In a rare show of agreement, lawmakers from both parties introduced legislation Wednesday that would treat the phrase "it should already be there" as a sworn statement, after pharmacies told Congress the claim has never once been accurate.
The bill, titled the Already There Accountability Act, would require any person who uses the sentence at a pharmacy counter, on a phone line, or from a prescriber's office to affirm it under penalty of law. If the prescription, refill, or prior authorization was not, in fact, already there, the remark would enter the record as sworn testimony that did not hold up.
"This is not a Republican issue or a Democratic issue. This is a queue issue," said Sen. Harriet Fillmore (D-OH), a lead sponsor. "Pharmacists have testified that they checked the e-prescription queue, the fax tray, the voicemail, and the will-call bin, and that the item in question has, without exception, been somewhere else, or nowhere."
Sen. Grant Stockwell (R-NE), the bill's other lead sponsor, called the hearing record "unusually consistent." A review by the Congressional Pharmacy Workflow Office of 2.4 million reported uses of the phrase found zero instances in which the prescription was present at the moment it was spoken. In 61 percent of cases, it had been sent to a different pharmacy. In 22 percent, it had been sent under a former last name. In the remainder, the office had not sent it at all.
"I have spent fourteen years looking a patient in the eye and saying I will call the office," said Marisol Vega, PharmD, who testified before a joint committee. "The office says they sent it an hour ago. I put them on hold and I look again. It is not there. I would like, just once, for the statement to be true, or at least notarized."
A companion provision would place a short card at every consultation window. Patients and office staff could still use the phrase, but would be asked to initial a confirmation that they have personal knowledge the prescription was transmitted, that they know which location it was sent to, and that they are prepared to wait while the pharmacist checks a third time.
"We transmit in good faith," said Lionel Pruitt, an office manager at a midsize primary-care clinic. "If the pharmacy cannot see it, that is a matter for the software, not for an oath. We sent it. It should already be there."
At press time, both sponsors said they were confident the bill would pass before the next long weekend, when volume at the counter is expected to rise. A draft amendment would extend the same standard to the sentence "I was just there yesterday."
