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<chapter num="17" heading="Waiver of Full Service Requirements for Recognized Pharmaceutical Specialties" title_num="10" subtitle_num="34">
  <regulation prefix="Regulation" num=".01" heading="Definitions.">
    <paragraph num="A.">
      <text>In this chapter, the following terms have the meanings indicated.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Terms Defined.</text>
      <paragraph num="(1)">
        <text>“Board” means the State Board of Pharmacy.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>“Comprehensive care facility” means a facility which admits patients suffering from disease, disabilities, or advanced age, requiring medical service and nursing service rendered by or under the supervision of a registered nurse.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>“Continuing care in a retirement community” means providing shelter and providing either medical and nursing or other health related services or making the services readily accessible through the provider or an affiliate of the provider, whether or not the services are specifically offered in the written agreement for shelter:</text>
        <paragraph num="(a)">
          <text>To an individual who is 60 years old or older and not related by blood or marriage to the provider;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>For the life of the individual or for a period exceeding 1 year; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Under one or more written agreements that require a transfer of assets or an entrance fee notwithstanding periodic charges.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(4)">
        <text>“Full service pharmacy” means a pharmacy that provides complete pharmaceutical services to the general public and does not restrict or limit its services to any group of individuals.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Pharmaceutical Specialty.</text>
        <paragraph num="(a)">
          <text>“Pharmaceutical specialty” means a limited pharmaceutical service provided by a pharmacy that:</text>
          <paragraph num="(i)">
            <text>Is in or makes use of a specialized setting by virtue of certain equipment, systems, location, or physical structure; and</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Restricts or limits its services to a group or groups of individuals requiring such specialty services.</text>
          </paragraph>
        </paragraph>
        <paragraph num="(b)">
          <text>“Pharmaceutical specialty” includes the following services:</text>
          <paragraph num="(i)">
            <text>Assisted living facilities;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Comprehensive care facilities;</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Developmental disabilities facilities;</text>
          </paragraph>
          <paragraph num="(iv)">
            <text>Home infusion;</text>
          </paragraph>
          <paragraph num="(v)">
            <text>Inpatient hospital;</text>
          </paragraph>
          <paragraph num="(vi)">
            <text>Nonsterile compounding;</text>
          </paragraph>
          <paragraph num="(vii)">
            <text>Nuclear pharmaceutical;</text>
          </paragraph>
          <paragraph num="(viii)">
            <text>Research;</text>
          </paragraph>
          <paragraph num="(ix)">
            <text>Sterile compounding;</text>
          </paragraph>
          <paragraph num="(x)">
            <text>Veterinary care;</text>
          </paragraph>
          <paragraph num="(xi)">
            <text>Provision of pharmaceutical services across all settings of care within a continuing care in a retirement community; and</text>
          </paragraph>
          <paragraph num="(xii)">
            <text>Other services approved by the Board.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(6)">
        <text>“Waiver pharmacy” means a pharmacy that has been issued a waiver permit by the Board.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Pharmaceutical Specialty.">
    <paragraph num="A.">
      <text>The Board may recognize as a pharmaceutical specialty not listed under Regulation .01B(4) of this chapter, upon written application and supporting documentation to the Board by an applicant for a waiver permit.</text>
    </paragraph>
    <paragraph num="B.">
      <text>When evaluating an application for a waiver pharmacy, the Board shall consider whether:</text>
      <paragraph num="(1)">
        <text>The pharmaceutical specialty service is necessary to meet a specific therapeutic need;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The location is accessible without endangering public health and safety;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>The pharmacy is properly equipped to perform the pharmaceutical specialty;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>The applicant has provided a full and detailed description of the pharmaceutical specialty that clearly substantiates the basis for the request of a waiver permit; and</text>
      </paragraph>
      <paragraph num="(5)">
        <text>A policy and procedure manual is included with the application which sets forth a detailed description of the pharmacy operation.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>No one criterion or combination of criteria listed in §B of this regulation shall be binding upon the Board.</text>
    </paragraph>
    <paragraph num="D.">
      <text>The Board's determination of whether a limited practice or setting constitutes a pharmaceutical specialty is final.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Requirements of a Waiver Pharmacy.">
    <paragraph num="A.">
      <text>The Board shall issue a waiver permit to an applicant that:</text>
      <paragraph num="(1)">
        <text>Meets the requirements of this chapter; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Performs pharmaceutical specialty services:</text>
        <paragraph num="(a)">
          <text>Listed in Regulation .01B(4) of this chapter; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Approved by the Board.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>The applicant shall:</text>
      <paragraph num="(1)">
        <text>Submit an application form approved by the Board;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Pay a fee as set forth in COMAR 10.34.09;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Submit any other documentation as required by the Board;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Employ at least one pharmacist at the applicant's proposed facility who has received education or training in the pharmaceutical specialty in addition to that required for licensure; and</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Notify the Board in writing within 30 days of any change in the information given on the initial or renewal waiver pharmacy application.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Restricted Practice.">
    <paragraph num="A.">
      <text>A waiver pharmacy is restricted to the pharmaceutical specialty services approved by the Board in the waiver permit.</text>
    </paragraph>
    <paragraph num="B.">
      <text>A waiver pharmacy may not perform functions of a full service pharmacy.</text>
    </paragraph>
    <paragraph num="C.">
      <text>A full service pharmacy may perform pharmaceutical specialty services as long as the full service pharmacy is able to demonstrate competency in performing the pharmaceutical specialty.</text>
    </paragraph>
    <paragraph num="D.">
      <text>A full service pharmacy and a waiver pharmacy may operate on the same premises provided that the full service pharmacy and the waiver pharmacy:</text>
      <paragraph num="(1)">
        <text>Obtain separate permits from the Board;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Are supervised by separate licensed pharmacists who are responsible for the operations of their respective pharmacies at all times the pharmacies are in operation; and</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Maintain separate inventory and record keeping for each pharmacy permit.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <annotations>
    <annotation type="Authority">Health Occupations Article, §12-403, Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: June 15, 1987 (14:12 Md. R. 1350)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .04A amended effective January 17, 1994 (20:1 Md. R. 34)</annotation>
    <annotation type="History" subtype="Administrative History">Chapter revised effective October 19, 2009 (36:21 Md. R. 1591)</annotation>
  </annotations>
</chapter>