[NPInfo] Medicare and changes

[Scott]

D,

I graduated from USC in 1999 and was in SC for 10 years.  Moved to NC to
practice behavioral peds, (heavy schedule II med writing).  Left SC because
I was not allowed to write for them there and I understand the frustration.
Some of the NP's in Columbia are organized; maybe you could try and restart
the movement for change in SC practice.  Not sure if that will help as
federal laws may be involved (Adult care is not my specialty).  Stephanie
Burgess was a good NP to look up.  She used to be very involved with
practice change.   Good luck and you can always move to NC.

Scott


-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
Of MIRONNYE at aol.com
Sent: Monday, March 03, 2008 11:36 PM
To: npinfo at nurse.net
Subject: [NPInfo] Medicare and changes

Hi
My name is Dee and I am FNP in South Carolina.  Has anyone had the  
frustration I have had with Medicare changing all the patients' medicines?
I work 
with indigent patients and they cannot afford some of the medicines when  
Medicare changes their drug programs.  They are being changed every year
and I spend 
most of the first new year visits changing their medications so they  can 
afford them.  At first, I was happy with this Medicare part D, but  after I 
started getting calls from pharmacies about changing the medicines  because
they 
weren't covered on part D, I began to get weary.  Sometimes I  have to
change to 
medicines that don't help as well and I feel it is the patient  that
suffers. 
 A lot of my patients don't take all of their medicines  because they can't 
afford them.  I had one patient tell me one of her  medicines was $65 and
she 
probably will not be getting it. She absolutely  refused to use Crestor as
it 
would cost her $111 a month.  And her  cholesterol is well controlled!  She
has 
already had stents placed twice;  so I was not too crazy about changing her 
medicine.  Lipitor was even  listed as a tier 3 which would have been $65 or

more.
 
Also, I just realized I could not order home health for my patients.   I
work 
in a nurse practitioner run clinic.  I do have MD who can sign for  this,
but 
she never sees these patients-I do.   Now I'm getting forms  saying I can't 
sign for diabetic shoes or equipment.  Am I just being  overly sensitive?
 
Anyone else feeling this frustration??
 
Thanks for letting me vent.
 
D. Devlin, FNP
Columbia, SC



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