Effective January 1, 2018, OptumRx will be enabling an enhanced prescriber DEA license scope of practice check at point
of sale for all Schedule II-V controlled medication claims to prevent payment of scheduled medication claims from
unauthorized prescribers.
This scope of practice check will validate submission of a valid, non-expired DEA prescriber license and then match the
submitted prescriber’s full two alphabetic letters and 7 digit numeric license number string to the submitted controlled
drug GPI. Successful validation of these two steps will allow the claim to proceed to adjudication. However, failure of
the check will result in a hard reject at point of sale for any of the following reasons:
*Please see attachment for more information.