CIIs in CA

[chicagoboy1984]

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Hi all.

I did not see anywhere in the Weissman CPJE Review book where he talks about the maximum days supply a prescriber may prescribe for a CII. Am I correct in assuming CA follows the federal law stating that a prescriber may only write a prescription for a maximum day supply of 90 days for a CII?

Thanks.

 

[GreyFox2002]

There is no federal law stipulating the maximum days supply on a CII prescription. A prescriber can write for a 5 year supply if they want.....the problem is the patient's insurance coverage is unlikely to cover it. The other problem is you won't wind a pharmacist who will fill such an excessive quantity when the patient pays cash.The real issue though is that 1: the prescription is only good for 90 days, and 2: you cannot partial a CII.

Many states I believe will limit the days supply to 30 (or 90). I'm in Michigan and they don't address this at all.

 

[Farmercyst]

The DEAs position statement would indicate they prefer 30 days, but I haven't seen a concrete max. (By position statement, I mean the statement that allows prescribers to write 3 rx's on the same date each for a 30 day supply with a fill on/after date not to exceed 90 days from the write date.)

 

[GreyFox2002]

The DEAs position statement would indicate they prefer 30 days, but I haven't seen a concrete max. (By position statement, I mean the statement that allows prescribers to write 3 rx's on the same date each for a 30 day supply with a fill on/after date not to exceed 90 days from the write date.)

I was under the impression that the reason the DEA now allows for the 3 30 day supply rx's with the same original date was to make it more convenient for patients who are stable on their therapy and do not require monthly visits? I've never actually come across a DEA rule stating the maximum days supply allowed on a CII Rx.

 

[All4MyDaughter]

I was under the impression that the reason the DEA now allows for the 3 30 day supply rx's with the same original date was to make it more convenient for patients who are stable on their therapy and do not require monthly visits? I've never actually come across a DEA rule stating the maximum days supply allowed on a CII Rx.

This is my understanding as well. I don't think it has anything to do with the DEA "preferring" 30DS.

 

[Farmercyst]

I was under the impression that the reason the DEA now allows for the 3 30 day supply rx's with the same original date was to make it more convenient for patients who are stable on their therapy and do not require monthly visits? I've never actually come across a DEA rule stating the maximum days supply allowed on a CII Rx.

The reason I suggested it as a preference was because a 90 DS would accomplish the same purpose, but it wasn't even mentioned. I understand 90 DS aren't available from all insurers. Probably guilty of over-thinking again.

 

[owlegrad]

The reason I suggested it as a preference was because a 90 DS would accomplish the same purpose, but it wasn't even mentioned. I understand 90 DS aren't available from all insurers. Probably guilty of over-thinking again.

To be honest, I read it the same way you did. If the DEA doesn't prefer 30DS why not mention 90DS as an option? Having three 30DS prescriptions, each with their own do not use before date, seems more complicated than a single 90DS script. I figured the DEA prefers 30DS, even if it is not an outright requirement.



On the other hand, what do I know?

 

[positivesign]

In my pharmacy, we don't fill C-II prescriptions with the written date of 30 days before or more (California). (perhaps there was an update with the regulation?) We limit C-II's for 30 days and CIII-V's for 120 days.

 

[222pharmD]

There is no federal law stipulating the maximum days supply on a CII prescription. A prescriber can write for a 5 year supply if they want.....the problem is the patient's insurance coverage is unlikely to cover it. The other problem is you won't wind a pharmacist who will fill such an excessive quantity when the patient pays cash.The real issue though is that 1: the prescription is only good for 90 days, and 2: you cannot partial a CII.

Many states I believe will limit the days supply to 30 (or 90). I'm in Michigan and they don't address this at all.

Is that the law in Michigan or something 😕? In CA you can partial a CII and fill the rest within 72 hours, otherwise it becomes void.

 

[All4MyDaughter]

To be honest, I read it the same way you did. If the DEA doesn't prefer 30DS why not mention 90DS as an option? Having three 30DS prescriptions, each with their own do not use before date, seems more complicated than a single 90DS script. I figured the DEA prefers 30DS, even if it is not an outright requirement.



On the other hand, what do I know?

Prescriber may not want the patient to have a 90DS at one time.

 

[Carboxide]

Is that the law in Michigan or something 😕? In CA you can partial a CII and fill the rest within 72 hours, otherwise it becomes void.

You can ONLY partial a CII if you are out of stock/unable to fill the full quantity. Not due to patient reasons, patient can't pay all at once, etc.

If they wrote an rx for 90 DS and insurance only pays for 30, the patient would lose the rx and have to go back...so probably safer to just write for 30. Not that MDs ever consider insurance...