Medicaid Back Dating Early Fills
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I've looked all over the Internet and cannot find a straight answer to this question. My mother has been on the same Rxs for almost 20 years, and has always had the same doctor. She has medicaid. She has chronic pain, from lupus and fibromyalgia. In the past she has been able to refill some of her 30 day scripts at only 28 days. I know some pharmacies won't fill until the 30 days, however it usually is not an issue as long as medicaid approves. This month the pharmacy told her that the laws have changed and that since she has filled early in the past, they now are documenting and back dating all the times she's filled early and said that she should have a stock pile of all of those days. So even if its been 30 days since last month's (30 day) script is up for refill at the 30 days, she was told that now it can't be filled because they have back dated all previous early fills and they have added up all these days and tacked it on as if she was trying to fill at 2 weeks early. Basically that she had to wait however many days that added up to. I'm not sure quite how to word this so to clarify what I'm asking here's an example : She had filled her Rx at 28 days instead of 30 for the past 6 months. They have added up that she should have 12 days of medication on hand due to the early refill. So even though it has been 30 days, on a 30 day Rx, she can't fill it for another 12 days. so that would be a 42 day wait to fill a 30 day Rx. Obviously with chronic pain, 12 days without meds could cause severe problems. Is this true? And is this legal?
3 Replies
I go to rite aid there is one girl that gives me a hard time she a pharmacy TeX she yelled at me last time I called I got my clonazpam this time the same thing can you fill every 28 days can u help me and let me know
We are located in Colorado. Our next step is to try to contact medicaid directly; was just hoping for others experience. This is the first time it has been this big of a problem for her.
I am very sorry about the problem that your mother is having.
Quite honestly, unless she took extra, or disposed of the extra pills in some other way, they are correct. She should have a small surplus due to the early refills.
However, as to whether or not this is true, I don't know. Medicaid laws vary from state to state, it would be best to call them and ask.
As to the legality, I'm also unsure on that. The pharmacy can set its own rules on such things and really, they aren't supposed to fill them early.
What state are you in?
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