View Full Version : Getting 3 Rxs (30 days each) at one time


pattipeeples
04-26-16, 11:02 AM
My son is treated with Vyvanse. We live in Florida but will be living in South Carolina for 2 months during the summer so he can work. His pediatrician will NOT give us 3 separate Rxs for 30 days each at ONE time, and requires me to go into the office each month to get a new Rx (not for a visit, just to pick up Rx). Obviously, for 2 months, I won't be here. She will not mail the Rx to me or to the pharmacy. What options do I have - LEGALLY?

What is the legal rule in Florida about whether the MD can mail your Rx to your pharmacy (in South Carolina or in Florida)? What is the legal rule in Florida about whether the MD can mail the Rx to me, living in South Carolina?

Annoying.

Socaljaxs
04-26-16, 09:21 PM
Legally doctors are not allowed to write post dated scripts. They can get in major trouble if caught, while some doctors do it regardless, they legally are not supposed to. Also sending a perscription by mail offers additional problems such as lost in the mail, no proof of receiving it wrong hands ext. even filling these types of medications in different states can be an issue, when the Doctor is in another state. Sadly even though we may need our medication to live and function day to day. Medications and treatment for any illness or condition is considered a privilege, not, a right

The class of drugs is what and why your doctor is following the rules. Sadly you may just have to pick up the perscription, only other thing would be to offer you a referral to a local doctor while out of town..

My son is treated with Vyvanse. We live in Florida but will be living in South Carolina for 2 months during the summer so he can work. His pediatrician will NOT give us 3 separate Rxs for 30 days each at ONE time, and requires me to go into the office each month to get a new Rx (not for a visit, just to pick up Rx). Obviously, for 2 months, I won't be here. She will not mail the Rx to me or to the pharmacy. What options do I have - LEGALLY?

What is the legal rule in Florida about whether the MD can mail your Rx to your pharmacy (in South Carolina or in Florida)? What is the legal rule in Florida about whether the MD can mail the Rx to me, living in South Carolina?

Annoying.

Laserbeak
04-27-16, 01:10 AM
Tell your doctor you are going on vacation. You may be able to simply get a 90 day prescription instead of a 30 day prescription. It is legal at the federal level but some states don't allow it, check with your doctor.

Otherwise, doctors and pharmacies can dispense more than a 30 day supply for vacations, you may have to provide proof you are leaving the area.

Worst comes to worst, you may need your doctor to mail you a prescription at the appropriate times. States honor out-of-state prescriptions, although the pharmacy may give you trouble and call your doctor so expect delays getting it filled.

Cyllya
04-27-16, 03:56 AM
Legally doctors are not allowed to write post dated scripts. They can get in major trouble if caught, while some doctors do it regardless, they legally are not supposed to.

This sounded pretty crazy, so I looked it up. It seems it's totally okay for them to write a prescription to be filled at a future day; the law is just that they can't pretend to have written the prescription on a different day than they wrote it on.

Actual text of the relevant statute from the government's web site:

"All prescriptions for controlled substances shall be dated as of, and signed on, the day when issued. . ."(CFR 21 Section 1306 (http://www.deadiversion.usdoj.gov/21cfr/cfr/1306/1306_05.htm))

"An individual practitioner may issue multiple prescriptions authorizing the patient to receive a total of up to a 90-day supply of a Schedule II controlled substance provided the following conditions are met: . . . practitioner provides written instructions on each prescription . . . indicating the earliest date on which a pharmacy may fill each prescription;" (21 CFR 1306.12 (http://www.deadiversion.usdoj.gov/21cfr/cfr/1306/1306_12.htm))

Here is an article about it (http://www.medscape.com/viewarticle/587412).

It seems to be completely legal, according to federal law, for the doctor to do what pattipeeples wants. Not sure about the mailing, but giving her three months of prescriptions at one time should be okay. Maybe Florida is stricter though. More likely the doc is just uncertain of the specifics of the rules and is unwilling to take legal risks, similar to how my doctor insisted on following on the extraneous controlled substance rules when she was prescribing Strattera, even though it is not a controlled substance.

Laserbeak
04-27-16, 08:47 AM
Right Cyliya , but in some states the prescriptions will have expired. In New York State, prescriptions for controlled substances only were good for 30 days. I am not sure if replacing paper prescriptions with electronic prescriptions has changed that, but probably not.

Caco3girl
04-27-16, 10:12 AM
My sons doctor is the same way. I HAVE to pick up the prescription in person monthly and sign off that I got it. It's their office policy.

The suggestion of having the doctor refer you to a doctor out of state may not fly unless you are in a network of doctors that is national. The legal issue is Dr X. will not just write a prescription for a controlled substance because Dr. Y told him to. You will have to be seen by Dr. X.

My best suggestion is to get a copy of the kids medical file and call the doctors offices that will be close to where he is vacationing and see if they will accept him as a new patient and explain exactly why. And FYI, you may have to clear an out of state doctor visit with your insurance company and get a list from them on who is in your network.

CrazyLazyGal
04-27-16, 11:49 AM
In my state they can fill prescriptions if the doctor writes, "Fill on or after...." They aren't allowed to mail the prescription though.

If your doctor won't or legally can't do it, I'd try to have your doctor arrange for you to see another doctor those two months.

At the minimum, have your doctor write a letter describing the situation and indicating the medication and dosage. As the offices are very busy, you can help her by drafting the letter. Something like,

"[Name] has been taking [medication and dosage]. It is my policy [or state law if that's the case] to only prescribe one month of this medication at a time, and all prescriptions must be picked up in person. As [name] will be away from the area for the summer and will therefore be unable to pick up the prescriptions in person during that time, he will need a way to obtain a prescription. [Name]'s last prescription was dated [date], so he will need prescriptions written 30 days and 60 days after that date. Please feel free to contact my office for [name]'s medical records or if you have any other questions."

With this letter in hand and the previous medication bottle, you might be able to get the prescription at an urgent care. They might not write one at that moment because they might need time to verify with the doctor, but you might get one after they have verified. I would try to arrange this ahead of time or as soon as you get there even though the prescription would not be written until later.

Make sure a copy of this letter is included in your son's chart so that the receptionist can easily verify without asking the doctor.

Socaljaxs
04-27-16, 12:01 PM
This sounded pretty crazy, so I looked it up. It seems it's totally okay for them to write a prescription to be filled at a future day; the law is just that they can't pretend to have written the prescription on a different day than they wrote it on. that is what a post dated script is...the doctor writing the perscription on say for example april 27 but dating the perscription for may 27. That is post dating a script. Which they can not do.

Actual text of the relevant statute from the government's web site:

"All prescriptions for controlled substances shall be dated as of, and signed on, the day when issued. . ."(CFR 21 Section 1306 (http://www.deadiversion.usdoj.gov/21cfr/cfr/1306/1306_05.htm))

"An individual practitioner may issue multiple prescriptions authorizing the patient to receive a total of up to a 90-day supply of a Schedule II controlled substance provided the following conditions are met: . . . practitioner provides written instructions on each prescription . . . indicating the earliest date on which a pharmacy may fill each prescription;" (21 CFR 1306.12 (http://www.deadiversion.usdoj.gov/21cfr/cfr/1306/1306_12.htm))

Here is an article about it (http://www.medscape.com/viewarticle/587412).

It seems to be completely legal, according to federal law, for the doctor to do what pattipeeples wants. Not sure about the mailing, but giving her three months of prescriptions at one time should be okay. Maybe Florida is stricter though. More likely the doc is just uncertain of the specifics of the rules and is unwilling to take legal risks, similar to how my doctor insisted on following on the extraneous controlled substance rules when she was prescribing Strattera, even though it is not a controlled substance.
each state follows these laws differently. Also insurance companies are the other issue here. They may refuse to honor a 90 day supply. My state is very strict about schedule 2 and above and as laser mentioned her state they allow electronic submission while in ca we aren't alowed too.

I went on vacation last year to Florida went to a chain pharmacy that I'm in the system with and monthly receive my medication. They refused to honor it because it was out of state doctor doing the prescribing

sarahsweets
04-27-16, 03:49 PM
Wow, I am wondering if you can find any advocacy sort of groups that help kids with disabilities to weave through this mess. My doctor never post dates scripts in fact I just got back from seeing her and she said bluntly- "what if I die tomorrow? Then there are all these scripts floating about with no doctor to get input from. If anyone altered it I wouldnt be able to clarify it. " Macabre but true. My insurance allowed for a vacation override but only by a week. NJ allows for stimulants to be filled for a 90 day supply but my doc doesnt do that. What alternatives did your doctor offer? You cant justy have a child abruptly stop a medication.