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<chapter num="10" heading="Pharmacist, Pharmacy Intern, and Pharmacy Technician Code of Conduct" title_num="10" subtitle_num="34">
  <regulation prefix="Regulation" num=".01" heading="Patient Safety and Welfare.">
    <paragraph num="A.">
      <text>A pharmacist shall:</text>
      <paragraph num="(1)">
        <text>Abide by all federal and State laws relating to the practice of pharmacy and the dispensing, distribution, storage, and labeling of drugs and devices, including but not limited to:</text>
        <paragraph num="(a)">
          <text>United States Code, Title 21,</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Health-General Article, Titles 21 and 22, Annotated Code of Maryland,</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Health Occupations Article, Title 12, Annotated Code of Maryland,</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Criminal Law Article, Title 5, Annotated Code of Maryland, and</text>
        </paragraph>
        <paragraph num="(e)">
          <text>COMAR 10.19.03;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>Verify the accuracy of the prescription before dispensing the drug or device if the pharmacist has reason to believe that the prescription contains an error; and</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Maintain proper sanitation, hygiene, biohazard precautions, and infection control when performing tasks in the prescription process.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>A pharmacist may not:</text>
      <paragraph num="(1)">
        <text>Engage in conduct which departs from the standard of care ordinarily exercised by a pharmacist;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Practice pharmacy under circumstances or conditions which prevent the proper exercise of professional judgment; or</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Engage in unprofessional conduct.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Therapeutic Interchange.</text>
      <paragraph num="(1)">
        <text>A pharmacist may not perform a therapeutic interchange without the prior approval of the authorized prescriber except as provided in §C(2) of this regulation.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>A pharmacist who provides a pharmacy service to a patient of a hospital, as defined in Health-General Article, §19-301, Annotated Code of Maryland, or a resident of a comprehensive care or extended care facility, as defined in COMAR 10.07.02.01B, may perform a therapeutic interchange without the prior approval of the authorized prescriber if the governing body of the hospital, comprehensive care facility, or extended care facility has established procedures for therapeutic interchange.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>This section does not permit any act not otherwise authorized by Health Occupations Article, Title 12, Annotated Code of Maryland.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Compensation.">
    <text>A pharmacy technician, pharmacy intern, or a pharmacist may not fraudulently seek or accept compensation for a pharmacy product or service not provided.</text>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Patient Privacy.">
    <paragraph num="A.">
      <text>The pharmacy technician, pharmacy intern, pharmacist, and pharmacy permit holder shall ensure confidentiality in creating, storing, accessing, transferring, and disposing of a patient record.</text>
    </paragraph>
    <paragraph num="B.">
      <text>A pharmacy technician, pharmacy intern, or pharmacist may not disclose identifiable information contained in a patient’s medical record:</text>
      <paragraph num="(1)">
        <text>Without the patient's consent;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Without order or direction of a court; or</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Unless the disclosure is authorized pursuant to Health-General Article, §§4-301 — 4-307, Annotated Code of Maryland.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Competence.">
    <text>A pharmacy technician, pharmacy intern, or a pharmacist shall:</text>
    <paragraph num="A.">
      <text>Maintain knowledge of the current pharmacy and drug laws and health and sanitation laws relevant to the practice of pharmacy; and</text>
    </paragraph>
    <paragraph num="B.">
      <text>Provide a pharmaceutical service only within the scope of the pharmacy technician’s, pharmacy intern’s, or pharmacist’s training and education.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".05" heading="Duty to Report.">
    <paragraph num="A.">
      <text>Except when the conduct in question includes drug or alcohol abuse or dependency, a pharmacy technician, pharmacy intern, or pharmacist shall report to the Board:</text>
      <paragraph num="(1)">
        <text>Conduct which violates a statute or regulation pertaining to the practice of pharmacy;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Conduct by a pharmacy technician, pharmacy intern, or pharmacist that deceives, defrauds, or harms the public; and</text>
      </paragraph>
      <paragraph num="(3)">
        <text>The unauthorized practice of pharmacy.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>A pharmacy technician, pharmacy intern, or pharmacist shall report to the pharmacist rehabilitation committee, as defined in Health Occupations Article, §12-317, Annotated Code of Maryland, conduct by a pharmacist technician, pharmacy intern, or pharmacist that involves drug or alcohol abuse or dependency.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".06" heading="Discrimination, Harassment, and Sexual Misconduct.">
    <paragraph num="A.">
      <text>In the practice of pharmacy, a pharmacy technician, pharmacy intern, or pharmacist may not:</text>
      <paragraph num="(1)">
        <text>Discriminate based on age, gender, race, ethnicity, national origin, religion, sexual orientation, disability, socioeconomic status, or other basis as proscribed by law; or</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Sexually harass a patient, coworker, employee, or supervisee, which includes but is not limited to an unwanted, deliberate, or repeated comment, gesture, or physical contact of a sexual nature.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>Sexual Misconduct. A pharmacy technician, pharmacy intern, or pharmacist may not:</text>
      <paragraph num="(1)">
        <text>Dispense or offer to dispense a prescription drug or device in exchange for:</text>
        <paragraph num="(a)">
          <text>A sexual act such as anal intercourse, analingus, cunnilingus, fellatio, or vaginal intercourse as specified in Criminal Law Article, §3-301(e) and (g), Annotated Code of Maryland, or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Sexual contact such as the intentional touching of an intimate part of an individual's body, whether clothed or unclothed, for the purpose of sexual arousal, gratification, abuse of either party, or penetration as specified in Criminal Law Article, §3-301(f), Annotated Code of Maryland; or</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>Engage in sexual behavior including but not limited to a sexual act or sexual contact as specified in §B(1)(a) of this regulation, with a client or patient:</text>
        <paragraph num="(a)">
          <text>In the context of a professional evaluation, treatment, procedure, or other service to the client or patient, regardless of the setting in which the professional service is provided, or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Under the pretense of diagnostic or therapeutic intent or benefit.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Sexual contact does not include an act commonly expressive of familial or friendly affection.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".07" heading="Disposition and Return of a Prescription Drug or Device.">
    <paragraph num="A.">
      <text>A pharmacist may accept the return of a properly labeled and properly sealed manufacturer’s package or individual unit dose of a drug or device that the pharmacist determines to have been handled in a manner which preserves the strength, quality, purity, and identity of the drug or device during an interim period between the sale of the drug or device and its return to the pharmacy.</text>
    </paragraph>
    <paragraph num="B.">
      <text>A pharmacist may not:</text>
      <paragraph num="(1)">
        <text>Return to the pharmacy's stock or offer for sale a prescribed drug or device that has been previously sold and has left the pharmacy's possession except as provided in §A of this regulation; or</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Sell, give away, or otherwise dispose of a drug, drug accessory, chemical, or device if the pharmacist knows or should know that the drug, drug accessory, chemical, or device is to be used in an illegal activity.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>A pharmacy technician or pharmacy intern may not accept the return of prescription drugs or devices from a patient.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".08" heading="Refusing to Dispense a Controlled Substance.">
    <paragraph num="A.">
      <text>If, based on generally accepted professional standards for the practice of pharmacy, a pharmacist has reason to believe, or should have reason to believe, that a prescription for a controlled dangerous substance was not issued for a legitimate medical purpose in the usual course of the prescriber's practice, the pharmacist may not dispense the controlled dangerous substance until the pharmacist:</text>
      <paragraph num="(1)">
        <text>Consults with the prescriber; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Verifies the medical legitimacy of the prescription.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>If, after consulting with the prescriber, and based on generally accepted professional standards for the practice of pharmacy, a pharmacist has reason to believe that the prescription for a controlled dangerous substance was not issued for a legitimate medical purpose in the usual course of the prescriber's practice, the pharmacist shall:</text>
      <paragraph num="(1)">
        <text>Refuse to dispense the drug; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Report the incident to the regulatory board that licenses the prescriber.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".09" heading="Sanctions.">
    <paragraph num="A.">
      <text>The Board may take action to reprimand a licensee, place the licensee on probation, or suspend or revoke the licensee's license if the licensee commits a violation of this chapter.</text>
    </paragraph>
    <paragraph num="B.">
      <text>The Board may take action to reprimand a registrant, place the registrant on probation, or suspend or revoke the registrant's registration if the registrant commits a violation of this chapter.</text>
    </paragraph>
    <paragraph num="C.">
      <text>The Board may impose a monetary penalty as authorized under Health Occupations Article, §§12-314, 12-410, and 12-6B-10, Annotated Code of Maryland.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".10" heading="Whole or Substantial Ownership of a Pharmacy by an Authorized Prescriber.">
    <paragraph num="A.">
      <text>In this regulation, “owned wholly or substantially” means ownership of 10 percent or more of a pharmacy.</text>
    </paragraph>
    <paragraph num="B.">
      <text>A pharmacist may not associate as a partner, coowner, or employee of a pharmacy that is owned wholly or substantially by an authorized prescriber or group of authorized prescribers.</text>
    </paragraph>
  </regulation>
  <annotations>
    <annotation type="Authority">Health Occupations Article, §§1-212, 12-205, and 12-601, Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: August 3, 1981 (8:15 Md. R. 1307)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .01 amended effective February 19, 1990 (17:3 Md. R. 299)</annotation>
    <annotation type="History" subtype="Administrative History">Chapter, Standards of Pharmacy Practice, repealed and new chapter, Pharmacist Code of Conduct, adopted effective July 12, 1999 (26:14 Md. R. 1082)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .01 amended effective November 12, 2001 (28:22 Md. R. 1937)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .02 amended effective January 28, 2008 (35:2 Md. R. 127); July 1, 2015 (42:7 Md. R. 569)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .03 amended effective January 28, 2008 (35:2 Md. R. 127); July 1, 2015 (42:7 Md. R. 569)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .04 amended effective January 28, 2008 (35:2 Md. R. 127); July 1, 2015 (42:7 Md. R. 569)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .05 amended effective January 28, 2008 (35:2 Md. R. 127); July 1, 2015 (42:7 Md. R. 569)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .06A, B amended effective January 28, 2008 (35:2 Md. R. 127); July 1, 2015 (42:7 Md. R. 569)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .07A, C amended effective July 1, 2015 (42:7 Md. R. 569)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .07C adopted effective January 28, 2008 (35:2 Md. R. 127)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .09 amended effective January 28, 2008 (35:2 Md. R. 127)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .10 adopted effective February 1, 2016 (43:2 Md. R. 127)</annotation>
  </annotations>
</chapter>