I had a patient come by the pharmacy on Saturday to have me help her call CVS Caremark to opt out of mandatory mail order through CVS Caremark. I had helped the patient's child with medications, and the patient wanted to fill at my pharmacy too. We called the CVS member's help desk together and the patient asked to opt out. The help desk said the member did not have that option under the plan. I said "so the patient doesn't have a right to choose their pharmacy?" and this triggered a script from the help desk person. The help desk then said the member does have a second insurance coverage plan. The member was confused and said she only had one insurance. So I asked if I could get the processing info for the second plan.
The second insurance plan was also a CVS plan with the same BIN # but a different group and ID for the patient. This plan did not give the rejection that the patient must fill at CVS or CVS mail order (where the help desk stated the medications were covered at no charge and had been filled prior), but now required prior authorizations for 3 very common generic drugs. This patient works for a large national retail company that very possibly could be one affected in the Oklahoma lawsuit. The patient left with two insurance plans and zero medications.
I feel strongly that this new "second insurance" plan is in retaliation to the Oklahoma lawsuit and is CVS's phantom attempt to abide by Oklahoma law and claim they are not steering, when in fact they are still steering by adding additional steps for members to get medications. Can anyone else help to confirm this?