I think it's wonderful that Medicare covers test strips and lancets for diabetics. My only complaint is why do they have to have such strict prescription requirements. I fully understand the need to have specific directions, quantities, and a diagnosis code as to whether the patient requires insulin or not. I don't understand why pharmacists can't take that information over the phone.
Why can pharmacists accept a phoned in prescription for Vicodin or Lortab, but we need a hard copy (faxed or brought into us) in order to bill Medicare for test strips and lancets? Why are there no requirements like this for Medicaid? What makes Medicare different than Medicaid in this regard?
It's really just a giant pain in the ass, and it inconveniences both patients and doctors. What often happens is that the patient will call the pharmacy and use the telefill to ask for a refill on their test strips. Our, and many other pharmacies', telefill system will automatically fax the doctor a renewal request if the patient is out of refills. The doctor's office will get the request, and in a day or so, they'll fax the approval back to us.
This creates a problem because when we go to process the approved refill, we'll realize that the patient has Medicare. Therefore, we need to contact the doctor's office again for a new script that has all those wonderful Medicare requirements (specific product, quantity, directions, diagnosis code). Getting verbal confirmation over the phone simply isn't good enough, so we have to wait for the doctor to send the Medicare compliant prescription to us before we can fill it.
I just don't understand why all of this can't be accomplished with a phone call and the pharmacist documenting on the script the proper directions, quantity, and diagnosis code. Why does it have to be directly from the prescriber? Like I said, if we can get verbal confirmation of a Vicodin script, what's the harm in allowing it on a Medicare prescription? It's just a waste of time, in my opinion.