John Curry to Gary Russell: I still haven't received an answer

From John Curry, March 20, 2007
Subject: Re: Gary, I still haven't received an answer!

Gary,

Thank you for the immediate response. Your response on March 8, 2007 still (in my mind) doesn't divulge a timetable thus leaving retirees and myself still wanting:

"John, I don't want to speak for the Caremark representative; however, I would guess that the representative was implying that it is STRS Ohio who makes the final determination of the drug plan and the plan's provisions and Caremark administers those provisions. While the prior authorization program is developed in conjunction with Caremark, STRS Ohio determines whether or not we utilize a prior authorization program. Caremark pharmacist and doctors make the approval or denial decision.

In regards to the timetable, I know that there has been communication back and forth between the doctor's office and Caremark to resolve the issue. The decision is always delayed when additional follow up information is needed."

Gary

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Gary, please let me clarify: In regards to a "timetable" that you addressed above that I still am looking for actual numbers i.e. "days" that Caremark is held to (if, in fact they are) for initially contacting the physicians office of ANY retiree if the a denial is to be issued. This is not related to this specific retiree's experience but to all STRS retirees who are awaiting their mail-in prescriptions from Caremark. If, in fact, the divulging of this information to me and others would result in the violation of "trade secrets," I would understand as Nancy Hamant and the Warren County Retired Teachers Association have been down that road before.

While I have your ear, I would also like to ask you this:

Who is legally allowed to come to STRS and view our contract (in its entirety) with Caremark...are STRS Board members.....are STRS retirees.....is the general public?

I am concerned about this issue because I am concerned about all STRS retirees and their prompt attention when it comes to medical issues. I am concerned because many retirees don't have the knowledge that sometimes PBMs aren't always the most honest "kids on the block." If you get some time I ask that you take a look at a recent federal complaint against the PBM Merck-Medco in 2003 which resulted in an out of court settlement for millions of dollars and, of course, no admission of wrongdoing.

In this document, Merck was accused of "canceling and destroying prescriptions, failing to perform the professional pharmacists' services needed by patients and required by law, by switching patients' prescriptions to different drugs without their knowledge and consent, by shipping medications and billing patients for drugs they never ordered, by creating false records of contact with physicians, by soliciting and receiving inducements from pharmaceutical manufacturers to favor their products, and by making false and misleading statements to the United States about its conduct. Here is the link to this 60 page Adobe download http://www.usdoj.gov/usao/pae/News/Pr/2003/sep/medcocomplaint.pdf It contains some eye-opening accusations that would make most retirees (and prosecutors) shake their heads in disgust.

Thank you, Gary for listening to my long email and I do know that you and I only want the best for our retirees. I will be awaiting your reply... not only in regards to the actual timetable but also equally to your answers as to whom may inspect our current contract with Caremark.

John