Effective June 28, 2013, CHN is increasing the SF PATH income eligibility threshold. This will mean that several thousand uninsured patients who may be in Health San Francisco (HSF) can now enroll in SF PATH before the end of the year. A small number (100-300) of these patients will be transferring care from the Ryan White AIDS Drug Assistance Program (ADAP).
Prescriptions for SF PATH clients must be written by an active CHN provider from the patient’s assigned CHN Medical Home or referred SFGH Specialty Clinic. Prescriptions written by out of network providers will be denied.
To avoid disruption of antiretroviral (ARV) therapy, we are temporarily allowing use of the Code 3 override for new SF PATH patients when an ARV prescription is initially written or refilled by an out-of-network provider. This override should ONLY be used for a ONE TIME FILL per ARV with a maximum 30 day supply. For subsequent fills, the prescription must be written by an active CHN prescriber.
Here’s how this will impact staff working at the pharmacy:
Mr. Jones is a new client with the Positive Health Program. He has made his first appointment with his new provider but he needs a refill of his Truvada before he will be seen.
What should the pharmacy staff tell the prescriber and patient?
The provider who wrote his ARV prescription is not part of the SF PATH provider network.
- You will fill a one-time dispense for a maximum supply of 30 days using the Code 3 override for emergency medications.
- Subsequent fills must be written by Mr. Jones’ new SF PATH provider.