|My local CVS Pharmacy refuses to fill my valid/legitimate prescriptions|
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..."
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 dirty...like 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.
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.