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Re: OPTUM RX completely botched take over of prescription plan for State of NJ Employee's and Teach

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Message 11 of 13
I'm not on Medicare.
But why are mail order drug companies allowed to over ride The Dr.'s orders. Their the one's with an intimate relationship with the patient.
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Re: OPTUM RX completely botched take over of prescription plan for State of NJ Employee's and Teach

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Message 12 of 13

@m573000l

 

I don't know if this is part of your problem but it could be -

Last year, the CDC issued new guidelines for opioid prescribing and Rx filling.

Most all prescription fillers have established some sort of management system.

 

Here is what OptumRX did:

OptumRX Opioid Risk Management Program Leads to Better Outcomes for Patients - Aug.22, 2017

 

CMS (Medicare) has a new rule in the works for those on Medicare and if it passes the approval process and most likely it will, those plans will begin its implementation in 2019.

 

 

* * * * * * It’s Always Something - Roseanne Rosannadanna
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OPTUM RX completely botched take over of prescription plan for State of NJ Employee's and Teachers

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Message 13 of 13

In Dec 2017 I recieved notice that they would be cutting back my pain meds in Jan.

I called them and was told to call back in Jan to see if I was approved for the amount of the dose I have been on for 7 years. 

I called Jan 4, was told to have Capital Health send over the script marked Urgent so there would not be a problem refilling Jan.21.

Cap. Health did as requested. A few day's later I called to check with Optum if everything was complete. They have no records.  I call Cap. H and they sent again. Rinse and repeat. Optum still has nothing.

Jan 22, my doctor sends script to Pharmacy, they call Optum and Optum would not approve.

Today I called Optum and I'm told New law went into effect now they need to speak with Dr, personally. They said he called they would fill it today.

I sent my Dr. text and he was in Boston but called them because he knows the trouble I have been having with them.

Dr. gave me rep. name and case#. He also called Pharmacy and said it should be ok now. Pharmacy called Optum for approval and now, 1 hour later and they say the script has been terminated and we need to start process all over again.

So I call back Optum they pull up case # given by Paul Riviera to my Dr, and there is no record of my Dr calling.

The pharmacy said it's not just me, they are screwing up everyone's scripts.

They should have worked more closely with Primary's so there would be a smooth transition.

If your haveing similar problems call the Board of Pharmacist, Attorney General and NJ state emplyee benefits. Tell them to cancel contract with Optum.

P.S. I have a feeling Christie has something to do with this.

Follow the money trail.

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