Microsoft word - informed consent for psychotherapeutic medication update.doc

Dear Providers, effective September 1, 2011 please see the below alert from Florida Medicaid:
Better Health Care for All Floridians A Division of the Agency for Health Care Administration Informed Consent for Psychotherapeutic Medication Update
Pursuant to statute 409.912(51) The Agency may not pay for a psychotropic medication prescribed for a child in the
Medicaid program without the express and informed consent of the child's parent or legal guardian. The physician shall
document the consent in the child's medical record and provide the pharmacy with a signed
attestation of this documentation with the prescription.
Florida Statute 394.492(3) “Child” means a person from birth until the person’s 13th birthday.
Psychotropic (Psychotherapeutic) Medications include antipsychotics, antidepressants, anti-anxiety
medications, and mood stabilizers. Anticonvulsants and ADHD medications (stimulants and non-stimulants) are not included at this time. The generic names of those medications subject to the informed consent are listed below. Please note that chloral hydrate, diazepam, lorazepam, and midazolam have beenremoved from the list.
Effective September 1, 2011, the Bureau of Pharmacy Services will implement this legislative directive as 1. The prescriber must complete either the Medicaid “Informed Consent for Psychotherapeutic Medication” attestation form; the Department of Children and Families CF1630, or CF FSP 5339 form (page 8 only); the Department of Juvenile Justice Consent Form (page 3 only), or provide thecourt order for the medication. By accepting a variety of consent forms, the Medicaid Program is providing flexibility with respect to acceptable documentation. Dispensing pharmacists areencouraged to use good judgement, especially in the early phases of implementation, to work with families and prescribers to provide care to children AND obtain the necessary documentation tofulfill the legislative intent of the statute.
2. The completed form must be presented to the pharmacy with every new prescription for a
psychotherapeutic medication. Prescription refills where the original script was filled prior to September 1st will not be denied. However, pharmacies may not add refills to old prescriptionsto circumvent the need for an updated informed consent form.
3. In order for a prescription claim for a psychotherapeutic medication to pay, the pharmacy must enter the medical certification code “2” to certify that the consent form has been filed with the prescription. This process is similar to the pre-existing family planning “6” and dialysis “8” coderequirements.
4. The completed form must be filed with the prescription (hardcopy or imaged) in the pharmacy and held for audit purposes, for a minimum of five years.
5. Every new prescription will require a new informed consent form. “NEW” means every time a
new prescription number is assigned, and includes all new prescriptions including same drug / same dose prescriptions for continuing therapy.
6. Prescriptions may be phoned in or emailed for these medications when the child is younger than 13. However, the pharmacist will need to obtain a completed consent form from the prescribervia fax, mail or from the guardian, prior to dispensing.
7. If a prescription with remaining refills is transferred to another pharmacy, the consent form should be transferred to the new pharmacy, along with the prescription, to facilitate claim processing.
Otherwise the receiving pharmacy should obtain a new consent form.
8. The informed consent forms do not replace prior authorization requirements for non-PDL medications or prior authorized antipsychotics for children and adolescents from 0 through 17years of age.
9. Medicaid HMOs have been directed to implement the policy, but may choose to operationalize it in a different manner from Medicaid fee-for-service. They may require something other thana medical certification code.

Source: http://ezcaremhpfl.com/Documents/Informed_Consent_for_Psychotherapeutic_Medication_Update.pdf