When valid prescriptions are refused

April 3, 2014

When patients present valid prescriptions for controlled medications and pharmacists refuse to dispense, the patients have options. And the ADA is just the beginning.

Drug Topics contributor Steve Ariens is a nonstop crusader for the rights of pharmacists. A cause about which he is equally passionate is the suffering inflicted upon chronic pain patients denied access to the medications upon which they depend and for which they hold legitimate prescriptions. He has warned in the pages of Drug Topics about possible consequences for pharmacists who refuse to fill valid Rxs. Now he offers a page of simple instructions for patients on how to file complaints. 

Steve AriensIf a patient is denied a medication upon presentation of a valid/on-time prescription for a controlled substance, that patient may be eligible to file an ADA complaint.

If the patient is disabled, as determined by coverage under Social Security, Medicare, or private disability insurance, that patient is covered under the Americans with Disabilities Act (ADA). Many chronic pain patients meet this criterion.

The ADA parallels the Civil Rights Act of 1964. People who are disabled cannot be discriminated against because of their disabilities.

 

Causes

Legitimate refusal: A pharmacist can refuse to fill a valid/on-time prescription for a controlled substance if doing so would harm the patient, such as when the patient is allergic to the medication, the medication would adversely interact with other medications that the patient is taking, or the prescribed dose is above the recommended dosage, although some specialists can and do prescribed above normal doses for a patient and the practice is perfectly legal.

Civil rights violation: The failure of the pharmacy or pharmacist to fill a valid/on-time prescription for a controlled medication is a violation of the patient’s civil rights under the ADA. This may happen because of the pharmacy’s policies, the pharmacist’s “professional discretion,” or rationing by the wholesaler of the amount of controlled medications available for pharmacy purchase.

Rationing: Three major drug wholesalers have elected to establish arbitrary monthly rations, limiting the amounts of controlled medications that each pharmacy can purchase. This may prevent a number of patients from obtaining necessary medications upon which they rely.

 

Options

Patient action: Only the patient can help rectify these issues, by filing complaints with appropriate governmental agencies. The patient does not need an attorney. Individuals can go to the websites listed below and complete a complaint form.

Boards of Pharmacy: The permit holder/store owner, the pharmacist in charge, the pharmacist who refuses to fill a prescription, and the wholesaler are all licensed by their state’s Board of Pharmacy. A complaint for unprofessional conduct can be filed against each with the appropriate Board of Pharmacy.

Medical Licensing Board: Some believe that persons who refuse to fill valid/on-time prescriptions are in essence “practicing medicine.” In that case, a complaint to the state Medical Licensing Board may be appropriate.

HIPAA: If the prescription department staff has disclosed a patient’s private health information (PHI) in a manner that someone else could overhear, the patient may be able to file a HIPAA complaint.

 

Links

State Boards of Pharmacy

http://www.nabp.net/boards-of-pharmacy

ADA complaint form

http://www.hhs.gov/ocr/privacy/hipaa/complaints/index.html

Medical Licensing Boards

http://www.ama-assn.org/ama/pub/education-careers/becoming-physician/medical-li censure/state-medical-boards.page?

HIPAA complaint form

http://www.hhs.gov/ocr/privacy/hipaa/complaints/index.html

 

Contact information for the major drug wholesalers

McKesson Corporate Headquarters
One Post Street
San Francisco, California 94104
415-983-8300

Cardinal Health
7000 Cardinal Place
Dublin, Ohio 43017
614-757-5000

AmerisourceBergen Corporation
P.O. Box 959
Valley Forge, Pennsylvania 19482
610-727-7000

Steve Ariens is a pharmacist, pharmacy advocate, blogger, and National Public Relations Director for The Pharmacy Alliance (www.thepharmacyalliance.com). E-mail him at steve@steveariens.com.