Practice Update

Most states have issued emergency health declarations as a result of the COVID-19 epidemic. Most of these declarations require third-party payors (health plans, HMOs, etc.) to reimburse pharmacies for early prescription refills (in Florida, the payor has to cover at least an additional 30 days' supply of prescription medications (see Section 252.358, FS[1])). They may be willing to cover longer periods for less expensive drugs.  This means that you do not have to wait until your drugs are running out to get a prescription refill. 

If your regular medical or pharmacy staff is exposed to the virus, some providers may have to close temporarily, making it difficult for you to receive care. Even if you are healthy now, not under a quarantine, and all your health care providers are open, you should consider getting a refill of your maintenance medications now. If you run into resistance, send the pharmacy or payor a copy of the emergency order.

Most maintenance prescriptions are valid for one year, so if you are getting near the expiration date, talk to your prescriber about issuing you a new prescription now. See if your prescriber will issue the prescription after talking to you over the phone or via telemedicine so you and the prescriber do not increase the chance of infection to you and others by going in to see your prescriber. If your prescription expires and you cannot reach the prescriber, some of the emergency declarations allow 30-day emergency refills (in Florida, see Section 465.0275, FS[2]).  Now may also be a good time to check your online health records to make sure that your diagnosis and prescriptions are all listed in case you have to see a substitute prescriber. 

If your pharmacy has to temporarily close, there may be a way to still get your prescription filled elsewhere.  Chain pharmacies normally have a "common database" which allows any of their chain pharmacy locations to access your prescription profile remotely. Pharmacies can also transfer your prescription to another pharmacy if someone is there to transfer it. When a chain or independent pharmacy closes, it must: "Affix a prominent sign to the front entrance of the pharmacy advising the public of the new location of the former permittee’s prescription files or otherwise provide a means by which to advise the public of the new location of their prescription files."[3]  The pharmacy also has to tell the Board of Pharmacy where the records are. While this requirement is for permanent closings, it would be prudent for the pharmacies to provide a process for the patients to obtain access to their prescriptions during a temporary closing.

Most pharmacy drug plans have a mail order component, and using mail order may be a good way to limit your contact with others at the pharmacy. Community “brick and mortar” pharmacies may also be willing to mail you your prescriptions as well to provide you your medicines while safely keeping you out of the pharmacy.

Finally, try to be patient throughout the Pandemic. Resources will be stretched or limited. Medical and pharmacy staff will be stressed with trying to provide care while trying to prevent the spread of the disease. Follow the CDC's recommendation on hygiene and help prevent the spread of the virus.  If you have not done so recently, get up and wash your hands for 20 seconds. And, it is perfectly polite nowadays to decline to shake someone's hand.  As a friend told me recently, "You have no idea where my hands have been."

[1] http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0200-0299/0252/Sections/0252.358.html

[2] http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499/0465/Sections/0465.0275.html

[3] Rule 64B16-28.202(4)(b), F.A.C.

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