Sunday, August 11, 2013

Anonymous Cowards - Thank You!

It seems that people have become so complacent with regards to their internet usage, that they feel they can somehow hide behind their computer screens or cell phones and believe they remain "anonymous" because they do not leave their name, phone number, email address, or other personally identifiable information. However, in this day and age, even the most basic and simplistic website has  tools to track user activity and where such activity originated from. One does not need a subpoena or warrant signed by a judge...or any police involvement whatsoever. Quite simply, we leave digital footprint everywhere we go online. All of your internet activity can be traced back to your computer or phone...or to your IP address at a minimum.

Why am I wasting my time writing this nonsense? Well, it has come time to terminate my site. There are people that are determined to make my life miserable. Since they have not succeeded with their hurtful emails, Facebook messages, text messages, and blog comments, they have decided to start harassing my family and girlfriend.

A line was crossed a few weeks ago. Not only did I suffer the loss of my father on July 12, but the next morning I awoke to another hurtful and ridiculous message. The following Friday, hours after the funeral, I received a similar message through this website. I know who the people were and did not confront them directly, but merely passed along what they said to my girlfriend (since the messages originated from her friends and her family). I did not instigate these attacks. I have never responded to any of the messages over the years. I simply delete and move on with my life. However, it has become clear they will not cease. While, in these two specific instances, the individuals "felt awful" and were very "sorry" and "apologetic" though their sentiments were sent via proxy (my girlfriend) and were never sent directly to me. At least I have the moral and testicular fortitude to apologize to people I have wronged or hurt directly and not sent some disingenuous apology via proxy.

This site will remain dormant going-forward, which is a shame. It was a wonderful outlet for me to write about various topics of interest and to write about things I am strongly opinionated and passionate about. It helped me through a very difficult time in my life as an avenue of expression. I am by no means an artist or professional writer, but I always felt some sense of accomplishment as the creative process was somehow...cathartic. I could have written under a pseudonym but chose to write under my real name. I would have removed this website completely, however I average about 500 users a day that read some of my legal and technology posts for advice and my opinions on antiquated laws. I will leave it online for an undetermined amount of time. This will likely be the last post.

Thank you to those that went out of their way to interfere in my life and my relationships and hurt those around me by making them unhappy. Thank you to those who thought they they "knew what was best"  not only me, but for my girlfriend as well. Rest assured, our relationship is over...and it is a shame. It ended not for the reasons you think. In fact, if those that were interfering actually knew the truth, they would be saddened to know what actually transpired and how it ended today. They would be shocked and realize I am genuinely a good guy that supported, loved, cared for, and gave happiness to her unconditionally. So I thank you, anonymous cowards...who somehow consider yourselves "friends" of hers.

Wednesday, August 7, 2013

CVS is refusing my VALID prescriptions. Is this LEGAL?

CVS Pharmacy Refuses To Fill My Prescriptions
My local CVS Pharmacy refuses to fill my valid/legitimate prescriptions
Last month, I went to my local neighborhood CVS and proceeded to the pharmacy to leave some prescriptions to be filled. There was nothing different on this day. After handing the pharmacy technician my drivers license and confirmed a few identity questions, she located me in the computer and I confirmed by insurance had not changed. I have been using this particular location for a little over two years. I also have used another CVS location, which is in the same state, as it was more convenient when I was at work in Boston. The pharmacists, pharmacy techs, and PIC (pharmacist in-charge) all knew me, or at least my name and medical history. The pharmacy tech said she wanted to verify that she had the medication and quantity in stock and went behind the counter to verify the medication and quantity. She returned after a moment and confirmed they had the medications and quantity available and that she did not need to order any. Every few months or so, they would have low inventory and would have to order the medication for me. She said it would be about fifteen minutes and I decided to wait.

A few moments later, the pharmacist called me up to the register. I commented that he filled that much faster than anticipated. He then said he was unable to fill any of the prescriptions that I had dropped off. I thought it was a joke at first, but he was quite serious. He said that there was an "error" message on their computer system and that the "corporate office" said to "refuse" and "do not fill" prescriptions from my doctor. Now, I would understand their hesitation to fill certain prescriptions if I were perhaps unknown to this pharmacist or CVS... but I have been frequenting that location for over two years and have used many CVS locations in the last ten years (during college and while I was living in different towns throughout my career). I must have had a quizzical look on my face because he apologized profusely. I asked if it was perhaps an insurance issue or if I should call my health insurance or prescription benefits company? He said "No, Chris. There is no issue with your insurance. You're not refilling too soon or anything...and when I entered your prescription information, your health insurance approved the medications so we would get paid." At this point, I was literally scratching my head. Had I done something wrong?

I asked the pharmacist if he thought it was a "fraudulent" or "invalid" prescription or if he felt uncomfortable filling the medications because of something I had done or said? Again he said, "Chris, it's not you. I would fill these for you without any issue. Your prescriptions are valid and are verified. I even telephoned the doctor to confirm once I received this error. Your insurance approved them but the corporate lockout says I cannot fill them. I cannot do an override. I might loose my job..."

CVS Refuses to fill prescriptions
I did not want to push the issue...quite frankly, I was starting to become embarrassed as other CVS patrons could overhear the conversation. I inquired if I could pay "cash" and again he said that my insurance wasn't the problem. He suggested I try another pharmacy, but not another CVS since this is a company-wide decision from the corporate office. He handed the prescriptions back to me and again apologized. Before I left the pharmacy counter he said, "If you have another physician write the prescriptions, I will gladly fill them. The computer will not accept his NPI or DEA number. I specially ordered one of your medications and you are my only patient on it...and it is very costly so I hope you come back so I can fill them!"

That was a kick in the pants. Two of the medications are 'scheduled' or 'controlled' substances. The other two prescriptions were not. I have previously written about the absurdity of medication prices and insurance versus cash prices. A 28 day supply of one of the medications is about $1,800. The other medication costs around $1,200 and is only 9 tablets. The other two aren't as much, though they are quite expensive considering I receive generics.

I felt as if I had been accused of someone making "fake" prescriptions or trying to refill too early. I felt I had done something wrong. I've never done anything of that sort in the past. I never asked for "early refills" and have always been open and honest with my physicians. I have never "doctor shopped" or done anything remotely wrong. I left the pharmacy and telephoned my doctor.  I spoke to his assistant and then his nurse. She said they were aware of the troubles with CVS, since other patients had alerted her to the same problem. She suggested I change pharmacies and to call her back and let her know which pharmacy I change to so she could update my medical file.

Switch Pharmacies from CVS
I have switched pharmacies and decided to support a local pharmacy, not a national chain retail pharmacy. Is it the most convenient option for me? No. Do I feel better supporting a "mom & pop" business? Absolutely. I only question the legality or liability that CVS is incurring by refusing to fill prescriptions by a few selected physicians. Just for clarification, I took the same four prescriptions that I presented at my local CVS to the pharmacy I switched to and there were no issues. I found this pharmacy through a friend that knows the owners. The new pharmacy and pharmacist(s) were a bit skeptical when I brought those same four prescriptions to them, however I said they were free to verify them and I even brought a copy of my prescription history from the last two years. I am sure they could access this information through the Massachusetts Online Prescription Management Program, but I felt it would be to my benefit to include it. The pharmacist did call and verify the prescriptions and processed them through my insurance without any issue. He had to order one of the medications, as he had no other patients currently taking it and it is a fairly new medication. A few days later the order arrived and I was able to pickup the remainder of my prescriptions. I have since transferred all of my prescriptions to them and have found better service. Although I knew the pharmacists and staff at my local CVS and had built a rapport with them, I am happier supporting the local business and know that I am not just a number to them and they truly value my business.

So is what CVS did legal? I do not believe it is. When I telephoned my local pharmacy to speak to the pharmacy manager or PIC, I was told that "we will not fill any prescriptions from that physician because there is a DEA investigation and he is going to jail." I laughed on the phone and inquired if she was joking. Apparently, she was not joking as she hung-up on me. I telephoned my physician again and after speaking to his nurse, I was able to speak to him. I reiterated what the CVS pharmacy manager had told me and before I could even finish her words he interrupted me with a very weary sigh. He said there was no investigation or anything involving law enforcement nor the DEA. He said they were likely referencing a lawsuit and fine from the US Department of Labor from five or six years ago (I was aware of this fine and lawsuit since I assisted him with some accounting matters in his defense from the allegations back in 2008). He apologized for any issue, but he cannot control CVS' corporate policy and suggested I use a different pharmacy. I explained I had switched to another local pharmacy and we spoke briefly about other news and politics before ending the call.

Still, I was curious. I performed some additional due diligence and found that there were no issues with his NPI or DEA numbers/licenses. I contacted the Massachusetts Board of Registration in Medicine and found his license was in good standing. There were no malpractice claims or criminal/civil charges or lawsuits pending or in the past. The final step I completed was calling the local Boston field office of the DEA. Though I was transferred around a few times on the phone, I finally spoke to an agent there that could not officially confirm nor deny any ongoing investigation against my doctor, but unofficially said there was not. He then asked if I was a patient of the doctor and if I wished to file a complaint or if there is anything that he should be aware of. Since there was nothing for me to report, I explained that I was a patient but had nothing to report other than good things about him and his medical practice. The DEA agent said that if there was an investigation, typically their DEA number and license would be suspended pending the outcome of the investigation. Since my doctor's license was still in good-standing and his DEA number active, it doesn't seem to support CVS' claims.

I spoke to the Board of Pharmacy Registration in Massachusetts and they directed me to their website where I could file a complaint. I'm not certain that is the route I intend to go, but I'm not certain if their practice is discriminatory or illegal. Since my prescriptions are valid, were executed properly by my physician, were approved by my health insurance provider, and they met all federal and state guidelines...does the pharmacist have the right to refuse to fill the medication? Rather in my case, does the corporate office of a retail pharmacy chain have the right to refuse a prescription, even though the pharmacist at their store would have filled it if there were not some sort of computer block citing an internal corporate memo to "refuse prescriptions from a specific physician" though the physician is in good standing with all regulating agencies and the customer's insurance approved the medication that he has been taking for years? I'm not sure they can. I was told by CVS customer service that "a pharmacist works under their own private license and reserves the right to refuse to fill for any reason." They seem to contradict themselves here. If the pharmacist in my local store was indeed free and able to work under his own license and has the ability to permit or deny prescriptions, then why is the corporate office mandating that their pharmacists not fill prescriptions from a particular physician? To clarify, I am speaking about refusing all prescriptions from a particular physician...not only controlled or scheduled substances.

My calls to the CVS Caremark corporate offices have not been returned. I have called nearly a dozen times and have left messages with different persons and departments asking for an explanation. I was transferred to disconnected extensions and mailboxes. I was given non-working phone numbers to call. The last person I contacted today was their corporate communications director, Danielle Marcus. I have not received a return call or email. I was provided with the contact information for CVS Caremark's assist communications director, Caitlin O'Donnell. I telephoned and emailed her as well and have not yet received a reply.

I believe there is a greater issue at hand here. It would be very odd if CVS had a vendetta or some sort of negative predisposition against my physician... it is simply illogical. I suspect CVS has similar "do not fill" corporate policies or memos regarding other physicians, but I have not confirmed this yet. I will post supplemental information if and/or when I am contacted by CVS corporate communications department and will post other information as I work through the discovery process. Feedback and comments are appreciated and you may do so below.

Friday, August 2, 2013

Is The Post Office Spying On You?

The USPS takes pictures of every piece of mail processed in the United States — 160 billion last year — and keeps them on hand for up to a month.
In an interview, Postmaster General Patrick Donahoe said the photos of the exterior of mail pieces are used primarily for the sorting process, but they are available for law enforcement, if requested.
The images are generally stored for between a week and 30 days and then disposed of, he said. Keeping the images for those periods may be necessary to ensure delivery accuracy, for forwarding mail or making sure that the proper postage was paid, he said.
"Law enforcement has requested a couple of times if there's any way we could figure out where something came from," he said. "And we've done a little bit of that in the ricin attacks."
The automated mail tracking program was created after the deadly anthrax attacks in 2001 so the Postal Service could more easily track hazardous substances and keep people safe, Donahoe said.
"We've got a process in place that pretty much outlines, in any specific facility, the path that mail goes through," he said. "So if anything ever happens, God forbid, we would be able very quickly to track back to see what building it was in, what machines it was on, that type of thing. That's the intent of the whole program."
Processing machines take photographs so software can read the images to create a barcode that is stamped on the mail to show where and when it was processed, and where it will be delivered, Donahoe said.
The Mail Isolation Control and Tracking program was cited by the FBI on June 7 in an affidavit that was part of the investigation into who was behind threatening, ricin-tainted letters sent to Obama and Bloomberg. The program "photographs and captures an image of every piece of mail that is processed," the affidavit by an FBI agent said.
Mail from the same mailbox tends to get clumped together in the same batch, so that can help investigators track where a particular item was mailed from to possibly identify the sender.
"We've used (the Mail Isolation Control and Tracking program) to sort the mail for years," Donahoe said, "and when law enforcement asked us, 'Hey, is there any way you can figure out where this came from?' we were able to use that imaging."