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New Controlled Substance Prescription Requirement

March 5, 2020

As a part of our PBM’s strategy for battling the national opioid epidemic, effective March 1, 2020, home delivery through OptumRx will require e-prescriptions for ALL controlled substances, [for example, opioids for pain, stimulant drugs used to treat Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD)]. 

Prescriptions for controlled substances sent via hard copy, fax or phone will not be filled by the home delivery pharmacy. The following states/territories will initially be excluded from the OptumRx ePrescribing requirement: Alaska, Puerto Rico, Guam, and the US Virgin Islands.

A provider exemption process has been put in place. Providers can inquire about an exemption by emailing EPCSquestions@optum.com.

Why the change?

  • Thirty-six percent of all opioid-related deaths in the United States involve a prescription.
  • Electronic prescribing helps improve prescribing accuracy, reduce dispensing errors and improve administrative and cost efficiency.
  • More and more states are mandating e-prescriptions for controlled substances.
  • Federal law will require e-prescriptions for controlled substances under Medicare Part D by Jan. 1, 2021.

What will be the impact?

The majority of the impact will fall onto providers. Providers must also be Electronic Prescribing for Controlled Substances (EPCS) certified, to meet the requirement. OptumRx has a comprehensive communication strategy to support providers and their patients during the transition.