Do I have any legal recourse? Pharmacist violated my privacy?

Question

Ok here's the story. I have chronic low back pain. I've had it for almost a decade. I've had surgery, physical therapy, shots, you name it. Pretty much the only thing that helps is stretching, hanging on my inversion table, and medication. Norco works best.

Anyway, I've been seeing a specialist and getting meds from them, but I recently began having more pain due to an accident, so when I called my specialist and told them, they said, just take more of your pills. So I did, and I ran out before I could get them refilled. I called the specialist again and they told me to see my primary care doc if I needed more meds. So I did, and he wrote me a prescription for some Lortabs.

I took this prescription to a pharmacy, and later in the evening I got a call from them saying that they could not fill the Lortab prescription until they verified some information from my doctor. Apparently my insurance company told her that I recently had a pain pill script filled.

So this pharmacist told my primary care doctor that I had already gotten pain medication from my specialist, and she somehow convinced him that I didn't need the pills and he ended up changing my prescription from Lortab to Ultram, which does nothing for me at all. I am furious and I'm in excruciating pain. Just sitting here typing this is causing the pain to become worse, but I wanted to post this and find out if anyone knows if I have any sort of grounds to hire a lawyer over this.

To me, the pharmacist violated my privacy and divulged information (withouth my permission) to my doctor. The result was me not getting the medication I need. I already explained the entire situation to my primary doctor, and he wrote the script with no problems. Then this pharmacist talked him out of it and he changed the script.

Anyway, that's basically what happened. Now I'm stuck without my meds for almost 2 weeks and I just don't know how I'm going to live with this pain for that long.

Okay more details: I just got back from one of those urgent care centers, and the doctor wrote me a prescription for pain pills. I took the script to a grocery store pharmacy that I've never used before, and told them that I would be paying cash for them. I had no problems whatsoever getting these meds. So basically, it was my insurance company's fault that I didn't get the Lortabs the other day. It had nothing to do with my name being "flagged", or the grocery store pharmacy would have rejected it.

Something else I'd like to add.. the day I dropped off the Lortab script, after the pharmacist said she had to verify it with my doctor before she would fill it, I told her to just give me back the script and I'd have it filled somewhere else (and not use my insurance, the pills are pretty cheap). Well guess what? They couldn't find the original script from my doctor. It was in their system but they couldn't find the paper copy. Doesn't that seem a bit suspicious?

Answer 1

As a pharmacist I can assure you that he has a legal responsibility to monitor your prescription history within his means. Should you have an accidental overdose due to multiple prescriptions for the same type of medication from several doctors, he has legal liability for the outcome. He also has a legal duty to inform your physicians of apparent duplication and overuse of medication. Wouldn't you want him to inform your doctor of a potential drug interaction or allergy to medication prescribed? Believe it or not, he is looking out for your best interest besides fulfilling the legal requirements of his profession.

Answer 2

Hmmm...I really don't know, but I'll gladly give you my opinion :)

Insurance companies and doctors/pharmacists communicate medical information for the purposes of billing. That's why your insurance company knew about the pain meds being filled. The question is whether they violated your privacy by telling the pharmacist that you recently had a pain med script filled. They are allowed to use your medical info for billing purposes, but I'm not sure if they are allowed to do what they did.

In these days of forged prescriptions and "doctor shopping" to get pain meds, they were just wanting to make sure that your prescription was legitimate, since you had already filled a pain med script recently, and this wasn't your normal pain medication.

It's not uncommon for the pharmacist to have to verify info with the doc to make sure it's a genuine script, but was it illegal for the insurance company to inform him?

Do you always go to the same pharmacy, or chain of pharmacies? Because if you do, they might just have seen that you recently filled a pain script (it would be on your pharmacy records). That would be legal. If their sole information source was the insurance company, though, that definitely bears looking into. The pharmacy didn't do anything wrong, but was it OK for the insurance company to reveal that info to the pharmacy?

In answer, get the privacy policies from your insurance company and from your pharmacy (everyone signs them but no one really reads them). Check to see what kind of info your insurance company is allowed to release to the pharmacy. If that type of info isn't mentioned, then you might have legal recourse.

It wouldn't hurt to check with http://www.hhs.gov/ocr/hipaa/
That's the government organization in charge of healthcare privacy. You might find something useful that pertains to your situation there.

Answer 3

Your pharmacist did EXACTLY what they are supposed to do. Certain heavy-duty pain meds have a potential to become addictive, or people may abuse them (like oxycontin). My husband used to take Lortabs before he had hip surgery. What your pharmacist and your insurance company were doing was actually to help you, not hinder you.
Was the original prescription for Lortabs written by the specialist? If so, the pharmacist and insurance company may have 'flagged' your prescription if it was for the same pain meds, but prescribed by a different doctor.

Call your doctor, tell him (or at least the person in the office that deals with insurance and pharmacy companies) that you are taking extra meds.

Answer 4

The pharmaist did not violate your privacy. Since you have a long history of taking narcotic pain pills he was doing his job in double checking with your Dr. It is also probable that the computer kicked it out since the last time you got Norco was to close. If you have drug insurance the ins company will alos reject a prescription if it is to soon and the pharmasist can talk to the Dr. so he can talk to the insurance company about why you need more medicine.

Answer 5

The HIPPA act (health information privacy and portability act) was designed to prevent providers from transferring any UNESSECARY information to the third party. When you go to the pharmacy, you are giving the pharmacist the right to information he or she needs to do her job for your safety and benefit....and she is entitled to ONLY that information.

Some examples of HIPPPA violations include:
1. Talking about a patient to someone not involved in their care and giving identifying information
2. A doctor tells a patient's husband that his wife had an abortion without telling him
3. A pharmacy selling the names and addresses of its clients to a pharmaceutical rep.


Your pharmacist needed to provide your PCP with information relavant to your care in order to protect you from harm (or what she believed could harm you).

I will agree with you that it was probably not handled in the best manner, but she did not violate your privacy. If I were the pharmacist, I would have called you personally first.

Answer 6

Lortab and Norco are the same medication, Acetaminophen with hydrocodone. If you take too much of it, it can cause liver failure.
There are many people who do doctor shop for narcotics, and so, caution is advised. If you need more pain relief, it is time to put away the APAP with hydrocodone and take out the full strength opiates.

Answer 7

read the HIPPA agreement that you signed at your pharmacy. It is NOT a violation of your privacy to discuss your medications with your physicians.

Answer 8

I think this is computerized so they don't give people drugs that have bad interactions. I'm sure this was all stuff that the insurance company demands.