Case: 4:18-cv-01005 Doc.

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Exhibit F
 Case: 4:18-cv-01005 Doc. #: 1-6 Filed: 06/20/18 Page: 2 of 3 PageID #: 56

BSF
llJO IES
- SCHI LLER
..... I FLEXNER

July27,2017

Shon Riley
Senior Legal Counsel II
Express Scripts, Inc.
One Express Way
St. Louis MO 63121

Re: Response to June 30, 2017 Letter on Behalf of Express Scripts, Inc.
Re: NCPDP 5654137

Dear Ms. Riley:

I am writing in response to your letter of June 30, 2017. In that letter, you request
that CZ Services do two things: (1) provide Express Scripts with a copy of all valid
Signature Logs for prescriptions dispensed from 5/1/2017- 6/15/2017 and (2) refrain from
conduct that breaches the Express Scripts agreement.

With respect to the first request, the requested signature logs are attached.

With respect to the issue of the Express Scripts Agreement, as I set forth in detail
in the May 1?111 letter sent to Express Scripts, CZ Services does not violate any of the
terms set forth in the Express Scripts agreement or provider manual. CZ Services is a
retail pharmacy, serving poly-chronic patients- many of whom are on Medicare and or
Medicaid. The pharmacy does not mail anything. Patients come to the pharmacy in
various ways- some are walk-in patients, some are through federal programs like
Medicaid' s Pace program, and many come to the pharmacy via a health management
service that performs a variety of services for those individuals, including acting as a
patient's agent to select a pharmacy and pick up medications on his or her behalf.

In your letter, you ask for authority that supports the concept of an agent picking
up prescriptions on behalf of a patient. My original letter referenced 16 Cal. Code Regs.
1714.l(b). That code section acknowledges that a patient's agent can pick up
prescriptions on their behalf. This is consistent with many other provisions of California
law, which all incorporate the concept that a prescription may be picked up by a patient's
agent. E.g., 16 Cal. Code Regs. 1707.2(a) (requiring a pharmacist to provide oral
consultation to a patient "or the patient's agent" (a) on request or (b) whenever warranted
in the pharmacist's professional judgment); 16 Cal. Code Regs. 171 l(b) (defining
"medication error" to exclude any variation that is corrected before "furnishing the drug

BOI ES SC HI LLER FLEXNER LLP

!401 New York Avenue NW. W ashi ngton. DC 20005 I (t) 202 237 2727 I ( f) 202 237 613! : Wf.''i\/.bsfl lp .com
 Case: 4:18-cv-01005 Doc. #: 1-6 Filed: 06/20/18 Page: 3 of 3 PageID #: 57

BSF
Shon Riley
July 27, 2017
Page 2

to the patient or patient's agent"); 16 Cal. Code Regs. 1707.4(b) ("Nothing in this section
shall be construed as barring a pharmacy from also filling new prescriptions presented by
a patient or a patient's agent or transmitted to it by a prescriber.") (emphasis added in all).
This is also consistent with the general principle of agency- a widely accepted and
common legal concept.

In your letter you also say that "regardless of the regulations regarding agency, we
must ensure that any such practice is not being practiced in a way that circumvents the
law." CZ Services operates in complete compliance with the law. The pharmacy is
regularly inspected by the California Board of Pharmacy, which is aware of the agency
model, and the pharmacy has never been disciplined. In addition, the pharmacy is
licensed and in good standing in all 50 states, along with the District of Columbia.

I am available to discuss if you have any questions.

Very truly yours,

Isl William A. Isaacson

William A. Isaacson