Large chain pharmacies such as Walmart and CVS began refusing to fill or delaying Adderall and other ADHD drug prescriptions written by prescribers working for telehealth startups such as Cerebral and Done Health. As a result, other pharmacies who fill ADHD drug prescriptions resulting from telehealth visits and prescribers who perform telehealth services in the mental health space should prepare for increased scrutiny into the validity of their services.
During the COVID-19 Pandemic, regulatory changes to, in part, the reimbursement of telehealth services allowed both pharmacies and prescribers alike to expand the extent of their business and allowed for an expansion of access to healthcare. However, the regulatory changes also led to increased scrutiny of telehealth services provided. The Office of Inspector General specifically noted its focus on conducting significant oversight in assessing telehealth services to ensure that the benefits are not overshadowed by fraud, abuse, or misuse.
While there have been other enforcement actions related to telehealth services, it appears that large chain pharmacies, along with Truepill, Inc., Cerebral’s preferred pharmacy, are taking preemptive steps to curb filling for potentially problematic ADHD drug prescriptions. Such preemptive measures may be the reaction to comments provided by Cerebral employees which called into question the medical necessity of ADHD prescriptions, stating that Cerebral may be aiding in the overprescribing of Adderall and other stimulants by, in part, prescribing such medications after short telehealth visits where follow-up appointments are rarely scheduled.
The move by large chain pharmacies as well as Cerebral’s preferred pharmacy to distance themselves from ADHD prescriptions resulting from telehealth visits will likely increase scrutiny of the dispensing and prescribing practices related to mental health drugs in the telehealth space. Pharmacies and providers should prepare for an increase in audits and enforcement actions pertaining to the prescribing and dispensing of ADHD drugs where such enforcement actions and audits may result in recoupment of claims and exposure to False Claims Act liability.
How Frier Levitt Can Help
Frier Levitt can help pharmacies and providers review potential exposure and navigate various options to boost compliance and business practices as well as mitigate any issues before an audit, investigation, or enforcement action occurs. If you believe that your practice or pharmacy may face potential exposure as a result of prescribing or dispensing ADHD drugs, reach out to Frier Levitt today to explore your options to proactively address any areas of concern.
