What is this about?

• IPCA has so many patients who need pain medicine that we cannot see every patient once a month - and it is not medically necessary to always see every patient once a month, 12 times a year.  Therefore, many patients will come into the IPCA office for prescriptions, between appointments.
• When prescriptions for schedule II pain medications are provided outside of the context of an appointment with a provider, we charge $20 to the patient (or to the insurance company when the health plan has agreed to cover this - but that is rare).
• You will not be charged the $20 if you are given a prescription refill at an appointment with the doctor or nurse.
• The amount is $20 regardless of how many prescriptions are filled.
• It is payable by cash, check, or credit card at the time that you pick up your prescriptions; if you use a credit card an additional processing fee raises the total payment to $23
 

Why am I being charged this $20?
                
Because IPCA is taking up slack in caring for patients who need prescription pain medication. 

Have you noticed that many health care providers will not prescribe opioid/narcotic pain medicine at all?  Even many pain clinics in Tucson will no longer prescribe needed pain medicine to patients - here is a quote off of the website of one of Tucson's oldest pain clinics: "For patients seeking a physician to prescribe narcotics, we would be happy to assist you in finding a local physician who specializes in outpatient opioid management." 

Because taking up the slack in prescribing opioid/narcotic pain medicine consumes more resources than are required for prescribing other types of medications.

We have hired extra staff and purchased additional computer software to track opioid/narcotic medications and to comply with state and federal guidelines for prescribing narcotic medications.  We put our staff through extra training.  We have developed special guidelines, procedures and protocols.  It takes time and money to do all this.  EVERY time you come in to the office - even if your visit to IPCA is to pick up prescriptions - IPCA is making this extra effort. 

Because health plans do not pay for these extra resources.

In Summary: We want to maintain your access to safe and efficient pain medication management services.  We simply can't do this without your help.  We have developed a system that allows us to provide these services for patients taking tightly regulated opioid and other medications. We want to continue providing these services, but we must ask our patients to bear a portion of the cost now - because most health insurance plans refuse to cover the additional work this service requires. If patients do not pitch in, we cannot afford the extra work and we would have to discontinue prescribing medications for hundreds of patients.

I thought my insurance companies payment and my co-pay covered all the costs of prescription refills.
If you are being charged the $20, then your health plan DOES NOT cover all the costs that a medical office faces when prescribing opioid/narcotic medications.                

Does this apply to everyone?

No.  A few insurance companies will cover prescription refill visits without requiring burdensome prior authorization, etc.  Check with your IPCA provider to see if your health plan is one of these.

Also, Medicare and Medicaid (AHCCCS) laws prevent a medical provider from charging for this service - even though these government health plans Do NOT COVER it themselves.  We are trying to work this out with these plans, and we expect to succeed; but if we cannot do so - opioid prescribing may simply become impossible for those covered under these plans.  Many primary care physicians have given up on prescribing opioid medication, already!