Correa v. SchoeckAnnotate this Case
A pharmacy has a limited legal duty to take reasonable steps to notify a patient and his or her prescribing physician of the need for prior authorization each time the patient tries to fill a prescription.
Only the pharmacy, and not the physician or the patient, is notified by a health insurer when a prescribing physician must complete a prior authorization form and submit it to the insurer. In this case, prior authorization was necessary for Yarushka Rivera to obtain insurance coverage for Topamax, a medication she needed to control life-threatening seizures. When Rivera reached age nineteen, her insurer refused to pay for the prescription because it had not received the necessary prior authorization form. Rivera, who was unable to afford the medication without insurance, suffered a fatal seizure at the age of nineteen. Plaintiff brought this action for wrongful death and punitive damages against Walgreen Eastern Co., Inc. The superior court concluded that Walgreens had no legal duty to Rivera to notify Rivera’s prescribing physician of the need for prior authorization. The Supreme Court reversed, holding that Walgreens owed a legal duty of care to take reasonable steps to notify Rivera and her prescribing physician of the need for prior authorization each time Rivera tried to fill her prescription.