Pharmacists under Barna's supervision knew to take such warnings seriously. In a March 2011 email, he declared that unsatisfactory performance would cause him to make "major personnel changes in multiple stores."
"Please understand this is not the road I wanted to go down," Barna wrote, "but action plans/phone calls/advice haven't yielded the result we're all looking for & it's time for a change in leadership in certain stores."
CVS' DeAngelis said that Barna's instructions to pharmacists weren't representative of the company's policies. "The messages in the emails in question were not authorized by CVS pharmacy," he said.
DeAngelis said the company's management first learned of the situation from another supervisor, "who recognized that the messages were not in compliance with our pharmacy policies and procedures."
He said CVS has "already addressed this matter" with Barna "and educated the pharmacy teams about our correct policies and procedures." Barna apparently remains a supervisor for the company's drugstores.
DeAngelis declined to specify when the company first became aware of the refill practice.
A spokeswoman for a leading health insurer, who requested anonymity because her company does business with CVS, confirmed that claims are submitted to insurers when prescriptions are filled. Payments can be made at any time over the next few weeks, depending on the insurer's reimbursement cycle.
If a CVS customer failed to pick up the refilled prescription, the medicine typically would be restocked after two weeks and the insurance claim canceled. Any money paid by an insurer presumably would be refunded.
But one consequence of CVS' practice, the insurance spokeswoman said, is that a patient who tried to fill a prescription elsewhere during that time may have found that CVS had already secured reimbursement for the order, thus preventing the patient from dealing with the pharmacy of his or her choosing.
It could also slow a patient's access to medicine until the insurance issue had been addressed.
By CVS' own estimates, people not taking required medication on time results in about $290 billion in annual healthcare costs.
David Lazarus' column runs Tuesdays and Fridays. he also can be seen daily on KTLA-TV Channel 5 and followed on Twitter @Davidlaz. Send tips or feedback to email@example.com