VA Prescription Fulfillment Information

U.S. Department of Veterans Affairs (VA) is primarily responsible for supplying Veterans with all prescribed non-urgent/non-emergent medications and nutritional products. These must be prescribed in accordance with the VA National Formulary Handbook.

Routine Prescriptions

Routine prescriptions may be needed to treat a variety of conditions and must be obtained through the Veteran’s local VA pharmacy. All routine prescriptions must be filled at VA pharmacies to be eligible for reimbursement. Providers should consult the VA National Formulary to determine which medications are available.

Prescriptions must be transmitted by:

  • Faxing the prescription to the local VA pharmacy*
  • Giving Veterans a copy of the Health Net Federal Services, LLC (HNFS) authorization to physically take or mail along with the prescription to a local VA pharmacy for fulfillment

Note: If the Veteran does not have a copy of the provider’s authorization from HNFS, the VA pharmacy cannot fulfill the request.

Prescribing according to the VA National Formulary whenever clinically possible can prevent prescription fulfillment delays and inconvenience to Veterans.

If a prescription does not follow the VA National Formulary, a VA pharmacist will follow up with the prescribing provider to determine if the prescription can be re-written for a prescription available on the VA National Formulary or if certain criteria is met in order to initiate a medically necessary non-formulary drug review. Non-formulary drug reviews are performed on a case-by-case basis.

*Schedule II prescriptions cannot be faxed and must be presented by mail or in person in original form. Schedule III-IV prescriptions can be faxed by the provider as long as a manual, pen and ink provider’s signature is present. Electronic signatures are not acceptable.

Note: Medications prescribed through an office-based buprenorphine service must be filled through a VA pharmacy after the initial 30-day induction and stabilization phase.

Urgent Prescriptions

An urgent prescription is one which in the provider’s clinical opinion cannot wait to be filled by a VA pharmacy and mailed to the Veteran (approximately four days). Urgent prescriptions may be required to treat a variety of conditions such as acute pain management or infections.

Providers may issue Veterans prescriptions for up to a 14-day supply of a VA National Formulary medication when needed urgently. Veterans may take urgent prescriptions to any non-VA pharmacy to be filled at their own expense and seek reimbursement from the Purchased Care office at their local VA health care facility. While not encouraged, if the Veteran chooses to take the urgent prescription to a local VA pharmacy to avoid out-of-pocket expenses, the provider must give the Veteran a copy of HNFS' authorization letter. If the Veteran does not have a copy of the provider’s authorization letter from HNFS, the VA pharmacy cannot fulfill the request.

Prescription Requirements

The following prescribing provider information is required on all routine and urgent prescriptions:

  • name
  • address
  • personal DEA number (not a generic facility number)
  • telephone number
  • fax number
  • National Provider Identifier (NPI)
  • Social Security number
  • date of birth
  • gender

Incomplete prescriptions cannot be filled and will be returned to the prescribing provider.

Medications Administered in an Office Setting

Under Veterans Choice Program (VCP) and Patient-Centered Community Care (PCCC), VA pharmacies cannot dispense medications, including injectable medications, to VCP or PCCC providers. If your VCP or PCCC patient needs a medication to be administered during an office visit, please purchase the medication per your office protocol and submit a claim to HNFS for reimbursement.

Note: Medications administered under an opioid treatment program (OTP) must be dispensed and administered at the OTP, not through a VA pharmacy.

Visit our Claims page for EDI and paper claims submission details. Health Net Federal Services encourages electronic data interchange (EDI) claim submissions through Change Healthcare. In order to expedite claims processing, please include the authorization number specified on the HNFS provider packet you received.

Veterans Crisis Support

Support for your patients who are U.S. Veterans:

  • 1-800-273-8255 Press 1
  • Confidential chat at VeteransCrisisLine.net or text to 838255

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