Dallas Business Journal: Payment system stymies DFW independent pharmacies

August 27, 2012 · Medicaid, News

A new payment system in Texas is squeezing independent pharmacies with reduced dispensing fees and lower reimbursements for prescription drugs.

The Dallas Business Journal reports that with pharmacy benefit management companies (PBMs) are now setting reimbursement rates and dispensing fees, Texas Medicaid dispensing fees have been cut by 80 percent, from $7 to less than $2.

According to independent pharmacist Ronald Barrett, “Every day, I have to make a decision about whether to fill a prescription because frequently the reimbursement — the cost of the drug and our dispensing fee — is actually less than we pay for the cost of the medicine. That’s not on every single drug, but it happens enough that it’s scary.”

Barrett goes on to explain that he’ll typically take a loss on one drug if he’s making a profit on another drug the customer is buying. But if the loss-inducing drug is the only prescription the customer is filling, he’ll decline the business and suggest that they go elsewhere.

There’s an inherent conflict of interest in this system because PBMs are frequently both paying claims and filling prescriptions. The fear is that PBMs are setting unrealistically low prices to force many independent drug stores out of the program and in some cases, force them out of business altogether.

The sad fact of the matter is that it’s frequently in the best interests of PBMs to follow these practices, or as Glenn Staley, partner in Acorn Pharmacy in Dallas, puts it: “They have a built-in incentive to destroy their competition.”

9-1-12  ”The Vampire Squid” is no different than the big banks that almost put the USA into a depression.  All they do is move money.  They provide no medical care whatsoever.  They drain probably 18% right off the top.  They pay their overhead and deposit the balance.  The PBMs take billions of dollars from our industry and we just lay back like fat hookers and let them stick it to us.  How did the industry allow them to insinuate their banks into the middle-man position?  Pharmacy is not the PBM’s industry.

Mail order.  What the fuck?  Read the temperature requirements in the USP.  78 degrees is the max.  Drugs kept at temperatures above 78 degrees are “adulterated”.   How many mail order envelopes sit for hours in a closed truck in the sun?  The temperature could get higher than 120 degrees in a matter of minutes.  Then, the package could sit in a mailbox in the sun for a couple days.  The APhA’s stated mission is:  ”Improving Medication Use.  Advancing Patient Care.”  Okay APhA, time to shit or get off the pot.  Medicines kept at a temperature over 78 degrees does not Improve Use or Advance Patient Care.  Here is a political piece of shit.

Take a look at a box of lanatoprost Ophth 0.005%, Greenstone.  ”Important information for mail-order patients.  Contact dispensing pharmacy if prescription is not received within 8 days of dispensing date”.  Then  ”During shipment to the patient, the bottle may be maintained at temperatures up to 104 degrees F for a period not exceeding 8 days”.  Why do we keep this stuff in the refrigerator?

A few months ago, a technician failed to put a filled Rx for lantanoprost Ophth Soln in the refrigerator.   She put it in the regular filled Rx bin.  The patient noticed and refused the Rx.  He had me filled it again with a fresh box from the fridge.

We can kill Mail-Order, you guys.  Google “Pharmacists United for Truth and Transparency”.  I sent them $100.00.  I am a two day a week pharmacist.  If I can afford to send $100.00 to go after “The Vampire Squid”, you can afford $50.00.  Less than the cost of a good meal in  a nice restaurant.  Jay Pee

About that cheating claim.  Google “CVS in Trouble” and enjoy your afternoon.

It seems that paying fines is part of the algorithm that they operate with.   The profit they make from cutting corners is more than the fines they have to pay.   I cannot imagine a major drug store chain AGREEING to pay a $75,000,000.00 (75 million) fine for selling pseudoephedrine illegally, but that is our BIG EVIL.   CVS was a major supplier to the methamphetamine cooking industry until they were busted in 2010.  This has been well-known.

From 2008:  ”It’s not just the Chinese selling us poisonous products, add NEW YORK CITY area CVS pharmacies to the mix. Attorney General Andrew Cuomo (Now New York Governor) is suing the drug peddling chain for selling expired goods like “food, medicine and baby formula.” And we’re not talking about just a few bad apples in the bunch, try almost half: “Across New York City, 50 percent of CVS Stores were still selling outdated goods.”

You can go find more, but the news stories are pathetic for a major player in our industry.  That’s OUR industry.  CVS does not get any wiggle room.  The company is a disgrace.  We should all be ashamed.  CVS pharmacists?  I honestly do not know about CVS pharmacists.  I do know that taking the job of a PIC with CVS could ruin your career.

Why should you, a pharmacist, take the blame when something goes wrong and all you did was your job the way CVS wants you to, to the best of your ability?  It looks as if CVS has found a new strategy.  Allow the PIC to twist in the wind until she gags to death at the end of the rope.

My advice.  Do not take the job as a CVS PIC unless YOUR attorney writes the contract.  Every company that runs pharmacies will say that they expect their pharmacists to comply with all pharmacy laws.  They never say, “Unless it is really busy and the metrics are all fucked up.”

We all know that the metrics come first with CVS.

“But, Your Honor, it is not CVS’s responsibility that Roberta Martin’s baby suffered brain damage because Ginger Doe, Pharm D, failed to warn Roberta about the dangers of the drug.   CVS expects all of the company’s pharmacists to comply with all laws and to maintain the highest professional standards.”

I believe that the Taliban-Like standards about the metrics puts patients in danger.   CVS pharmacist.  Your take?

I have been told that CVS is getting rid of veteran career pharmacy merchants and are hiring “Dispensing Robots” who are barely adults.   Can any of you confirm this?

Essentially, I do not like the way CVS treats pharmacists.  They treat you as if you are a piece-work laborer in a factory.  They show no respect unless you have them in a corner.  Not a difficult thing to do if you just use your head and act like a licensed professional.  You are just a hunk of meat to CVS.

I am a CVS-watcher because so many people send me their stories.  I can’t see how CVS can keep their head above the sewage.  Swim in the sewer and you will get crap in your nose.   Can’t be avoided.

I would never suggest that CVS pharmacists undermine or sabotage.  That is not gentlemanly (Is there a word Gentlewomanly) behavior.

However, I will suggest to CVS pharmacists that you cover your asses.  Document, document, document EVERYTHING.  Who said what, when and time of day.  Record what was said.  If your PIC says, “Girl, you are getting too old for this” AND YOU ARE OLD, you have his balls in your fist, even if he did laugh.

Invest in a surreptitious digital recording device.  You can afford one.  I like the recorder hidden in the “Groucho Glasses”.    You can get a device that looks like a pen that records AUDIO and video and snaps still pictures for $79.99.   An ex-CVS pharmacist turned me on to this alternative.  Apparently, she has hours of damning audio.

Do I believe that pharmacists can bring Big Evil to its knees and cause a huge shake-up?  Perhaps cause Merlo to use his golden parachute?  Yes, I do.  You are the professionals in this scenario.   Your job is governed by the law.  Lots of laws.  Comply with the law and just dare some CVS Yay Hoo to tell you not to be so anal about pharmacy law.   Talk about a dream outcome.  You should all allow yourselves to think like Jay Pee.  A life with possibilities is so much more fun that going under in despair.

Read it and weep, you guys.

What a girl. You took a thorn out of Big Evil’s ass. That’s too bad. Please, stay in the loop.
J

I might want to work at Block Drug Stores.  It looks cool.  If I was younger, I might want to work the overnight shift.  It seems cool.  Alas, I believe that Block Drug Stores are from a different time, like Hopper’s “Nighthawks”.

Big Evil, Big Stupid and WAG are our time.  Those three are the drug store business.   I pay attention to these three because I don’t have the time or energy to watch Wal-Mart or Target or Publix or Safeway.  They aren’t drug stores anyway.

Let us start with “Big Stupid”.   Rite-Aid is the embarrassment of our industry.  I’m tired of writing about them.  From Wikipedia.

Company troubles

Rite Aid  had a major accounting scandal that led to the departure (and subsequent jail time) of several top ranking executives, including the CEO, Martin Grass, son of company founder Alexander Grass. Former Rite Aid vice chairman Franklin C. Brown is serving a 10-year sentence in a medium-security facility at Butner Federal Correctional Complex in Raleigh, North Carolina.^[11] After serving six years in prison, Grass was released on January 18, 2010.^[12]

At the time, Rite Aid had just acquired Thrifty PayLess and was integrating those into the company. As a result, Leonard Green, who ran the investment firm that had sold those stores to Rite Aid, took control of the company and placed Mary Sammons from Fred Meyer in as CEO.

In July 2001, Rite Aid agreed to improve their pharmacy complaint process by implementing a new program to respond to consumer complaints.

On July 25, 2004, Rite Aid agreed to pay $7 million to settle allegations that the company had submitted false prescription claims to United States government health insurance programs.

In August 2007, Rite Aid acquired approximately 1,850 Brooks/Eckerd Stores throughout the United States in hopes of improving their accessibility to a wider range of consumers. On December 21, 2007, The New York Times reported that Rite Aid had record-breaking losses that year, despite the acquisition of the Brooks and Eckerd chains.The following fiscal quarter saw an increase in revenue but a sharp fall in net income as Rite Aid began the integration process. Rite Aid shares fell over 75% between September 2007 and September 2008, closing at a low of $0.98 on September 11, 2008. Rite Aid shares subsequently dropped to $0.20 on March 6, 2009, the all-time low as of 8 December 2011

Scott Cole & Associates, APC filed a class action lawsuit against Rite Aid Corporation on behalf of its salaried California Store Managers. It was alleged that Rite Aid failed to pay overtime to these workers and denied them their meal and rest periods. In 2009, the action settled for $6.9 million. Scott Cole & Associates – Rite Aid Class Action

In June, 2010 John Standley who was CEO of Pathmark Stores (A regional grocery chain) was promoted from Chief Operating Officer to Chief Executive Officer, with former CEO Mary Sammons retaining her position as Chairman; Ken Martindale, previously co-President of Pathmark, was named Chief Operating Officer.

Rite-Aid has around 4700 stores.  That’s a lot to be dragging the industry down.

Forgot, I have an appointment.  Will continue. JayPee

Yes, it was a UFCW Union issue that really got up Rite-Aid’s ass, not the benign, adult, modern, 21st Century, harmless testosterone-charged threat of violence. Those of you who are pharmacist members of this union need to bring some pressure to bear. If the UFCW Union throws David Stanley under the bus, what about you?  Why pay union dues if they are not going to stand up for you.  Pharmacists are not some ancillary membership group.   They are real members.

I was looking through my archives and found this.   The Drug Monkey’s Blog and then Drug Topics taking him on as a regular columnist must have been eating RAD’s lunch.  I wonder what took them so long?  The second message is an anonymous (Smart Manager) laying the leather to Big Stupid.  RAD Stock price as I write this $1.18 per share.  How much less that a 20 ounce Mountain Dew?   Trust me, all of you RAD loyalists, your company is one missed payment to Cardinal from the “Raika”.  That is Finnish for hole.  Once in, never out.  I’d start peddling myself and my talents and experience right now.  If I was young .. under 40.. I’d be at the Small Business Administration with my hat in my hand.  You would get the loan.   With all of the “Dispensing Robots” coming out of the for-profit pharmacy schools,  you could easily take CVS and Rite-Aid customers.  You need more than Rx, however.  You need a good 40% t0 60% niche department.

May, 2011.  A source at Rite-Aid called and reported on Rite-Aid’s “Social Networking Policy”.  This is new and the craziest idea yet from an executive suite that is in a death spiral

Pharmacists are asked to sign off on this policy.  It is aimed at their use of Facebook and Twitter primarily, but could extend to their private e-mails.

Pharmacists are not allowed to discuss their jobs on any social media.  This is obviously an attempt to stifle negative comments.  If they say anything, they are required to post a disclaimer that they do not represent Rite-Aid.  Twitter?  Impossible.  Not enough characters!

They agree not to use pseudonyms.  I fall down laughing.  They are not allowed to call themselves “Ass-Wipe RAD RPh”.

They agree, as an RAD employee, not to use bad or adult language.

They agree not to disparage Wal-Mart, CVS, WAG, Kroger, Safeway or any other “competitor”.

Supervisors are not allowed to take action against bad boys and girls until they have talked with Human Resources.

According to my source, this policy applies to all employees, cashiers and up.

Now, From The Non-Pharmacist Manager

I have worked for a number of major companies, in a number of different fields. But I can confirm that Rite Aid is by far the most blatantly mismanaged I have ever come across. District Manager vary wildly on requirements, enforcement and expectations. Store openings are not based on performance strictly, they are kept within districts. Even if those districts are arbitrary locations. The ability of this company to manage talent is beyond reprehensible. I do agree however that there is a place for Rite Aid, and it fills an important void that can’t be filled by the CVSs and Walgreens. I will give Rite Aid a bit of credit in now finally realizing we are not ever going to be the same as the 2 leaders. Instead finding decent ideas (like actually marketing the 15 minute guarantee), increasing partnerships based on areas and needs. I actually really enjoy my job, and hope the company can continue its slow road back. But unfortunately it appears to be the old story of 2 steps forward…

I am a Rite Aid Manager (not RX), and can confirm a large percentage of the social networking information you mentioned from your source. However a point of contention: the policy does not state pseudonym is not allowed- it merely states that if needed they will take steps to FIND OUT WHO YOU ARE. The worst part is, thats not even the most troubling thing in this new policy. It is very explicit in stating that as a Rite Aid employee you are responsible for the content of your social media communications, even if your social media communications are done entirely off the clock, not on company equipment or company property. Even if your communications are set to being entirely private.

As far as it pertains to representing Rite Aid, I can almost understand the policy. There have been instances of Rite Aid managers and pharmacists joining Couponing Message boards, or complaint boards and inflaming customers, while admitting they work for Rite Aid. This of course makes the company look terrible, because in those instances they are actively representing the company. I understand the need for a strongly worded policy regarding the importance of not disclosing any information that may be considered a HIPPA violation. These type of communications are the ones where you are required to indicate that you do not represent Rite Aid in anyway.

Unfortunately, the policy does not restrict itself to situations where Rite Aid is being represented. The policy basically states any personal private social media communication is subject to the policies and procedures of Rite Aid. No obscenity, profanity, mentions of drug use, or jokes/comments about protected classes of people. In theory, you could not have a discussion about terrorism with a former college prof. as you may meander into discussion that could be seen as offensive to Muslims. You can’t debate the merits of gay marriage on a message board for the same reason. And obviously you can’t do far more offensive things that are protected by the constitution- even if you do them on your own time. Furthermore, the expectation is that you would delete any comment you have control of that someone else makes. Again, this is expected even if your profiles are set to private.

Now I presume that these policies are mostly just lip service. Overstatements of discipline in order to cover themselves should an egregious issue occur like a HIPAA violation, or a gross misrepresentation of the company on a public forum. However, Rite Aid has significantly overstepped the bounds of their ability to restrict the rights of their employees off the clock, as rite aid employees are not public figures, and not representatives of the company they work for. This is not weight clause at Hooters, or a non-compete for a News Anchor. These are, by and large, part time associates making $8-$9 an hour while working. I’m not sure that sum buys away their rights off the clock.

Just to be safe, This message was not in anyway endorsed, nor approved by my employer.

I can 100% CONFIRM that as a cvs pharmacist that we indeed received the same information from our regional supervisor. In addition they will monitor our phone calls to patients who have made the switch from WAG’s to CVS on a call list that is automatically generated weekly. We must call them at least twice and try to get them to sign up with cvs programs such as autofill and text messaging (funny how we are a pharmacy innovation company but yet field a computer system that is a garbage mirror shell of instability). I believe that ( I can’t confirm because my tech hours are so low that I had to reprimand a tech from giving what could be construed as counseling to a patient about a benign OTC product due to me having to be more concerned with metrics to save my own ass) CVS is offering a specific 20% off store coupon to those customers who stay at CVS and we all know they are not checking profiles to see if federal funds are being used for their scripts. This is just the tip of the iceberg with this company. They are already telling pharmacists they are overpaid and hiring young inexperienced pharmacists (you know the ones that trash your pharmacy because they are thrown to the wolves often) at about 10 dollars an hour LESS than the rest of us) and the new employee optimization committee is going to put all of us “overpaid” pharmacists into boxcars and send us off into the unemployment lines while Larry Merlo laughs his ass off…dickbag…

Osupharm11, Are you are an Internet Troll, working for Big Evil? My friend, it is not working.

I have had up to close to 800 unique visitors a day visit this site.  They are mostly pharmacists.  They are intelligent.  How else could they get out of pharmacy school alive?  They are working pharmacists and they know what is going on.  Many of them are stuck at CVS.  They are the most vocal.  Basically, they hate it.  Worse, they feel that it is hopeless. What is life if there are no possibilities?  Young doctors tell me that they feel like Insurance Pimps.  If you really work for CVS, how long before you realize that you are a CVS pimp?

Coming up, there will be plenty of prescriptions to fill and plenty of niche side businesses at 40 to 60% gross profit.  Use your head, OSU.  Get out while you have a soul.  Open your own store.  Southern Ohio is ripe territory.  If you have the personality, the energy and the brains, you will do well.

If you chose to stay with Big Evil, insist on a contract and have your attorney weigh in.

I did not know about the arbitrary and execution-style, bullet-in-the-back-of-the-head firing of The Drug Monkey (David Stanley) by Rite-Aid until yesterday when I read an e-mail from Julianne Stein.
She said, “The suits got David”. Julianne is the editor at Drug Topics who rides herd on the stable of writers that includes myself, David Stanley, Ned Milenkovich and others who write columns in Drug Topics magazine. Without Julianne, we could be undisciplined hacks.
I have received a bunch of e-mails from pharmacists who have asked, “Why don’t you write something about The Drug Monkey getting fired at Rite-Aid?” I wanted to see what David had to say first. I asked him. He sent me an e-mail, telling me the story. David can tell you what he wants to tell you. David has never been a chicken-shit so I will include SOME of what he said right here.
Here is Jay Pee’s take. The Monkey was indelicate in his view of Rite-Aid and the coming strike in Southern California. (Go to his blog. There is a link to your right) He threw in some man-talk that Rite-Aid jumped on. They said that David was inciting violence. What the fuck? We are all adults. This is the 21st Century. It is the Age of Aquarius.
The Internet. There is nothing that Rite-Aid can do to prevent pharmacists from figuring out that Rite-Aid certainly appears to be a company in a death spiral. My opinion is that Rite-Aid doesn’t even have fingernails to hold on with. Would you keep shipping $$Millions a week if you were Cardinal and death-spiral company missed a payment? Marginal companies are in business only because the suppliers like the sales. If they do not get the money, they will not ship. Period. Nada.
With a Rite-Aid closing stock price of $1.17 per share on Friday 8/10/2012, David can cash out all his stock for a weekend at the Travel Lodge in Encino, the one by the highway, with the hookers hanging out by the algae-filled pool at midnight.
Violence! Rite-Aid declared that this was such an egregious inflammatory move by The Monkey that Rite-Aid sent the Loss Prevention Rooster to fire him, all the way from Camp Hill, Pennsylvania, I believe. Imagine this: A little pudgy peacock, guinea cock strutting little man. I would bet that he could get so excited at the execution of a prominent pharmacist that white spittle formed on the corners of his mouth. And why would a man in an executive position use “Da” instead of “The” in a conversation with an intelligent, well educated medical professional?
Oh, by the way, wake the fuck up, Rite-Aid. Your pharmacists are intelligent, well-educated medical professionals. All they have to do is start acting like it and you Masters of the Universe are doomed.
More on this, I am sure.
From David’s e-mail. I asked him if he was in a union.

Hi Jim,

The first step to getting the union to do something would be for them to return my calls, which hasn’t happened yet. I’m in the UFCW, a grocery workers union that happens to include some pharmacists. As an organization, they sadly leave a lot to be desired. They are complacent and comfortable and on the edge of getting their clock cleaned. In the last contract for Northern California, they agreed, for whatever reason, that any pharmacist hired after ratification would not be unionized. Now Rite-Aid is going in for the kill in Southern California. The company has forced the union to take a stand, betting that they can finish the union off.

The official reason I was let go was a comment I wrote on the blog about Rite Aid’s plan to bring in scabs should a strike happen. Specifically, that they “run the risk of me driving down there and kicking their ass so hard their rectum ends up past their incisors.” According to the suits, that violated RAD’s policy against workplace violence. They flew the head of Loss Prevention out here, which I suppose should be some sort of compliment.

The picture above is NOT our friend in the Rocky Mountain State.   This technician is pretty.  I happen to know that our friend at the Big Box Store in Utah is drop-dead, Hollywood gorgeous.  I believe that they work for the same company.

We need to start paying attention to our technicians.  Without them, we are screwed.  What would you (a pharmacist) do with an insurance card from the Little Sisters of the Poor Elementary School in Keokuk, Iowa?  At 9:30 PM, on a Friday night.  With two cars at the drive-through.  The second driver pissed off at the first driver and threatening to beat her up.  The phone won’t stop ringing.   Three people lined up at the register and the teenager is getting Advair for the first time.  The doctor wrote on the Rx (Give instructions on use).  You closed the drop off window.  That helps, but the husband of the worker from Little Sisters of the Poor has had too many beers.  He just shouted, “What the fuck, man.  Are you a pharmacist or not?  Do your fucking job or I’m coming back there to show you how.”   Your mouth has chocolate smeared on it.  You have to eat something.   The bag of Fun Size Snickers is almost empty.  Next come the Butterfingers.  And you gotta pee.  You really gotta pee.

Who wants to tell me that technicians are not important to our industry?  Truth?  They are treated like they are indentured servants.

I have exchanged e-mails with this woman.  She knows her stuff.  She is loyal and productive.  She does not need to tolerate bullying.  I suggest that she buy “The Dangerous Book for Pharmacists” and read about sexual harassment.  Non-sexual bullying is included.

Here we go again.  For Crissake what is wrong with her pharmacists?  The bullies are non-pharmacists.  They are not MBA Masters of the Universe. They started out with this company gathering shopping carts from the parking lot.  They have NO Standing in the pharmacy.   Come on, you guys, stop it.  Stop letting them intimidate you.  They are not even allowed in the pharmacy without your permission.  Pharmacy is a profession.  I know, hardy har.  You can’t even find the time to holler, “Ma’am, your new Rx of Nexium may interfere with your Plavix”.   Fuck it, your waiting time is puckering up your asshole.  You don’t have the time to counsel.  Okay, don’t read that asshole part if you are sensitive.  Those of you who did read it know exactly what I am talking about.  You are a professional failure.  All 230,000 retail pharmacists in the USA fail all day long. I did a little searching.  Get this, it is estimated that there are TEN preventable deaths from drugs EVERY DAY because the pharmacist did not live up to her/his duty to warn.

So, we have pharmacists with little back bone (Peon, you need to lecture them.  They get their paychecks from the same place you get yours) and a really good technician who is regularly bullied by non-pharmacist management.

What to do?  PharmacistSteve started this line of thinking a year ago.   I like it a lot and pass it on every chance I get.  The pharmacists can become bullet-proof just by writing a simple letter to the non-pharmacist middle manager and by sending a copy to the Corporate Compliance Officer. That is the company cop.  All you do is write that it is your intention to comply with all pharmacy laws, both federal and state, in your job with XXX-XXXX.   Make sure you add these sentences at the end.   I believe that it is XXX-XXXX policy and procedure that all pharmacists comply with the law at all times, in every instance.  Please advise me if this is not correct.

A pharmacist who writes this letter will be bullet-proof.  Anything the company might do to try punish you could be considered retaliation.  I believe that PharmacistSteve can expand on this part.   Technicians live and work obligated to obey the law.  I suppose a technician could write this letter, but she would never have to if the pharmacists wrote it.  Guaranteed, they will leave you alone.  This particular company is paranoid.  They will seriously reprimand the non-pharmacist middle managers and that will be that.

For your protection.   Document, document, document.  Jay Pee

Visit www.thepharmacyalliance.com for more guidance.

I am a Certified Pharmacy Technician.  I am not a “Newbie”.  I have been around for awhile.  I love my job! My current employer, not so much love there.

I started out in a soda fountain drug store delivering prescriptions, dipping cones and running the gift store. I was immediately hooked on pharmacy and to this day I love the relationships that I gain with patients and co workers.

Hometown Drug stores are, of course, a thing of the past. Now I work for a big box retailer. I’ve been here 12 yrs. There is nowhere else to go.  I live in a Rocky Mountain state.  Not that many technician jobs around here.

They threaten my job several times a day, making sure I realize what a peon I really am. I am not allowed to have so much as a drink of water in the pharmacy because I might be slipping a pill in it.

The pharmacists won’t stand up for us because they are just as worried about keeping their jobs as we are. I once had my district manager tell me how important we all are, I quote “A warm body is better than nobody!”

We work all but three major holidays and I’m sure it’s only a matter of time before we work them all. I’m underpaid, under-appreciated and over-worked. I often dream of going back to that good old hometown drug store, where people stopped for a Coke while they waited for their prescription and ended up visiting half the day away.
Maybe it’s time to shelve my counting tray, get on welfare and have some rosy cheeked little girl technician fill some Xanax (brand name only please) prescriptions for my personal use. That was meant to be funny.  Me?  Xanax?  Not in a million years.  I am a professional tech and I know that cooking with Xanax, Vicodin and Soma (and plenty of others) make for a dangerous, bitter stew.  But, Xanax and Welfare seems to be working for so many people.  At least in our town.

Thanks for letting me vent.  Is that all we (pharmacy grunts) can do?

Rocky Mountain Low

I just watched this video for the second time.  This is big stuff.  CVS actually gave “Length of Pharmacist’s shift” as a good reason for exceeding the RX limit and gave time of day (like the 12th hour) as an excuse for errors.  That asshole MBA Master of the Universe PR person was probably fired the next day.

BEFORE THE NORTH CAROLINA BOARD OF PHARMACYIn the Matter of:CVS/PHARMACY(Permit No. 10878)CONSENT ORDER OFDISCIPLINETHIS MATTER came on to be considered at a prehearing conference (hereinafter,”Conference”) before a member of the North Carolina Board of Pharmacy (hereinafter, “Board”)pursuant to 21 N.C. A.C. 46 .2008. This Conference was scheduled for June 18,2012 and, afterappropriate notice, was heard on that day by Board member Gene W. Minton at the offrces of theBoard. Respondent CVS/pharmacy (Permit No. 10878) (hereinafter, “Respondent” or “CVS”)was present and was represented by Counsel George G. Hearn and Brenda Maloney Shafer.Counsel Rebecca L. Cage represented the Board. Members of the Board’s investigative staff andrelated respondents were also present at the Conference.CVS has agreed to waive a formal hearing in the above-referenced matter. Both partiesstipulate and agree to the findings of fact and conclusions of law recited herein and to the orderof discipline imposed. By its consent, CVS also stipulates that it waives its right to appeal thisConsent Order or challenge in any way the sufficiency of the findings of this Order. Based uponthe consent of the parties, the Board hereby enters the following:FINDINGS OF FACT1. The North Carolina Board of Phannacy is a body duly organized under the lawsof North Carolina and is the proper body for this proceeding under the authority granted it inChapter 90 of the General Statutes of North Carolina, and the rules and regulations promulgatedthereunder.))))))2. CVS is and was, at all relevant times referred to herein, the holder of Permit No.10878 from the Board, and located at 3001 Fayetteville Road, Lumberton, North Carolina. CVSis and was, at all relevant times referenced to herein, subject to the rules and regulations of theNorth Carolina Board of Pharmacy and the laws of the State of North Carolina.3. On June 1,2011, CVS held a training program in Wilmington, N.C. for theadministration of vaccines, which was attended by nine pharmacists and two pharmacy interns(“Participants”). As set forth below, it was later determined by the Board that the trainingprogram did not meet the requirements for a certifrcate program under North Carolina law.4. On September 15, 2011, the Board received an anonymous complaint notifringthe Board of alleged deficiencies in the vaccination training program offered by CVS on June 1,2011, including allegations that the training program did not include the required twointramuscular injections and one subcutaneous injection and that the trainer provided each of theassessment examination answers to the Participants of the program.5. On October 20,2011, Jay Campbell, Executive Director of the Board, notifiedCVS, through Michael Sherry, Manager, Retail Clinical Operations, of the anonymous complaintreceived by the Board and requested a response. Mr. Campbell wrote that it appeared that thepharmacists who participated in the purported training program were not properly trained andcertified to administer vaccines. Mr. Campbell notif,red Mr. Sherry that, based upon theinvestigation, it appeared that any permits who permitted these pharmacists to administervaccines were violating North Carolina law.6. On November 10, 2011, Mr. Sherry provided a written response to Mr. Campbell.Mr. Sherry identified the Participants, the trainer, and, based on CVS’s investigation, confirmedthat the training program did not include the required two intramuscular injections and one2subcutaneous injection. Mr. Sherry also conveyed that the Parlicipants would be retlained andwould retake the examination, and until they did so, the Participants were notified that they werenot permitted to administer vaccines. Mr, Sherry provided the number of vaccinations that theParticipants administered between the training on June I ,2011 and the time at which they wereinstructed by CVS to cease any vaccination administration, which was on or about October 24,20IL After further investigation and during the Conference, Mt, Sherry also confirmed that thetrainer provided each of the assessment examination answers to the Participants of the program.7. From on or about November 14 to November 24,2011, a new CVS trainerconducted retraining on injection technique. Participants April Rogers, Edmund Wellons, MyraRochelle, Nathaniel Brooks, Lauralyle Weavel and Amos Brinson underwent injection tecl-rniqueretraining. Participants Matt Rettig, Ashok Chandarana and David Kopaczewski opted not toundergo retraining and instead decided to no longer administer vaccinations. Following injectionretraining, Parlicipants April Rogers, Edmund Wellons. Myra Rochelle, Nathaniel Brooks.Lauralyle Weaver and Amos Brinson again began to adrninister vaccines based ollcommuniçation fiom CVS that they were permitted to do so, The retraining that took place inNovember 20 i I did not, however, require the Participants to repeat the didactic coursework ol toretake the assessment examination.L On December 5, 2011, Ml. Sherry received a letter from Mr. Campbell inl-olrr-ringhim that not all participants had been retrained on injection technique and that none of theparticipants had repeated the didactic course work or had retaken the exam. Accordingly, theParticipants remained irnpropelly trained and not certified to adrninister vaccines under NorthCarolina law.39. From on or about December 5 to December 19,2011, CVS conducted exam retestingof certain of the Participants. April Rogers, Edmund Wellons, Myra Rochelle andLauralyle Vy’eaver re-took the examination. Participants Nathaniel Brooks and Amos Brinsonelected not to re-test and instead decided to undergo the full training for certification for the Fall,2012 flr;- season.10. On or about December 79,2011 Mr. Campbell contacted CVS Wilmington areapharmacy supervisor Betsy Ramsay and informed her that the Participants were not permitted toadminister vaccines.11. From on or about December 19,2011 upon direction from CVS, none of theParticipants administered any vaccines as directed by the Board.12. Between August 30,2011 and December 14,2011, CVS permiued R. Ph. AprilRogers, as pharmacist-manager, to unlawfully administer 118 vaccines.13. Further, between September 23,2011 and October 18, 2011, CVS permitted R.Ph. David Kopaczewski to unlawfully administer 6 vaccines under the supervision ofpharmacist-manager April Rogers.14. In addition, a number of the vaccination records maintained by CVS did notcomply with North Carolina law in that 19 of the records failed to adequately describe theadministration site of injection.CONCLUSIONS OF LAWBased on the above findings, the Board concludes as a matter of law:l. All parties are properly before the Board, and the Board has jurisdiction over CVSand the subject matter of this proceeding.42. CVS’s conduct, as set out in the findings of fact above, constitutes grounds fordiscipline pursuant to N.C. Gen. Stat. $ 90-85.38 because CVS’s acts were in violation of N.C.Gen. Stat. $ 90-85.3(r), 90-85.38(b), and 90-85.40(Ð; and 21 N.C.A.C. 46 .1804(a),46 .2302(a), and 46 .2507.Based upon the foregoing, and with the consent of the parties, IT IS THEREFOREORDERED that the permit of CVS is hereby subject to the following conditions:1. CVS shall administer no vaccinations for a two-year period commencing on thedate of the entry of this Order and running for two consecutive years;2. CVS shall violate no laws goveming the practice of pharmacy or the distributionof drugs;3. CVS shall violate no rules and regulations of the Board;4. CVS shall cooperate with the Board, its attorneys, investigators and otherrepresentatives in any investigation of compliance with the provisions of this Consent Order; and5. If CVS fails to comply with any terms or conditions of this Order, CVS may besubject to additional disciplinary action by the Board.This the ay of July, 2012.NORTH CAROLINA BOARD OF PHARMACYBy:Jack W.5veCVS/pharmacy, the holder of permit number 10878, has full knowledge that it has theright to a formal hearing, at which it would have the right to be represented at its expense bycounsel, in this matter. The undersigned freely, knowingly and voluntarily waives such right byentering into this Consent Order. The undersigned understands and agrees that by entering intothis Consent Order, it certifies that it has read the foregoing Consent Order and that it voluntarilyconsents to the terms and conditions set forth therein and relinquishes any right to judicial reviewof Board actions which may be taken concerning this matter. The undersigned furtherunderstands that should it violate the terms and conditions of this Consent Order, the Board maytake additional disciplinary action. The undersigned understands and agrees that this ConsentOrder will not become effective unless and until approved by the Board. The undersignedunderstands that it has the right to have counsel of its choice review and advise it with respect toits rights and this Consent Order, and represents that it enters this Consent Order afterconsultation with its counsel or after knowingly and voluntarily choosing not to consult withcounsel.The undersigned certifies that its agent executing this Consent Order is duly authorized toaccepf the Consent Order on behalf of CVS/pharmacy, and to bind the permit holder.ACCEPTED AND CONSENTED TO BY10878)Date ôrl-t3 -)Ðl)-By:Ph*”,no$O”,rø2nr gSTATE OFUttLCOTINTYI, the undersigned Notary Public of the County and State aforesaid, do hereby certify thatthe following personally me this acknowledged the due execution of theforegoing document:DateEDNA BROI’YI{Public6My commission expires: 1* * * * * ,1. * * ‘F * *:ß * * * * * * * * * * * * {.,1. * * * * t< * ,1. * * * d. * * ‘ß ‘ß * tF * t * * {. ¡1. * *’|<* {< * * {. {<’1.REJECTED BY:DateCVS/pharmacy (Permit No. 10878)7