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Prescription Assistance

Elaine of TSA started this conversation

Guide to Prescription Assistance Programs

http://www.consumerreports.org/health/resources/pdf/best-buy-drugs/money-saving-guides/english/AssistancePrograms-FINAL-April2007.pdf

 

Prescription Assistance Programs

https://www.rxhope.com

https://www.pparx.org/Intro.php

http://www.needymeds.org

http://rxassist.org/

http://www.freemedicine.com/index.html

http://www.rx4nj.org/

http://www.patientassistance.com/programs.html

 

Generic Brands Discount Programs

http://www.rxoutreach.com/padv/PatientInfo.aspx

http://solutiondiscountcards.com/faq.html

 

Pharmaceutical Mfg's. Assistance Programs 

Glaxo Smith Kline (1) - for Oncology Medications

http://www.commitmenttoaccess.com/

Glaxo Smith Kline (2) - Breakthrough Medications - Non Oncology

http://www.bridgestoaccess.com

Glaxo Smith Kline (3) - Other Meds

http://www.gsk-access.com/ 

Lilly  (1)

http://lillymedicareanswers.com/index.jsp

Lilly  (2)

http://lillymedicareanswers.com/lilly_medicare_answers_program2.jsp?reqNavId=1.3

Novo Nordisk - Diabetic /Insulin

http://www.novonordisk-us.com/documents/article_page/document/diab_pap.asp

Abbott Labs - Diabetic Supplies -

Open page to Needymeds.org and on the left side of page under patient assistance programs select company list and then Abbott Labs to find their programs which include diabetic supplies.

http://www.needymeds.org

Pfizer

http://www.pfizerhelpfulanswers.com/pages/misc/Default.aspx

Multi - Mfg's

Click on the link to Needymeds.org and from the left side of page under patient assistance programs, select company listing, which opens an alphabetical listing by mfg.

http://www.needymeds.org

http://www.togetherrxaccess.com/Tx/jsp/sponsors.jsp

 

 

Medically Necessary

Nutritional Food Supplements & Specialized Infant Formulas

 

Abbott Labs

Click on the link to Needymeds.org and from the left side of page under patient assistance programs, select company listing, which opens an alphabetical listing by mfg. Scroll thru Abbott Labs programs till you find Medical Nutritional Foods.

http://www.needymeds.org

 

Helping Hands for Special Kids

Click on the link to Needymeds.org and from the left side of page under patient assistance programs, select company listing, which opens an alphabetical listing by mfg. Select the letter G and then select Genentech or M for Mead Johnson programs till you find specialized formula program.

http://www.needymeds.org

 

 

 

Prescription Cost & Availability Guide

http://www.aarp.org/states/nj/articles/prescription_drug_retail_price_registry__your_link.html

http://www.consumerreports.org/health/bestbuy-drugs.htm

 

Rx Price Comparision links

http://www.drx.com/

http://www.healthpricer.com/

 

 

Discount Prescriptions Programs

http://plansponsors.scriptsave.com/default.aspx

http://freedrugcard.us/

 

Free Discount Card for Pet Meds:

http://www.petmedicationcard.com/

http://freedrugcard.us/

 

 

Prescription Discounts for Seniors and or Disabled

 

PAAD

http://www.nj.gov/health/seniorbenefits/services.shtml

Senior Gold - Rx Discount

http://www.nj.gov/health/seniorbenefits/pbp/senior-gold.shtml

HAAD

http://www.nj.gov/health/seniorbenefits/services.shtml

 

 

Rx Programs by Region

Bergen County, NJ Residents

http://www.co.bergen.nj.us/rx_plan/prescription_discount_cardold.htm

 

 

Emergency- Temp Rx Assistance - Need Based

Mercer County, NJ Residents

http://www.thecrisisministry.org/srvFinancialAssistance.cfm

Somerset County, NJ Residents

http://somersetfoodbank.org/progs_rxprog.php

 

 

Analysis for Rx Benefits from Government Resources

http://benefitscheckup.com/

 

Online coupons for medications & prescriptions

http://www.internetdrugcoupons.com/

 http://www.optimizerx.com/

 

 

20 ways to cut prescription costs

From Women’s Day magazine

1. Try to reduce the number of meds you're taking. If you've been on a drug for a long time, ask your doctor whether you still need it. Or, if you're taking several drugs for different problems, your doctor may be able to prescribe a combination pill to effectively treat multiple ailments.

2. Ask about generic drugs. Don't assume that your physician knows that you're uninsured or are having trouble paying for your prescriptions. Speak up, and let him know that you'd prefer the best value medication that he can prescribe—generics can cost 30 to 80 percent less than their brand-name counterparts.

 

3. Consider a less expensive brand. The Consumers Union drug comparison website (
crbestbuydrugs.org) lets you compare different brand-name medications based on price, effectiveness and safety. You can also request a copy of your insurance plan's formulary to help your doctor choose the drugs that will save you the most money.

4. Ask for the cheapest form of the medication. You'd be surprised, but there can be a significant price difference depending on whether the drug is manufactured in gelcap, tablet or capsule form.

5. Ask about splitting your pills. Ask whether it's possible for your doctor to prescribe tablets that are double the dosage of the ones you are taking. By halving each tablet with a pill-splitter, you can get twice the number of pills for essentially the same amount of money (the price difference between different dosages of the same drug is usually very small). However, keep in mind that you can’t do this with every medication or every form (for instance, extended-release forms, capsules and gelcaps cannot be split).

6. Ask for samples. Your doctor may have free samples of the drugs you're taking. These are brand-name pills that drug manufacturers give doctors to help promote their product—but keep in mind that when it comes time to fill your prescription, you may save more money by getting a generic version. Also, make sure that you inform your pharmacist that you're on a new medication, so he can alert you of any potential interactions.

7. Comparison shop. This is especially crucial if you're uninsured or underinsured. Depending on the size of the pharmacy and the size of their order of a particular drug, the final cost can vary by as much as 50 percent. Prices may even vary at individual pharmacies that are part of the same chain. Shop around to find out which store has the lowest price, or ask your regular pharmacy to match the prices given by its competitors. If you’re taking more than one drug, it may be cost-effective to buy different medications at different locations—but make sure that each pharmacist is aware of all the medications you're taking, so you can stay abreast of potential interactions.

8. Consider a switch. Ask whether a pharmacy will offer a discount for transferring your prescription from another drugstore. Just like long-distance providers and credit-card companies, pharmacies will often reward you for your business.

 

9. Try comparison-shopping websites. Sites like
destinationrx.com, pharmacychecker.com or pillbot.com can help you find the most affordable place to purchase your prescriptions. Many individual states also have drug price comparison sites, which compare prices for common prescription medications among all or almost all pharmacies in the state.

10. Shop online. But use reliable, credible pharmacies. In 2006, the Consumers Union (which publishes Consumer Reports) did a price comparison of common prescription drugs. The median cost for generic drugs at Internet pharmacies was 34 percent cheaper than the median cost at large drugstore chains. Even buying through the website of a large chain (such as cvs.com or walgreens.com) may offer better prices than purchasing in-store. However, don't do business with any site that doesn't display the VIPPS (Verified Internet Pharmacy Practice Sites) seal. You can also go to pharmacychecker.com, which lists sites that require prescriptions, use encryption technology to safeguard your information, and display clear contact info and privacy policies.

 

11. Start a bidding war. At
bidrx.com pharmacies compete to fill your prescription. Register for free, then post the name and dosage of your prescription. Pharmacies have 72 hours to bid on the price. Once you make your selection, you can pick up your medication in person, or have it mailed to you.

 

12. Purchase in bulk. If you take certain medications on a regular basis, bulk-buying can be significantly cheaper than buying month-to-month. Your pharmacist can tell you whether it's possible to get a longer-term supply. Most insurance companies also have mail-order programs that allow you to receive multiple months' worth of drugs at a time. You can usually enroll by logging on to your insurer's website or contacting your employer's benefits department.

13. Ask about OTCs. Check with your doctor to see if an over-the-counter drug might work as well as a prescription, especially if you're uninsured. However, if you are insured, check that your prescription copay isn't actually cheaper than a supply of OTC medication.

14. Get your discounts. If you're on Medicare, check whether you're a candidate for special discounts for low-income beneficiaries with the new Part D coverage. You can find a list of these programs—offered by more than 40 states—as well as a brief rundown on eligibility at the Medicare Rights Center's website. Click on "state prescription drug assistance programs." If your state doesn't offer a program or you need more assistance, click on "help paying for prescriptions" for a list of charity, discount and government programs.

15. Sign up for discount cards. A store-associated or government-associated discount card can lower the price of your pharmacy bills by 10 to 25 percent. Many pharmacies offer discount cards even if you’re not insured, and regardless of income, usually for free or a small fee. State and government agencies also offer free discount cards, but eligibility is usually based on age or income. However, not all drugs are eligible for markdowns, so make sure your medications are on the discounted list before you enroll. And don't sign up for discount cards with a telemarketer or by replying to spam e-mail—there are plenty of scams out there.

 

16. Look into patient assistance programs. Nearly every pharmaceutical company has an assistance program for low-income patients. If you qualify and have no coverage, in many cases you can even get your medication for free. For help finding a program, visit
rxassist.org, pparx.org, benefitscheckuprx.org or needymeds.com

17. Visit your drug's website. You may find rebates, coupons or free sample offers. You can usually find the drug's site by just doing a quick Google search of the medication's name. However, keep in mind that these are typically one-time savings offers for new prescriptions.

18. Try a wholesaler such as Costco. Don't want to cough up the money it costs to join? Don't worry—you can get your prescriptions filled there even if you're not a member (though you may be charged a small fee). You'll just have to resist the urge to grab any impulse purchases on the way to the cashier.

 

19. Research special benefits if you're a vet or AARP member. The Veterans Administration negotiates with drug manufacturers and distributors on behalf of its members, offers low copays and covers 90 percent of the cost of most prescriptions. The AARP offers prescription savings cards and Medicare supplement insurance cards, as well as their own MedicareRx plans through United Healthcare.

20. Store drugs properly. Make sure those expensive pills don't break down or lose potency before the expiration date by keeping them in a cool, dry place.

 

http://www.womansday.com/health/12623/20-ways-to-cut-prescription-costs.html

 

Click here to add your comment...
haiki
 in response to oldsalt...   Oldsalt; I found that you can get the VA to allow you to get your VA medication filled at your local pharmacy. I recently had my VA clinic allow me to do this. The following found on the internet is from 2006. Should your VA hesitate you must insist.

"In a Nov. 21 memo to network directors, a senior VA health official said medical personnel can write prescriptions to be filled at private-sector pharmacies as long as certain restrictions are followed.

The memo is the VA’s reaction to an expanding phenomenon in which the two chains — Wal-Mart Stores Inc., and Target Corp. — are filling some generic drug prescriptions for $4.

Because this is less than the $8 co-pay charged for veterans in health care priority categories 4 through 8 — mostly those being treated by the VA for injuries and disabilities not connected to military service — VA officials have been pressed by veterans to help them get the lower-cost drugs.

VA spokeswoman Laurie Tranter said the department understands that veterans, like all consumers, want to pay as little as possible for prescription drugs, which is why it issued the guidance to its networks….

In the memo to network directors, William Feeley, VA deputy undersecretary for health operations and management, said the VA cannot transfer a prescription directly to a private-sector pharmacy, as veterans have been asking, because it is illegal.

But VA doctors can write prescriptions for veterans that local pharmacies can fill, Feeley said. His memo cautions that medical staff must meet state requirements for writing prescriptions, and that when a new one is written, any existing prescription within the VA system must be canceled “to prevent patients from receiving excessive quantities” of drugs.”
Talk to haiki
oldsalt
 in response to haiki...   You are correct, The VA is overcharging and is blowing smoke up your rear. The government has been caught with their hand in the cookie jar and is turning mean to defind their pay and jobs. To take a simple issue such as this and make it so complicated is a crime. You were in the miltitary and i'm sure this is not the first time you were lied to, and left with your ass hanging out. Yes, the idea is to make you go away..or die. They will win, Best to save your sanity and move on. I stopped taking two of my meds because I was getting a bill from VA for $150 a month on pills I could get from Walmart for $40. The problem is I can't use VA prescription anywhere but the VA!
Talk to oldsalt
haiki
 in response to haiki...   VA billing methodology examined.

To remind you of the Veterans Administrations arbitrary, and unreasonable billing practices, regarding veterans prescription copay obligations. Example; a veteran is dispensed a prescription for 90 pills for a 30-day period, taking 3 pills per day, copay cost is $8. Another veteran is prescribed the same exact dispensed 90 pill prescription amount that requires splitting, meaning a 6 month, one split pill per-day supply. Copay cost $48. A $500 % increase over an $8 dispensed supply.

Until you can get past the cost for the same exact VA dispensed $8 pill medication, as explained in paragraph (2), of 38 USC 1722A, “The Secretary may not require a veteran to pay an amount in excess of the cost to the Secretary for medication described in paragraph (1),” and as well, the Federal Register, forget what it says about 30-day supply in paragraph (1).

Title 38 USC 1722A, paragraph (1) codification is clarified in the Federal Register dated 12/6/2001, Final Rule, as to the actual cost in dispensed prescription supplies. “Also, under 38 USC 1722A, VA may not require a veteran to pay an amount in excess of the actual cost of the medication and pharmacy administrative costs related to the dispensing of the medication. VHA conducted a sturdy…and found that VA incurred a cost of $7.28 to dispense an outpatient medication even without the consideration of the actual cost of the medication…Under these circumstances, we believe that a $7 copayment would not exceed VA’s cost.” [Present day copayment now $8.]

In contrast to the VA’s over-charges in split pill billings, veterans do not receive the same billing consideration, or billing practices, as devised by VA methodology that involve third party collection problems. One in particular being, significantly the crux of the problem, an “…amount that the third-party payer would pay to a provider other than VA…”, for the same prescription drugs. Such providers, as Kmart, and Wal-Mart who offer, as an example, 90 pills of the same exact prescription, which results into 180 split pills, a 6 month supply, cost $10. A cost which is demonstrated because it is common knowledge.

One would only wish that the following considerations be extended openly and fairly to all VA prescription, and medical care billings. This 10/6/2010 ruling by the Veterans Affairs Department (VA), regarding a veterans 3rd party billings. “This document amends the medical regulations concerning “reasonable charges” for medical care or services provided or furnished by VA to a veteran for a nonservice-connected disability.” Effective March 18, 2011.

As you will again see, some veterans are treated differently when it comes to prescription billing. There are thousands of veterans having to split their VA pill medication, adding to costs many cannot afford. Which is why, “…the increase in co-payments adversely affected the use of these usually long-term medications, especially since the prevalence of heart disease is higher in the VA population [Jalpa A. Doshi, Ph.D., lead author of the study and research assistant professor of medicine at the University of Pennsylvania School of Medicine.”

the increase in co-payments adversely affected the use of these usually long-term medications, especially since the prevalence of heart disease is higher in the VA population than in the general population,”


Review the following third-party rulings by the Veterans Affairs Department.

“…VA amends the regulations regarding charges billed for prescription drugs not administered during treatment by changing the billing formula…..”

“..VA has the right to recover or collect reasonable charges for medical care or services (including the provision of prescription drugs) from a third party.”

“..a third-party payer….has the option of paying, to the extent of its coverage, either the billed charges or the amount the third-party payer demonstrates it would pay for care or services furnished by providers other than entities of the United States for the same care or services in the same geographic area.”

“VA has authority to bill third-party payers in an amount constituting “reasonable charges.”…Moreover, VA has taken steps to keep costs at a minimum.”

“..in some cases, a third party payor may be allowed to pay less than the VA billed amount….either the billed charges or the amount the third-party payor would pay for the prescription drugs to private sector providers in the same geographic area.”

“…a third-party payer's liability is limited, to the extent of its coverage, to the lesser of the billed charges or the amount that the third-party payer would pay to a provider other than VA.”

“As required by 38 U.S.C. 1729(c)(2)(A), we consulted with the Comptroller General of the United States prior to promulgating this final rule.”

Link: Charges Billed to Third Parties for Prescription Drugs Furnished by VA to a Veteran for a Nonservice-Connected Disability

A claim regarding VA split pill billings is presently before the United State Court of Appeals for Veterans’ Claims.
Talk to haiki
haiki
 in response to haiki...   

VA prescription copayment studies

The following study is from “Reforming VA’s Medication Copayment Statute” by Timothy J. McDonald. “..graduate of the Health Law Certificate Program at the University of Pittsburgh School of Law and is currently serving as a Presidential Management fellow in the Patient Care Services Office of the Veterans Health Administration.” A link follows. This is followed by studies showing the effect of the VA copay increases.

“The limitation imposed by the copayment legislation that prevents VA from charging the veteran more than the cost of the medication to VA has led to at least one case before the Board of Veterans’Appeals (Board). 31 This case involved “pill splitting,” a practice where VA provides medication in a dosage that is higher than needed, and then has the patient split a single pill into two separate doses”

“However, the current medication copayment that many veterans are charged is based on outdated legislation…”

“This problem is not limited to cases where the veteran is splitting tablets. In fact, based on VA’s increased efficiency and price negotiation in the pharmaceutical arena, it seems very likely that under the current copayment plan many veterans are charged excessive copayments by VA.44”

http://www.va.gov/vbs/bva/manuals/vlr1mcdonald.pdf

 

Co-Payment Increases Result in Gaps in Veterans' Prescription Usage

American Heart Association rapid access journal report:

Study highlights: -- Cholesterol-lowering drug adherence drops with an increase in VA prescription co-payments.

DALLAS, Jan. 13, 2009 — Fewer veterans filled their prescriptions for cholesterol-lowering drugs after an increase in co-payment costs for prescription drugs, researchers report in Circulation: Journal of the American Heart Association.
http://www.reuters.com/article/pressRelease/idUS212289+14-Jan-2009+PRN20090114

Impact of a prescription copayment increase on lipid-lowering medication adherence in veterans.

http://www.ncbi.nlm.nih.gov/pubmed/19139387

The Effect of a Medication Copayment Increase on Metformin Adherence by Veterans with Diabetes

Rationale: Copayment increases have been shown to affect health care demand in many settings, and adherence to essential medications may decrease when medication copayments rise. In 2002, the Veterans Administration (VA) increased medication copayments from $2.00 to $7.00 per 30-day prescription fill.
http://www.allacademic.com/meta/p_mla_apa_research_citation/0/9/0/4/4/p90444_index.html

 

 

Talk to haiki
Rosie327
 in response to haiki...   

The VA situation is terrible and there are no excuses for the way they treat our country's defenders.  This may not help, but Ameriplan offers prescription discounts and even a Prescription Advocacy Plan.  You can learn more at http://www.BenefitsByRosie.com.  Best wishes, Rosie

Talk to Rosie327
haiki

For the reasons made obvious as you read, the Board of Veterans' Appeals, so-called veterans’ court, once again, are determined in frustrating my efforts in appealing my claim, by a still further delay. Is there something about this case that warrants this delay?

Could the reason be, of the well over 1.1 million VA prescriptions, veterans are being over-charged?

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My claim, VA violation of 38 USC 1722A was denied by the Board of Veterans Appeals. I then filed with the United States Court of Appeals for Veterans Claims (CVA). On 7/11/2007 was remanded back to the Veterans Board of Appeals (BVA). The BVA lost and rebuilt the file, that being the reason for the remand. After repeated checking, as of 5/20/08, now 10 months later, this remand, has not been returned to the BVA. So they say. It is obvious they may have lost it again in order that this claim, or I, would go away. Disappear. Perhaps I'll die? Case closed!

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VA prescriptions are dispensed in supplies of 90 days. However, for those unfamiliar with my claim, to explain these over-charges by the VA in violation of 38 USC 1722A, this example will be at it's simplest and most understandable throughout my explanation, . Let's say that you are at the VA, standing in line getting your prescription. The vet in front of you is getting the exact same prescription. She picks up her 30 day supply of 30 pills. Her copay for a 30 day supply of 30 pills is $8. You also are dispensed an $8 supply of 30 pills of the same exact prescription. Being that your condition is not as severe, your prescription requires you to split this 30 pill $8 supply. After you sit down at your kitchen table and split your 30 pill supply, now you have 60 split pills, a 2 month supply. But hold on! Except your co-payment cost for this 30 pill, $8 supply, now that it has been split, has increased. It now carries a co-payment of $16. This explains how veterans' has been overcharged by the VA since 2002. Shafted again (3/13/07) by the Board of Veterans Appeals in their phony denial. Do you see anything wrong? You should!

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"Pursuant to Section 20.1404(b) (2002), the motion alleging clear and unmistakable error in a prior Board decision must set forth clearly and specifically the alleged clear and unmistakable error, or errors, of fact or law in the Board decision, the legal or factual basis for such allegations, and why the result would have been different but for the alleged error."

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The two persons listed on the denial that had crafted, and fashioned up the logic that follows? Board of Veterans’ Appeals counsel M. Taylor, and Veterans' Law Judge, Judge John E. Ormand. I will show you exactly where, in their efforts to mislead, and to rewrite the law. This is the kind of garbage veterans have to put up with! Let's look at the reasoning in their BVA denial.

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Cited on the cover page of my denial was, "THE ISSUE. Whether the veteran is obligated to pay the Department of Veterans Affairs (VA) a copayment for each 30-day or less supply of medication provided by the VA on an outpatient basis in an amount established under 39 C.F.R. § 17.110."

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Criteria & Analysis by the Board of Veterans Appeals.” 3/13/ 2007
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Here the Board understands the problem. "The record reflects that the appellant is prescribed a 12.5 mg daily dose of his medication. Because the medication is not dispensed in a 12.5 mg tablet, his physician has instructed him to split a 25 mg tablet in half to achieve the proper daily dosage. Thus, he receives a 30-day prescription consisting of fifteen 25 mg pills, each of which he splits in half to take one half of a pill per day. The appellant contends that the standard co-payment is excessive in light of the pill splitting." However, no where in my claim did I mention the word ‘standard', nor was the word 'standard' mentioned in 38 USC 1722A, or Federal Register, Final Rule. Here, in introducing 'standard', supposedly for the purpose of establishing two (2) ‘standard’ co-payments, counsel Taylor purposely has rewritten the law, in order to mislead.

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In addition, the Board notes that the reference to the cost of medication contained in 38 U.S.C.A. Sec. 1722A clearly pertains to VA’s cost in dispensing the medication, not the cost to the appellant.” Is there a difference? My claim...clearly pertains to VA's co-pay cost in dispensing medication, and it’s inflated cost to the appellant! Which is the "excess of the cost" for the 'standard' co-payment, and is then arbitrarily increased, to those veterans required to split their 30-pill, $8 supplies. Dispensed exactly the same, and in like manner, as all other VA dispensed 'standard' co-payment and abundant 30-day $8 supplies of 30-45-60-90 pills.

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Counsel Taylor references remarks from the July 16, 2001 Federal Register. “Also, as we stated in the proposal, under 38 U.S.C. 1722A, VA may not require a veteran to pay an amount in excess of the actual cost of the medication and the pharmacy administrative costs related to the dispensing of the medication. VHA conducted a study...and found that the VA incurred a cost of $7.28 to dispense an outpatient medication even without consideration of the actual cost of medication..”

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Dispensing! Where there is no difference in the prescription, supply amount, handling, or dispensing time, a 30 pill supply is dispensed, with a $16 co-payment. Interestingly, in the same exact manner as all 30-day, 30 pill $8 supplies are dispensed, as explained in the Federal Register! No splitting of pills was involved in the dispensing procedure. However, of an exact same 8$ dispensed supply, automatically these 'standard' 30-day $8 co-payment whole pill supplies are increased 100% (2 month split pill supply).

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Counsel Taylor, citing, "1722A clearly pertains to VA's cost in dispensing". Counsel Taylor just does not get it! Nor does Judge Ormand. Their is no difference! No difference in dispensing two supplies that are exactly alike in prescription and supply, or to the cost related to dispensing! However, counsel Taylor is emphatic in making the point, conclusive, that it clearly pertains to the cost in dispensing? Or is it the ISSUE, the " 30-day or less supply"? For some unknown reason, which counsel Taylor did not elaborate on, a second exact duplicate supply increases, double the co-pay cost? Although, counsel Taylor may have tried, but failed.

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“38 USC 1722A; (a)(1) Subject to paragraph (2), the Secretary shall require a veteran to pay the United States $8 for each 30-day supply of medication furnished such veteran under this chapter on an outpatient basis for the treatment of a non-service-connected disability or condition. If the amount supplied is less than a 30-day supply, the amount of the charge may not be reduced.”

Which then also means, if the amount is not less than 30-day supplies, as described in paragraph (1) the Secretary may not require a veteran to pay an amount in excess of the cost for medication provided to a veteran as described in paragraph (2).

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Citing my argument, BVA’s counsel Taylor, quotes inaccurately, to confuse, again to mislead. 38 USC 1722A “Copayment for medications. Paragraph (2) The Secretary may not require a veteran to pay an amount in excess of the cost of the Secretary for medication as described in paragraph (1).”

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The correct reading is, “(2) The Secretary may not require a veteran to pay an amount in excess of the cost to the Secretary for medication described in paragraph (1).”

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"The appellant has not cited to, and the Board is unable to find any authority allowing for a deviation from the standard copayment." The Board is right! I too, am unable to find that authority.

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Where the Board got it wrong! Of all what you have understood and read so far, what follows puts to rest any doubts as to the 30-day medication over-charges in my claim, and refutes the reasoning of the Board of Veterans’ Appeals in their reading of 38 USC 1722A. Of everything that has been explained, BVA counsel Taylor’s reference to 38 USC 17.110, (addressed in my claim) is the key to explaining, what counsel Taylor and Veterans Law Judge John E. Ormand, and the VA failed to, or did not, want to comprehend, or consider in their thinking, in understanding 38 USC 1722A.

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The Board counsel Taylor, referenced 38 USC 17.110; Copayments for Medication. “..a veteran is obligated to pay a copayment for each 30-day or less supply of medication provided by the VA on an outpatient basis (other than medication administered during treatment).”

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Counsel Taylor made it a point to reference 17.110. Veterans' do know we have to pay a co-payment. THE ISSUE was obviously a "30-day or less supply." The Board's main argument to my claim, is their erroneous interpretation of what the law is. "Each 30-day or less supply", is suggesting to them, an across the board 30-day 15 pill supply is less. However, "..each 30-day or less supply", refers to only one (1) condition. Veterans who may visit a VA facility on a one time basis as an outpatient. For emergency room care, or see a doctor for a cut finger, brief illness, etc. I wish counsel Taylor would explain another circumstance in which a veteran may be charged an “excess of the cost”? Please enlighten us. I know of no other "excess of the cost" than what I claim.

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Counsel Taylor better not again, bring up 15 pills is less than a 30-day supply! The reality is, a veteran who falls under the 17.110 meaning, "obligated to pay a co-payment for each 30-day or less supply...on an outpatient basis (other than medication administered during treatment.)", refers to medication, in a dispensed 30-day supply of 15 pills, for treatment on an outpatient basis. The veteran in fact is not receiving less than a 30-day supply, this is his full 30-day monthly supply during outpatient treatment! For this reason, as described in 1722A, paragraph (2) is the basis for my claim. A 30-day, 30-pill, dispensed supply, for treatment, whether or not it is split, according to 1722A carries the maximum co-payment of $8. Which the Board refuses to recognize, but rather relies on a "each 30-day or less" argument. "The secretary may not require a veteran to pay an amount in excess of the cost, for medication described in paragraph (1)." $8 for each dispensed 30-pill, 30-day supply co-payment, includes supplies of the abundant 30-day supplies of 45-60 or 90 pills, and as well for all veterans' under treatment, receiving a same exact dispensed 30-pill supply. A prescribed 2 month supply (split pill).

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Counsel Taylor in an effort in re-enforcing the Board's position cites “(b) The Secretary, pursuant to regulations which the Secretary shall prescribe may-...(1) increase the co-payment amount in effect under subsection (a);..” Pursuant to regulations? Means according to the law! To regulations as written. Where is this regulation mentioned in the Code of Federal Regulations, this "standard" co-payment you talk about, for $16 split pill supplies? Where, counsel Taylor, does it mention increased co-payment cost for one of two (2) exact duplicate 30-day prescription supplies? Other than my example, where is it mentioned 15 pills is less than 30-day supply? "The Administrative Procedure Act requires that agencies publish administrative regulations in the Federal register before they can be legally effective." Where?

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The VA, and the BVA , they want me to pass on, disappear. When that happens, veterans you lose. They don't want you to win. However, this claim will live on, when other veterans think it's important enough of a veteran's issue to file a claim. It's (BVA) $50 filing fee is well spent. A younger veteran, whose prescription requires splitting, can file right now, and can keep playing the same silly game that the VA and the BVA insists on playing, just as long as they can.

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haiki

You mention the Veterans Administration, I then have to mention....

VA overcharges/violations.

Sunday April 6, 10:13 am ET
By Hope Yen, Associated Press Writ

AP IMPACT: VA Workers Charge $2.6B on Gov't Credit Cards at Luxury Hotels, High-End Retailers
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WASHINGTON (AP) -- Veterans Affairs employees last year racked up hundreds of thousands of dollars in government credit-card bills at casino and luxury hotels, movie theaters and high-end retailers such as Sharper Image and Franklin Covey -- and government auditors are investigating, citing past spending abuses.
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All told, VA staff charged $2.6 billion to their government credit cards.
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Yes, and then there are those few veterans, including my brother, criticize me for going after my claim, VA violation of 1722a, split pill co-payment overcharges. Well, along with the acknowledgement by many veterans, I’m glad I’m doing it.  Because this is what happens when you are not vigilant, with nobody watching the store.  Here are just a few remarks, regarding my claim, from those that apparently have more money than others, and march to a different drummer.
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“So what exactly do you want them to do? Other than waste the time and money of the VA dealing with a trivial claim so that they can't help other veterans."
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"It really bothers me to see people waste the VA's resources on things like this. It probably cost the VA thousands of dollars to work this claim up to the point of the BOVA, not to mention a lot of time of the people working in the VA. Even if you would have won on the claim, it would have wound up costing the VA more money so they could set up a new accounting system to deal with the change. That would likely cost them hundreds of thousands of dollars and would not really have benefited anyone that I can see.”
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Veterans get prescription drug benefits? I'd love to complain about $8.00 prescriptions. Every attempt I've made to get into the VA Health System I've been told I don't have any benefits.
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It's annoying to hear some people complain about what they are getting while others of us are "locked out" of the system entirely.
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HOGWASH! I suggest you do some homework.
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No one is doubting your claim, as much as why you are doing it. What they are trying to say is, you are tying up valuable resources that could be better served to adjudicate an individuals claim that had to go the way of the courts. What they are saying, also, is be thankful you have the VA who charges much less a co-pay than what most greedy outside civilian insurance companies charge. When I had outside insurance, before I became TDIU, I was paying $15.00, $20.00, and $25.00 as my co-pays for my medication, so 8 dollars is fairly trivial an amount to pay for prescriptions, not to mention people that have to pay full price for medications...co-pays do not exist for them. So I do understand where you are coming from and where you are trying to go, it just seems like you are trying shove this issue down everyones collective throats to get your point. Good luck in your endeavors, yet I hope some other veterans claim hasn't been backed up because of your want to change what seems to you to be an inequity seen only by you.
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The VA violation of 38 USC 1722a problem is not petty, or trivial as suggested, using the words of another veteran who thought that the VA money and effort should be spent doing the serious work of the VA in helping veterans. How did the VA employee do that? By living it up, buying and enjoying things for personal use on the government dime. My claim, VA violation of 38 USC 1722a effects all veterans, and I imagine most veterans, that receive VA prescriptions that require pill splitting.

 If a veteran is charged $16 for, using the Board of Veterans' Appeals description, of an  actual dispensed 30-day $8 medication supply, add up this VA dispensed $8 overcharge by the well over 1.1 million veterans that require their medication be split. (You'll be adding up just one months overcharges). All the while, employee's using government credit cards for what-ever.

John E. Ormand, Jr. BVA Veterans Law Judge, writes, "Also, under 38 USC 1722a, VA may not require a veteran to pay an amount of the actual cost of medication and pharmacy administration costs related to the dispensing of medication." And what is the dispensing cost for a 30-day supply? $8. Why then does this dispensed actual 30-day $8 supply cost a veteran $16? Because he is required to split his pill medication. In other words, you can have any amount for a 30-day, $8 supply, but if you are required to split any supply over 30 pills, the VA will double the copay cost. The USC or the CFR do not mention anything about doubling the cost of prescriptions, when the prescription requirement calls for the veteran split their pill medication.

Should I prevail, this is not money the VA would be losing, this is money the VA should never had taken from veterans in the first place. My claim was remanded back to the BVA from the United States Court of Appeals for Veterans Claims. I was notified of this remand on July 16, 2007. On Feb. 11, 2008, I called the BVA inquiring about my claim. I was told it was "coming back from the Court, but hasn't reached us yet." 4/10/2008, I called asking for it's status. "Still at the Court of Veterans Appeals." It's now been 9 months! Are they not in the same town? Is this such a hot item that the VA does not want to adjudicate it? This is how our courts work. This is how the VA works. Think this is bad? You haven't seen nothing yet. Wait till our men and women return from Iraq and Afghanistan.



 

 

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