To the Members of the School Board:
I am writing to formally file a complaint regarding the ongoing denial of medically necessary prescription medications under the district’s health plan for employees, retirees, and other covered individuals. These denials appear to be occurring without adequate medical justification and without appropriate consideration for the health and safety of the people who depend on these medications.
Specifically, I am aware of denials affecting medications that treat, among other conditions, high cholesterol, high blood pressure, abnormal blood sugar levels, osteoporosis, acute and chronic injuries, cardiovascular disease, endocrine disorders, and impaired liver and kidney function. The denial of these medications places patients at significant and unnecessary risk and may interfere with the continuity of care recommended by their licensed healthcare providers, actual Medical Doctors!
It is deeply concerning that decisions about coverage and access to treatment are being made by individuals or committees who do not have direct medical knowledge of the patients’ conditions, histories, or treatment plans. When non‑medical decision makers override the judgment of prescribing physicians, the result can be serious harm and potential liability for the district.
I respectfully request that the School Board:
- Immediately review its policies and practices related to prescription medication approvals and denials.
- Ensure that all coverage determinations are made in consultation with qualified medical professionals and are consistent with evidence‑based standards of care
- Establish a transparent, timely appeals process so that employees and retirees can contest denials and protect their health in a timely manner to not miss dosages
We all look forward to your prompt written response outlining the steps the Board will take to correct these issues and to prevent further improper denials of medically necessary medications.
Stop playing doctor and trying to save $$s on the backs and medical conditions of your people!