled substance prescription \u2014 refuse, retain, report, notify police?","a":"Retention and reporting duties vary."},{"id":"D3-B-17","d":"D3","s":"3B3","t":2,"q":"Does the state separately register controlled substance distributors, manufacturers or researchers; does a pharmacy need one to transfer stock; and does the state add anything to the federal DEA Form 222 / CSOS ordering scheme (21 CFR Part 1305)?","a":"Ordering itself is federal. State registration tiers and any state-added filing are the variable part."},{"id":"D3-B-18","d":"D3","s":"3B2","t":2,"q":"What controlled substance records are required in an institution \u2014 proof-of-use sheets, floor stock reconciliation, discrepancy resolution?","a":"Institutional recordkeeping is separately specified."},{"id":"D3-B-19","d":"D3","s":"3B6","t":1,"q":"How must controlled substance waste be documented and witnessed, and who qualifies as a witness?","a":"Witness qualification is state-defined and frequently tested."},{"id":"D3-B-20","d":"D3","s":"3B6","t":2,"q":"Has the state adopted EPA's hazardous waste pharmaceuticals rule, and what is the position on sewering non-controlled pharmaceutical waste?","a":"RCRA-authorized states adopt Subpart P on their own schedules; some have not adopted it.","f":"40 CFR 266 Subpart P.","fc":"40 CFR 266 Subpart P"},{"id":"D3-B-21","d":"D3","s":"3B2","t":2,"q":"What is the pharmacist's role, if any, with medical cannabis in this state, and is it reportable to the PDMP?","a":"Pharmacist involvement is mandated in a handful of states and prohibited in others."},{"id":"D3-C-01","d":"D3","s":"3C","t":1,"q":"What must a pharmacist report, to whom, and when \u2014 suspected diversion, forged prescriptions, impaired colleagues, child or elder abuse?","a":"Mandated reporter status for pharmacists varies."},{"id":"D3-C-02","d":"D3","s":"3C","t":1,"q":"Must a dispensing error be reported to the board or the patient? Is there a continuous quality improvement program requirement, and is it privileged?","a":"CQI mandates and privilege protections differ."},{"id":"D3-C-03","d":"D3","s":"3C","t":2,"q":"What is the statute of limitations for a pharmacy malpractice claim, and is there a damages cap?","a":"Tort rules are state law."},{"id":"D3-C-04","d":"D3","s":"3C","t":3,"q":"Is professional liability insurance required to hold a license or permit?","a":"Rare; prune if uniform."},{"id":"D4-A-01","d":"D4","s":"4A","t":1,"q":"What pharmacy permit classes exist, and which activities require which class?","a":"Permit taxonomies are entirely state-specific."},{"id":"D4-A-02","d":"D4","s":"4A","t":1,"q":"Must a non-resident pharmacy shipping into the state hold a license? What are the conditions, and must a pharmacist be licensed in-state?","a":"Non-resident requirements are heavily tested."},{"id":"D4-A-03","d":"D4","s":"4A","t":2,"q":"What must be reported to the board on a change of ownership, location, name, or telephone number, and by when?","a":"Notification deadlines differ."},{"id":"D4-A-04","d":"D4","s":"4A","t":2,"q":"What is required when a pharmacy closes \u2014 notice period, records disposition, controlled substance transfer, public notice?","a":"Closure checklists are state-specific."},{"id":"D4-A-05","d":"D4","s":"4A","t":2,"q":"May a non-pharmacist own a pharmacy? Are there restrictions on prescriber ownership or self-referral?","a":"Ownership restrictions exist in some states."},{"id":"D4-A-06","d":"D4","s":"4A","t":1,"q":"May a prescriber dispense from their office? Must they register with the board of pharmacy, and are there quantity, labeling or recordkeeping limits?","a":"Some states prohibit outright, some require a dispensing permit, some allow samples only. Distinct from pharmacy ownership."},{"id":"D4-B-01","d":"D4","s":"4B","t":1,"q":"How long must each record type be retained, must it be kept on site, and does the state require retention of any record type with no federal analogue?","a":"Retention periods differ by record type and state, and some states create record types federal law does not \u2014 Texas, for example, requires a seven-year retention on the log tying an identification code to the person who used it, against two years for most records.","x":"One fact record per record type. Each carries its OWN citation \u2014 these sit in different titles. Always enumerate: original prescriptions, refill records, purchase invoices, patient profiles, CQI records, CS records. Then add any STATE-ONLY record type found; do not stop at the standard list."},{"id":"D4-B-02","d":"D4","s":"4B","t":2,"q":"May records be kept electronically only? Must they be retrievable on site, and within what time?","a":"Readily-retrievable standards vary."},{"id":"D4-B-03","d":"D4","s":"4B","t":2,"q":"What is required when the pharmacy computer system fails \u2014 downtime procedure, manual records, reconciliation?","a":"Downtime duties are specified in some states."},{"id":"D4-B-04","d":"D4","s":"4B","t":2,"q":"Is a daily printout or electronic verification log of dispensed prescriptions required, and who must sign it?","a":"Signature requirements vary."},{"id":"D4-B-05","d":"D4","s":"4B","t":1,"q":"Are automated dispensing systems permitted? In which settings, who stocks and checks them, and what accuracy auditing is required?","a":"ADC rules differ between retail and institutional."},{"id":"D4-B-06","d":"D4","s":"4B","t":1,"q":"May prescriptions be processed or verified remotely, including from another state or from home? What registration applies?","a":"Remote verification expanded sharply post-2020."},{"id":"D4-B-07","d":"D4","s":"4B","t":1,"q":"Is telepharmacy permitted? What are the site, supervision, camera, and distance requirements?","a":"Telepharmacy regimes are entirely state-built."},{"id":"D4-B-08","d":"D4","s":"4B","t":3,"q":"Are there state cybersecurity or access-control requirements for pharmacy systems?","a":"Emerging; prune if absent in the first three states."},{"id":"D4-B-09","d":"D4","s":"4B","t":1,"q":"Is central fill or centralized prescription processing permitted? Must the central site hold a separate permit, whose name and address appear on the label, and which pharmacy owns the dispensing record?","a":"Named in the outline and distinct from remote verification. Entirely state-structured.","f":"21 CFR 1306.15 addresses central fill for Schedule II prescriptions only.","fc":"21 CFR 1306.15"},{"id":"D4-C-01","d":"D4","s":"4C","t":2,"q":"What minimum equipment, references, and physical space must a pharmacy maintain?","a":"Required reference lists still exist in some states.","x":"Three sub-records: equipment, references, physical space. Cite each separately."},{"id":"D4-C-02","d":"D4","s":"4C","t":1,"q":"May the store remain open while the pharmacy department is closed? What securing is required?","a":"Securing standards differ."},{"id":"D4-C-03","d":"D4","s":"4C","t":2,"q":"Must pharmacy hours be posted, and where? Must the board be notified of a change?","a":"Posting duties vary."},{"id":"D4-C-04","d":"D4","s":"4C","t":2,"q":"Must licenses and permits be displayed? Original or copy? May a home address be obscured?","a":"Display rules differ."},{"id":"D4-C-05","d":"D4","s":"4C","t":2,"q":"What notices must be posted for the public \u2014 price, complaint, counseling rights, opioid warning?","a":"Mandatory notices are state-specific."},{"id":"D4-C-06","d":"D4","s":"4C","t":1,"q":"How must controlled substances be stored \u2014 dispersed, locked cabinet, safe? Does the answer differ by schedule or setting?","a":"Storage standards differ from federal in some states."},{"id":"D4-C-07","d":"D4","s":"4C","t":2,"q":"Who may hold a key to or access the pharmacy in the pharmacist's absence?","a":"After-hours access is tightly specified."},{"id":"D4-C-08","d":"D4","s":"4C","t":2,"q":"What are the storage, accountability, and floor-stock rules for controlled substances in a hospital?","a":"Institutional rules are separate."},{"id":"D4-C-09","d":"D4","s":"4C","t":2,"q":"What are the equivalent rules in a long-term care facility, including emergency kits and their contents?","a":"Emergency kit contents are state-approved."},{"id":"D4-C-10","d":"D4","s":"4C","t":3,"q":"Are storage temperature monitoring and excursion documentation required?","a":"Prune if uniform."},{"id":"D4-D-01","d":"D4","s":"4D","t":1,"q":"May prescriptions be delivered or mailed? What packaging, identification, and signature requirements apply, and do controlled substances differ?","a":"Delivery rules are state-built."},{"id":"D4-D-02","d":"D4","s":"4D","t":2,"q":"May prescriptions be left at an unattended address, with a third party, or in a locker?","a":"Unattended delivery is restricted in some states."},{"id":"D4-D-03","d":"D4","s":"4D","t":2,"q":"Are drive-through windows permitted, and does counseling have to be offered there?","a":"Drive-through counseling duties vary."},{"id":"D4-D-04","d":"D4","s":"4D","t":3,"q":"May a pharmacy use a courier or a locker at a remote site, and must that site be registered?","a":"Overlaps telepharmacy; prune if redundant."}]}