Prescription Dispensing During a Phar

macist Temporary Absence PURPOSE: This rule establishes requirements for dispensing prescriptions when a pharmacist is temporarily absent from a pharmacy. (1) Notwithstanding any other provision of law, a pharmacist in his/her professional judgment may authorize a pharmacy technician or intern pharmacist to provide a new or refill prescription/medication order to a patient or the patient’s authorized designee when a pharmacist is temporarily absent from the pharmacy if— (A) The pharmacy has written policies and procedures au thorizing prescription dispensing during a temporary absence that comply with section (3) of this rule; (B) The pharmacist reasonably believes pharmacy security and security of medication inventory will be maintained in his or her absence; (C) The prescription/medication order is completed, labeled, sealed, and verified by a pharmacist or verified as authorized by law. No manual intervention with the prescription/medication order may occur after the pharmacist verification required by this rule. For purposes of this section, manual intervention does not include preparing a finished prescription for mailing, delivery, or storage; (D) The patient must be offered patient counseling as re quired by 20 CSR 2220-2.190. If the patient declines patient counseling, the refusal of counseling must be manually or elec tronically documented in the pharmacy’s prescription records. If the patient requests counseling, the patient must be asked to wait for the pharmacist to return from break or asked to leave a telephone number for the pharmacist to contact the patient. A pharmacist must promptly call the patient at the provided telephone number to offer counseling, but in no event later than twenty-four (24) hours after dispensing. In the event of an emergency, a pharmacist must call the patient to offer counsel ing as soon as reasonably practicable; (E) The pharmacist on duty must have authority to restrict the sale/dispensing of a prescription/medication order during the pharmacist’s temporary absence if deemed necessary or appropriate in the pharmacist’s professional judgment; and (F) Counseling must be provided for Class R Remote Dispensing site pharmacies as provided in section 338.215, RSMo, and 20 CSR 2220-2.680. (2) A pharmacist shall be considered to be temporarily absent from the prescription department if the pharmacist is not within the confines of the permitted pharmacy/confines of the dispensing area. An authorized temporary absence under this rule shall not exceed more than sixty (60) minutes in a rolling twelve- (12-) hour period, provided a permit holder may establish a shorter authorized time period if deemed necessary or appropriate. The no-pharmacist-on-duty sign required by 20 CSR 2220-2.010 must be posted during the pharmacist’s temporary absence. (3) Pharmacies must have current and documented policies and procedures governing authorized activities, including but not limited to— (A) Authorized dispensing; (B) Security requirements; (C) Restricting sale/dispensing of a prescription/medication order if deemed necessary or appropriate by a pharmacist; (D) Staff training; (E) Offering and documenting patient counseling and phar macist telephone contact requirements; and (F) Contacting a pharmacist in the event of an emergency or when necessary or appropriate. AUTHORITY: sections 338.085, 338.200, 338.280, 338.350, and 338.400, RSMo 2016, and sections 338.140 and 338.210, RSMo Supp. AND INSURANCE 2025.* Original rule filed Feb. 26, 2026, effective Aug. 30, 2026. *Original authority: 338.085, RSMo 2016; 338.140, RSMo 1939, amended 1981, 1989, 1997, 2011, 2019; 338.200, RSMo 2013, amended 2016; 338.210, RSMo 1951, amended 2001, 2011, 2020; 338.280, RSMo 1951, amended 1971, 1981; 338.350, RSMo 1989, amended 1993, 1995; and 338.400, RSMo 2011.