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To: Second Amendment First
We don't have sufficient information to say the woman could have gotten the prescription filled by simply paying for it.

Give you an example ~ I need a certain medication. I went on a trip and forgot to take my pills. I went to a pharmacy and asked if they could call my pharmacist and get authorization for 14 pills ~ a very minor fraction of what I needed.

They did that. I got my pills and it was all good.

Little did I know that "the law" requires that when I change pharmacies, even under the conditions I described, I have effectively made a permanent change and will have to go back to my doctor for a new prescription to restart service at my old, local pharmacy.

The "law" that did this to me is called MEDICARE. The bureaucrats don't care one way or the other if I pay for my medications out of my pocket, or the taxpayer's, they've decided that my acquisition of life sustaining medications is a very secondary issue next to the question of WHERE I GO for those medication.

This little boy's medication is more carefully monitored than the stuff I use ~ probably because it costs more AND can be dangerous to some people. It's unlikely his mother could have gotten the medicine ever again if she changed the payment method since that would disrupt the activities of the sleuths looking for misuse.

Someone at Denver's Human Services probably knows the answer ~ and that's going to be that Medicaid reporting requirements supercede the needs of the patients, even in cases where absence of the medication will cause death.

There's no reason Medicaid should be less stringent than Medicare.

42 posted on 02/04/2010 3:03:09 PM PST by muawiyah ("Git Out The Way")
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To: muawiyah
Last March, Lucero went to fill her son's prescriptions at a Walgreens near her home in Montbello. A worker there said Zumante didn't have prescription-drug coverage anymore.

Sounds like she had the script in hand, but wasn't willing to pay for it.

47 posted on 02/04/2010 3:07:06 PM PST by Second Amendment First
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To: muawiyah

You can always pay cash and submit the claim yourself.


69 posted on 02/04/2010 3:35:01 PM PST by Jim from C-Town (The government is rarely benevolent, often malevolent and never benign!)
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To: muawiyah

I just explained this in a post and totally agree. When you are on Medicare your Doctor, pharmacy and you are all under very strict rules which have severe limitations and real risks if anyone goes outside the system.


83 posted on 02/04/2010 4:16:35 PM PST by Vendome (Don't take life so seriously... You'll never live through it.)
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