CVS/AETNA SHITHOUSE UPDATE

My All Our War with Payers (Part II)

I present Chapter Two in my ignominious and Sisyphean war with CVS Health CVS Pharmacy Aetna, a CVS Health Company CVS/Caremark per this recent post: https://emz.ee/cvs1.

After ignoring the problem across a long overdue 10-day family vacation—including a visit to my parents in Myrtle Beach, an excursion to Dollywood, and a finale in Nashville—I've hit the ground running again in my all-out war against the health insurance industry.

They clearly messed with the wrong guy.

After the denial of a prior auth denial, a second denial for generic Dexilant (which doesn't work anyway), and a formulary exemption falling into limbo, thanks to my PCP, I unnecessarily and unnervingly procured a 90-day Dexilant (brand) stash from Canada, buying me a few months to rally the troops.

I continue to seek counsel, guidance, navigation, and advice from my BFF network of fellow advocates, activists, policy wonks, lawyers, etc. I am practically getting a Master's Degree in a sector of healthcare that—until now—I have gratefully never had to deal with—a proverbial 401 regarding possible illegal practices and state/federal policy violations.

I am on my wife's policy and spoke to our union rep, who has stepped in to work her side of the equation in conjunction with my PCP, who is also as fiercely pissed off as I am.

I spoke with Allied Health's advocates for guidance on approaching exactly who at Caremark directly—and who should be joining me on those potential calls.

I've learned all about urgent external formulary reviews and the extraordinary value and power that engagement with the proper legal counsel can have to share the shit out of payers and force them to do the right thing that is best for me and not them.

I've also learned about the power the New York State Attorney General's office can have if it comes to that.

So, thank you again to my fellow ignominious disreputable and undignified troglodytes, for allowing me to become even more powerful and influential in the healthcare sector..

I can't tell you how much I appreciate your blind determination—on behalf of my PCP, specialty physicians, and oncology care team—that you clearly know better than they do about what's best for me as a 27-year cancer survivor.

All the other lions are joining me to form the most badass Voltron you've ever known. The hounds are released.