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Medicare and having to keep logs to get refills on medicine
Old 05-02-2013, 01:34 AM   #1
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Medicare and having to keep logs to get refills on medicine

Went to the Pharma today to get refill on Blood Sugar test strips and they told me that Medicare won't let them fill my doctor prescribed refill untill I turn in a daily log showing that i actually used the test strips and results that I had. WTF!
When did big brother get into my personal life so much. While I may be doing testing, and occasionally remember to log it - readings are fairly consistent so I didn't feel need to repeatedly write down same things over and over - reminded me too much of W*rk activities.

And it's a hassle to take a log from home with you to Pharma as I usually stop by on way home, depending on how day went and what time it is, and I'm not coming from home at that point.

And, did I mention it's a legal prescription from my doctor - who is supposed to be the one prescribing things NOT the d@*&%m Govt.

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Old 05-02-2013, 06:00 AM   #2
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Apparently Medicare developed this procedure to deal with useage above the "Maximum monthly allowance"

Quote:
For blood glucose testing supplies in quantities above the maximum monthly allowances, documentation that supports the patient must meet criteria A-F as follows:

A. Coverage criteria 1-5 (noted above) are met.
B. The supplierís files contain a copy of the treating physicianís order.
C. The patient has nearly exhausted the supply of test strips and lancets, or exhausted the useful life of one lens shield cartridge previously dispensed.
D. The treating physicianís order for testing frequency exceeds utilization guidelines, and the medical record documentation supports the need for testing frequency above utilization guidelines.
E. The treating physician has seen the patient and evaluated his or her diabetes control within□six□months of the date of the order for the quantities of supplies exceeding utilization guidelines.
F. The physician/supplierís records contain a copy of the patientís testing log or other physician records, such as a narrative statement, that adequately documents the patientís testing frequency.

Note: If the patient regularly uses quantities of supplies that exceed the utilization guidelines, new documentation to support these supply quantities is obtained every six months.
From here http://www.cms.gov/Outreach-and-Educ..._ICN905104.pdf
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Old 05-02-2013, 06:50 AM   #3
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I have noticed ads in the local paper for people wanting to buy test strips, apparently from people that get them for nothing. I know my wife has a bunch of test strips but she doesn't use them. They just sit in limbo and collect dust. I can't remember the details on how she got them but there are companies out there that will provide the strips for nothing in order to get you on their mailing list to sell you other medical supplies. Maybe there is a push to stop people from making a little money on the side by selling their test strips. Is there any money to be made here?
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Old 05-02-2013, 07:36 AM   #4
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Quote:
Originally Posted by MichaelB View Post
Apparently Medicare developed this procedure to deal with useage above the "Maximum monthly allowance"
So it sounds like the pharmacy is wrong. You only need this if you are above your monthly allocation. Which would tie into what Johnnie36 mentioned.

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Originally Posted by JOHNNIE36 View Post
Maybe there is a push to stop people from making a little money on the side by selling their test strips. Is there any money to be made here?
Unfortunately always someone trying to scam the system. Selling foodstamps for cash is popular also, resulting in EBT cards.
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Old 05-02-2013, 08:50 AM   #5
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Old 05-04-2013, 01:58 AM   #6
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Quote:
Originally Posted by MichaelB View Post
Apparently Medicare developed this procedure to deal with useage above the "Maximum monthly allowance"
Not sure what Maximum monthly allowance would be, but only testing once a day sure seems like I would be under that.

I never had heard of the selling of test strips, I guess we should look forward to having to pass a mental and physical exam, and become licensed, with continuous retraining classes to be able to posses these test strips.
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Old 05-04-2013, 05:37 AM   #7
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Quote:
Originally Posted by whitestick View Post
Not sure what Maximum monthly allowance would be, but only testing once a day sure seems like I would be under that.
Good question for the pharmacist.
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