Q: I order my prescriptions through the mail to save money. Recently when my expensive brand drug went generic, I switched to a new, less expensive, drug plan. Shortly thereafter, I received an unordered shipment of the expensive brand drug shipped from my former drug plan's mail order pharmacy. Even though the prescription had expired, the mail order pharmacy called my doctor, got a refill authorization, and shipped just prior to my final day of enrollment in the former plan — all without any authorization from me! I was told the drugs could not be returned and then I was sent the bill. I refused but got some many notices I finally sought legal help. Am I obligated to pay for medications that I did not order?
A: Your attorney undoubtedly told you that if you receive merchandise that you didn't order, you are not obligated to pay for it, but may keep it as a free gift. According to the Federal Trade Commission, it is unlawful to send merchandise by any means without the express request of the recipient. It is also unlawful to try to obtain payment for, or return of, the unordered merchandise.
The actions of the mail order pharmaceutical provider of your former drug plan appear to me to be abusive at the very least and potentially fraudulent. First of all, the former drug plan and its mail order provider would have automatically received notice of cancelation in November or December, when you switched to your new drug plan. The provider's unauthorized call to your doctor raises questions as to whether it was a deliberate move to get a sort of "de facto" authorization. The provider may have bet on a reaching a typically busy doctors' practice that would not have time to double-check with the patient, prior to issuing the prescription.
You are not the only victim of this type of billing abuse. The Centers for Medicare and Medicaid Service (CMS) recently announced a new proposed rule to ensure that drug stores refill prescriptions only after receiving the patient's express approval. The CMS press release stated that the proposal is "in response to complaints from beneficiaries who have received and been charged for unnecessary and unwanted prescriptions because of 'auto-ship' services." The belated move follows investigations of claims that major drug store chains were refilling prescriptions and billing Medicare Part D plans and their enrollees without the knowledge or authorization from customers.
If you haven't already done so, it's a good idea to write a letter to the company stating that you didn’t order the prescriptions, nor did you authorize your physician to release a prescription on your behalf. Therefore, you have a legal right to keep the prescription meds at no charge. Send your letter by certified mail and keep the return receipt. Keep a copy of your letter for your records.
Source: Federal Trade Commission Mail or Telephone Order Merchandise Trade Regulation Rule, 2013.
