My mom has been in the same AL facility for several years. I have been getting her meds from Express Scripts and giving them the bottles to dispense as directed. Now they are telling me that new New Hampshire laws starting in Feb. have put restrictions on what LNAs can do with meds and they are REQUIRING me to use their (expensive) pharmacy service that gives a prepackaged supply of dialy pills.
I can't find a reference to new laws on the web. I can't believe this is legal. Has anybody encountered this? Please HELP! I can't afford their service!
Anyone know where you can get Depends ( or similar) cheaper than Wal Mart or Costco? My husband goes through 70 a week. My bill for Depends also runs close to $ 200. a month- all this over and above the AL fees.
Good for you for questioning this inadequate "system" and attempting to save money in this present health care crisis.
The reason "they" cannot explain the rules to your satisfaction is that they don't know why or how to interpret the regulations. I am going to give you some ideas so you can seek the answers you need. The new regulations have to do with Medicaid regulations requiring all Medicaid recipients to choose from within a managed care network; and who is qualified to administer medication at the AL.
For licensing purposes, and so the LNA's can give the meds at the AL, the state regulatory agency (www.state.nj.us/health) may have required the bubble packages be administered (by the technically unqualified LNA), therefore the leap to pharmacy rules. Think of it like a hospital's requirement that you pay $$$huge amount for one tylenol so that the nurse can administer the meds, and you are not allowed to take your own.
I would try to bypass these rules, stating that you require mom's meds be administered by an R.N.
IF mom is able, can she take her own meds that you put in a 7 day minder box ahead of time?
If you are private pay, do not let them treat you under the rules required for Medicaid patients for their own convenience.
Posting this unfinished, sorry.
If your mother is in a facility that is full service and you assigned her health insurance to them, their doctors, their labs, their pharmacy, then your choices may be limited, like with any HMO. Are you calling Medicare? Be sure the "laws" they are quoting are not just the policy of the facility for their convenience.
Hang in. I know how hard it is, and everybody who hasn't had someone in AL or a NH thinks that you do little to nothing because you loved one is "being taken care of." HUH!!!
Your state representative's office will be able to tell you if there is such a law.
Pharmerica is a part owner of their SNF and as such requires all Medicare patients to use them for drugs. I was upset as my ILs have great insurance through Express- Scripts (3 month supplies one low copay)
The business manager had us sign some Pharmerica form during admission. I tried to explain to her we wanted to use their prescription coverage, she told me MEDICARE required they use Pharmerica. Huh.
Later when I read about Pharmerica - after googling them- and receiving a $600 bill for just one of FIL's meds from them- I went to the same business manager's office as at that point no one was on Medicare, both were private pay. At this meeting she informed me that SHE had nothing to do with med ordering and I should take it up with the nurses. (?)
I transferred all of their meds from Pharmerica (who was submitting to Express -Scripts but many of the meds has been ordered for more than 3 months which ends the coverage for Pharmerica ordered meds) now all of the meds are ordered through Express-Scripts.
When I googled Pharmerica I found out this nursing home "game" of theirs is a bit shady.
Of course this may not be your problem. But, could you contact Express Scripts and see if they would package differently to be in line with supposed law?