I-Team: Prescriptions denied - News, Weather and Classifieds for Southern New England

I-Team: Prescriptions denied

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An NBC 10 I-Team investigation reveals that thousands of subscribers to Blue Cross & Blue Shield of Rhode Island, as well as hundreds of medical providers, are outraged over a new pharmacy benefits manager hired by BCBSRI.

The company, called Catamaran and located in Illinois, was hired by BCBSRI in January to take over the management of most pharmacy benefits covered under the Rhode Island company's policies.

 But many doctors are outraged, because prescriptions are routinely denied when something called "prior authorization" is requested.

"It's been a disaster," said Dr. Gary L'Europa, a neurologist in Warwick. "Prior authorization has always been a problem but since January a number of patients had their medications denied for no apparent reasons."

An official of BCBSRI, Dr. Gus Mancchia, says the non-profit is well aware of the problems with Catamaran, but claims steps are being taken to correct them.

"We've established a direct mail order phone and fax number for providers. Catamaran has added staff to work directly with Blue Cross on prior authorization requests and the firm is simplifying the prior authorization form," Mancchia said.

But the efforts of Blue Cross and Catamaran are not satisfying patients and medical providers in Rhode Island.

"We wait weeks and weeks and weeks, you're advised when you call your request can take up to four weeks," said an officer manager for a local doctor's office.

Doctors say many of their patients have had to go without their medications, sometimes for weeks. But BCBSRI denies that. The company says when a prior authorization is denied, BCBSRI makes sure the patient gets the medications they need on a temporary basis.

Calls placed to Catamaran were not returned.

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    NBC 10's I-Team was the first investigative unit in Rhode Island.

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  • Katie Davis

    Katie Davis

    Katie Davis is an I-Team reporter at NBC 10. She joined the team in January 2010 and is excited to live and work in New England.
    Katie Davis is an I-Team reporter at NBC 10. She joined the team in January 2010 and is excited to live and work in New England.
  • Parker Gavigan

    Parker Gavigan

    Parker Gavigan is an Associated Press award-winning journalist, and was named to the NBC 10 I-Team in January 2013. Parker digs deeper to get the answers that matter to you.
    Parker Gavigan is an Associated Press award-winning journalist, and was named to the NBC 10 I-Team in January 2013. Parker digs deeper to get the answers that matter to you.
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