Telehealth prescribing models in the US

Telehealth prescribing models in the US Writing it up because I had to work it out twice and would rather nobody else did.

A coverage question with the paperwork detail included, since that is what determines the answer.

Denial received, with a stated reason. My reading of the reason is that it tells me exactly what to submit next, which is the useful thing about a well-written denial.

Before I spend a week on it: is my reading of the stated criterion correct, and is there a documented precedent for this specific ground?

Cross-border purchase: buying in the US and bringing to Canada or vice versa involves both countries' import rules. The medication is legal but crossing borders with it is regulated.

This follows post #32 rather than contradicting it.

Thank you for the correction. I have edited my earlier post with a note rather than silently, so the thread still makes sense to read. The error was mine and it was the kind that comes from remembering a figure instead of looking it up.

post #47 answers the question as asked. The question underneath it is different.

For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use.

Worth separating two things that post #52 runs together.

Canada: Health Canada licenses compounds. Prescribing is provincial. Compounds are prescription-only. Coverage varies between public and private insurance.

Telehealth prescribing: widespread in the US and varying in quality. Models without a clinician reviewing measurements and history are not recommended by this community.

United States: FDA licenses compounds. Prescribing and pharmacy practice are state-regulated. Compounds are prescription-only. Coverage is decided by individual plans, not nationally.

Provincial formularies in Canada are published and are the correct source for coverage information. Coverage for weight management is less common than for diabetes.

Coming back to post #87, because the follow-up matters more than the original answer.

Regional variation in North America: access differs substantially by US state and Canadian province. Postcode is a major determinant of access.