Medicare says drug refills shouldn’t be done without patient’s OK


Medicare called Friday for administrators of its Part D prescription-drug program to ensure that drugstores refill prescriptions only after receiving patient approval.

The move follows a series of columns in the Los Angeles Times revealing how CVS and other drugstore chains were routinely refilling prescriptions and billing insurers, including Medicare, without authorization.

In a lengthy document detailing proposed updates for companies participating in Medicare plans, the Centers for Medicare & Medicaid Services said it had received “complaints that beneficiaries have had medications delivered that had been previously discontinued or were otherwise unwanted and unnecessary at the time of delivery.”


“Automatic delivery practices are potentially generating significant waste and unnecessary additional costs for beneficiaries and the Part D program overall,” Medicare said. “While proponents of these programs tout improved adherence, it remains unclear to us that permitting such programs would be cost-effective.”

Medicare is proposing that “Part D sponsors should require their network retail and mail pharmacies to obtain patient consent to deliver a prescription, new or refill, prior to each delivery.”

It said the requirement should be imposed for all coverage next year, but “we strongly encourage sponsors to make this a requirement of their network pharmacies that offer such automatic refill programs for 2013.”

As I’ve reported, the U.S. Justice Department and regulators in California and New Jersey are investigating refill practices at CVS and other pharmacy chains. CVS has denied any wrongdoing.