Difference between a Prescription Drug and a Supplement and an Herbal Remedy under law in Virginia

Learn about laws that regulate the use and possession of drugs, including prescription drugs and household products, as well as penalties involved. Schedule II drugs include PCP, cocaine, methadone, and methamphetamine. Schedule I drugs are highly abused with no accepted medical use, including heroin and LSD. Schedule V drugs have a low potential for abuse, a low risk of addiction, and accepted medical use.

Excluded drugs are not covered by Part D, but can be offered as an optional benefit under certain enhanced plans. Part D plans are allowed to place restrictions on some formulary drugs in an effort to contain costs. An individual prescription drug plan offers benefits for drug costs that are not covered under your health insurance, sometimes with optional benefits such as drug shipment via mail.

As supplemental insurance plans covering prescriptions only, prescription drug plans typically complement coverage under Medicare or other medically exclusive health plans. Veterans who have private health insurance can elect to use these sources of coverage as supplements to their VA benefits. If you have other forms of health insurance, such as private insurance plans, Medicare, Medicaid, or TRICARE Medicare, you can still use VA in conjunction with those plans.

If you are eligible for prescription drug coverage under Medicare Part D, enrolling in the VA Health Care System is considered to be comparable coverage for purposes of Medicare Part D. Medicare Part D is the voluntary prescription drug outpatient benefit for people who have Medicare, provided through private plans approved by the federal government. The Part D drug benefit, also known as theMedicare Rx, helps Medicare beneficiaries pay for outpatient prescription drugs purchased from retail, mail-order, home-infusion, and long-term care pharmacies.

Prescription Drug

A Preferred Pharmacy has a contract with your prescription drug plan provider to provide medications for less out-of-pocket costs for you. For medications that are not listed in your formulary, or for prescription drug plans that have an out-of-pocket coinsurance fee, discount plans such as RxSaver and HoyMeds can help you save. The medications covered under your plan are listed on your plans medication formulary. The Medicare Act defines drugs covered in Part D by reference to their coverage in the Federal Medicaid Program and in the rest of Medicare.

In some cases, the law bars certain types of drugs from being covered by Medicare. Federal law currently prevents the secretary of health and human services from interfering with negotiation of drug prices between Medicare Part D program sponsors and drug manufacturers. Such proposals include allowing Medicare to negotiate drug prices, restructuring Part D benefits to add a hard cap to out-of-pocket drug costs, requiring manufacturers to pay rebates to the federal government if their drug prices rise faster than inflation, and shifting more of the responsibility for catastrophic coverage costs to Part D plans and drug manufacturers.

In 2022, beneficiaries in every state would have the option to enroll in a Part D plan that participates in an innovation center model, where enhanced medication plans would cover insulin products with a $35 monthly copayment during the deductible, introductory coverage, and the $35 monthly copayment during the gap in Part D benefits. Beneficiaries may choose enrollment in either a standalone prescription drug plan (PDP) that supplements traditional Medicare, or in Medicare Advantage prescription drug plans (MA-PD), mostly HMOs and PPOs, which cover all Medicare benefits, including drugs. People with creditable prescription drug coverage (coverage as good or better than part D) are not required to enroll, and are generally better off with their private plans than they are with part D. They should not consider enrolling in part D without consulting with the benefits administrator of their existing plan.

For example, veterans who are enrolled in either program will have access to non-VA physicians (under either Medicare Part A or Medicare Part B) and may be able to obtain prescription drugs that are not in the VA formulary, as long as they are prescribed by a non-VA doctor and filled at a local retail pharmacy (under Medicare Part D). For example, a determination of coverage could be made by the program if a medication is deemed medically unnecessary or if a medication is obtained at a non-network pharmacy.

Under the conditions in subsections A and B, a pharmacist may not disseminate a formulated medication product for later distribution or sale to another individual or commercial entity, including distribution to pharmacies or other entities that are co-owned or controlled by the facility where the formulated medication was manufactured; however, the pharmacist may disseminate a compounded medication product to a veterinarian pursuant to Federal law. Pharmacists shall mark all compounded drug products that are dispensed under prescription pursuant to this chapter and the regulations of the Board, and they shall provide an appropriate date of use on the labeling, as determined by the pharmacist pursuant to USP-NF standards for compounding by pharmacies. A drug listed in Schedule II Schedule II shall be dispensed only upon receipt of a written prescription properly executed, signed by the person who prescribed the drug on the day of issuance, and having the full name and address of the patient for whom the drug is prescribed, or of the owner of the animal for whom the drug is prescribed, and the full name, address, and registration number under the federal laws of the person who prescribed the drug, if he is required by those laws to be so registered.

A drug listed in Schedule II Schedule II shall be dispensed only upon receipt of a written prescription that is properly executed, dated and signed by the person prescribing on the day when issued and bearing the full name and address of the patient for whom, or of the owner of the animal for which, the drug is dispensed the owner of the animal for which, the drug is dispensed, and the full name, address, and registry number under the federal laws of the person prescribing, if he is required by those laws to be so registered. A controlled substance is defined in Code of Virginia, in accordance with Virginias Narcotics Control Law, in accordance with Virginias Narcotics Control Law. The drug possession offense occurs when an individual possesses any controlled substance without a valid prescription (Code of Virginia SS 18.2-250). Drug paraphernalia is defined in Code of Virginia SS 18.2-265.1 as equipment, products, and materials of any type intended to be used for planting, propagating, growing, harvesting, producing, compounding, converting, producing, processing, making, strength testing, analyzing, packing, repackaging, containing, concealing, injecting, ingesting, inhaling, or otherwise injecting a controlled substance into a persons body. In this stage of coverage, beneficiaries on the Standard Drug Plan, having met the deductible, pay 25% coinsurance on both brand-name and generic prescriptions, until reaching catastrophic levels.