“The moral test of a government is how it treats those who are at the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadow of life, the sick and the needy, and the handicapped.” – Hubert Humphrey
passionate pachyderms
Pharmacist Steve steve@steveariens.com 502.938.2414
Steve I have a CPP that is in a very bad place. Is there any way you can guide her through this. She was denied all of her meds. and now today is cold turkey. She said she wishes she was dead
she was denied her meds from prescriber or pharmacy ?
Pharmacy and now medicare pulled her prior approval
Now everyone has gone home knowing she has nothing
why was PA pulled
She has no idea
let me guess she is dealing with a chain … maybe CVS or Walgreen ?
CVS
I would bet that the pharmacist is opiophobic and called the Part D prgm and told them some sort of lie
Oh I am guessing same
She is in late 60’s to early 70’s
have her find a independent pharmacy http://www.ncpanet.org/home/find-your-local-pharmacy call CMS 800-MEDICARE and file complaint against CVS… have her go on line pharmacy board and file complaint with board of pharmacy unprofessional conduct, denial of care, pt abuse.. for starters… have her call the Part D and ask for reason PA was withdrawn – IN WRITING … file a complaint with CMS against them as well … tell me that it is not SILVER SCRIPTS Part D ?
Not Silver Scriots it’s the other one and I am beain dead
who is the PBM ?
She has an electronic script and they are refusing cash pay. It’s Express Scriots
Scripts
Paying cash when a pt has insurance is consider a RED FLAG by DEA
She tried that after pharmacy refused to fill
Dr. told them to let her pay cash
My understanding is that some chains … no insurance … no controls filled… even if the pt doesn’t have insurance… which means that they will not fill Rxs for about 10% of the population that doesn’t have insurance
She has Medicare Part D and I am pretty sure it is because Rx is ER
have doc to send new Rx to local indepenent and pay cash and argue about insurance covering when the sun comes up tomorrow
Dr. went home
doc could call in some Tylenol No.4 to hold her over for the night
Good idea. I even thought Clonidine
Clonidine MAY help with withdrawal issues but not pain…. Tylenol No.4 is still C-III and can be called in
I am letting her know
sorry couldn’t give you much more help tonight
I understand. I hate all of this
Once this is all straightened out… I would still file complaints with various oversight agencies
Ih I am making sure she does
She just sent me this Believe me, I realize that!!!!! Dr won’t call Tyl 4 in. He wants me to get thru til tom’w & see how it goes. So I don’t offend him, I gotta do what he asks. He really has been very good to me. He is the one who got me emergency surgery 10 mos ago after a Henry Ford Hospital neurosurgeon put surgical date 3 mos out. My MRI showed just millimeters away from severed spinal cord at C2 ( not conducive to life). PMP got me different Dr & surgery within 36 hrs!!! I owe him some respect
Also
My PMP called CVS pharmacist. Tonite’s “fill in” pharmacist absolutely REFUSES to fill my MS 60 at all!!!
Dr says the regular pharmacist will be there tom’w & he will fill it for cash. . Those night time hours tick by so slowly under circumstances like this.
Both my sons are very upset because they feel so helpless. They remind me that this will only get worse & worse every month. They think I am at a crossroad – put up & shut up OR. Sign myself in & get off MS & pray I will be able to function
You know what is happening here
As if # dozen Tylenol No.4 could cause the his world to come to a end… i guess that his empathy is only good during office hours
Floater pharmacists are the worse… they don’t know the pt… they don’t know the prescriber… so … they just say NO
I fear tomorrow reality is gonna hit. I’m afraid she is losing her Dr. Will blame on DEA flag
Part D prgms don’t normally pull a PA without some outside “bad news” being pushed at them
They want her tapered
who is “they”
Medicare
This is her current dose MS Contin 60mg 3x/day. Plus MS Contin 15 mg 2x/day breakthru
one of the basics of the practice of medicine is starting, changing. stopping a pt’s therapy… Part D is NOT MEDICARE .. it is private FOR PROFIT insurance … so the private insurance company is attempting to practice medicine ?… no license… just interested in increasing their bottom line
Yes
Find out who the Part D medical director is… he/she is responsible for this… is the only one who has legal authority to practice medicine… but…doubt if he/she has a license to practice medicine in the state the pt lives – ILLEGAL… and according to the Controlled Substance Act… it is ILLEGAL for a prescriber to prescribe for a pt .. who they have not done a in person physical exam… call the Part D and tell them that she is going to file a complaint with the state he/she is licensed in and the state the pt lives in … as well as the DEA for violating the controlled substance act.. I have had to do that a couple of time with our Part D and they seem to quickly change their mind about PA
Thank you Steve
I have NEVER lost a PA nor a rejection with our Part D… I know too much… and it is easier just to approve the PA for me or wife… than to risk just how much trouble I could cause
she would like your email so she can update you on her status and thank you for your advice and compassion
Linda just heard from Exoress Scriotscand this is what they said You will NOT BELIEVE THIS!!!!! I just got a call from EXPRESS SCRIPTS PHARMACIST in approval Dept. He says my rxs were NOT DENIED. They continue to be approved thru Feb 2020. Those CVS pharmacists yesterday were called by him to tell them they were coding wrong AND how to fix it STAT so I could get my rxs. Both those pharmacists told him they refuse to fill them anyway! UNFUCINBELIEVABLE!
She just got her rx
This is an exchange with a chronic pain pt’s advocate/friend. Once again this sort of scenario involves a “floater pharmacist” and one of the two major chain stores.
Pt can file complaints with the Pharmacist’s employer, the state board of Pharmacy, the PBM/insurance company and most likely the pt will get the response that “they” can’t force a Pharmacist to fill a Rx… which is true…
But we have a very serious and growing Pharmacist SURPLUS and if the Pharmacist’s employer was not happy with how their employee Pharmacist is treating pts who wish to patronize their pharmacy… They could fire them on the spot… but.. they don’t… so are they condoning this sort of denial of care ?
The Board of Pharmacy will tell the pt the same thing… Is this because the pt has not filed a complaint about being lied to, denial of care, pt abuse – intentionally throwing a pt into cold turkey withdrawal… IMO … all involving UNPROFESSIONAL CONDUCT… it is normal for bureaucrats not to really look for trouble.
The PBM/Insurance company MAKES MONEY when they don’t have to pay for a prescription that they should have paid for… because Pharmacists deny filling legit prescriptions most of these are FOR PROFIT COMPANIES.
UNPROFESSIONAL CONDUCT is a very broad/vague concept and maybe it is time for pt denied appropriate care start filing complaints with the state board of pharmacy for all the UNPROFESSIONAL CONDUCT that I heard from pts every week…
One or two complaints are not going to get the BOP to take action… they will dismiss the complaints are “disgruntled substance abuser”… because they don’t know/understand that a substance abuser would never call attention to themselves with anyone in law enforcement.
Steve I have a CPP that is in a very bad place. Is there any way you can guide her through this. She was denied all of her meds. and now today is cold turkey. She said she wishes she was dead
. Those night time hours tick by so slowly under circumstances like this.
she would like your email so she can update you on her status and thank you for your advice and compassion
This is an exchange with a chronic pain pt’s advocate/friend. Once again this sort of scenario involves a “floater pharmacist” and one of the two major chain stores.
Now WE know ‘too much’. Thanks.