Saturday, November 15, 2003
::: Granny's Gone Insane :::
Just thought I would check in ...
Am not really dead as some have suspected ...
But ... Tenncare is trying to kill us at the pharmacy! Tenncare has a new "save money" program ... (wow...another set of absurd rules obviously thought up late at night in smoke filled rooms ... the smoke having a peculiar odor) whereby they are instituting a new PDL (Preferred Drug List) so every other claim is denied ...
At that point we have to enter secret codes on secret lines of the SIG (instruction) fields and provide a 3 day supply to the patient, then print out that rejection, stamp it PDL, fax it to the doctor and wait for the patient to explode when we tell them about it.
If the doctor says ... do not change in response to Tenncare's preferred drug (yep, the state is now prescribing drugs), we wait for the customer to return (naturally we must keep track of these responses from the doctors) and dispense the remainder of the prescription, inserting another secret code that tells Tenncare the doctor would prefer Tenncare did not practice medicine on their patient.
If the doctor is OK with the drug selection suggested by Tenncare, we make a new Rx and try to explain to the patient why their pill is blue instead of green.
Tenncare decided to institute this brilliant plan in three stages. One list of drugs came out on October 15th (blood pressure, cholesterol, heart meds, etc). the next comes out November 15th (today and thank God I am not there) and includes drugs near and dear to the patients hearts -- narcotics, i.e. Oxycontin, Duragesic Patches and Actiq Suckers are removed. I truly hate to imagine what they must be going through at the store today, but Monday will be a Super Hell Day, another group of drugs will be implemented December 15th (list not out yet, but I suspect some of the more expensive antibiotics as well a expensive chemo blood builders (Procrit), Enbrel for arthritis, maybe Betaserons.
But this group ... the narcs ... is the one we have been dreading. If the patients taking the drugs are in dire need of them for cancer, etc, this is a terrible shame. Oxycontin is especially great for pain because it is time released and contains not Tylenol. When patients take something containing Tylenol (Percocet is one) and the dosage has to be increased, that delivers more and more Tylenol and it is toxic in large doses ... liver and kidney damage. If they are addicts, they will raise hell, perhaps wait outside the store and attack us, come into the store brandishing weapons, call and whine and cry, and are generally unable to grasp the work "no" in reference to their drugs. If they are selling them (quite profitable) they are sick to death with worry on whether they will lose their house or car.
So ... there you have the gist of it ...
Other than that... everything has been peachy.
Oh.... one more horrid thing I heard on the news ... missed the name of the state and the ins program, but I suspect it is a state program such as Tenncare ... now get this!!!
In an attempt to save money on drugs dispensed for seniors, they have sent letters stating they plan the recoup the dollar amounts spent on seniors by charging it to their estates.
As one of the customers at the store (a crusty former tobacco grower .. the lady of the house) exclaimed when I told here what I had heard ... "Well, they can kiss my ass and bark at the hole." I swear I burst out laughing so hard I had to go in the office to get a grip. She was still cursing all the way out to her truck!
Gran, who is not sorry one bit for the bad language