The sanction means no new people can enroll but those who are in it for better or worse right now have to deal with the issues. This all comes back to IT infrastructure and the data flowing correctly, along with some human input. About 4 million seniors are part of the program. We hear about transaction fees with hospitals, well here’s a new one with prescriptions. They insisted she pay a charge of $70 for this.
The algorithms were bad here as over 2,000 complaints were registered in a week. When you cry and whine about wanting data service connectivity faster than what is being provided sometimes, think of this story.
Also keep in mind that all the data information has to be formatted so it can be sold as there’s big money made on selling prescription and other data and the competitor of CVS, Walgreens made short of $800 million selling data in 2010. In other words the data has to be ready to sell as well and be routed to either a central collection area to to direct customers who buy data from CVS and Caremark. The problem with some of the accounting is that the prescription gets billed when it is filled, not when you pick it up. BD
The Prescription Auto-Refills Still Out There With CVS and Others as Pay for Performance Efforts Ramp Up at US Corporate Retail Pharmacies To Meet Quotas and Make Those Profit Numbers for the Shareholders
The Automatic Prescription Refill Algorithm Causing Havoc at CVS When Not Personally Authorized By the Patient–Attack of the Killer Algorithms Chapter 40
Shapiro was one of many seniors who found themselves facing inexplicably large bills that CVS refused to negotiate. As a result of cases like hers, CVS was sanctioned last month by Medicare, which means the company can't enroll new people in SilverScript until it cleans up its act.
The federal Centers for Medicare and Medicaid Services said in a letter to CVS' SilverScript subsidiary that its inability to process prescriptions correctly "poses a serious threat to the health and safety of Medicare beneficiaries."
The federal agency blamed the problems on "widespread data system failures" that have "created disruptions in tens of thousands of Medicare beneficiaries' access to prescription medications."
Shapiro said she got the runaround from three separate CVS supervisors until a company representative finally insisted that she had to take what she was given and pay the amount CVS was demanding.
She said the company deemed the $70.61 bill a "transition fee" from her former drug insurer, which, as it happens, was also run by CVS.