Tinfoil hats for everyone!

I saw this comment on Kevin MD’s blog about a rant of mine. The url is: http://www.kevinmd.com/blog/2008/01/paying-cash-for-narcotic-prescription.html#comments

The attitudes shown on the referenced blog also show why there is no confidentiality once a RX is filled.
I had a doc who needed an antidepressant as a patient. The big clinic/hospital that he worked for also owned the insurance company, and he was in a political struggle within the administration. Given a history of personal destruction as a political tool, he didn’t trust them to not use his medical care history against them.

Okay, right there screams that we aren’t getting the entire story. I fill Rx’s for Doctors all the time for stuff like this, and to be honest nobody gives it a second thought or look.

So he paid privately in cash for the treatment, and then went to a different pharmacy than his usual one, gave them no insurance information and paid cash for the prescription.
The pharmacy somehow uploaded the information to the insurance company anyway, where it was tapped by administration.

Something obviously isn’t right there. I can’t fill an Rx for an Insurance company 99% of the time WITH the card, what makes you think that we can just ‘transmit’ and have it magically go through? Gimme a break, now this story either screams exaggerated or made up. The chances that some pharmacy can just ‘guess’ the information from a private insurance patient who did not provide any card/info is on the same playing field as us getting U&C for Rx’s.

His investigation uncovered all this after he was beat over the head and insulted with his “mental disability” as evidenced by taking prozac during a contentious meeting with his medical director.

Prozac for a ‘mental disability’? Right. I wonder where the HIPAA police were during all of this? Oh, they were paid off by the ‘administration’ to keep their mouths shut.

Stopping drug addicts is all well and good, but the patient’s right to privacy and need for it is not obviated by the “war on drugs”—and he shouldn’t have to give that up to stop addicts from gleefully killing themsleves. I understand where the pharmacist is comming from. The state puts him in the position of policeman. But it shouldn’t be like that. We shouldn’t have to go to a policeman for our medical care.

You’re right, we should just make Vicodin over the counter, and when a doped up addict comes crashing through your front door looking for more cash for his dope and murders/rapes your family you can rest assured that his privacy was protected. Give me a fucking break and come back from bizarro-land. Addicts dont just kill themselves, they hurt other people in the process of their dope. Those that don’t end up on the state system that US working folk have to pay for over something that THEY did to themselves. I dont know about you, but I don’t want to pay for a liver transplant for someone who has never worked an honest day in his life, and who’s only accomplishment is how much vicodin he can pop before passing out.

Regarding these databases to catch pill poppers—anyone who doesn’t think that is going to be used sometimes by snoops to personally or politically destroy enemies fell off the turnip truck yesterday. It’s very existence creates a barrier to legitimate medical care for some.

Let me get some more tinfoil for your hat.

Anyone thinks that Rush Limbaugh wasn’t a political target? Notice how they used search warrants rather than supoenas to get his records? Remember the viagra incident–cleary a deliberate ploy to use his (non-controled) med use to embarass him.
Any number of public and not so public characters have legitimate reason to fear filling something so benign as Prozac, viagra, or a properly used opiate RX in the information juggernaut that the pharmacy industry has created.

Uh, a supoena is a form of search warrant. If the police come with a search warrant and want Rx records, then by all means I need to provide them just as if they came with a subpoena. Just a search warrant is “Dont get up, i’ll get those myself” vs “fax these over when you get a free moment”. Rush was getting a huge amounts of oxycontin, a C-2 narcotic. A tad bit different than the person who gets his vicodin 2 weeks early.
That being said, here is some more tinfoil for your hat.

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9 Comments

  1. BlueTech says:

    Well, here they go again. Gimme a freakin break. Hipaa isn’t going to destroy the world. Geez, the only time it’s mentioned to patients where I work is as an excuse to revoke their cellphone privileges.

  2. williamrph says:

    woopdidoo…prozac and his mental disability. more like premature ejaculation.

  3. PharmAd4Lyfe says:

    This entire story is a bunch of crap. *IF* MD (who attempted to pay cash) and had his claim sent to his ins company and this information was somehow thrown back at him, that is a text book HIPAA violation.
    It’s not at all the pharmacy’s fault, someone at the ins company dropped the ball and let the cat out of the bag. Unfortuantely, on this alone, I call BS. It just doesn’t happen like that. I have a hard enough time keeping track of what Rx’s patients are on when it’s in my own system. My non-RPh upper management have no right to see what goes on in the system though and therefore do not.
    Either way, damn right I’m going to push a Vicodin Rx through on a customer who will pay cash “just for this one.” And by gosh, it comes back refill too soon through the ins… now I wonder why they didn’t want me to process it through?
    Prozac on the other hand… meh… pharmacy computer systems are setup to automatically bill what your default payment plan is. If you have ins it will use to… SAVE YOU MONEY. Even if you don’t want it on ins, it’s just as easy as backing it out and that claim isn’t there any more.
    Grrr… outright lies and bullsh*t about what pharmacists “do” according to people who have never worked in a pharmacy is the exact reason why retail pharmacy pisses me off so damn much.

  4. one_angry_tech says:

    I’m confused.. so we actually care what people fill? Do I feel differently about the nice lady that gets AIDS medications? Not really.. Do I give a shit what doctors take? Not really.. Hell, my Pharmacy Supervisor takes Adderall…
    Come get me HIPPA! I’m all yours!!!!!!!!!!!!!1

  5. dimndgal says:

    As a pharmacist, I love your site. It’s refreshing to get someone who tells it like it is! It gets really old being blamed for insurance and doctor issues (not to mention the prescribing janitors – which I can go on about for HOURS!). I read your blog to make me laugh everyday, although I have to do it at home because I am too busy working during my 13 hour shifts to just kick back, relax, and enjoy some great entertainment.

  6. rph3664 says:

    Prescribing janitors? LOL if it weren’t almost true.
    I once called a university hospital eye clinic for refills for a patient who clearly had a very serious condition. The person to whom I was speaking tried to do the refills but it was quite obvious she didn’t know what she was doing. So, I told her, “Will you get someone who knows what they ARE doing?” and she did.
    Also, when I was in retail, “Just give them what they had before” didn’t cut it with our pharmacy. They had to tell us what exactly the patient needed – did I ever learn my lesson about that!

  7. pharmacygirl says:

    If a person wants to “pay cash” for a prescription for a non-controlled medication (excluding Ultram), I will always let them. If they don’t want their insurance company to know that they take psychiatric medications, Valtrex, Viagra, or whatever, it’s not a big deal. We only are persistent about getting insurance information when the prescription is for a controlled substance. And yes, in that case I will call neighboring pharmacies to make sure that the patient really doesn’t have insurance, that they aren’t lying to me.
    Pharmacists aren’t the enemy. We’re not trying to make life harder for other people. We are trying to do our jobs, just like the rest of you. I’m sure they are some pharmacists out there with enormous egos (I know a few), but by and large, most would never force a person to use their insurance on a Prozac Rx.

  8. WannaBeDrInTraining;-) says:

    WTF, this story is full of BS. The insurance thing is crap. A “political struggle within the administration” would lead me to believe there is more to this story. “taking prozac during a contentious meeting with his medical director” since when is prozac prn / why would you bring your meds into a meeting?
    Now lets address this RPh as Policemen thing. I am a little bit more liberal than your average red blooded American, I’m a fan of needle exchanges, maintenence Tx in some cases, and a more medical approach to addiction rather than the prohabition BS that the “war on drugs” has forced into the psyche of the avg American. I am of the opinion that pharmacists have a duty to there patients to help treat there disease. The best way to treat an addict, consequences, esp legal ones, cause a doc can’t force a drug addict into treatment, but the court can. So as a pharmacist, every fake Rx/ every “my dog ate it” story, anything that is even remotely illegal should involve you calling the cops. It sucks, it takes your time, but you could save a number of lives. First the addicts life, second your life cause if the addict is in treatment he isn’t gone a put a couple bullets in your chest to get at your narcs. Lets get this straight, ADDICTION IS A DISEASE, not a choice, not a lifestyle, a biomedical disease. We are healthcare professionals with an obligation to treat disease, not judge, not chastise, treat. So next time you get a story from someone trying to score drugs, call the cops, with any luck they are drinking too and get picked up for DUI as they try to drive way from your pharmacy.

  9. karrirx says:

    Wow!! I fill scripts for docs/pa’s/np’s all the time. I could care less what they take. Just because you take prozac doesn’t mean that you’re “mentally unstable”. If that were the case half the world is unstable..including myself. Who ISN’T taking something these days??
    I also find it insulting that it is implied that pharmacists would break HIPPA just to slander someone else.
    Get a clue!

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