Rx forgers are getting pretty talented.

[MountainPharmD]

---

Members don't see this ad.

I almost posted the Dr. Heit letter, but was thinking someone might balk b/c it's 9 years old. But as far as I can tell, it has not been superceded by any new rules.

Funny! I thought the same thing and realized it hasn't been updated since then. No need to since it is quite clear on what the requirements are for dispensing.

Trust me this is not the first time I have had to argue this with someone. Back in 2005 when it was still fairly new I had a huge argument with a pharmacist about this. I presented all the documention and the law. He was stunned. He had no idea.

 

[All4MyDaughter]

Funny! I thought the same thing and realized it hasn't been updated since then. No need to since it is quite clear on what the requirements are for dispensing.

Trust me this is not the first time I have had to argue this with someone. Back in 2005 when it was still fairly new I had a huge argument with a pharmacist about this. I presented all the documention and the law. He was stunned. He had no idea.

Yeah, it's in my law review too. For my home state anyway. Can't remember if it was addressed in my review for my other state of licensure. I think it's one of those things that is poorly understood, but often spoken about with authority. And we know how much pharmacists love to make up their own laws and their own interpretations of laws!!

 

[Pharmpills]

They need stricter laws that states if you forge a script you get 10 years or something crazy because the situation is getting out of hand and legit scripts are being denied bc they appear suspicious.

 

[rxlea]

Thanks guys!

I think I got the part confused about narcotic treatment vs pain.

I remember the story about the pharmacist and physician going down and I think it was because the DEA found out the physician was doing narcotic withdrawal out of his office without being registered to do so. He was writing them for pain, though.

So, if you get one for "pain", and the physician is actually doing narcotic withdrawal without proper registration, I suppose you could still get in trouble.

I'm going to check AZ law too because I know you go with the "stricter" law.

I'm going to bring this up in class tomorrow and ask for clarification. Our first exam is next Monday and I haven't studied 😛

Econ, kinetics, and biostats tests this week. 😡

 

[rxlea]

They need stricter laws that states if you forge a script you get 10 years or something crazy because the situation is getting out of hand and legit scripts are being denied bc they appear suspicious.

Ten is a bit much. Maybe if you were producing them en masse for others and what not. That's a lot of money to pay to keep an addict in jail for ten years for forging a fake script for some roxicet.

 

[AlPacino]

So basically you spend most your day lieing to people. Good job, they teach you that in school??? Valuable member of a healthcare team, yeah.....right...

Have you ever worked in a retail pharmacy?

 

[npage148]

Have you ever worked in a retail pharmacy?

I work in retail and I stopped lying to pt when I was an intern (and realized it was a trashy thing to do). If they are smart enough to forge a script, they know when you are lying so it's pointless and makes you look like a puss that's scared to be working there

I don't confirm stock over the phone but I will quote a price saying that I can't confirm if it's in unless I see the script so I don't give you the wrong info. If you ask me to fill it for cash, i'll run your insurance first and I have to qualms about telling them I need to call the doctor to confirm the RX because we've had problems in the past with this drug, doctor, etc.

EDIT: did you know the Scumy spelled correctly is censored!?

 

[Ackj]

If you ask me to fill it for cash, i'll run your insurance first

I usually do this too (if we have insurance on file) but I have often wondered how hipaa plays into that. They're basically telling you "do not share my phi with them" and you're going against their wishes.

 

[BidingMyTime]

I usually do this too (if we have insurance on file) but I have often wondered how hipaa plays into that. They're basically telling you "do not share my phi with them" and you're going against their wishes.

I always run insurance first to, to make sure its not early. As long as its backed out, I don't see how its a HIPAA violation....for all the insurance knows, we typed the RX under the wrong name, then back it out to fix it (and that commonly happens.) Besides, the HIPAA disclosure the patients have agreed to says that we can share their information with their insurance.

 

[All4MyDaughter]

I always run insurance first to, to make sure its not early. As long as its backed out, I don't see how its a HIPAA violation....for all the insurance knows, we typed the RX under the wrong name, then back it out to fix it (and that commonly happens.) Besides, the HIPAA disclosure the patients have agreed to says that we can share their information with their insurance.

Don't you have to pay a per claim fee to submit? Plus insurance won't tell you if it's early if they paid cash for it at the last fill.

If I suspect someone is getting an early fill (via using multiple pharmacies), I just run a report through our state RX drug monitoring program. Reveals all secrets.

 

[Old Timer]

I usually do this too (if we have insurance on file) but I have often wondered how hipaa plays into that. They're basically telling you "do not share my phi with them" and you're going against their wishes.

HIPAA DOES NOT play a role at all.

There are exemptions that allow you to share information without the patient's consent.

They include:

Providing treatment and payment of claims are two of the exemptions.

Treatment is the provision, coordination, or management of health care and related services for an individual by one or more health care providers, including consultation between providers regarding a patient and referral of a patient by one provider to another.
Payment encompasses activities of a health plan to obtain premiums, determine or fulfill responsibilities for coverage and provision of benefits, and furnish or obtain reimbursement for health care delivered to an individual21 and activities of a health care provider to obtain payment or be reimbursed for the provision of health care to an individual.

You guys act like HIPAA came from God right after the 10 commandments.....

 

[joetrisman]

HIPAA DOES NOT play a role at all.

There are exemptions that allow you to share information without the patient's consent.

They include:

Providing treatment and payment of claims are two of the exemptions.

Treatment is the provision, coordination, or management of health care and related services for an individual by one or more health care providers, including consultation between providers regarding a patient and referral of a patient by one provider to another.
Payment encompasses activities of a health plan to obtain premiums, determine or fulfill responsibilities for coverage and provision of benefits, and furnish or obtain reimbursement for health care delivered to an individual21 and activities of a health care provider to obtain payment or be reimbursed for the provision of health care to an individual.

You guys act like HIPAA came from God right after the 10 commandments.....

HIPAA didn't come from a burning bush? 😕

 

[Mister M]

HIPAA DOES NOT play a role at all.

There are exemptions that allow you to share information without the patient's consent.

They include:

Providing treatment and payment of claims are two of the exemptions.

Treatment is the provision, coordination, or management of health care and related services for an individual by one or more health care providers, including consultation between providers regarding a patient and referral of a patient by one provider to another.
Payment encompasses activities of a health plan to obtain premiums, determine or fulfill responsibilities for coverage and provision of benefits, and furnish or obtain reimbursement for health care delivered to an individual21 and activities of a health care provider to obtain payment or be reimbursed for the provision of health care to an individual.

You guys act like HIPAA came from God right after the 10 commandments.....

Freaking hate trying to get info on a patient from a doctors office in order to bill. They act as if im trying to murder them or something...

 

[Old Timer]

Because people don't have to register phone numbers in the area code where the business is being conducted. My uncle's rugby shop in Massachusetts has a 214 area code since his phone is registered through Skype.

OK, how many physician's have skype phone numbers, three? It's more likely to be a fake number than a skype number.

 

[owlegrad]

Why would a doctor not want to register an area code local to their practice? 😕

 

[Old Timer]

So basically you spend most your day lieing to people. Good job, they teach you that in school??? Valuable member of a healthcare team, yeah.....right...

You have a great deal to learn....

 

[Mister M]

So basically you spend most your day lieing to people. Good job, they teach you that in school??? Valuable member of a healthcare team, yeah.....right...

lame

 

[BidingMyTime]

Don't you have to pay a per claim fee to submit?

Maybe ??? I don't know, I'm an employee pharmacist and I have never heard of this....but then there is a lot I haven't heard of.

Plus insurance won't tell you if it's early if they paid cash for it at the last fill.

Well yeah, but if they are specifically telling you NOT to run it through their insurance, then the most likely reason is because they did get their last fill through insurance and they know its going to be early.

If I suspect someone is getting an early fill (via using multiple pharmacies), I just run a report through our state RX drug monitoring program. Reveals all secrets.

My state has a monitoring program, and it is helpful in tracking a patient's history. Unfortunately, there is a 10 day delay with my state's program....running it through their insurance may catch early refills/duplicate prescriptions that aren't posted yet on the state's website.

 

[Sparda29]

Don't you have to pay a per claim fee to submit? Plus insurance won't tell you if it's early if they paid cash for it at the last fill.

If I suspect someone is getting an early fill (via using multiple pharmacies), I just run a report through our state RX drug monitoring program. Reveals all secrets.

Yep, there is a pay per claim fee, usually like 10 cents or something. This is according to the owner of the independent pharmacy where I work. For example, when someone comes with 10 prescriptions, he wants me to enter all info on patient and type up prescriptions but bill all of them at once instead of one at a time.

 

[BidingMyTime]

Yep, there is a pay per claim fee, usually like 10 cents or something. This is according to the owner of the independent pharmacy where I work. For example, when someone comes with 10 prescriptions, he wants me to enter all info on patient and type up prescriptions but bill all of them at once instead of one at a time.

Interesting. This wouldn't be possible with the computer system used in my pharmacy, the claims can only be submitted one RX at a time.

 

[All4MyDaughter]

Interesting. This wouldn't be possible with the computer system used in my pharmacy, the claims can only be submitted one RX at a time.

I have no idea how what Sparda is describing would work anyway. Each claim is a separate entity, as far as I know.

 

[rxlea]

She comes for xanax
It fell into the toilet
Can't pay the copay

 

[Doctor M]

I have no idea how what Sparda is describing would work anyway. Each claim is a separate entity, as far as I know.

Many systems allow for batch filling. You may submit 1 rx at a time and get charged the fee or send a batch of rx's to the PBM and get charged 1 fee still. Medicare D does not allow for batch fills.

 

[cycloketocaine]

She comes for xanax
It fell into the toilet
Can't pay the copay

Holy chit....I laughed out loud.

 

[rxlea]

Holy chit....I laughed out loud.

I've got more where that came from

 

[Doctor M]

Interesting. This wouldn't be possible with the computer system used in my pharmacy, the claims can only be submitted one RX at a time.

Double check on that cause many systems allow for batch filling.

 

[All4MyDaughter]

Many systems allow for batch filling. You may submit 1 rx at a time and get charged the fee or send a batch of rx's to the PBM and get charged 1 fee still. Medicare D does not allow for batch fills.

I don't think ours allows that. But I also never work input.

 

[owlegrad]

I've got more where that came from

I liked the Escalade one myself. Oh oh something about:

no jobs
clean needles


bonus points for CC vs Uni (prepharmacy I know, but you gotta love the classics)

 

[rxlea]

Needles on the ground
Won't dispense to an addict
Spreading HIV