CVS Caremark contacted my doc about pain med prescription

I will try this again....LOL....I went to see my rheumy today for a scheduled appt. He informed me that CVS Caremark had sent him a letter informing him that I was taking to much hydrocodone a month. I took it exactly as he prescribed 2 every 6 hours. I have never had this to happen before.
I have arthritis, Crohnes Disease, and Fibromyalgia. I've had both hips replaced, knee and ankle surgery and a colon resection. I have NEVER abused my prescription. I refilled it every 30-31 days. I only once asked for it 2 days early because I was going out of town.
Has anyone else experienced this? Thanks for letting me vent!!

I had a similar incident at Walgreens. Yes, I posted about this in my thread, but it's certainly relevant to this one as well.

I had an online account with them and had set my prescriptions to auto refill so that when they came due I didn't have to call to get them refilled. When those prescriptions ran out of refills, I got new ones from my doctor and got them filled. In the past when I got a new prescription to replace the one with no more refills, Walgreens had always deactivated the old prescriptions. On this occasion, they didn't.

So a few days after getting some prescriptions filled, Walgreens computer alerted them that my old prescriptions needed refilled. Since those prescriptions had no refills, they faxed my doctor to ask for authorization to refill them. Somehow the Wellbutrin slipped past him and it got approved (even by my insurance, which makes no sense), but since he'd given me a prescription for 180 Tramadol the previous week, he was justifiably curious as to why he was being asked to give me 120 more just a few days later.

His nurse called to inform me that my doctor would no longer be giving me the Tramadol because I was apparently taking way too much of it. I told her that wasn't true, but she said my pharmacy had indicated otherwise. So I called Walgreens to find out what the flip was going on, and figured things out very quickly. The pharmacist even admitted it was an error on their part, but refused to call my doctor, saying that if he had any questions, he could just contact them.

Well, I had my sister pick up the Wellbutrin that did get refilled only a few days after having been filled previously and was able to take both of the bottles to my doctor to show him that it was not my screw up, but Walgreens.

My doctor gave me another prescription for Tramadol and I got his trust back.

But what burned me and still does is that even though Walgreens pharmacist conceded that it was their mistake and not mine, she didn't even have the courtesey to call my doctor and tell him the same. That was left up to me. And the only way I was able to prove my case was by having picked up the unnecessary prescription for Wellbutrin that in some way slipped past my doctor, insurance, and even Walgreens. All three had it on their records that it had been already filled just a few days earlier. If just one of them had said no to the very early Wellbutrin refill, I would have had no way of proving my side of things.

So in closing, good luck to you. Hopefully your pharmacy will re-evaluate their records and have the integrity to admit they made a mistake.

Post Edited (newname) : 6/16/2011 6:40:12 PM (GMT-6)

Thanks for responding. I went online and looked at the dates that my Hydrocodone was filled. Every month has been consistent within one day. I will contact customer service in the morning when I can talk with a real live person...LOL...My doctor only mentioned the letter. My original prescription was for Lortab 7.5 take 2 every 6 hours for a quantity of 240 a month. And for 3 months I was almost pain free and I could function. I didn't need a wheel chair or my walker!!

My doc calls in my refill and when I picked it up from the pharmacy I noticed the new prescription was for same dosage and 120 a month. I am adjusted to the lesser amount but I do have more pain. He is a great doctor and he has no problem writing my prescription each month under the CVS guidelines. I was just wondering if anyone has any idea why CVS questioned this? Thanks for you input :):)

Harley...did this just happen or was this last month or so...I'm only asking since you said you are now on the lower dosage of 120 and used to it now..but obviously have more pain...

For me...there is no way in the world I would just be accepting a cut in medication by HALF without knowing why your Dr. did this...and without seeing the letter...

Did he refuse to let you see the letter the time of your appt?

I don't think you will get anywhere talking with customer service...they will have no clue about the letter...If it came from the Pharmacy...it would come from a head Pharmacist...and they will not discuss something like this over the phone...I wouldn't start with them..

I was only saying to print out all your Pharmacy information for as long as you have been taking the Hydro....then make another immediate appt. with your Dr...bring this into him to show that you have been compltely compliant...

Then he has to show you the letter as we mentioned, it's part of your medical file because your Dr. is using this to cut your medication...

You need to do this asap because unfortunately....if you did not do anything during your last appt. and are just 'accepting' what has happened without any complaints...it makes it seem to them that you actually did something and realize it...

I would be making a HUGE noise over this and getting to the bottom immediately...

As I said...customer service won't do you any good...and they cannot talk with you because of HIPAA laws...they do not have access to your medical files...

Only the head Pharmacist, your Insurance, and your Drs...

You are much to calm about this...I would not be taking a dent into your good name lightly at all and not stop until you get answers...

You can do this politely but firmly....

I wish you luck..

Yep..something isn't adding up here....NOT with you Harley...just what is going on behind the scenes...

It could be that since the DEA is monitoring pain medicine and the Dr.s who prescribe them with much more scrutiny...and if someone has chronic pain...it's not usually handled with so much short acting medicine....those are meant for acute pain episodes for a month or two....or added to a long acting medicine for breakthrough pain....and that is 'as needed'....not 8 every day...

Harley...what did you say to him at the appt. when he told you this? Did you call your Dr. the moment you picked up the 120 amount prescription from the Pharmacy to ask whey you are cut in half since you say he didn't mention this at your appt?

It could be the Pharmacist was asked to send to Dr.s information about their clients that are taking this type of medication for a long period of time..

All I know...is I would be demanding..(in a firm but nice way..LOL) to see this letter..as well as you can see anything in your medical files you want...as in the Dr.s notes about this letter as well and his reason for making the change....(you have to pay for the copies)....and then working everything out with the them..

Thanks for more info..

I apologize for being still a bit confused...So you didn't make any calls to your Dr. last month when you picked up your prescription and is was cut in HALF? If you thought it was a mistake at the Pharmacy...I'm not sure why you wouldn't stand right there and ask the head Pharmacist what happened..or contact the Dr. as soon as you got home..

So then you just went home and for the last month...until yesterday...you didn't call to talk/and or meet with your Dr. about the change? Sorry...I just think our good name is all we have, especially when it comes to CP..

And then your last paragraph I'm a bit lost..

Are you seeing two different Dr.s an it was a previous one that prescribed the Lortab 7.5? Or are you saying it is just your Rheumatologist and now they have you on the 10/500 with the refills....that's where I am lost...


So before you were taking 60mg a day...and now you are on 40mg a day...so it's still a change...but not in half...

And are you going to still follow through and find out about the letter from your Dr.? or are you just letting this go since you don't see them until Sept...I certainly wouldn't have let one day go by with a change and not knowing why...and finding out what is going on with this letter...

Ok..about the Savella....it is used for Fibromyalgia...and it's not used to treat depression...even though it is in the same class of medicines...selective serotonin and norepinephrine reuptake inhibitors..SNRI's..

It's to help with muscle stiffness, tenderness, tiredness and helping with staying asleep or falling asleep.

You can take with/without food...but with food may cause more stomach
upset...

It's usually prescribed two times daily..but your Dr. may start with a lower dose and move up....and to try and take it at the same time like at (7am and 7pm each day for example)


But obviously follow the exact directions of how YOUR Dr. wants you to take this if starting with one...and read all the enclosed medicine information about this medicine and making sure you don't have any other medicines or OTC's that will cause an interaction...

I usually never try to drive with any type of medicine that can cause fatigue until you get used to it...and most medicines...unless you have a life threatening reaction....can take up to a few weeks or a month to figure out if it's helping and for the nuisance side effects to subside...

Hope it helps!! It's great that there are now medicines like this or Lyrica that are helping with Fibromyalgia!!

And keep us posted on the letter issue..:)

Post Edited (Snowbunny21) : 6/17/2011 9:12:47 AM (GMT-6)

SE...I think it's still a dip in dosage...since Harley was taking Eight 7.5 Lortabs per day...that is 60mg total...and now with the 120 count for the month....they are taking Four 10mg...so a total of 40mg per day...

(forgive me for not knowing if you are male or female:)..

I still don't know if that was the prescription last month as well....but still...there was a change in dosage because of this 'letter'..I would be leaving no stone unturned to figure this out...unfortunately it's already been a month...and Harley just accepted the lower amount last month without talking to the Pharmacist or Dr. that day...and then again at this appt...not asking to see the letter..or talk in detail with the Dr. about it...and now just waiting until September to see the Dr. again...

As we said...Customer service at CVS has nothing to do with this and won't be able to access their medical records...Only the Head Pharmacist probably knows and wrote the letter...and their Dr...or Dr.s as I'm not sure if seeing two..

We do care and want to help the best we can Harley:)

Oh...LOL...I was thinking that they went straight from the 240 7.5 to the 120 10mg...and not a month of 120 of 7.5....so yes...that math would be different...or...as if we said...getting two different prescriptions from two different Drs...

I am confused too...Harley...hope you can look at the past few posts when you get time...no rush...and then let us know where we are missing something...thanks:)

And SE...I'm sure your lovely wife knows you are ALL man!!! LOL

Ok...I think we are close..and I see where the confusion is..

Usual prescription was 7.5mg take 2 every 6 hours which is 8 a day..this equals 240 a month...at 60mg per day..

It's the prescription in May that doesn't add up..**unless it was for only 15 days instead of a 30 day prescription?

The May one was for 7.5 and you wrote above that they were 2 every 6 hours which is (8 a day)...but that would be 240 pills....

they only gave you 120 pills..so that would mean you had to take them 1 every 6 hours...(4 a day) ...which equals 30mg....*so that was your drop in half


So that's where we are messed up...you said it was the same prescription but less pills...but it went from 8 to 4 a day on the May prescription..


Now the new prescription is raised in dosage to 10 to take 1 every 6 hours...(4 a day)...that equals 120pills....and 40mg

Ta da!!! LOL...


I know all the math stuff is figured out...but I think we are more curious why you didn't call him immediately or one of his staff to ask about the change right at the Pharmacy in May!....I would not have driven home before calling and and find out what is going on..

By waiting an entire month to talk to him...you already went through withdrawals....and it made it seem to him that you had no complaints...

And it's not about the Dr. offering for you to read the letter...it's about saying/demanding in a nice way...to see the letter!...As we said...it's part of your medical file...and it's directly effecting your medical care...and they are saying something falsely about your prescriptions...If they are lying or it is a computer mistake...you cannot take this lightly!!

So he has still ended up changing your prescription from 60mg daily to 40mg for your new one....so he lowered them for a reason...you absolutely need to know that reason...I can't imagine why you wouldn't ask him this at your appt.? If you say he 'trusts' you...then why change your prescription? So you just said 'ok..thanks...see you in Sept?

Were you able to see and print your entire prescription history? I really think you should make a quick appt. to see him and discuss this...otherwise you are agreeing with them on what CVS has said in this letter....

And because you accepted these two prescription the last months without any complaints and it's less pain relief then before...you are following along just like they wanted....you are 'acting' to them like you are guilty since you aren't trying to do everything to clear your name!!!!

I guess I'll stop bugging you as I feel more fired up than you are...it sounds like you are just accepting what has happened and not going to talk to him again until September!

I know it's your choice...I just would be doing things totally differently....

I do wish you well:)

Again you guys amaze me with such wonderful advice. When I picked up the prescription in May and I asked the pharmacy about the decrease in medication she said "I filled what your doctors office called in". When I inquired at my doctors office all I got was an office person that said she called in what she was authorized to call in, and stated that my doctor was out of town for a month(that why my appt was changed)

So I accepted the lesser amount and I dealt with it until I was able to speak with my doctor in person. I told him that my pain level was not as manageable at the lower does. And he told me that Caremark had sent him the letter and that's why he decreased the dosage. I honestly didn't think to ask him to see the letter. And because of the stigma on pain meds I didn't want to over react and him think that my need for the higher dosage was because of a dependency.

I fill my prescriptions at a local pharmacy. CVS Caremark is part of my insurance company. After getting such great advice from you guys I will contact my doctors office on Monday and request a copy of that letter. I am going to research my refill activity on line and check all of my dates.

Again, thanks for taking the time to respond :):)

***I posted this before I read your last post so will read that and respond in a bit:)

I think what happened since I just went back and read the entire thread...is that in each post...you would give us a bit more information...so it wasn't until your second to last post you say your Dr. had an emergency...so the appt. got moved....and then the post above said he was gone for the entire month...as well as the misunderstandings with the numbers for your Lortabs...so SE and I were wracking our brains trying to figure it out...LOL

We didn't know all of this and why we kept wondering why you wouldn't call him immediately...

So...now we have the whole story...and glad you are going to follow through...he should know by looking at his own records that you have been on the other higher amounts based on his prescriptions..

It's a lesson for all of us how imperative it is to do everything to clear our name when there is mistake on their end or change and we haven't done anything wrong...In Chronic pain...a red flag on our record can change everything...

*and just as a side note...Harley you wrote you are worried he might think badly of you because of dependency.....
There are previous threads on here as well as information online about the difference between addiction and dependency.....total opposite..

Pretty much every one of us who are chronic pain patients will become 'dependent' on our pain medicine...that is not a negativ, it's just like a diabetic is on their medicine...it just means our bodies are used to medicine...
Addiction is someone who takes more than prescribed to get high, not for pain, buys/sells medicine illegally, goes from Dr. to Dr. to get narcotics, etc.

So...we care about you...and all others that come to HW...

Hope your weekend is fun and you can relax some:)

I am so sorry this happened to you. I had the same thing happen to me at CVS and Walgreens when I was out of back surgery, and at the time they couldnt figure out why I was still having pain. Anyways, back then, I had gotten 240 norco's from my spine doctor, every month. I started out going to Walgreens, but, quickly learned that my prescriptions would never be ready on time, or they would just do what they wanted, no matter what. Too much waiting!

So, I went to CVS, at first no problems, but, all of the sudden. I received a phone call from a pharmacist there, that told me I was taking too much meds, and he wasnt going to fill my prescriptions any longer. I was stunned, embarassed, and everything else you are feeling with this situation. He told me that he would call my doctor, I said fine, do it. My doc called me and advised me that everything was fine, and I wasnt doing anything wrong. They said, that I wasnt getting refills early, but, they were concerned. My doctor told me that, again, all was okay, we will continue on this route. It was fine, until the next month, they refused to give me my meds. I was angry to say the least.

THe doctor's office finally said, you are going to have to find a pharmacy that is more of a 'maw-paw' pharmacy. I did, and now with my pain management doctor, and different meds, they have never once said anything to me. Apparently some law went through that I had read, where pharmacists can refuse to fill a med, if they feel to do so. That isnt right, they are not our doctors. I will never go back to a Walgreens, or a CVS pharmacy, EVER!!! They treat me at the new pharmacy I go to, like gold!!!

Its very sad, that some of these pharmacists blame the patient for their meds. You are under doctor's care, following directions, and somehow they make it out to be YOUR fault. Sad, sad, sad!

I pray this gets better for ya, and maybe you can find a small, family owned pharmacy....its a whole new world!!

I have been reading this as it has went along and I have to agree with Stingray. Why is this dr backing off because Caremark thinks the patient is taking too much medication. The dr should take the time to call Caremark and explain why his patient needs this medication.

The way I see it, Caremark is not the one with the medical problem. I too use Caremark and I can tell you first hand they are money grubbing heathens!!! Every stinking time I turn around I keep getting letters from them saying did you know you can save money by switching to this medication or that medication? I ignore those letters and here is why, we pay $730 a month for my secondary insurance and this script card is included. That is a lot of money a month to fork out every month plus paying for Medicare on top of it.

I really think your dr should go to the mat for you Harley, instead of rolling over.