Nobody Told Me.

The last time my doctor ordered a prescription for me from Postal Prescription Services it arrived in less than a week. This time, after waiting almost two weeks, I called them to ask whether they had received the order. The customer service representative told me that my Blue Shield carrier had informed the pharmacy that I must “give permission” before the pharmacy can fill the order. I gave permission. My prescriptions arrived a few days later.

Nobody told me.

I called Blue Shield. A customer service representative explained that a new CMS rule took effect January 1 requiring the patient to “give permission” before they can approve reimbursement for a refill. Both of my prescriptions were new -- not refills. She told me the company had sent a letter informing subscribers of the change.

I could not recall such a letter. However, a quarterly insurance company newsletter that arrived a few days later included an announcement explaining the intent of the new rule: to “ensure that you are not unnecessarily paying for unwanted medications.” Fair enough.

I wonder how many patients will remember months or years after receiving this notice that before a pharmacy fills their prescription they must call to give permission? How many will die waiting for their medication? Would it not make more sense for the pharmacy, or even the payer, to contact the patient and request permission as soon as they receive the order? Or does that makes so much sense that federal law probably prohibits it?

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