Wednesday, January 7, 2009

Rules, rules, and more rules...

There are a hell of a lot of rules and regulations in pharmacy. As there should be. Most of them are intended to protect the patient. But one rule has me all worked up lately...
As of October 1, 2008, CMS (the group that makes the rules for Medicare and Medicaid) requires that all prescriptions be on security paper. Three security features are required - and the list of options for which security features a prescriber can use is quite long. I have been audited by my company's internal audit team twice in the past month.
The thing that really pisses me off about this rule is that the weight of it falls squarely on my shoulders. If the doctor doesn't comply with this rule, nothing happens to him. Just yesterday, I had to call one office 4 times, and send 5 patients back to the office to get new prescriptions. I know this doctor knows the requirements - I've seen scripts come from him on security paper. But, for some inexcusable reason (they 'forgot' to order more paper), every person who came from that office to my pharmacy had plain old white paper. The first 2 calls I made, I was pleasant, then I got progressively nastier as the day went on. I finally said "If this continues, I will refuse to take any prescriptions from your office." But who gets hurt there? Me, and the patient. Now, my techs have to take extra time when taking in a script at the drop-off window to see which insurance the patient has before they can accept a new one - that adds about a minutes to each drop off, and when we're doing 500 scripts a day, that really adds up! I have three options when presented with these kind of prescriptions: 1) Call the doctor and get a verbal order - not allowed if it's a schedule II controlled substance - which wastes MY time; 2) Send the patient back to the office for a new script - in the case of the CII's - which wastes the PATIENT's time; or 3) Fill them as they are, which puts me at risk of getting fined if I'm audited. Did you notice that none of these options creates a hardship for the doctor???
When are these rule makers going to come up with something that impacts the doctor if the rule isn't followed?

3 comments:

mensch said...

SOSP,

You need to see

http://oleapothecary.blog.com/4379844/

The Ole' Apothecary

Tracey said...

I stopped calling. I created a template fax and send it to the office with the 2 pages explaining what they are supposed to do to comply with a copy of the offending prescription. Then I wait. And...I tell the patient what I've done and why. It's the office's responsibility.

NY pharmacy intern said...

The one thing that is nice about NYS is for a while now, scripts need to be on offical state pads with alot of security features in them. Usually we never have a problem as the scripts we get are electronic or printed on state issued pads. I don't think we have ever sent a patient back with a script for not being on state pads. The only times we usually send the script back with the doc is when they did something really stupid like forget to sign their name (had a patient with a huge amount of percocets come in with a script on a friday night right before closing that had that happen).