We, Gary, are getting nowhere .... and are also getting there quickly

John Curry to Gary Russell, March 23, 2007
Subject: Re: Gary, I still haven't received an answer!

Gary, I thank you for getting back to me re. my March 20, 2007 letter to you concerning some questions about pharmaceutical issues. But, there's a lot of uncertainty that's not clear in my mind.

5 complaints (out of 35,000 prior authorization requests) escalated to STRS Ohio management is an interesting statistic but..... it is also an ingenious answer to a non-existent question. For convenience, I'll restate my questions:

1. Is there a timetable that Caremark is held to for initially contacting the physician's office of any retiree if the denial (for an Rx) is to be issued?

2. 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 sent Dr. Leone a letter a few days ago in which I told him that I'd bet these questions would not be "touched with a 10 foot pole." I think you've proved me right.

I will not bother you anymore with these two questions above as I don't really feel I'll receive a reply of substantive matter....kinda' like many retirees who have just "given up on the system" after they received a refusal of a certain medication for one reason or another and didn't have the physical health and strength to continue the battle. We, Gary, are getting nowhere .... and are also getting there quickly.

---

From Gary Russell, March 23, 2007
Subject: RE: Gary, I still haven't received an answer!

John, Typically Caremark responds to a prior authorization request of a doctor within 48 hours. The timeline is really driven by the doctor's office based on whether the prior authorization questionnaire is completed in its entirety and how soon the doctor's office returns the questionnaire.

Reviewing the number of transactions there doesn't seem to be any sort of systematic problem with the retirees on this issue. During the last year there were more than 35,000 prior authorization requests made to Caremark. There have been less then five complaints escalated to STRS Ohio management.

Gary