Sorry for the lack of updates. Between vacation, work/life, and lack of good and funny rants things have been sorta slow here. I intend to fix that for 2010. One rant twice monthly if it kills me. Too many posts don’t get the awesome comments, and too little makes people lose interest in the site. Twice a month is a happy medium.
On with the rant!
As you all well have known, we are in 2010 and we are one week past the dreaded first of the year mayhem. If you are a pharmacist, and have not died from alcohol induced liver failure you obviously have first hand experience about HealthNet (Or their processor, CVS/Caremark) screwing up SO bad that I can’t even believe that they are still in business.
For those not “in the know”, lets set a few things straight so people don’t get confused.
- You have Medicare + Medicaid
- You have no deductible (of usually $250 – $300 depending on plan)
- You have little to no premiums
- No doughnut holes (ie: the coverage gap)
Pretty much if you are on the state tit because you cannot take care of yourself, you get all the benefits of a Medicare part D plan without the annoying doughnut hole, deductibles, and screaming high copay tiers. Nice isn’t it? The rest of us however have the initial deductible, blah blah blah.
Now, lets rewind to HealthNet’s Medicare part D plan oh, a week ago. At least in California, NONE of the “Dual Eligibles” (the people with Medicare AND a state welfare insurance) were flagged in HealthNet’s computer system as being on a state welfare program. Which means that almost all of the people who should of had NO deductible suddenly got one (with a $200 copay for their Advair)! Compound this with the usual first of the year plan changing clusterfuck and you have yourself a 2 hour hold time with HealthNets pharmacy help desk!
Oh, lets not forget that HealthNet also didnt flag generic Vicodin and Septra DS as being covered items. So for one insurance company, we have a shitpot full of welfare-recipients pissed off at us because “we” want to charge them more than $1.10 or $3.20 AND their vicodin is no longer covered. So whats a pharmacist to do?
Easy. Let the fucking patient get off of their asses and take care of it themselves. Why should we have to suffer the fallout because some computer idiot over at CVS/Caremark (which I wonder if CVS pharmacies had this problem) totally fucked up the data import from California MediCal. Yeah, I’m a heartless asshole but I’m tired of being the human fucking shield for these PBM’s who make more per prescription than I do. What happened with HealthNet was completely unacceptable and embarrassing. Of course HealthNet/CVS/Caremark will continue to collect their fat ass subsidization checks from California as they tinkle in our faces with their whopping $3 above cost reimbursement. Here me now HealthNet, unless I see some MAJOR lawsuits from you to CVS/Caremark over this bullshit, I will do everything in my power to switch my Dual Eligible patients to any plan that is not administered by you.
Oh, and just icing on the cake, I got the fax yesterday evening from HealthNet that everything was fixed. Thats 8 days of chaos due to a company that makes more in 1 week than I’ll see in 10 years.
Post your hateful HealthNet comments (or funny first of the year stories) and lets see if I get a response from them (and hopefully not a C&D letter).