In my last post, I covered a recent settlement of $2.75 mil where an LTC pharmacy – AlixaRx – was allegedly improperly filling “emergency” scripts for LTC patients. A part of this settlement also included an allegation that AlixaRx billed Medicare Part D for claims that had already been reimbursed through claims paid to long-term
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An LTC pharmacy pays $2.75 mil for dispensing “emergency” prescriptions
A national LTC pharmacy – AlixaRx – agreed to pay federal government $2.75 mil to resolve allegations that it improperly dispensed controlled substances at long-term care (LTC) facilities. AlixaRx dispensed prescriptions drugs to LTC patients primary through its on-site automatic dispensing units (ADU). According to the complaint, the pharmacy violated the federal Controlled Substances Act…
Working conditions and medication errors
About eight years ago, I represented Pharmacists Planning Services Inc (“PPSI”) (led by the late Fred Mayer) in front of the Board of Pharmacy regarding medication errors and working conditions of the pharmacists.
Fred was advocating for the reduction of errors due to difficult working conditions of the pharmacists employed by chain drug stores.…
Remote Data Entry – is it allowed in California?
In March 2020, the California State Board of Pharmacy issued a “Remote Processing” waiver, which is still in effect today (with some modifications). For the purpose of the waiver – as the Board explained – “remote processing” means the entering of an order or prescription into a computer from outside of the pharmacy or hospital…
A recent court victory for pharmacies
I often say that pharmacies that bring legal actions against PBMs do not have a good precedent to rely on. Things might be changing soon with a recent California case holding that Optum’s provider agreement is unconscionable and thus unenforceable (specifically, its arbitration clause).
The court noted that the search for the true meaning of…
Transition to Medi-Cal Rx is postponed
The announced Medi-Cal Rx implementation date, which was initially set for April 1, 2021, is postponed. (See a related Blog Post).
Magellan Haelth, Inc – a PBM that will administer the program – is in the process of being acquired by Centene Corporation. Centene operates managed care plans and pharmacies that participate in the…
Pharmacy software designed to optimize profitability
If you are into pharmacy technology, you might have heard of a new pharmacy software designed to optimize profitability – UGO. It was built by pharmacy owners who know the industry and day-to-day problems that independent pharmacies face. For example, the platform integrates and functions with most existing pharmacy operating systems and provides “Key…
The US Supreme Court: ERISA does not preempt states’ PBM regulations
The news are full of excitement regarding a recent US Supreme court decision in Rutledge v PCMA. But there is still lots of confusion what this decision means for independent pharmacies.
So let’s look at what the case is really about.
It all started in Arkansas when the state passed Act 900, which provided that:…
New PDMP rules for California pharmacies
Currently, California pharmacies must report dispensing of Schedules II-IV to CURES (California’s PDMP database) “as soon as reasonably possible, but no more than 7 days after a controlled substance is dispensed.”
Effective January 1, 2021, California pharmacies will have to report the dispensing of a controlled substance prescription to CURES no more than one working…
Problematic patients? Some may cause serious troubles as this case illustrates.
Every healthcare provider has at least one problematic patient who demands extra attention. Some of these patients continue to cause troubles even after they are “discharged.” A recent case coming from Utah illustrates this.
Ms. Reynolds was a regular customer of Kent’s Market pharmacy. On many occasions, she complained to the pharmacy staff about the…