Pharmacy changing RX, other RX ?
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| Sun, 09-16-2007 - 9:19pm |
When I was 1st dx'd back in May my now X-GP, fouled up my rx for test strips and didn't write it for the 3 months required by Medicare, at the time they told me they had got it "fixed". I was lucky enough to be given some extra strips by one of my diabetes classmates and even with testing extra times (doc had said twice a day) had more than enough until the first part of August. Went to refill and they tell me Medicare denied it! I talked to Medicare & they tell me it had never even been submitted. Went round & round with Walgreen's & they finally said I hadn't completed some form they needed (which I had mailed twice & faxed once), so I drop off another copy, then they tell me Medicare wouldn't approve because my 90 days supply wasn't up. Apparently my idiot doc never returned their calls & Walgreen's "fix" was to change the number of times I was to test to once a day, instead of twice and my refill couldn't be handled until 8/23. Figuring I'd run into problems filling the new rx if I went ahead and filled the old one & I had an appointment with my new GP (who is wonderful!!!) on 9/10, I decided to wait since the dieticians had recommended I test 4 times a day until I got better control, given our family history of heart attack/stroke along with all my other health problems. Finally got back to the pharmcy to pick up ALL my new rx's and am told Medicare won't approve the new rx (which was for 4 times a day) because my previous rx was for once a day. Of course, no one at Walgreen's bothered to double check with Medicare about this.
A) Given that this is a new rx, is it likely that Medicare would have denied it based on the previous rx?
B) Wouldn't Walgreen's changing the original rx from twice a day to once a day be some major ethics violation?
I'm calling both Medicare & Walgreen's in the AM, but would like to have some proper "ammunition"!
Thanks,
Marci
P.S. Glad to be back, my DSL modem died and trying to use dial up again proved to be an exercise in frustration!

Marci,
I am not sure but I thought Medicare would let you test twice per day. Walgreens had no right to change your prescription without the approval of your physician. That is practicing medicine without a license and that is illegal. You new doctor can petition to Medicare for you to be allowed to test four times per day. I bet there is paperwork that the pharmacy has that just needs your doctor'signature for this to happen.
I get a little frustrated with medicare over their testing rules as it doesn't seem logical but there are ways around it. So when you talk to the pharmacy in the morning demand (assertively but nicely!) that they complete the paper to fill the RX as the physician wrote. You may then need to contact your physician to get their help with this matter.
Cheryl,
THey are not supposed to change your prescription without consulting your doctor. If they are given a prescription with an error in it, they are not supposed to fill it or change it without contracting your doctor. They can't practice medicine without a license. They do find errors but they can't unlaterally do things except refuse to fill a prescription with errors or in some cases violate thier moral code. For example if they are given a legally valid prescription for a medication such as a pain narcotic that they know would cause the patient to expire because of the dosage they can question it and eventually refuse to fill it. Sometimes when people are terminal they get very large doses of narcotics which are prefectly legal but could be lethal. They would need to talk to the hospice and the prescribing physician before filling the prescription.
I hope this makes sense!