Are pharmacies violating federal laws with transfer coupons?

[BMBiology]

As many of you know, federal and state law prohibits pharmacies from giving transfer coupons to those who are enrolled in public funded healthcare programs.

However, many of patients are enrolled in private insurances funded by the federal and state government. Besides Medicare Part D, there is no way for pharmacists to know if these patients' insurance is paid with public money. Therefore, are pharmacists, unknowingly, violating federal law by giving transfer coupons to these patients?

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[MountainPharmD]

As many of you know, federal and state law prohibits pharmacies from giving transfer coupons to those who are enrolled in public funded healthcare programs.

However, many of patients are enrolled in private insurances funded by the federal and state government. Besides Medicare Part D, there is no way for pharmacists to know if these patients' insurance is paid with public money. Therefore, are pharmacists, unknowingly, violating federal law by giving transfer coupons to these patients?

I think we are violating common sense and our patients safety by doing them. Coupons are them dumbest idea next to the pharmacy drive through window.

Other than medicaid, medicare and tri-care what insurances are partially or totally governemt funded? Workers comp is goverment mandated not funded. I still tell people they can't use the coupon for workers comp though.

Boy do people with medicaid get pissed when you tell them they can't use a coupon. I had one idiot tell me we were discriminating against him because he was poor and he was going to call his laywer and sue us. As if a medicaid recipient has the resources to have a lawyer on call...sometimes ya just gotta laugh.

 

[Doctor M]

From what I understand, coupons redeemed for a gift card are as good as cash; so when a patient with private insurance redeems his/her coupon, he pays his/her copay and then is given the gift card. That gift card is as good as cash so he/she may use it on future copays or whatever merchandise they wish. I have to agree that transfer coupons are a bad idea as well as the drive thru😡

 

[BMBiology]

Other than medicaid, medicare and tri-care what insurances are partially or totally governemt funded?

There are a few in California such as Blue Cross of California. The state enrolls patients into private insurances to save money. There's no way for the pharmacist to tell whether or not the patient's insurance is paid with public fund by looking at the card.

 

[Doctor M]

There are a few in California such as Blue Cross of California. The state enrolls patients into private insurances to save money. There's no way for the pharmacist to tell whether or not the patient's insurance is paid with public fund by looking at the card.

If you knowingly distribute the gift card then I think you could get in trouble. Im thinking if you try your hardest to verify the ins and guess wrong and give the GC, im sure the gov't wouldn't prosecute you. Anyhow, i am very vigilant with those coupons. I hate them.

 

[BMBiology]

Ignorance is not an excuse according to the law. As a taxpayer, I am actually pissed that public money is being abused.

 

[Doctor M]

Ignorance is not an excuse according to the law. As a taxpayer, I am actually pissed that public money is being abused.

Who's being ignorant?

 

[BMBiology]

Who's being ignorant?

All due respect, ignorance (a noun) is defined as the state or fact of being ignorant; lack of knowledge, learning, information, etc.

http://dictionary.reference.com/browse/ignorance

Lets stick to the topic.

 

[Doctor M]

All due respect, ignorance (a noun) is defined as the state or fact of being ignorant; lack of knowledge, learning, information, etc.

http://dictionary.reference.com/browse/ignorance

Lets stick to the topic.

i misunderstood you and i am on topic🙂

 

[Doctor M]

anyway, to the best of my knowledge you are not violating any law as long as the patients ins is private and you are charging them their copay. The GC is as good as cash. Thats how I take it.

 

[Farmercyst]

I'm still learning this, but isn't medicare part C available through private companies using federal funds similar to Part D?

 

[sdn1977]

I'm still learning this, but isn't medicare part C available through private companies using federal funds similar to Part D?

Medicare Part C is the plan which incorporates all the Medicare A & B services into one plan (HealthNet, Kaiser, etc.....HMOs).

These patients may have Part D (HealthNet) or not (Kaiser).

But, there is no Part C which covers drugs alone.

 

[sdn1977]

There are a few in California such as Blue Cross of California. The state enrolls patients into private insurances to save money. There's no way for the pharmacist to tell whether or not the patient's insurance is paid with public fund by looking at the card.

You are referring to Blue Cross MediCal. MediCal is our states Medicaid plan. There are many choices & Blue Cross MediCal is only one & is not offered by all counties.

There are many, many (80 or more) Blue Cross plans which are private insurance only & not funded by state or federal money.

So, don't get confused when you see a Blue Cross plan. These patients may have just signed up for that particular plan at work. I myself have had Blue Cross thru an employer twice in my 30 years of work & they were DEFINITELY not funded by government money.

 

[sdn1977]

anyway, to the best of my knowledge you are not violating any law as long as the patients ins is private and you are charging them their copay. The GC is as good as cash. Thats how I take it.

Yep! This is it. There is no violation as long as you don't apply the coupon, gift card, whatever to the copay. The patient must pay their copay & receive their incentive in another form.

If that form is a gift card & they choose to spend it on a copay for a different rx, no problem. The incentive is just like cash.

 

[Old Timer]

As many of you know, federal and state law prohibits pharmacies from giving transfer coupons to those who are enrolled in public funded healthcare programs.

However, many of patients are enrolled in private insurances funded by the federal and state government. Besides Medicare Part D, there is no way for pharmacists to know if these patients' insurance is paid with public money. Therefore, are pharmacists, unknowingly, violating federal law by giving transfer coupons to these patients?

I don't know this to be 100% per accurate. I believe this applies to Medicaid. It does not apply to Federal Blue Cross or Tri-Care. I am not sure about Part-D. I know that CVS gives extra bucks for prescriptions, basically 50 cents per RX. I know they do not give it to welfare patients or welfare patients enrolled in a state mandated HMO. I am not sure about Part-D, though it may apply there as well. I also know there disclaimers on the coupons that list the exclusions. Next time you get a coupon, look at it and post the disclaimer. I am in a poorer area now and I see almost no coupons. When I was in a more affluent area I saw loads. I just don't remember what the disclaimer said.