`You Can't Stock Everything'

Partial Prescription Problem Is Widespread, Pharmacies Say

February 6, 1998|By BOB LaMENDOLA Staff Writer and Staff Researcher Barbara Hijek contributed to this report.

Every pharmacy does it.

A customer comes in for 60 pills but the store has only 30. So the pharmacy bills the insurer for the full amount and asks the customer to return for the rest of the pills in a day or two.

``You can't stock everything,'' said Jerry Delman, owner of Community Pharmacy in Boca Raton. ``There are thousands and thousands of drugs. It's just impossible to have a lot of all of them. You could have a run on a drug and just be out.''

Once in a while, the customer doesn't show up for the rest, and that has prompted an investigation into Eckerd Drug Stores by state and federal prosecutors with help from a whistle-blower.

On Wednesday prosecutors sued Eckerd, Florida's largest pharmacy, alleging the company improperly kept $11.5 million paid for undelivered drugs, $3.3 million from Medicaid and the rest from two medical plans for federal workers.

Eckerd blames problems with a computer billing system used by large pharmacies, but independent druggists said it's easy to give refunds to Medicaid and other insurers on their computers.

``We reverse the charge right away. Everyone should,'' said Paul Elias, owner of the Prescription Pad in Plantation.

Pharmacies usually try to call customers to remind them to pick up their medications, but druggists admitted they are sometimes too busy. That might be especially true at large pharmacies with high volume.

``In this day and age, I don't know if we have time to do that all the time,'' Elias said. ``We tell them to come back and it's up to them. It's the patient who is suffering.''

Those who don't return may have paid for all or part of the medicine they didn't get.

A spokesman for Eckerd, which is based in Largo and has 573 Florida stores, said the company ``flatly denies'' intentionally overcharging.

The problem is that an industrywide computer program used by large pharmacies to bill major insurers does not allow partial bills, even if prescriptions are only partially filled, Eckerd spokesman Dan Pero said on Thursday.

Attempting to file a partial bill can result in future refills being denied, patients being charged two co-payments and other woes, he said.

Pero accused the state of exaggerating the problem. Florida alleges overpayments on 188,000 of the millions of Medicaid prescriptions that the company filled since 1986.

``This happens so infrequently in our pharmacies that this didn't even come to our attention until the authorities told us,'' he said.

State officials would not say whether they thought the overbillings were intentional or sloppy practices, but said Eckerd did not keep enough drugs on the shelves.

``It's fair to say that the origins of the problem lie in a tight inventory policy that makes short prescriptions a somewhat commonplace occurrence,'' said Mark Schlein, an assistant attorney general who heads the state Medicaid fraud unit.

Since the state first pointed out the problem two years ago, Eckerd has changed its policy, Pero said. Druggists call several times if the customer does not pick up undelivered medications, and mails out the remainder after 30 days.

But Schlein said Eckerd did not correct the billing problem quickly, thoroughly or ``in a fair way.'' He would not elaborate.

Other undisclosed companies are under investigation, too, Schlein said.

Walgreen Co., No. 2 in Florida with 401 pharmacies, was cited in similar lawsuits in Illinois and California. The latter has been dismissed.

A Walgreens pharmacy shorted Frank Horward of Deerfield Beach last year on his refill for blood pressure medicine. His prescription was for 100 pills but he got only 60 and had to go back later for the rest.

``It's an inconvenience,'' Horward said. ``It's no skin off my nose but . . . they're doing the same thing.''

Walgreen spokesman Michael Polzin would not comment. He said the company has strongly denied wrongdoing in the other states.

Staff Researcher Barbara Hijek contributed to this report.

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