Medicaid recipient was properly placed in the Pharmacy Lock-In Program to eliminate prescription abuse.
Docket Number: ***** , Decision Date: September 16, 2013
Attachment: Click here to download the decision.
Petitioner, a Medicaid recipient, was placed in Department of Community Health’s Pharmacy Lock-In Program after discovering a pattern of behavior indicating prescription abuse. First, Petitioner’s drug therapy did not correlate with his diagnoses. Second, his provider triggered the investigation upon suspicions of prescription drug abuse. Third, more than 10% of his filled prescriptions were for controlled substances. Finally, Petitioner received duplicate drug therapy from different physicians.