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laws regarding pain medicine refills?
Does anyone have any idea where I can find out whether it is legal or illegal to ask a pharmacist to bypass insurance and allow me to pay cash for controlled substance? They are schedule III and some schedule IV. My prescription has valid refills on it. The pharmacist keeps saying it's illegal to allow me to pick it up earlier than usual. Yes, I'm running out sooner than usual, and my pain isn't controlled. I have an appoitment in april to fix this issue. I'm just curious what the law is in MIchigan regarding this subject? I googled it, but can't find a straightforward answer. I only get this medicine from one prescriber so it is not like I have multiple scripts floating around by different doctors. Thanks!
First off, I'd like to say this is an old thread, so you may get more response to your questions if you start a brand new question. You can do this by clicking on the forum name and then on "Ask A Question".
However, I believe I can answer your question in one simple word - NO and NO!! Pharmacies have absolutely no right to decide which medications it will accept insurance for and which ones they won't. If you have insurance and it the medication is covered by that insurnace, they are required to accept it.
I'm presuming your second question/comment is that this same pharmacy GIVES their friends and family pain medications without a valid prescription? Is that right? If I am right as to what you were saying, again, the answer is an emphatic NO!! If the pharmacy is doing that, they are no more within the law than a drug dealer on the street corner!
Is this pharmacy a well-known chain or a small mom&pop type pharmacy? Either way, this type of practice needs to be reported to the authorities. OF COURSE, BE SURE YOU HAVE PROOF OF WHAT YOU ARE REPORTING THEM FOR - or else it could become a situation of he said/she said. But if you go to the DEA website, there should be a section there where you can report illegal practices. If nothing else, perhaps ask the assistance of your local police to find out where and how to report such things.
However, I believe I can answer your question in one simple word - NO and NO!! Pharmacies have absolutely no right to decide which medications it will accept insurance for and which ones they won't. If you have insurance and it the medication is covered by that insurnace, they are required to accept it.
I'm presuming your second question/comment is that this same pharmacy GIVES their friends and family pain medications without a valid prescription? Is that right? If I am right as to what you were saying, again, the answer is an emphatic NO!! If the pharmacy is doing that, they are no more within the law than a drug dealer on the street corner!
Is this pharmacy a well-known chain or a small mom&pop type pharmacy? Either way, this type of practice needs to be reported to the authorities. OF COURSE, BE SURE YOU HAVE PROOF OF WHAT YOU ARE REPORTING THEM FOR - or else it could become a situation of he said/she said. But if you go to the DEA website, there should be a section there where you can report illegal practices. If nothing else, perhaps ask the assistance of your local police to find out where and how to report such things.
I went to the pharmacy at 24501 W.Warren Dearborn Heights mi. 48127 with my script, insurance and ID and this pharmacy would not us my insurance for my pain medication he wanted to charge me $900. but still wanted to us my insurance to cover all my other medication. when i told him no my insurance cover my pain medication he then got mad. and stated to me that he do not us any insurance for pain medication its cash only or you dont get them. I then left the pharmacy is this legal for a pharmacy to do? I have also went in to a pharmacy who holds pain for there friends and family is this legal?
its totally up to your pharmacist, i work at the drug store cvs so i am positive about this , but if the pharmacist does keep refilling your meds like 6 days early they will be questioned, 4 days is usually fine though, anytime u really need your meds early and your not tryin to get over on anybody and do it too much u just have to kall your dr and they will kall the pharmacist and say it is okay fill the meds..
Normally when someone wants to pay cash instead of using the insurance the pharmacist questions this because of the people who divert or abuse or doctor shop try to avoid being caught this way.
Those who doctor shop get caught when using insurance as the record shows up as far as what you had filled and when even from other pharmacies.
Paying cash this does not show up.
As I sad it is mainly the pharmacist discretion. The laws are very clear but each pharmacy has their own policy's.
Those who doctor shop get caught when using insurance as the record shows up as far as what you had filled and when even from other pharmacies.
Paying cash this does not show up.
As I sad it is mainly the pharmacist discretion. The laws are very clear but each pharmacy has their own policy's.
Where I get my meds I can always tell them to rather bill the insurance or if I want to pay cash for them. Some of my family meds are cheaper if I use my discount card cause I work there, insurance don't pay to much so it is cheaper for me to pay cash and they never ask me why (maybe cause I work there) but even if I call and talk to them I will tell them I am paying in cash not to bill insurance and they say no problem.
Jamie
Jamie
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