Health Plan Agrees To Improve Pharmacy Complaint Process

Attorney General Spitzer today announced an agreement that will help make one of the state's leading health plans more responsive to its members.

The agreement - the first of its kind in New York - will help resolve ongoing consumer complaints in the wake of a decision by Blue Cross of Western New York to modify its pharmacy network to include Rite Aid and discontinue its relationship with other pharmacies.

"Ready access to needed prescription drugs is essential to quality health care," said Attorney General Spitzer. "As part of this agreement, Blue Cross will implement measures that will help ensure that people's complaints about pharmacy services are addressed promptly."

The agreement requires Blue Cross to establish a 24-hour toll free hotline for consumers, and to log and prioritize consumer complaints regarding pharmacy services. Urgent complaints - such as those involving possible medication errors, delays in filling prescriptions, or the inability to fill a prescription because it is out of stock - must be resolved by the end of the next business day. Non-urgent complaints will be addressed within 15 business days.

The agreement also provides that Blue Cross would take affirmative steps to identify problems by conducting a survey of Rite Aid customers as well as a survey of Blue Cross members who have filed complaints related to Rite Aid. Also, Rite Aid will provide additional training to pharmacy staff.

After Blue Cross's decision in July 1999 to include Rite Aid and exclude other pharmacies such as CVS and Eckerd from its pharmacy network, the Attorney General expressed concerns about access for home-bound seniors and others who relied on the delivery services that CVS and Eckerd provided but Rite Aid did not. Blue Cross responded quickly, promising to make delivery available and to add Wegmans supermarkets to its pharmacy network.

Since that time, however, some consumers have continued to complain about a variety of difficulties with the Rite Aid pharmacy network, ranging from the wrong medications being dispensed, to refills not being ready when the pharmacy stated they would be.

Spitzer commended the company for working with his office to address consumer complaints and for agreeing to take proactive steps to ensure that consumer complaints about pharmacy services are promptly addressed.

Blue Cross, based in Buffalo, provides health, dental and group insurance coverage to more than 300,000 Western New Yorkers.

This case was handled by the Health Care Bureau's Albany Section Chief Troy Oeschsner and Assistant Attorney General Heather Rubenstein.

Consumers and healthcare providers with questions or concerns about health care matters may call the Attorney General's Health Care Hotline at 1-800-771-7755.


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