http://en.wikipedia.org/wiki/Extortion
Extortion (also called shakedown, outwresting, and exaction) is a criminal offense of obtaining money, property, or services from a person, entity, or institution, through coercion. Refraining from doing harm is sometimes euphemistically called protection. Extortion is commonly practiced by organized crime groups.
I got a email from a chronic pain pts in Florida.. it would seem that this particular independent pharmacy has been declining to bill the pt’s insurance company for opiates and/or control meds. Forcing the pt to pay cash and prices of multiple times of what the insurance company would be reimbursed for. Claims that they are not a “participating pharmacy” with insurance companies.
Now here comes the new twist… this pt has been told that in the future that the pharmacy will bill the insurance company for these meds.. BUT.. that is only HALF of the total cost of the prescription(s) and the pt has to pay the other half in CASH.. can’t used a charge card or any other means of traceable payment… AND.. the pt will not be provided a receipt for the CASH PAYMENT portion.
Apparently, if the pt objects… the pharmacy will not fill any Rxs for the pt. Tells the pt that he has others that are willing to pay this way for their opiates/controls.
So.. I went out and checked two of the largest Part D providers and this particular pharmacy is a “participating pharmacy” in their network.. Yes, I have the name/address of the pharmacy.. AND.. of course it was relayed from this pt .. that the pharmacy was having to do this because of something to do with the DEA and the insurance company. I guess that the Pharmacist could not come up with a MORE LAME EXCUSE !
Of course, FL has a “price gouging law” http://myfloridalegal.com/pages.nsf/Main/5D2710E379EAD6BC85256F03006AA2C5?OpenDocument
but it only some into play… Florida Statute 501.160 states that during a state of emergency, it is unlawful to sell, lease, offer to sell, or offer for lease essential commodities, dwelling units, or self-storage facilities for an amount that grossly exceeds the average price for that commodity during the 30 days before the declaration of the state of emergency, unless the seller can justifying the price by showing increases in its prices or market trends. Examples of necessary commodities are food, ice, gas, and lumber.
So I guess that in FL… price gouging is LEGAL as long as there is not a hurricane on the horizon and is necessary medication a “COMMODITY”…maybe it is just a issue of survival of the most fit ?
Filed under: General Problems
Simply put…these pharmacies should be put out of business. If a person has insurance and your pharmacy takes that insurance, I think you are bound by a contract to fill a patients rx and bill the insurance. And, you certainly cannot take the patients copay and then charge them force them to pay extra too. This is clearly a violation of the insurance contract and it maybe illegal as well. Evidently, there are a lot of ‘bad’ pharmacies in Florida.