Delivery to site of administration

Patient-specific filled prescriptions must be delivered to the location where they will be administered. Certain fills may require special handling, including radiopharmaceuticals, ESRD (Medicare/Medicaid) fills, compounded medications, and prescriptions without a permanent secure mailing address.

• Deliver patient-specific filled prescriptions to the site of administration.
• Apply special handling for radiopharmaceuticals, ESRD-covered fills, compounded medications, and items lacking a permanent secure mailing address.

Naloxone must be protocol- or Rx-distributed (not OTC)

Naloxone may be distributed under a physician protocol or by patient-specific prescription; over-the-counter distribution is not permitted.

• Distribution allowed via physician protocol or patient-specific Rx only (NOT OTC).
• Local physician or State Medical Director may be used for protocols; patient/family education required.

Refill authorization workflow: technician vs pharmacist

A technician may accept refill authorization from the prescriber’s office for non-controlled prescriptions when no changes are made; the pharmacist must accept refill authorizations when changes are made to a non-controlled prescription and must accept all refill authorizations for any controlled substance.

• Technician may take refill authorization for unchanged, non-CDS refills.
• Pharmacist must take refill authorization if there are changes to a non-CDS Rx.
• Pharmacist must take refill authorization for any CDS Rx.

Mid-level practitioner licensure, supervision, and prescribing limits

Mid-level practitioners must be licensed in Oklahoma and supervised by an Oklahoma-licensed physician; prescribing limits differ by practitioner type and setting (e.g., CDS III–V supply limits and CII rules in hospitals).

• No out-of-state PAs or ARNPs; must be licensed in OK and supervised by an OK-licensed physician.
• CDS III–V: PA — up to 30 day supply (no refills); APRN — original plus refills up to 30 days.
• Hospital settings: PAs — CII limited to immediate or ongoing on-site administration per protocol; APRNs — no CII and must practice within scope with exclusionary formulary.

Vaccine storage logs and immunization documentation

Maintain calibrated thermometers and record refrigeration/freezer temperatures twice daily for vaccine storage, and keep immunization qualification documentation (e.g., current CPR) on file; multi-dose vial (MDV) dating must be recorded with a 28-day BUD unless the manufacturer specifies otherwise.

• No dorm-size refrigerators; use full-size refrigerator with separate freezer and remove crisper bins as directed.
• Record temperatures twice daily and use calibrated thermometers.
• Maintain current CPR and technician training records; date MDV vial when opened (BUD 28 days unless manufacturer states otherwise).

Document PMP checks in the patient chart

Prescribers must check the Oklahoma PMP for new patients and for existing patients every 180 days when prescribing opiates, carisoprodol, or benzodiazepines, and must document the PMP check in the patient's chart.

• PMP checks required for new patients and ongoing patients every 180 days for opiates, carisoprodol, or benzodiazepines.
• Document each PMP check in the patient’s medical chart.

Document controlled-substance transactions per OBNDD rules

Ensure complete documentation for all controlled-substance transactions: record partial fills, split-billing, and any pharmacist additions allowed to Schedule II prescriptions per OBNDD rules; maintain documentation when partial fills are provided or when pharmacist adds permitted fields.

• Document split billing and partial fills for Schedule II prescriptions; partial fill remainder rules apply.
• Pharmacists may add certain fields to CII (dosage form, strength, quantity, directions, patient address, generic, compounded) but must not change patient name, date, drug name, or physician signature; errors require prescriber reissue.

Regulatory risk for not performing 180-day PMP checks

Failure to check the PMP every 180 days for patients receiving opiates, carisoprodol, or benzodiazepines may be enforced by the prescriber's licensing board and could result in regulatory action.

• PMP checks every 180 days are required for applicable medications; enforcement is by the prescriber’s licensing board.

PMP check noncompliance may prompt board enforcement

Failure to check the PMP for new patients or every 180 days for existing patients on opiates, carisoprodol, or benzodiazepines may be enforced by the prescriber's licensing board.

• PMP checks cannot be delegated to pharmacy and must be documented in the patient's chart.
• Noncompliance may be subject to disciplinary action by the prescriber’s licensing board.

Deliver patient-specific fills to administration location

Deliver patient-specific filled prescriptions to the location where they will be administered and apply special handling procedures as required for items such as radiopharmaceuticals and compounded medications.

• Ensure delivery to the administration site (office/clinic) rather than using insecure permanent mailing addresses.
• Use special handling protocols for radiopharmaceuticals and compounded products.

Entity prescriptions permitted for epinephrine to schools/businesses

Epinephrine may be dispensed to schools or businesses under an entity prescription; the prescriber must write the prescription for the entity (e.g., school or YMCA) and ensure the entity has policies and procedures in place for proper use.

• Prescriber may write an entity prescription (e.g., up to 24 autoinjectors) and pharmacy may fill under the entity name.
• Prescriber is responsible for ensuring the entity has appropriate policies and procedures.

Oklahoma licensure/supervision and hospital-specific mid-level rules

Mid-level practitioners must be licensed in Oklahoma and supervised by an Oklahoma-licensed physician; hospital practice rules differ—PAs may have CII limited to immediate or ongoing on-site administration under written protocol, while APRNs may not prescribe CII and must operate within scope and exclusionary formulary.

• No out-of-state PAs or ARNPs; Oklahoma licensure and supervision required.
• Hospital: PAs — CII limited to on-site immediate/ongoing administration per protocol; APRNs — no CII prescribing in hospital setting.