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California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more
California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more

Partial Fill for Pain Management and Schedule II Drug Prescriptions

Date: 06/18/18

Opioid addiction and overdosing is a multi-faceted issue that is growing in the United States. In California there were over 2,000 opioid overdose deaths in 2014. According to the Drug Abuse Warning Network, prescription drug misuse and abuse is the intentional or unintentional use of medication without a prescription, in a way other than prescribed, or for the experience or feeling it causes. Abuse can stem from the fact that prescription drugs are legal and potentially more easily accessible. Data shows that individuals who misuse prescription drugs believe these substances are safer than illicit drugs because they are prescribed by a health care professional, and thus are safe to take under any circumstances. The California Legislature is taking steps to prevent the over prescribing of opioids and minimize the number of pills available for unintentional or intentional diversion.

PARTIAL FILL PRESCRIPTIONS
Assembly Bill (AB) 1048 amended health care pain management and Schedule II drug prescriptions as follows: Effective July 1, 2018, AB 1048 authorizes a pharmacist to dispense a Schedule II controlled substance as a partial fill if requested by the patient or the prescriber.

  • The pharmacy shall retain the original prescription, with a notation of how much of the prescription has been filled, the date and amount of each partial fill, and the initials of the pharmacist dispensing each partial fill, until the prescription has been fully dispensed.
  • The full prescription shall be dispensed not more than 30 days after the date on which the prescription was written. Thirty-one days after the date on which the prescription was written, the prescription shall expire and no more of the drug shall be dispensed without a subsequent prescription.

Effective January 1, 2019, the bill requires health care service plans and insurers, including California Health & Wellness Plan (CHWP), to prorate the member’s cost-sharing for a partial fill of a prescription of an oral, solid dosage form prescription drug.

REMINDER: PAIN ASSESSMENT
Effective January 1, 2018, the bill removes the requirement that pain be assessed at the same time as vital signs are taken. Pain assessment should be performed in a consistent manner that is appropriate to the patient and noted in the patient’s chart.

ADDITIONAL INFORMATION
Providers are encouraged to access CHWP’s provider portal online at www.CAHealthWellness.com for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.

If you have questions regarding the information contained in this update, contact your Provider Relations representative or call 1-877-658-0305.