VAC Prescription Drug Audits

I don't know if it has any ties to the MM Rex but I do wonder if there is going to be a change to our drug plan? I can see a surcharge coming.

I know there is a dollar limit on drugs that have a generic brand. I found this rule on my cymbalta prescription. If the doctor does not write "no sub" on the prescription VAC only pays the generic price.

That's really good to know that pharmacy can do that pinger, thank you. Take care.

Interesting.
But aside from the little drug history chit you get at Shoppers Drug Mart for every prescription, I got them to run a FULL print out of everything to help a new specialist of mine.
Very detailed, prescribing doctor, price splits, dosage, etc. etc.
I just asked, not knowing that they could do that.

I'm wondering if this has anything to do with the new MM limitations. One of the main things that came out was the fact that VAC was spending more on other pharmaceuticals, so now I'm wondering if VAC has got it in their collective brain, that they are paying too much for even that.So it wouldn't surprise me if at some point in the future, VAC changes the rules to limit their liability for drug costs.

Sorry you are going through this Teentitan. If I get audited I would not know the price of the prescription either and I would hope Costco pharmacy could give me a history of prescribed drugs.

Basically you get a letter with a stamped self-return envelope.

The letter states what drug they are looking at prescribed to me with the DIN and pharmacy that dispensed it.

They want to know:
The date filled
Name of the person receiving the drug
Quantity of the filled prescription
Cost paid by VAC

It's a Yes No answer to each question.

There's a comment section and date you filled the form and signature.

I never know the price because I don't keep the prescription cost only my drug history, Shoppers Drug Mart gives you a history of your prescribed drugs.

I don't mind doing an audit, it's all part of the administration. But 3 in one year?

Either they are leary of me or suspect the drug store is ripping them off.

Agreed pinger, we don't need that stress being a candidate of an audit. What does an audit entail Teentitan? Do you have to do anything or is it done by Blue Cross or DVA?

Forgo the 20% or flat fee future Teen. I'd burn hell in half smartly if I even received a first audit pdq
let alone three.

It would peev me off like doing my taxes 3 times over.
What does this 3 time audit look like ? Legit ?
Some kind of fracked up Blue Cross validation crap ?

Because we sure don't need that kind of static.

Nope same prescription's, doctor for the last 7 years.

I'm just wondering if VAC is thinking of adding a 20% or flat fee for all prescriptions sometime in the future. Because Blue Cross doesn't care how much they pay as they have a pretty good contract with VAC/GOC

Here's a little 2 cents for your info teen because your 3 in one year audit is odd to me
That said, I never even had one... would pixx me off if I ever did.

But I've had prescriptions/claims blue cross/green shield etc etc VaC for 25 years, irregardless of what for, living aids to very heavy meds.

Same doctor for 25 years as well.

Did something change in your last year?  That you may be overlooking that triggers 3 audits a year.
Frankly, I'd be scratching my head real quick about it !!!

Actually Binrat never been audited for any opiods. Heartburn, cymbalta and naropin.

If I remember correctly Blue Cross does these prescription audits as per VAC rules. I just find it odd that I have had 3 in one year.

Oh my doctor who prescribed these drugs has told me I'm her only veteran.

I think you are on to something BinRat. It could be scenario 1 and/or scenario 2. I think we have to always expect the unexpected when it comes to our benefits.

I've never heard of it, but then again I really haven't had any prescription drug cause my Ex Doctor wouldn't

prescribe anything stronger the T3's w/Codine.

The only thing I think it could be, again My Opinion or thought, was that it was found out / caught that someone

was doing a double dip in prescription drugs, from Multiple Doctors, So for Example he/she was getting Oxy

from Dr. A, and then Also see's Dr. B who then writes out another Prescription for More Oxy, which is also Billed

To BlueCross. So After find the this 1 occurrence they are now going through their files looking for people who

have been prescribed this Medication say "A" cause I dunno what one they are looking for, be it oxy, perc's or what

not.

Thats the only reason to me why some people are getting the Audit, and other aren't is because we aren't or haven't

been prescribe this medication "A" they are doing the Audit on.

OR

Due to a Freedom of Info request, Someone has asked, How much lower are the Costs for Medication "A" now that

a lot have Moved over to the MM treatment Plan.

I was released in 2006 and it is the first time that I hear of this. I have a list of prescription drugs.

Thanks Teentitan, I meant to say medical appointment mileages paid by Blue Cross. I find it odd that they are auditing our prescription drugs since it has to be approved and prescribed by a physician so it makes no sense for an audit. It's not like we can get a prescription any other way.