BCBS Still Limiting, Declined Response

Part II:
Blue Cross Blue Shield of Florida Neither Resolved This Case NOR Issued a Statement
   Continued from Blue Cross Limits Access To Meds 
       

More of this Feature • Analysis and Summary • YOU Can Make a Difference        On Our Forum "...I went for eight months fighting with the insurance co. (BC) to get it. I got one Rx at the pharmacy and did mail in. The Rx was for the 3 months worth that I was told I had to mail in, but they kept refusing it saying I was over the max allowed. I spent many trips to the ER, which they paid in full and had to go 3 months with out meds at one time before they would fill the Rx." Join the discussion         Related Resources • Blue Cross Limits Access To Meds • Is Your Insurance Company Limiting Your Triptans? • Triptans: Overview and Profiles        Elsewhere on the Web • MAGNUM: Drug Utilization Reviews • MAGNUM: Limits Burden Patients • MAGNUM: HMOs Limiting Use of Migraine Drugs

Where We Left Off Last Week:

• Blue Cross Blue Shield of Florida (BCBS) has been having Miss Brown's pharmacy change the prescription written by her attending physician so that less Maxalt is dispensed than her physician prescribed.
• When Miss Brown found BCBS to be unresponsive, she asked me to represent her as her patient advocate.
• Before contacting BCBS, I contacted the FDA to get a statement on record that none of their regulations would apply to this situation. They confirmed that they have no jurisdiction over the insurance industry and none of their regulations or policies would apply to this case.
• BCBS representative Chris Luke presented me with the "company line" on these limitations, and when shown to be incorrect, resorted to a clause he says is part of Miss Brown's policy even though neither Miss Brown nor I can find any such clause and BCBS could or would not tell me where it is allegedly located.
• In the interest of balanced and fair reporting, I consulted Blue Cross Blue Shield repeatedly during the writing of last week's article, inviting their comments and/or statement prior to the stated editorial deadline.

Events Since Last Week's Article:

• Tuesday, January 28: Chris Luke of BCBS (with whom I've been working) called me to let me know that a pharmacist from their staff would be contacting me sometime during the week. He also wanted to know where to find our article, and looked at it while we were talking. I told him that the content and headline of this article would be determined by the BCBS response, and again invited comments and/or a statement from the company for this article.
• Thursday, January 30: At 4:00 p.m., since the week was nearing its end, and I'd not heard anything from BCBS, I called Mr. Luke. I advised him that I had not heard from their pharmacist, and reminded him that the editorial deadline for my article was Friday, January 31, at 5:00 p.m. He replied that he'd contact the pharmacist to remind her to call me and remind company officials of my invitation to issue a statement regarding this issue.
• Friday, January, 31: The 5:00 p.m. editorial deadline came and went with no further contact from anyone at BCBS.

 

Please continue to the next page > Analysis and Summary > Page 1, 2, 3

             

for a printer-friendly version of this feature, click HERE
to recommend this page to a friend, click HERE

Previous Articles
   

---