Why Can't a C-II Script be Faxed to a Pharmacy?

[Eva 14]

I've often wondered why a doctor is not permitted to FAX a C-II script to the pharmacy. Over the years, I can't even count the times that I've had to drive fairly long distances to the doctor when I was in my worst pain, simply to pick up a NEW prescription. (I suppose the mail may be an option, but my doctor has never offered that, and I do worry that the script may get lost in the mail and then I'd have NOTHING).

With all of the caller ID technology these days, I can't even envision how a scammer could send a "phony script" via FAX to a pharmacy. When the pharmacy gets the fax, they can always CALL the doctor to VERIFY that he/she really DID write the script.

Some scripts are even sent electronically via computer to the pharmacy, but not C-II's. With computers, I suppose a brilliant hacker could pull a hoax, but again, the pharmacy can always CALL the doctor to VERIFY.

I don't understand why the PAPER C-II scripts are considered superior to everything else. Presumably someone could STEAL a prescription pad from their doctor's office and write out phony C-II scripts.

I've always felt that the current law puts a terrible burden on people who are in pain. This includes people with post-op pain, not just people with chronic pain. When we feel our worst, we are forced to get out and drive just to get a NEW script from the doctor.

My pain doc gives me my scripts ahead of time with fill dates typed on them, so in the ordinary course of things, this isn't an issue. But any time that there is a med shortage, a med change, an insurance issue, etc., this causes more hassle than I can describe.

It seems that on a C-II script, everything must be written or typed EXACTLY or else the pharmacy won't fill it. I understand that things need to be exact to comply with the law, but if you need an 8 mg. pill instead of a 16 mg. pill or even want a LESSER quantity than what's written on your script, the pharmacy probably won't fill it.

I'm NOT blaming pharmacists for this, because they are just following the law. I blame the SYSTEM for valuing the PAPER script above all else. Is there a good reason to not allow C-II scripts to be FAXED in to a pharmacy? Or sent electronically?

I wonder if someday this hassle will be removed and doctors will be able to send a C-II script electronically or via FAX. I'll bet this law has inconvenienced MANY of you. Driving in severe pain isn't the greatest idea, but the current state of C-II law forces us to.

Thanks for any thoughts or opinions on this!

Eva

[Mark N]

Eva, you make some good points but I think it is just a case of law moving slower than technology. With the current Opiod Phobia today I doubt we will see the law change any time soon. Lets face it, the law is made without considering the impact on us as we seem to be the last consideration.

[Pharmacist.steve]

The DEA has approved for docs to send all controlled Rxs electronically... but .. my understanding is that the coding/program/security required for this to happen is very difficult.. You will see more of this as computer programs catch up with what is allowed by the DEA... I am glad that I am no longer doing programming.. because everyone and their brother ( insurance, DEA, states, Feds) are always coming up with some new mandate for the computer to conform to. Obviously, some issues have to have a higher priority than others.. I suspect that meeting the electronic controlled substance standards is always low on the list.
As far a doc mailing to pharmacy.. have the doc write on the face of the Rx " mailed to & only to be filled at ***X pharmacy.. if it is a chain... putting the store number there as well " If you are a "regular" at that pharmacy... anyone else bringing it to that pharmacy or another pharmacy would be suspect that it is stolen.
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The pharmacy staff is so short-staffed... and everything is "measured" in what you do... called metrics... and calling a doc for something like this is not an important metric to the chains.. but.. taking time to do this.. will make the metrics that they consider important to deteriorate.. I have read/talked/emailed with Pharmacist after Pharmacist state that if their many metrics fall out of acceptable range on any given day.. they will get a call/email from district manager next day .. threatening their job.. if they don't improve their metrics. The general theme in the chains stores "you need to do more - faster - with less staff"
I have been told of at least one female Pharmacist was found in one of the corners of one of the bays .. in the fetal position .. sobbing uncontrollably.. because of all the stress of the job.
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I recently worked at a BIG BOX store and I had to turn down a C-II for ADD drug.. because the way that the doc wrote it.. it could be challenged in a insurance audit.. if it had been a cash patient.. I would have filled it.

[tortoisegirl]

Thanks as always for your input Steve. I'm curious on your example: What was wrong about how it was written and why would the insurance care more than the FDA?

[Pharmacist.steve]

The insurance companies take a 1% sampling to do a audit.. and if the find a clerical error their demand for repayment is multiplied by 100.. a $60 Rx that they find has a error turns into a $6000 recoup demand.
The doctor wrote the generic name & the brand name in the same line ( drug name ) and then signed may substitute ... and the insurance company would only pay for the brand name.. I guess because they get a bigger kick back... IMO.. to be safe.. the Rx had to be written for the brand name only and signed DAW (dispense as written)... If the patient had been paying cash.. I would have filled it for whatever the patient wanted brand or generic... The DEA would not have cared which was dispensed... the insurance companies look for anything they can to find a clerical error.. they can recoup a lot of monies for a failed "i" dotting or "t" crossing.

[tortoisegirl]

Wow that crazy. Thats Steve.