OptumRx policy requiring e-prescribing for controlled substances will now take full effect Mar. 1

February 11, 2020

Beginning March 1, 2020, the OptumRx home delivery pharmacy—the pharmacy benefit provider for UnitedHealthcare (UHC)—will no longer fill prescriptions received by hard copy, fax or phone for opioids and other controlled substances. Though the policy took effect January 1, 2020, OptumRx offered a two-month grace period in response to concerns raised by the California Medical Association (CMA). That grace period comes to an end on February 29, 2020.

After the new policy was announced, CMA reached out to UnitedHealthcare to share our concerns with the change in policy and to discuss the potential impact on our physician members and their patients. In response to CMA’s concerns including the potential for disruption in patient care if a physician lacked the technology, hardware or certifications required for Electronic Prescribing of Controlled Substances (EPCS), OptumRx elected to offer a two-month grace period where all prescriptions would be filled regardless of if they were sent electronically.

Prescriptions that are submitted by hard copy, fax or phone for controlled substances during the grace period will be filled, with OptumRx home delivery pharmacy sending a reminder to both the prescribing physician and patient advising that future controlled substance prescriptions must be submitted electronically.

If a prescription is submitted to OptumRx home delivery pharmacy for a controlled substance using a means other than e-prescribing on or after March 1, 2020, OptumRx will work with the provider and patient to help get the prescription filled at a local pharmacy if necessary.

For physicians who are unable to submit e-prescriptions due to a hardship or for patients that are unable to obtain or pickup their prescription from a local pharmacy, OptumRx has implemented several exemptions to the e-prescribing requirement.

Providers requesting an exemption should email EPCSquestions@optum.com with the following information:

  • A brief description of the obstacle for e-prescribing
  • Your name, address and phone number
  • Your National Provider Identifier (NPI) number

For more information on the OptumRx policy, visit professionals.optumrx.com/epcs. There you will also find a short video that provides more details regarding the transition to e-prescriptions.

Physicians who have questions about the new OptumRx policy should contact UHC at (877) 842-3210 or visit UHCprovider.com.


Was this article helpful?    
Download the New CMADocs app!

Download the new CMADocs app!

CMA's new mobile app lets you connect with your colleagues and engage with CMA content!  Download the "CMADocs" app today from the Apple or Google Play app stores for daily news updates, events calendar, resource library and more.

Latest News

Load More