Working for an independent gives you sort of a bond with other independent pharmacists. From shitty reimbursements to dealing with patients; we don’t have the luxury of a ‘corporate office’ and people in suits with fancy lawyers to cover our asses.
So I recieved this letter from a pharmacist in California. Since he claims he has bitched to everyone he can get his hands on via phone, I think its time to give some good ole public harassing.
My name is [Name Removed] from [Store Name Removed] in [City Removed]. California. Long time listener, first time caller. First off love your website. I was wondering if you could light a fire under a problem that I’ve been having.
In case you are not from California, our Medicaid system (Called MediCal) has a 6 Rx limit per patient per month. Any Rx over 6 needs to have a Treatment Authorization Request filled and sent in (Think of it as a retarded prior auth that they approve for like 6 months to a year). Since it is being done electronically now vs fax, the usual turnaround time was a day or two for maintenance medications and a bit longer for stuff that was non formulary.
Over the past few months, I have been getting TAR’s back for stuff like Lisinopril, HCTZ, glyburide with only 3 authorizations. Now why they would only give 3 fills for something the patient is on chronically is beyond me. To make matters worse, the turnaround times for maintenance meds is now approaching close to 14 days in some instances. Imagine if I did not dispense insulin or digoxin to a patient until I got that TAR back so I could get paid.
So I call the TAR office, and they say the delay is because they are “Really Busy” (yeah, who isnt?). Them giving us only 3 fill units on a lisinopril Rx is like if I dispensed 10 tablets at a time then used the “Really Busy” bullshit when they bitched as to why its taking so long.
I think they are giving away a low amount of refills for approved maintenance medications to save their own jobs. Unfortunately their shortsightedness is giving them such a backlog that approvals are not being sent out in a timely manner and people are not getting their medications.
I hope you publish this letter to your site to light a fire under the MediCal TAR office and to see if any other pharmacist from CA is having the same problem. I can be reached at [email TAP for address].
[Name Removed] RPh
Thats pretty shitty if the MediCal TAR office is screwing over TAR’s that THEY THEMSELVES REQUIRE in order to save their jobs. I always thought that PA approvers are just pharmacists/techs who could not cut it in the “real world” so they have to get some desk job hiding from the public behind an ID number so they cant be called out for being a fucking retard. If there is anyone from the MediCal office reading this, why don’t you get your own shit in order before you force your problems down the throats of the pharmacists who actually work for a living. I have his email address if you wish to get a hold of him and explain your case. 3 fills for a maintenance med, thats fucking absurd. “We’re busy” is also fucking absurd. Wah wah wah, cry me a fucking river and let me powder your balls while we’re at it. Hate to break it to you, but we ALL are busy, and judging from this letter you are just adding more shit onto this poor independent.
I’m just glad that there are still some people out there like myself who will fill an Rx even though they will not get paid this very moment just so they don’t end up in the hospital (actually, I think all pharmacists will do this, huge $ items excluded of course, we’re kind but we need to eat too).