Under the Department of Veterans Affairs (VA) Patient-Centered Community Care Program (PC3) and Veterans Choice Program (VCP), VA is primarily responsible for supplying Veterans with medications that are not urgent or emergent.
All medications must be prescribed in accordance with the VA National Formulary. For providers prescribing opioid-based medications, please review our Opioid Crisis Resource Page.
Key Points to Remember
- Always fax both the authorization and prescription to the appropriate VA medical center. If the Veteran prefers to take his or her prescription to the pharmacy, he or she will also need to bring a copy of the authorization.
- Providers may write a prescription for a Veteran as part of an episode-of-care authorized by TriWest.
- Medications may be filled in person at a VA Pharmacy or mailed to the Veteran’s home through the Consolidated Mail Outpatient Pharmacy (CMOP)
- If the Veteran needs a medication that’s not on VA’s National Formulary:
- Providers should contact their local VA Medical Center and request a Formulary Request Review Form.
- Fill out the form and return it to the VA Medical Center.
- Wait for approval or denial. Turnaround time may take around 96 hours. If approved, providers may proceed with prescribing the medication.
- We recommend you do not provide samples of medications to the Veteran if it is non-formulary. Giving samples of a medication is not a justification for non-formulary continued use and will likely lead to a denial of your request.
VA allows PC3 or VCP providers to write prescriptions for a Veteran, as long as the medication is prescribed during an authorized episode-of-care. Providers should follow the rules of the VA National Formulary when prescribing. Be sure to fax both the authorization and prescription to the appropriate VA Medical Center. If the Veteran prefers to take his or her prescription to the pharmacy, he or she will need to bring a copy of the authorization as well.
PC3 or VCP providers may also prescribe a Veteran medication for urgent or emergent care. In this case:
- Write a prescription for a 14-day supply without refills.
- If additional medication is needed after the 14-day supply, write a second prescription to be filled at a VA Pharmacy.
- If the prescription is for a non-formulary drug, the provider may write an initial 14-day supply. However, if the medication needs to be continued, the provider needs to contact its local VA Medical Center and fill out a Formulary Request Review Form, as outlined above. The use of the 14-day supply of a non-formulary medication will not affect the likelihood of approval of a non-formulary request.