Know Your VA- Prescription · The purpose of this presentation is to help our Veteran ... VA National Formulary: ... Know Your VA- Prescription ...

Know Your VA

Accessing Programs and Services at the Gulf Coast Veterans Health Care

System (GCVHCS)

Prescription Medications

Medications: WelcomeWelcome to the Gulf Coast Veterans Health Care System and thank you for your military service to the United States of America.

We are truly honored you have chosen to entrust the VA with your health care service needs.

We want to help you “Know Your VA.”

The purpose of this presentation is to help our Veteran clients learn more about prescription medications.

Medications: VAThe approved list of medications that may be prescribed by VA providers is available on the VA National Formulary website:

http://www.pbm.va.gov/nationalformulary.asp

VA providers may prescribe a medication if:• The medication is the best choice for you• The medication is on the list of VA-approved medications

Medications: VA 2Formulary medications prescribed by your VA provider may be filled at VA (preferred) and non-VA pharmacies (non-preferred):• VA Pharmacies and VA Consolidated Mail Order Pharmacies (CMOP) require an

electronic prescription from your VA provider to fill formulary medications• Non-VA pharmacies (e.g. DoD, Tricare, etc.) require a hard copy prescription from

your VA provider to fill formulary medications

Medications: VA 3Important Notes regarding medication fills of formulary medications at Non-VA pharmacies:• Veteran will need to request a hard copy prescription from the VA prescriber when

intending to fill a prescription at a non-VA Pharmacy (e.g., DoD, Tricare, etc.)• VA prescriptions filled at a Non-VA Pharmacy will be charted as “NON-VA MED” in

the Veteran’s health record

Medications: VA 3 (cont.)Important Notes regarding medication fills of formulary medications at Non-VA pharmacies: (cont.)• Veteran will need to alert the PACT RN Care Manager regarding the initiation of a

new hard copy prescription when VA prescriptions previously filled at Non-VA Pharmacies require refill or renewal

• Copays charged at Non-VA pharmacies may differ from copays charged at VA pharmacies

Medications: VA 4Non-Formulary medications prescribed by your VA provider may be filled at a VA Pharmacy or VA Consolidated Mail Order Pharmacy (CMOP):• Non-formulary medications require prior authorization review and approval by a VA

Pharmacy & Therapeutics (P&T) Committee prior to dispensing• Non-formulary medications are required to be filled by a VA Pharmacy or CMOP if

approved

Medications: VA 5Veterans may receive medications from the VA in two ways:• New prescriptions may be picked up at the VA Pharmacy during normal business

hours• All refill prescriptions and some new prescriptions may be sent from the CMOP to

your mailing address via U.S. Postal Service (USPS) or United Parcel Service (UPS)

Medications: VA 6Consult with your VA health care or pharmacy team to determine which delivery method works best for you.• Contact numbers for each Gulf Coast Veterans Health Care System (GCVHCS)

Pharmacy are located at the end of this presentation• GCVHCS Pharmacy hours of operation are located at the end of this presentation

Medications: VA 7Important Notes regarding the mailing of prescriptions from the VA Pharmacy and Consolidated Mail Order Pharmacy (CMOP):• Veterans are responsible for ensuring the primary address and phone number in

their health record are current• You may contact your PACT Clerk to verify your contact information• Prescriptions returned to the VA Pharmacy or CMOP as “Not Deliverable” cannot be

resent until the Veteran’s current contact information has been verified

Medications: Non-VAPrescriptions from non-VA doctors cannot be filled at the VA Pharmacy or VA Consolidated Mail Order Pharmacy (CMOP).

Certain exceptions apply to prescriptions written by non-VA doctors under the following programs:- Veterans Choice Program (VCP)- Non-VA Care Coordination (NVCC) / Fee

Medications: Veterans Choice Program (VCP)The community provider you see through the VCP may issue a prescription for up to a 14 day supply of a national formulary drug. VCP prescriptions may be filled at VA Pharmacies during normal business hours. Emergency VCP prescriptions may be filled at a non-VA pharmacy when the VA Pharmacy is closed (e.g., weekends and holidays). Only emergent VCP prescription fills may be considered for reimbursement in these situations.VA National Formulary: https://www.pbm.va.gov/nationalformulary.asp

Source: https://www.va.gov/opa/choiceact/documents/10-Things-toKnow-About-Choice.pdf (Retrieved 15 MAY 2017)

Medications: Veterans Choice Program (VCP) 2Prescriptions may/may not be reimbursed through the local Non-VA Care Coordination Office. This reimbursement may take 30-45 days to process and requires a copy of the prescription, the original receipt, and the TriWest or HealthnetLetter of Authorization.NOTE: Veterans cannot be reimbursed at the VA Pharmacy.

Source: https://www.va.gov/opa/choiceact/documents/10-Things-toKnow-About-Choice.pdf (Retrieved 15 MAY 2017)

Medications: Veterans Choice Program (VCP) 3For best results on prescriptions needed beyond 14 days, please visit your local VA Pharmacy.

IMPORTANT NOTES: • All VCP-approved prescriptions must be accompanied by a copy of the TriWest or

Healthnet Letter of Authorization for Veteran Choice Program services.• If TriWest or Healthnet did not mail Veteran a Letter of Authorization, a copy may be

obtained from the prescribing physician’s office or TriWest.• TriWest may be contacted by dialing (866) 606-8198.

Medications: Veterans Choice Program (VCP) 4Please refer to the following website for more information regarding medication benefits associated with the Veterans Choice Program:

https://www.va.gov/opa/choiceact/documents/10-Things-toKnow-About-Choice.pdf(Retrieved 15 MAY 2017)

Medications: Non-VA Care Coordination (NVCC) / FeeNVCC / Fee prescriptions allow an emergent 10-day medication fill if a full prescription accompanies the emergent 10-day prescription.

Only NVCC / Fee prescriptions for an emergent 10-day medication fill may be considered for reimbursement.

NOTE: All NVCC Pain Medication Prescriptions are considered recommendationsand must be reviewed and approved by the Veteran’s PACT provider.

Non-VA Medications: Moving medications to the VAYou may be able to move Non-VA medications to the VA.

Your VA provider will review the information and may write a new prescription for the medication if:• The medication is the best choice for you• The medication is on the list of VA-approved medications

Medication information required for review by your VA provider is outlined on the next slide.

Non-VA Medications: Moving Medications to the VARequired Information for Moving Medications to the VA ExampleName of the medication Lisinopril

Dose of the medication 10 mg

How you are supposed to take the medication By mouth

How often you are supposed to take the medication 1 time per day

Reason you will be taking the medication High blood pressure

(NOTE: Additional information may be required)

VA Medications: Cost (Formulary Medications)Service-Connected Outpatient Medications:- No copay required for medications

Source: https://www.va.gov/HEALTHBENEFITS/cost/copay_rates.asp(Retrieved 26 JUL 2017)

VA Medications: Cost (Formulary Medications) 2Nonservice-Connected Outpatient Medications:- Veterans in Priority Group 1 do not pay for medications- Veterans in Priority Groups 2-8 are required to pay for each 30-day or less supply of

medication for treatment of non-service connected conditions (unless otherwise exempt)

Source: https://www.va.gov/HEALTHBENEFITS/cost/copay_rates.asp(Retrieved 26 JUL 2017)

VA Medications: Cost (Formulary Medications) 3Copay Charges Required for Nonservice-Connected Outpatient Medications

Priority Group

Outpatient Medication Tier Copay / 30 days / Med

1 Tier 1 – Tier 3 $02-8 Tier 1 (preferred Generics) $5

Tier 2 (Non-Preferred Generics / Some OTCs)

$8

Tier 3 (Brand Name) $11$700 Medication Copayment Cap

VA Medications: Cost (Formulary Medications) 4More information regarding VA health benefit costs and copays for nonservice-connected outpatient medications may be downloaded, viewed, and printed at the following weblink:

https://www.va.gov/HEALTHBENEFITS/cost/copay_rates.asp (Retrieved 26 JUL 2017)

VA Medications: Refilling Active MedsOptions for Refilling Active Medications

NOTE: Place refill order at least 14-days before running out of medication

Telephone Internet MailDial PACT Phone Number- Select Option 3

(Preferred)or

Dial (228) 523-INFO (4636)or

Dial (877) 205-7368

Submit online request via your My HealtheVet (MHV) Account

www.myhealth.va.gov

Send refill slips to:Gulf Coast Veterans Health Care SystemPharmacy Service (119)400 Veterans AvenueBiloxi, MS 39531 ORPharmacy Dropboxes

VA Medications: Refilling Active Meds 2Refill slips may also be mailed or dropped to these GCVHCS Pharmacy locations:

NOTE: Place refill order at least 14-days before running out of medication

Mobile Pensacola Eglin Panama City BeachGulf Coast Veterans Health Care SystemPharmacy Service (119)1504 Springhill Ave.Mobile, AL 36604

Gulf Coast Veterans Health Care SystemPharmacy Service (119)790 Veterans WayPensacola,FL 32507

Gulf Coast Veterans Health Care SystemPharmacy Service (119)100 Veterans WayEglin AFB, FL 32542

Gulf Coast Veterans Health Care SystemPharmacy Service (119)2600 Veterans WayPanama City Beach, FL 32408

VA Medications: Renewing Expired/Non-Refillable MedsOptions for Initiating a Renewal Request for Expired / Non-Refillable MedicationsAudioCARE Automated Refill/Renewal Line(Preferred)

Telephone Advice Program (TAP) Nurse Line

Pharmacy Call Center Line

Dial PACT Phone Number- Select Option 3- Follow prompts

Dial (800) 929-7690 Dial (800) 296-8827 - ext. 34512

VA Medications: Controlled SubstancesControlled substances may be refilled using the AudioCARE Automated Refill/Renewal Line

Controlled substances cannot be renewed using the AudioCARE Automated Refill/Renewal Line

VA Medications: Controlled Substances 2Important Notes• By law, only schedule 3, 4, and 5 prescriptions may have refills; schedule 2

prescriptions are not allowed refills.• Schedule 2 prescriptions require a new prescription from a VA provider for each fill.• Schedule 3, 4 and 5 prescriptions require a new prescription after refills are used.

Pharmacy OperationsGCVHCS Outpatient Pharmacy Hours of Operation

Biloxi Mobile Pensacola Eglin Panama CityMonday 0800-1900 0800-1630 0800-1730 0800-1630 0800-1630Tuesday 0800-1900 0800-1630 0800-1730 0800-1630 0800-1630Wednesday 0800-1900 0800-1630 0800-1730 0800-1630 0800-1630Thursday 0800-1900 0800-1630 0800-1730 0800-1630 0800-1630Friday 0800-1730 0800-1630 0800-1730 0800-1630 0800-1630Saturday 0800-1630 Closed 0800-1230* Closed ClosedSunday Closed Closed Closed Closed Closed* 3rd Saturday of Month onlyNOTE: All VA Outpatient Pharmacies are closed on Federal Holidays

VA Medications: Information and Contact NumbersLocation Contact Number Toll-Free Number

Biloxi (24-hours) (228) 523-5428 (800) 296-8872 ext. 5428

Mobile (251) 219-3946 (888) 201-0110 ext. 3946

Pensacola-JACC (850) 912-2110 (866) 927-1420, press 2

Eglin (850) 609-2715 (866) 520-7359 ext. 2715

Panama City (850) 636-7000 (888) 231-5047, press 2

Gulf Coast Veterans Health Care System: Media Sites