If you're a resident of Las Vegas, Nevada, you may be wondering what the process is for obtaining prescription medications. The current Nevada law requires that prescribers obtain informed consent from patients regarding the potential risks of treatment with a controlled substance. Your supplier must write your prescription for a 90-day supply with three refills when applicable (not a 30-day supply) and submit a request for home delivery. Mail-order benefits are only available to group health plan members.
If you're a member of an individual health plan, local retail pharmacies can fill your prescription drugs for up to 30 days in a row. This does not affect any high-cost specialty medications you may receive in the mail from Optum Specialty Pharmacy (formerly BrioVarx). Your provider can send a request for prior authorization online, by fax, or by mail. CoverMyMeds helps providers electronically submit prior authorization requests to insurance companies. However, CoverMyMeds is NOT affiliated with the Health Plan of Nevada. If you received a communication from CoverMyMeds, you will need to contact them directly.
Contact your pharmacist directly to request medication synchronization. A specialty drug is a drug created to treat complex medical conditions and rare diseases. These medications are often very expensive and require special handling. They can be taken orally, injected, inhaled, or infused.
Specialty drugs are designated on your plan's drug list with the abbreviation “SP”.Your health plan requires specialty medications to be filled at Optum Specialty Pharmacy (formerly BrioVarx), which offers additional support to help members with their specialty prescription products. Specialty drug coverage is limited to a 30-day supply. No, over-the-counter (OTC) products are not covered by Health Plan of Nevada. The “limitations” and “exclusions” sections of your plan's pharmacy documents exclude coverage for OTC products. When it comes to generic and brand-name drugs, the main difference is the name and appearance. The Food and Drug Administration (FDA) requires that generic drugs have the same active ingredient, concentration, dosage form, and route of administration as the brand-name drug.
They are also developed and approved according to the same standards as brand-name drugs, ensuring that both versions are of identical quality. When both you and your health insurance company pay for your health care expenses, it's called cost-sharing. Deductibles, coinsurance, and copayments are examples of cost-sharing. If you need help determining your plan's deductible, coinsurance, and copayments, call Member Services toll-free at 1-800-777-1840, TTY 711, or log in to the online member center. The Board interprets “instructions for use” to require a prescription or label that specifies the dosage, frequency and manner in which the prescribed controlled substance must be taken or applied, unless the dose, frequency and manner in which the prescribed controlled substance is taken or applied are specifically described on or in the manufacturer's individual containers or containers for the prescribed controlled substance. Using the phrase “take as directed” or any phrase of similar importance does not meet the requirements set forth in this section. The Board will interpret the term “fax machine” to include, without limitation, a computer that has a fax modem through which documents can be sent and received. Anyone exempted from federal registration by federal laws or regulations is exempt from registration under this chapter.
The burden of demonstrating the right to an exemption lies with the claimant. If any official exempted from federal registration by federal law also participates as a private person in any activity or group of activities that require registration in this state, the official must obtain a record in accordance with these regulations for private activities. The Board shall release information obtained from the database in response to a request made pursuant to paragraph (a) of subsection 8 of NRS 453,164 only to the person to whom the requested information relates or to his lawyer. All applicants and registrants must establish and maintain effective controls and procedures to prevent or protect against the theft and misuse of controlled substances. NAC 453,410 states that dispensing controlled substances by a professional must be done according to certain restrictions. NAC 453,420 states that list II controlled substances can be dispensed in case of emergency. NAC 453,430 restricts the issuance of prescriptions; continuation of dependence on drugs; transmission of the prescription by fax. NAC 453,210 outlines application period; restriction of activities for which registration is required; expiration and renewal of registration; NAC 453,220 outlines registration and re-enrollment application forms; NAC 453,230 outlines submission of registration application; NAC 453,240 outlines acceptance of registration request; NAC 453,260 outlines modification or withdrawal of registration request; NAC 453,270 outlines issuance and content of registration certificate; display by registrant; issuance of duplicate certificate; NAC 453,280 outlines modification of registration; NAC 453,290 outlines suspension or revocation of registration; NAC 453 400 outlines safety of controlled substances.
