§17.96 Medication Prescribed By Non-va Physicians.

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§17.96 Medication prescribed by non-VA physicians.

(a) General. VA may not furnish a veteran with medication prescribed by a duly licensed physician who is not an employee of the VA or is not providing care to the veteran under a contract with the VA, except as provided in paragraphs ( :P through (i) of this section.

( ;) Medication furnished prior to an initial primary care appointment. Beginning on September 22, 2003, VA may furnish medication prescribed by a non-VA physician for a veteran enrolled under §17.36 of this part prior to July 25, 2003, who had prior to July 25, 2003, requested an initial appointment for primary care in a VA health care facility, and the next available appointment date was more than 30 days from the date of the request.

© Quantity of medication. VA may furnish a quantity of medication under paragraph ( :o of this section that is sufficient to appropriately meet the treatment needs of the veteran until the date of the veteran’s initial appointment for primary care in a VA health care facility.

(d) Appointment cancellation. If VA reschedules a veteran eligible under paragraph ( :P for an initial appointment for primary care in a VA health care facility, or if such a veteran reschedules the appointment for good cause, as determined by the local VA treatment facility, VA may furnish the eligible veteran with a quantity of medication under paragraph ( B) of this section that is sufficient to appropriately meet the treatment needs of the veteran until the date of the veteran’s rescheduled appointment for primary care in a VA health care facility.

(e) Written prescription and information requirements. VA may furnish medication under paragraph ( B) of this section only if the veteran provides VA with a written prescription for the medication signed by a duly licensed physician within the previous 90 days.

(1) The veteran must furnish the following information:

(i) Name;

(ii) Date of Birth;

(iii) Social Security Number;

(iv) Home address;

(v) Phone number (with area code);

(vi) Name of Health Insurance Company and Health Insurance Policy Number;

(vii) List of any allergies;

(viii) History of any adverse reaction to any medication;

(ix) List of current medications, including over-the-counter medications or herbal supplements; and

(x) Indication of whether the VA pharmacist may call a non-VA physician for information regarding medications.

(2) The non-VA physician must furnish the following information:

(i) Name;

(ii) Group practice name;

(iii) Social Security Number or Tax ID number;

(iv) License Number;

(v) Office address;

(vi) Phone number and fax number; and

(vii) E-mail address.

(f) Medications that may be furnished. VA may furnish medication under paragraph ( B) of this section only if the medication:

(1) Must be dispensed by prescription;

(2) Is not an over-the-counter medication;

(3) Is not listed as a controlled substance under schedule I through V of the Comprehensive Drug Abuse Prevention and Control Act, 21 U.S.C. 812;

(4) Is included on VA’s National Formulary, unless VA determines a non-Formulary medication is medically necessary; and

(5) Is not an acute medication, an intravenous medication nor one required to be administered only by a medical professional.

(g) Copayments. Copayment provisions in §17.110 of this part apply to medication furnished under paragraph ( B) of this section.

(h) Mailing of Medications. VA may furnish medication under paragraph ( B) of this section only by having the medication mailed to the veteran.

(i) Medications for veterans receiving increased compensation or pension. Any prescription, which is not part of authorized Department of Veterans Affairs hospital or outpatient care, for drugs and medicines ordered by a private or non-Department of Veterans Affairs doctor of medicine or doctor of osteopathy duly licensed to practice in the jurisdiction where the prescription is written, shall be filled by a Department of Veterans Affairs pharmacy or a non-VA pharmacy in a state home under contract with VA for filling prescriptions for patients in state homes, provided:

(1) The prescription is for:

(i) A veteran who by reason of being permanently housebound or in need of regular aid and attendance is in receipt of increased compensation under 38 U.S.C. chapter 11, or increased pension under section 3.1(u) (Section 306 Pension) or section 3.1(w) (Improved Pension), of this title, as a veteran of the Mexican Border Period, World War I, World War II, the Korean Conflict, or the Vietnam Era (or, although eligible for such pension, is in receipt of compensation as the greater benefit), or

(ii) A veteran in need of regular aid and attendance who was formerly in receipt of increased pension as described in paragraph (a)(1) of this section whose pension has been discontinued solely by reason of excess income, but only so long as such veteran’s annual income does not exceed the maximum annual income limitation by more than $ 1,000, and

(2) The drugs and medicines are prescribed as specific therapy in the treatment of any of the veteran’s illnesses or injuries. (Authority: 38 U.S.C. 1706, 1710, 17.12(d))

[32 FR 13816, Oct. 4, 1967, as amended at 36 FR 4782, Mar. 12, 1971; 45 FR 6937, Jan. 31, 1980; 47 FR 58249, Dec. 30, 1982. Redesignated at 61 FR 21965, May 13, 1996; 63 FR 37780, July 14, 1998; 68 FR 11977, Mar. 13, 2003; 68 FR 43929, July 25, 2003]

Supplement Highlights reference: Book I—19(1)

http://www.warms.vba.va.gov/Regs/38CFR/BookI/Part17/s17_96.doc