Missouri Administrative Code

sure (1) The board may issue a license to practice optometry by endorsement and without exam- AUTHORITY: section 336.160.1, RSMo PURPOSE: This rule states where to secure ination to an individual licensed in another Supp. 2018.* This rule originally filed as 4 an application. sta…

provided by the board. The licensee shall not Optometric Association or any other state or PURPOSE: This rule clarifies the license submit the record of C.E. attendance to the regional optometric association affiliated renewal requirements and procedures. board except in the case…

cies and procedures and techniques that can unless sufficient funds are available for that PURPOSE: The purpose of this regulation is assist the board in fulfilling its mission; and purpose within the appropriation for this to comply with section 536.023(3), RSMo (H) Interacting …

any errors before the drug, medicine, or poison is dispensed or PURPOSE: This rule defines the term “drug” as utilized in Chapter sold. A sign advising the public that no pharmacist is on duty 338, RSMo, and the rules of the board. must be manually or electronically posted when n…

pharmacy; PURPOSE: This rule defines terms used in the regulations of the (G) Pharmacy facilities and equipment must be maintained State Board of Pharmacy and outlines the conditions necessary for in a clean and sanitary condition at all times and trash must be the operation of a…

(Intern Pharmacists and Pharmacy Technicians) . . . . . . . . . . . . . . . . . . . . . 9 20 CSR 2220-2.013 Prescription Delivery Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 20 CSR 2220-2.015 Termination of Business as a Pharmacy . . . . . . . …

Emergency or Declared Disaster temporary pharmacy permit must be submitted on a form provided by the board with the applicable fee, and must PURPOSE: This rule establishes guidelines for temporary pharmacy demonstrate that the temporary pharmacy is needed to ensure operations dur…

Records PURPOSE: This rule establishes requirements for non-electronic 20 CSR 2220-2.018 Prescription Requirements (manual) prescription record keeping. PURPOSE: This rule establishes requirements for information (1) Pharmacies that maintain a non-electronic prescription required…

include: 1. The date of dispensing and the calibration time of the (7) Special Conditions. radiopharmaceutical; and (A) To comply with NRC exposure guidelines of keeping 2. The patient’s name for therapeutic prescription drug radiation exposure as low as reasonably achievable (AL…

previous and subsequent owners. PURPOSE: This rule outlines the requirements for obtaining and (C) All individuals or business entities owning twenty-five maintaining a pharmacy permit. percent (25%) or more of the ownership of any entity owning a pharmacy must notify the board w…

effective April 30, 2018. PURPOSE: This rule establishes licensure guidelines for nonresident pharmacies. *Original authority: 338.140, RSMo 1939, amended 1981, 1989, 1997, 2011; 338.210, RSMo 1951, amended 2001, 2011; 338.220, RSMo 1951, amended 1969, 1981, 1989, 1997, (1) Nonre…

(Rescinded August 30, 2013) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Pharmacy Schools (Rescinded August 30, 2013) . . . . . . . . . . . . . . . . . . . . . 16

Pharmacy Schools Who Have Been Licensed in Another State (Rescinded August 30, 2013) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 20 CSR 2220-2.036 Temporary License (Rescinded August 30, 2013) . . . . . . . . . . . . . . . . . . . . . . 17 20 …

(Rescinded August 30, 2013) (6) Both the complaint and any information obtained as a result AUTHORITY: section 338.140, RSMo 2000, and section 338.043, of the complaint investigation are a closed record of the board RSMo Supp. 2007. This rule originally filed as 4 CSR 220-2.036. …

Disposition Procedure (8) The board interprets this rule, which is required by law, to PURPOSE: This rule establishes a procedure for the receipt, exist for the benefit of those members of the public who submit handling and disposition of public complaints by the board, complaint…

prescription data; PURPOSE: This rule sets requirements concerning the issuance of (N) The number of authorized refills and quantity remaining; honorary gold certificates to pharmacists licensed in Missouri for (O) Whether generic substitution has been authorized by the fifty (50…

prescriptions, a hard copy representation of the prescription PURPOSE: This rule establishes requirements for utilizing an shall be made and filed which contains all of the information electronic data-processing system in a pharmacy. in section (2). Prescription hard copies must …

(B) Electronic prescription—Any prescription or medication PURPOSE: The purpose of this rule is to establish requirements order, other than an electronic image transmission, which is and guidelines for maintaining prescription hard copies in an electronically transmitted from a l…

PURPOSE: This rule defines the term pharmacist-in-charge, sets the requirements and standards for this title, and defines the term 20 CSR 2220-2.095 Collection of Medication for Destruction full-time pharmacy. PURPOSE: The purpose of this rule is to authorize pharmacies to (1) Ex…

Order Information between licensed pharmacies must meet all of the requirements of this rule. However, licensed pharmacies that share the same PURPOSE: This rule defines record-keeping required for transfer of electronic database and are under the same ownership are not prescript…

Long-Term Care Facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 20 CSR 2220-2.145 Minimum Standards for Multi-Med Dispensing . . . . . . . . . . . . . . . . . . . . . . 25 20 CSR 2220-2.150 Mandatory Reporting Rule . . . . . . . . . …

two (2) categories. PURPOSE: This rule establishes guidelines to be used by the board (A) Category A. Chemically impaired licensees where for licensure disciplinary agreements. additional information is evident that known distribution of John R. Ashcroft (11/30/24) CODE OF STATE …

to counsel may be provided within the information provided PURPOSE: This rule establishes standards for compliance with by the kiosk to the patient during the processing phase prior Chapter 610, RSMo as it relates to public records of the State Board to release of the medication …

are controlled as necessary. (F) Compounding: For the purposes of this regulation, PURPOSE: This rule establishes requirements for prospective drug compounding is defined as in 20 CSR 2220-2.400(1). Compounded utilization review prior to dispensing a prescription or medication st…

transfer processes and to provide an aseptic environment for PURPOSE: This rule establishes standards for the handling, Compounded Sterile Preparation (CSPs). labeling, distribution, and dispensing of compounded sterile (H) Compounding aseptic isolator (CAI): A RABS preparations …

in the course of professional practice. Compounding may PURPOSE: This rule establishes requirements for the confidentiality also be defined as the preparation, incorporation, mixing and and disclosure of records related to patient care. packaging, or labeling of a drug or device,…

for Drug Shortages PURPOSE: The purpose of this rule is to establish requirements for reporting compounding information to the Missouri Board of PURPOSE: This rule establishes requirements for Class B hospital Pharmacy to ensure compliance with state and federal law. pharmacies c…

(Rescinded August 30, 2013) Commission or Agreement State regulations. Nothing in this rule shall be construed as requiring a licensed clinical laboratory, AUTHORITY: sections 338.140 and 338.280, RSMo 2000. This rule which is also licensed by the Nuclear Regulatory Commission or…

for Operation or an equivalent company sponsored program that meets APhA guidelines for nuclear pharmacy technician training. PURPOSE: This rule defines minimum standards for the (J) “Practice of nuclear pharmacy” means a patient- operation of nuclear pharmacies and the preparati…

Renal Dialysis Pharmacy and the quantity prescribed. PURPOSE: This rule defines minimum standards for a Class F: (4) Personnel of the pharmacy shall assemble the products to Renal Dialysis Pharmacy. be delivered pursuant to the prescriber’s order(s). In assembling such products f…

Shared Services Pharmacy to the patient may be listed on the label as designated by the pharmacies by contract. PURPOSE: The purpose of this rule is to establish standards for Class (D) Each pharmacy involved in a Class-J arrangement must J: Shared Services pharmacies. maintain a…

Class L Veterinary Pharmacies authorized prescriber; and (C) Maintain a policy and procedure manual for pharmacy PURPOSE: This rule defines standards for a Class L veterinary operations. The policy and procedure manual shall be reviewed pharmacy. annually by the pharmacist-in-cha…

number, the date on which the person’s name was entered PURPOSE: This rule defines the requirements for pharmacy on the list and the date at which time the person will again technician registration. become eligible for employment in a pharmacy. The board may place a person on the…

Pharmacist Supervision AUTHORITY: sections 338.010 and 338.140, RSMo Supp. 2019, and sections 338.013, 338.035, and 338.280, RSMo 2016.* Original rule PURPOSE: This rule defines the required supervision for pharmacy filed Feb. 7, 2020, effective Aug. 30, 2020. Emergency rule file…

Dispensing Systems PURPOSE: This rule defines the minimum standards for a vacuum tube drug delivery system utilized in licensed pharmacies. PURPOSE: This rule establishes licensing standards and requirements for the use of Class N automated dispensing systems (1) Vacuum tube syst…

within ten (10) days after ceasing or terminating Program PURPOSE: This rule establishes the Missouri Board of Pharmacy’s participation. Unless otherwise agreed by the board for good medication disposal program as part of the Rx Cares for Missouri cause, Program participants shal…

Projects *Original authority: 338.140, RSMo 1939, amended 1981, 1989, 1997, 2011, 2019 and 338.143, RSMo 2019. PURPOSE: This rule establishes application requirements and criteria for pilot projects authorized by section 338.143, RSMo. (1) This rule establishes requirements for t…

lary and section 338.140, RSMo Supp. 2019.* tive April 30, 1996. Moved to 20 CSR 2220- This rule originally filed as 4 CSR 220-3.011. 3.011, effective Aug. 28, 2006. Amended: This rule originally filed as 4 CSR 220-3.010. Emergency rule filed April 26, 1979, effective Filed April…

tion Filed June 14, 1982, effective Sept. 11, 1982. 20 CSR 2220-3.040 Return and Reuse of Emergency amendment filed Dec. 6, 1982, Drugs and Devices PURPOSE: The purpose of this rule is to effective Jan. 1, 1983, expired March 10, establish requirements for generic drug sub- 1983.…

fee fixed by this rule is held invalid by a court of competent PURPOSE: This rule establishes and fixes the various fees and jurisdiction or by the Administrative Hearing Commission, the charges authorized by Chapter 338, RSMo. remaining provisions of this rule shall remain in fu…

visory Committee other documentation, reports or correspon- defined as anyone engaged in wholesale dis- dence to the board when necessary. tribution of prescription drugs, including, but PURPOSE: This rule establishes operating (C) Any official recommendations to be not limited t…

(3) The advisory committee shall organize by Licensing Requirements or trade a drug among hospitals or by a hos- the election of a chairman and vice-chairman pital to a healthcare entity under the same who shall hold their offices for one (1) year PURPOSE: This rule defines terms…

ards for Drug Wholesale and Pharmacy meet the minimum education/experience 5. Upon receipt of legend drugs, each Distributors requirements as set forth in this rule for a outside shipping container shall be visually total of one (1) year. examined for identity and to prevent the …

and authorized pharmacist. PURPOSE: This rule establishes requirements for authorized (A) HIV PEP protocols must adhere to CDC guidelines and pharmacists dispensing HIV post-exposure prophylaxis as include specific directions for the authorized pharmacist to authorized by section…

(Rescinded November 30, 2019) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 20 CSR 2220-6.040 Administration by Medical Prescription Order . . . . . . . . . . . . . . . . . . . . . . . . 5 20 CSR 2220-6.050 Administration of Vaccines . . . . . . . . . …

(6) Patient Medical Records. Authorized pharmacists shall Order maintain a patient medical record for each patient that documents the care provided for the patient pursuant to a HIV PURPOSE: This rule establishes procedures for pharmacists to PEP protocol. administer medication p…

ministering vaccines accredited by the Accreditation Council PURPOSE: This rule establishes procedures for pharmacists ad- for Pharmacy Education (ACPE), provided by an ACPE or re- ministering vaccines as authorized by section 338.010.1, RSMo. gionally accredited pharmacy or medi…

Plan Authority shall be governed by the rules of the Missouri State Board of Pharmacy governing pharmacist continuing education. PURPOSE: This rule establishes procedures for obtaining a certif- icate of medication therapeutic plan authority, as authorized by (4) The Missouri Sta…