The new mantra cited by Pharmacy and Medical is “out of money.” Several AICs who have multiple chronic care issues are not being referred out for specialist consultations. They also are being shorted on their medications by up to 50% and/or having refills delayed by as much as three weeks. One example: A 72-year-old male taking 300mg Diltiazem ER daily for high blood pressure was given a refill of 120mg, with no increase in pill count. So he is taking less than half his prescribed dosage when he needs a constant medication level to control his hypertension. That example is just one of 50+ I have been informed of.
We are also seeing an increased frequency of specialist consults being denied by the regional medical director, who is located 950+/- miles away. The URC Committee approved the consults after reviewing labs, radiographic reports, etc. Yet the regional medical director denied them. Even the providers are frustrated. This situation has not only forced AICs to wait for care but has over-burdened the already overwhelmed medical staff, who must resubmit to the URC with more supporting evidence.
AICs are dying due to the gross mismanagement of their health care needs. We have no other option for care and rely on the BOP. Yet we are not getting our treatment, exams or prescriptions. There are deaths monthly.