Board News and Announcements






Temporary Pharmacy Closures/Relocations Due to Hurricane Florence - last updated 9/21/18




NC MEDICAID EXTENDS CERTAIN COVERAGE WAIVERS AS HURRICANE FLORENCE RECOVERY CONTINUES.  North Carolina Governor Cooper has declared a state of emergency for North Carolina due to Hurricane Florence. See the NC declaration of a state of emergency here.

The destruction of property and flooding caused by Hurricane Florence has caused situations where North Carolina Medicaid and Health Choice beneficiaries in impacted areas may continue to require an early refill of their medications or medications that require prior authorization. For this reason, NC Medicaid has extended the waivers granted by CMS which allow for the following:

  1. Early refill of all covered medications beginning Tuesday, September 11th through Friday, September 28th.
  2. Waive prior authorization requirements for all covered medications beginning Friday, September 14th through Friday, September 28th.
  3. Waive prior authorization requirements for medically necessary medical equipment and supplies beginning Friday, September 14th through Friday, September 28th.

NC Medicaid will continue to evaluate the need to extend the above waivers and will communicate any changes.

Pharmacy providers may call the NCTracks Pharmacy Call Center at 1-866-246-8505 for additional information or assistance.

Additionally, NC DHHS has created the website below with specific info related to our NC Medicaid disaster response/recovery efforts to assist our beneficiaries and providers:




NC MEDICAID TEMPORARY PROVISIONS DURING HURRICANE FLORENCE RECOVERY.   North Carolina Medicaid has secured authority from the Centers for Medicare & Medicaid Services (CMS) to move forward with many interim Medicaid policies adjustments, and are continuing to work with our federal and state partners to seek additional remedies, to assist providers and patients through the Hurricane Florence recovery.

NC Medicaid has created two fact sheets – one for health care professionals (found here); and one for beneficiaries (found here).

NC Medicaid has also launched a NC Medicaid Hurricane Florence Response & Recovery webpage on the NC Medicaid website, that will continue to be updated as policies continue to be enhanced to assist recovery efforts, and to share other helpful information.




INFORMATION FOR PHARMACISTS SEEKING OPPORTUNITIES TO VOLUNTEER FOR HURRICANE FLORENCE DISASTER RELIEF.  Pharmacists who wish to volunteer for Hurricane Florence recovery efforts may find the following resources helpful:  Registration through; Registration with Carolina Voluntary Organizations Active in Disaster,; Registration with the American Red Cross,

A number of resources are also provided and linked here:




DHHS INFORMATION FOR PHARMACIES CONCERNING NEW PLATFORM FOR THE NORTH CAROLINA CONTROLLED SUBSTANCE REPORTING SYSTEM.    The North Carolina Department of Health and Human Services, which administers the Controlled Substance Reporting System (“CSRS”), is migrating the CSRS to a new software platform.  The below information has been emailed to CSRS users.  Please take note:

Dear CSRS User,

We are pleased to announce that thenew North Carolina Controlled Substance Reporting System (CSRS) is now available.

How It Affects Me:
Your existing CSRS account has automatically been transferred into the new software system.
IMPORTANT: Your username for the new system will be the e-mail address where you received this notice.

Action Steps:
Follow the steps below to access the new CSRS website:

Note that the old website,, is no longer available.

Please note that there will be a delay of some prescription drug monitoring data as a result of this transition. Data collected between September 6, 2018 and September 19, 2018 will be loaded within two weeks of the transition date. We appreciate your understanding and patience during this time of transition.

If you have any questions or concerns, please contact support directly at 855-962-4767. Technical assistance is available 24 hours a day, 7 days a week. Should you have any policy questions in the meantime, you may contact CSRS at by email at




INSURER CONTACT INFORMATION FOR PATIENTS AND PHARMACISTS AFFECTED BY HURRICANE FLORENCE.  Patients affected and/or displaced by Hurricane Florence and providers providing pharmacy services to such patients are directed to the following information, which provides contact numbers and information for insurers for help with prescription coverage:




NC HEALTHCONNEX ACTION TO IMPROVE ACCESS TO MEDICAL RECORDS FOR PATIENTS AFFECTED OR DISPLACED BY HURRICANE FLORENCE.  As North Carolinians and bordering states recover from Hurricane Florence, North Carolina HealthConnex (a project of the North Carolina Health Information Exchange Authority) has asked the Board to alert providers that the NC HealthConnex team built emergent connections to neighboring and regional HIEs via the eHealth Exchange for the care of patients displaced by the storm.

The NC HealthConnex team opened the gateway for bidirectional query and exchange of patient records via the national eHealth Exchange to:

With the storm forcing patients to seek care outside of their communities, health care providers in their organization may have a need to utilize the clinical portal to look up patient health information. Many of your members should have a Participation Agreement with the North Carolina Health Information Exchange Authority; however, if they do not, they are able to sign a Full Participation Agreement located on our website.  Participant Account Administrators will need to provide portal credentials to these users.

Existing participants can direct questions regarding portal access to the NC HealthConnex SAS Support Desk at
New participants may direct questions to our outreach team at or (919) 754-6912.

Additionally, NC HealthConnex encourage providers, patients, and other to download the ReadyNC app to your smartphone as it provides details on where shelters are open, road closures and evacuation routes, and other essential information. ReadyNC also may be accessed at




1.  South Carolina Medicaid is allowing expedited enrollment for North Carolina-based providers who need to provide services to South Carolina Medicaid beneficiaries.  More information found in these two bulletins:

Medicaid Bulletin - Emergency Response Provider Enrollment Requirements

South Carolina Health & Human Services Emergency Response Provider Registration

2.  North Carolina Medicaid has established RxOpen – – to assist beneficiaries and providers in locating pharmacies that are open and available to dispense prescriptions. 




BOARD ISSUES WAIVER OF CERTAIN PHARMACY PRACTICE ACT REQUIREMENTS TO FACILITATE EMERGENCY RESPONSE DURING AND AFTER HURRICANE FLORENCE.  Today (September 13, 2018), the Board of Pharmacy exercised its authority under G.S. 90-85.25(a) to waive certain requirements of the North Carolina Pharmacy Practice Act to facilitate the provision of patient care during and after Hurricane Florence. 

As a lead-in to the policy, pharmacists should note that Board staff and members certainly are aware of the significant public health issues that will be created by this storm and its aftermath.  Board staff and members are aware of the often superhuman efforts that pharmacists and pharmacies expend to ensure that patient needs are being met as well as possible under these circumstances. Be assured. Board members and staff support your efforts to ensure that patient needs are being met. Deviations from the letter of pharmacy law or rule are almost certainly going to be necessary to do so. Board members and staff understand this and know that you will use your compassion and good judgment to deal with the crisis.

The Board’s policy specifically authorizes, for the duration of the declared emergency, any pharmacist or nationally-certified pharmacy technician who has a license in good standing in another state to practice in the location of the state of emergency without being licensed by the North Carolina Board of Pharmacy, so long as a minimal notice requirement is satisfied.

The Board’s policy also specifically authorizes existing permits, as necessary, to operate in a temporary location without obtaining any sort of additional permit, again so long as a minimal notice requirement is satisfied.

The policy also provides for waivers of other deviations from the Pharmacy Practice Act and rules, subject to notification to, and approval by, the Executive Director.

The policy, which specifies the minimal notice requirements mentioned above, is found here: The referenced notification email address – – is already operative. 


INFORMATION FOR NORTH CAROLINA PHARMACISTS OR PHARMACY TECHNICIANS WHO MAY WISH TO PROVIDE EMERGENCY ASSISTANCE IN SOUTH CAROLINA OR VIRGINIA.  North Carolina pharmacists or pharmacy technicians who may wish to provide emergency assistance in South Carolina or Virginia are advised that waivers of South Carolina and Virginia licensure requirements to do so are in place.

South Carolina:  A pharmacist not licensed in South Carolina, but licensed and in good standing in another state, may assist with relief efforts during a declared state of emergency. The pharmacist must have some type of identification to verify current licensure in another state and must be engaged in legitimate relief effort during an emergency situation.  S.C.G.S. 40-43-170.  More information available at or (803) 896-4700.

Virginia:  Special allowances for dispensing drugs and authorizing assistance from out-of-state pharmacists and pharmacy technicians have been implemented in Virginia.  More information available at or (804) 367-4456. 




Governor Cooper has declared a state of emergency for North Carolina in anticipation of potential severe weather caused by the approach of Hurricane Florence. The North Carolina Board of Pharmacy reminds pharmacy owners, pharmacy managers, and persons-in-charge of DME businesses to ready their disaster plans for the preservation of records, medications and other inventory. Additionally, pharmacies use Rule .1815 (detailed below) to provide emergency prescription refills. Joshua Kohler, NCBOP Director of Investigations is your contact for questions: (919) 246-1050 x231 or (919) 698-1435.

Additionally, please see the NC Department of Insurance's 9/10/18 bulletin reminding health benefit plans of compliance requirements for operations under a state of emergency for purposes of obtaining extra prescriptions during a state of emergency or disaster.

In the event a pharmacist or device and medical equipment permit holder receives a request for a prescription refill and the pharmacist or permit holder is unable to readily obtain refill authorization from the prescriber because of the prescriber's inability to provide medical services to the patient, the pharmacist or permit holder may dispense a one-time emergency supply of up to 90 days of the prescribed medication, provided that:
(1) The prescription is not for a Schedule II controlled substance;
(2) The medication is essential to the maintenance of life or to the continuation of therapy in a chronic condition;
(3) In the pharmacist's or permit holder's professional judgment, the interruption of therapy might reasonably produce undesirable health consequences;
(4) The dispensing pharmacist or permit holder creates a written order entered in the pharmacy's automated data processing system containing all of the prescription information required by Section .2300 of these Rules and signs that order;
(5) The dispensing pharmacist or permit holder notifies, or makes a good faith attempt to notify, the prescriber or the prescriber's office of the emergency dispensing within 72 hours after such dispensing.

Governor Cooper's Executive Order Declaring a State of Emergency in NC.





During the 2019 renewal period, the NC Board of Pharmacy DME Subcommittee will hold an election for the Medical Equipment representative seat. This seat is presently held by Doug Tonucci, who plans to seek a second term on the committee.

The Board is requesting nominations for this position between now and October 15, 2018. More about the election and nomination process may be found here.




GUIDANCE FOR PHARMACISTS ON NALOXONE DISPENSING AND DISTRIBUTION.  As pharmacists know, the past three years have brought substantial change to North Carolina law governing the dispensing and distribution of naloxone.  These changes, intended to increase access to naloxone for vulnerable patients and caregivers, are often the subject of inquiries to BOP staff – particularly concerning North Carolina law authorization for certain organizations to distribute naloxone.  Amanda Fuller Moore, NC DHHS Division of Public Health Pharmacist, has coordinated with DHHS officials and BOP staff to produce this guidance chart, which pharmacists will find helpful as they develop their approaches to naloxone dispensing and distribution:




ACCORD HEALTHCARE RECALLS LOT OF 12.5 MG HYDROCHLOROTHIAZIDE TABLETS.  The FDA announced today that Accord Healthcare is voluntarily withdrawing LOT PW05264-46632 of 100-count 12.5 mg hydrochlorothiazide tablets to the consumer level.  At least one bottle of the HCTZ tablets has been found to contain spironolactone 25 mg tablets.  More information for consumers and pharmacies is found here:



MONDAY, JULY 30, 2018


In November of 2017, the NC Board of Pharmacy agreed to provide financial support to the North Carolina Association of Pharmacists (NCAP) to subsidize a series of educational programs to address opioid misuse and addiction. The first of several planned regional workshops will take place at NCAP’s Annual Convention, September 21-22, 2018 in Winston-Salem. Participants will hear a keynote address and participate in workshops and sessions all devoted to the opioid epidemic and the importance of dismantling stigma.

Details and registration information may be found here:

Following the convention, NCAP will host a series of Regional Advanced Opioid Workshops for pharmacists.  These workshops will educate pharmacists on Pain Management Topics and Best Practices, Harm Reduction Topics and Service Concepts, Use of SBIRT (Screening, Brief Intervention, and Referral to Treatment), and fundamentals of Medication Assisted Treatment.  More information on the regional workshops may be found here.



FRIDAY, JULY 20, 2018

FDA ISSUES WARNING ABOUT SYNTHETIC CANNABINOID PRODUCTS CONTAMINATED BY RAT POISON. The FDA has issued a warning that synthetic cannabinoid products marketed under names like “K2” and “Spice” -- and often sold at convenience stores -- may contain brodifacoum, a long-acting anticoagulant used in rat poison.  The FDA notes that these products are not legal, yet continue to be distributed – often with “not for human consumption” labeling intended (though utterly ineffectively) to allow manufacturers and distributors to dodge accountability for their products.  Consumption of products contaminated by brodifacoum can trigger severe bleeding and can be life threatening.  Consumers should not obtain or consume these products.  Pharmacies must not stock them.  More information here:  



NEW CE OPPORTUNITIES: PHARMACISTS & TECHNICIANS, Remember to check our CE page often for upcoming CE programs in your area. (LAST UPDATED SEPTEMBER 17, 2018.)



BOARD OF PHARMACY SELECTS ASHLEY DUGGINS TO FILL OPEN CENTRAL DISTRICT SEAT.  At The Board of Pharmacy members have selected Ashley Duggins to fill the Central District seat for a term to conclude on April 30, 2020.  Dr. Duggins is a 2002 graduate of the UNC Eshelman School of Pharmacy.  She owns and operates Prevo Drug in Asheboro.  Dr. Duggins’ many professional and community memberships activities show a deep commitment to public service.  The Board Members and staff welcome Dr. Duggins.

The Board Members and staff also thank all of the candidates who applied to fill the Central District seat.  Coming from a broad spectrum of practice backgrounds and experience, all were impressive.  They are:  Ismail Badjie, Jay Brown, Duke Calfas, Wes Cowell, Nicole Eastman, Jeff Eudy, Sam Forrester, Jennifer Funkhouser, Catherine Huemmer, Abdul Kader, Max Reece, Scott Romesburg, Angela Smith, Richard Sterling, Greg Vassie, Tim Weber, and Doug Yoch.



MONDAY, JULY 16, 2018

FDA ANNOUNCES RECALL OF SEVERAL MEDICATIONS CONTAINING VALSARTAN.  FDA has announced a voluntary recall of several medications that contain valsartan.  The recall stems for detection of an impurity, N-nitrosodimethlamine (NDMA), in the recalled products.  NDMA is a probable human carcinogen.  Not all valsartan-containing products have been recalled.  More information for health-care professionals and patients is found here:



FRIDAY, JUNE 29, 2018

*REMINDER* DEA POSITION ON TRANSFER OF “ON FILE” CONTROLLED SUBSTANCE PRESCRIPTIONS.  Pharmacists continue to call Board staff with understandable confusion on whether and how “on file” controlled substance prescriptions that were never filled may be transferred. To recap:

In April 2017, word began swirling that DEA viewed transfers of “on file” controlled substances as not allowed.  On July 7, 2017, Loren Miller, Associate Section Chief, Liaison and Policy Section, Diversion Control Division, Drug Enforcement Administration sent an email to Carmen Catizone, Executive Director of the National Association of Boards of Pharmacy, setting forth DEA’s view on the matter.

In that email (found here --, Mr. Miller states the view that 21 CFR 1306.25 allows a pharmacy, “once it has filled an original prescription for a controlled substance in Schedule III-V,” to “transfer the original prescription information to another DEA registered pharmacy for the purposes of allowing that second pharmacy to then dispense any remaining valid refills . . . .”  Mr. Miller further stated that “an allowance currently does not exist for the forwarding of an unfilled prescription from one DEA registered retail pharmacy so that it may be filled at another DEA registered pharmacy.”

Mr. Miller then stated that, based on “the preamble” of an “interim final rule,” it is DEA’s “policy” that an electronic prescription for a controlled substance of any schedule may be “forwarded from one DEA registered retail pharmacy to another DEA registered retail pharmacy” even if that prescription had not been filled.

To say that DEA’s positions in this matter create a mess is a gross understatement.  First, while Mr. Miller’s reading of 21 CFR 1306.25 is textually plausible, it represents a departure from decades of standard pharmacy practice and there has been no suggestion from DEA or anyone else that the standard practice of transferring “on file” but unfilled (as opposed to once-filled) controlled substance prescriptions has caused or materially contributed to controlled substance abuse or misuse.  Second, neither Mr. Miller’s email nor any language in the preamble he references contains so much as a hint as to what an appropriate mechanism for “forwarding” (and documenting the forwarding of) an unfilled electronic controlled substance prescription would be.  Third, Mr. Miller’s email does not explain why “forwarding” an unfilled electronic controlled substance prescription is substantively different than transferring an unfilled controlled substance prescription, whether electronic, verbal, or written.  Fourth, DEA’s position creates not only an incentive, but a practical necessity, for patients  seeking to change their pharmacy of choice to obtain duplicate controlled substance prescriptions from their caregiver.  Interpretations and policies that guarantee duplicate prescriptions for controlled substances in multiple pharmacies hardly seems consistent with the Controlled Substance Act’s purpose to create a controlled, closed distribution system and minimize controlled substance abuse and misuse.

All that said, however, DEA has shown no inclination to reconsider or clarify these positions.  Where does that leave us?

(1)  Though “forwarding” of unfilled electronic controlled substance prescriptions is available by “policy,” the lack of any guidance from DEA on how a “forwarding” should occur and be documented means that most pharmacies and pharmacists are reluctant to entertain the practice.  And who can blame them?

(2)  For unfilled verbal prescriptions for a Schedule III-V controlled substances, DEA’s position means that there is no mechanism for moving them from one pharmacy to another.

(3)  For unfilled paper prescriptions for a Schedule III-V controlled substances, a pharmacy could return the original to the patient to physically carry to another pharmacy.  Board staff understand completely the practical problems of this approach.

Some pharmacists have inquired why Board staff, the Board, or the North Carolina legislature have taken this position.  As the above makes clear, none of the three are to blame.  The present state of affairs is attributable solely, and entirely, to the DEA.  Board staff will, of course, update pharmacists if the DEA sees reason and backs away from these positions.  Until then, send your cards, letters, and calls to the DEA. 



MONDAY, JUNE 4, 2018

PHARMACISTS CAUTIONED ON PROPER FILING OF PRACTICAL PHARMACY EXPERIENCE AFFIDAVITS  Each spring sees an influx of Practical Pharmacy Experience Affidavits submitted by graduating pharmacy students.  Under North Carolina law, a pharmacist must obtain 1,500 hours of practical pharmacy experience as a condition of licensure.  21 NCAC 46.1503(a).  For North Carolina licensure, the Board deems the 1,500 hour requirement to be satisfied by completion of an accredited Doctor of Pharmacy program as certified by the school. 21 NCAC 46.1503(a).

Some states, however, require licensure applicants to demonstrate practical pharmacy experience obtained outside of the Doctor of Pharmacy curriculum.  Where the applicant obtained some or all of that practical experience in North Carolina, the Board of Pharmacy must certify the experience.  To certify that experience, the applicant must provide one or more Practical Pharmacy Experience Affidavits, found here:

It is critical to note that the pharmacist submitting the affidavit is stating, under oath, that he/she is a North Carolina licensed pharmacist in good standing and that the “applicant will have my immediate and personal supervision and can render no pharmaceutical services except when under my immediate and personal supervision . . . .”  In other words, the pharmacist submitting the affidavit is not simply confirming that an applicant worked a number of hours in a pharmacy with various pharmacists, but, rather, that the applicant obtained a number of hours of practical experience under the “immediate and personal supervision” of the pharmacist.  This may, of course, require the applicant to get affidavits from several pharmacists who provided “immediate and personal supervision.”  

Any pharmacist or license applicant with questions about the Practical Pharmacy Experience Affidavit should contact Stacie Mason,, (919) 246-1050.  





Beginning February 8, 2018, the Board of Pharmacy opened an opioid public service announcement campaign on Wilmington and Greenville-area television stations and on social media platforms. The advertisements feature Joe Adams, a pharmacist and past president of the National Association of Boards of Pharmacy, sharing his deeply personal story of losing his son to an opioid overdose in 2014. These ads emphasize the important of obtaining help and the critical role pharmacists can play.

The ads come in 30-second, 60-second, and 6-minute versions, and are available for download here. Board members and staff welcome and encourage pharmacists using these ads to educate their patients and communities about proper medication use and the dangers of opioid abuse.

The Board thanks Third Wheel Media of Chapel Hill and the National Association of Boards of Pharmacy (NABP) for their tremendous efforts on this issue. Pharmacists will note that texting “abuse” to 555888, as instructed in the ads, will result in a reply text providing a link to an NABP-created and hosted page containing resources for pharmacists to share with patients and their communities. That page may be accessed directly here:

These ads are the first phase of a multi-media campaign. Board staff will continue to keep pharmacists updated as the campaign progresses.

Please contact Board staff at 919.246.1050 with questions.




INFORMATION AND RESOURCES FOR PHARMACIES CONCERNING IV FLUID SHORTAGES.  As many pharmacists know, Hurricane Maria’s devastation of Puerto Rico has interrupted supplies of IV fluids.  This document provides additional resources and information on the shortage, FDA’s responses, and suggested means of mitigating the shortage’s effects on patient care.



The North Carolina Board of Pharmacy's monthly meetings are live-streamed via YouTube. Follow the link below to subscribe to the Board's YouTube channel. (Meeting dates found here.)



Health Advisories (last updated August 2018) - Check here regularly for the latest alerts and recall notices.



Medicare/Medicaid (last updated January 3, 2018) - Check here regularly for the latest updates regarding Medicare/Medicaid.


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The North Carolina Board of Pharmacy's mission is to protect the public health, safety and welfare in pharmaceutical matters. The Board sets standards for academic and practical experience programs prior to licensure, issues permits to operate pharmacies and DME facilities, and annually renews licenses, permits and registrations.

For more information, please see About the NCBOP.

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