WAND NBC17 November 13, 2019
NOKOMIS, Ill. (WAND) – Independent pharmacists tell WAND News they are seeing patients request prescription drug refills only to find the prescription has been transferred to a mail order facility without their knowledge.
David Falk of the Sav-Mor pharmacy in Nokomis and Lauren Young of Dale’s Southlake Pharmacy in Decatur tell similar stories: customers requesting a prescription drug refill and then the pharmacist having the refill rejected. It’s then determined the request is being filled through mail order. When the customer is contacted, the customer says they did not request the prescription be transferred from their local pharmacy.
Falk cites a case over the summer where a customer wanted her prescription refilled at his pharmacy. She is signed up to a plan through Medicare Part-D. She received a letter from a Pharmacy Benefit Manager, PBM, and was told her the order was on hold and she needed to call the PBM to confirm the order. PBMs are the middleman between the pharmacist and insurance companies.
Falk tells WAND News the patient did not ask her doctor to transfer the prescription to the PBM. Her order was eventually cancelled and the prescription has been reestablished with Sav-Mor.
The PBM, CVS/Caremark, tells WAND it received the prescription from the healthcare provider and attempted to contact the customer by phone. When Caremark could not reach the customer it sent out a letter requesting verification. The order, according to Caremark, was cancelled at her request.
To watch the broadcast of this investigative story, click HERE