Monday, April 28, 2014

The Mishaps of Medicaid Man

Medicaid Man went through a month supply of Percocet in about 23 days. He saw his regular pain management doc and was given a script which we filled later that day. It was unusual for us because most people on a pain medication want to wait and stare at us until it is finished. Medicaid Man left and came back later. It doesn't matter to Medicaid Man because not only does the state pay for his doctor visits and medication, they also pay for a cab to drive him around to these appointments.

Yesterday Medicaid Man was here with a script for Vicodin 5/300 from the 'Mergency room. I told him I could have it ready in a few minutes (I was thinking I could save the state and our tax dollar by squeezing this into one cab ride), but Medicaid Man didn't want to wait. A few minutes after he left, I processed the claim and it was rejected. Medicaid doesn't want to pay for the expensive 5/300. So I try to call Medicaid Man to keep him from coming back. I want to tell him that I'll get it straightened out the doc and not to come down again, but Medicaid Man doesn't answer his Obama phone.

So later in the day I have to give him the bad news. He took it well. I told him I'd take care of it tomorrow and he'll just have to wait. He seems ok with that. Off he goes for another free cab ride... free to him, paid for by all of us.

That was yesterday. TODAY here he comes again. He visited the 'Mergency room again last night and they gave him a script for Percocet. This time I won't let him leave. I process it and babble-ba-zoo, there it is, a REJECT. You see, it's only been 23 days since he obtained his 30 day supply of Percocet. Medicaid doesn't want to pay for it right now.

So just to keep track... since 23 days ago... we've had two visits to ER and six cab rides, ALL of which were tax-payer funded. The patient has yet to get any pain medication due to the government "cost containment system" that is just working so well.

If this was just ONE example, sure... we could just let it go. But it's not. Things are out of control people. Time to wake up.


Jono said...

So who is getting paid big bucks to keep Medicare Man from wasting all your time and our money? At least the cab driver is feeding his family.

pharmaciststeve said...

I knew a Pharmacist that owned/operated a Medicaid/cab system and he said that they would get a call to take some teenagers to "the pharmacy".. however in the same shopping center there was a "pizza joint".. and the teenagers seldom went into the "the pharmacy"
Also when I had my own store.. the local Medicaid office would not pay for a pt to take a cab from doc office to my pharmacy.. because we delivered.. but. they would take them to one of my competitors... the chains.. that did not deliver.. when I complained that they were denying the pt's freedom of choice. got absolutely NO WHERE with that one.

Tom McKee said...

Why is "the pharmacy" and "pizza joint" in quotes? I get your implying that they did not actually go to the pharmacy and instead went to the pizza joint... but just for the record the quotation marks make no sense there. Sorry for being a grammar nazi but its bothering me