It shouldn't be legal. It sounds absolutely dumb, doesn't it? This is how the health care industry works unfortunately, and I still can't wrap my head around it how these things are allowed.
When our pharmacy got audited last year, the insurance company (I forget which payer) told us not to refill medications 3 days early for HIV patients. They only wanted HIV medications to be filled exactly every 30 days or after. Otherwise, they would recapture all the money on the claim. We said, "Well you're the one's allowing for the refill". They said it didn't matter whether they okay the refill it or not in their systems, but if prescriptions were submitted early that they would recapture the money on the claim in the future. Now,we fill HIV medications as close to 30 days as possible. It's a shame.
So yea, how is this legal? It's legal because there is no one there to fight for us. And if we want to fight, we don't have the manpower or the resources to fight. I can't fight on my own, as much as I try.