1-ribbonFirst they came for the mentally ill addicts, and I did not speak out—
Because I was not a mentally ill addict.

Then they came for the empathetic prescribers, and I did not speak out—
Because I was not an empathetic prescriber.

Then they came for the Pharmacists, and I did not speak out—
Because I was not a Pharmacist.

Then they came for me—and there was no one left to speak for me

Rick Santorum: ‘Millions of Americans’ with preexisting conditions are health care thieves

Rick Santorum: ‘Millions of Americans’ with preexisting conditions are health care thieves

Veteran kills himself in storage shed in Murfreesboro

Veteran kills himself in storage shed in Murfreesboro

http://www.dnj.com/story/news/2017/02/10/veteran-kills-himself-storage-shed-murfreesboro/97764414/

A Murfreesboro veteran killed himself in a storage unit Thursday afternoon, according to Murfreesboro Police.

At about 5:25 p.m., police were called to Ideal Storage on South Church Street, according to an incident report.

Dinah Walker, a Veterans Affairs case worker, directed police to the storage unit where she found the man, who had hung himself.

The officer checked for a pulse but found none, the report said. Responding Murfreesboro Fire Department workers performed CPR, but the man was not responsive. He was pronounced dead at St. Thomas Hospital.

Walker said the 62-year-old veteran was a client of hers, the report said. She had last spoken to him at about 3 p.m. that day.

The VA Tennessee Valley Healthcare System confirmed the suicide in a news release Friday afternoon.

“The health and well-being of the courageous men and women who have served in uniform is our highest priority,” said Jennifer L. Vedral-Baron, Health System director, in the release.

“Suicide is a tragic outcome and hurts not only the victim’s family, but also the caregivers and the larger veteran community. VA is committed to ensuring the safety of our veterans, especially when they are in crisis.”

Veterans, service members, and their loved ones in crisis can call the Veterans’ Crisis Line at 1-800-273-8255 and press 1, send a text message to 838255, or chat online at VeteransCrisisLine.net to receive free, confidential support 24 hours a day, 7 days a week, 365 days a year, even if they are not registered with VA or enrolled in VA health care.

“Management and staff of TVHS offer our sincere condolences, and our thoughts and prayers are with this veteran’s family and friends,” Vedral-Baron said.

#CVS’ Pharmacy phone calls stopped and gives peace to Houston man

Pharmacy phone calls stopped and gives peace to Houston man

http://abc13.com/news/abc13-gets-cvs-automated-prescription-calls-to-stop/1776140/

Jerry Martin just wanted the calls to stop.

The 70-year-old from Cypress tried to get CVS to stop calling him every month to remind him to refill his prescription.

Martin told ABC13 Investigates that he takes six pills a day.

Martin even showed us the boxes he uses to keep track of them all, “This is how I keep track of my meds, when these get empty I know I need a refill.”

Martin told ABC13 Investigates’ Ted Oberg that he didn’t need the reminders.

“They call four to five times (every month). We started hanging up on them, they called right back,” Martin said.

To Martin, keeping track of his meds is part of living independently and that’s what he wanted to do, since Martin is spry at 70.

He exercises, keeps up a busy schedule and even bragged about making his own recent roofing repairs.

He just wanted us to tell CVS, “Stop calling senior citizens and treating us like we’re dumb and can’t handle our own business.”

Martin says he asked the pharmacy and they told him to call an 800 number on a card but the card they gave him didn’t have a number on it.

He enlisted help from his insurance company and finally, Martin reached out to us.

But it’s not just Jerry Martin.

A check of Better Business Bureau records shows other consumers had similar problems – and few got answers at their local pharmacy. We got in touch with CVS’ corporate offices in Rhode Island and got Jerry removed from their call list.

Recently Martin says the calls have stopped.

CVS explains the permission from the calls is part of an opt-in when you first shop at a CVS Pharmacy.

If you want to stop the calls, CVS says call them 1-800-SHOP-CVS.

If you have something you need our help with – tell Ted here: abc13.com/oberginvestigates.

in Medicine: if it isn’t documented… it didn’t happen !!!

Family-reported errors may go undocumented on hospital records

http://kfgo.com/news/articles/2017/feb/27/family-reported-errors-may-go-undocumented-on-hospital-records/

(Reuters Health) – Parents may notice medical errors and bad reactions to treatment that aren’t documented in their children’s hospital records, a U.S. study suggests.

Researchers surveyed parents of hospitalized children, asking them about mistakes and adverse events. They also conducted daily surveys of the doctors and nurses who cared for the children. Finally, they looked at medical records and formal hospital incident reports.

Overall error rates were nearly 16 percent higher with family reporting than without. And overall rates of adverse events were nearly 10 percent higher with family reporting, researchers report in JAMA Pediatrics.

Similar rates of errors and adverse events were reported by parents and by the doctors and nurses in the daily surveys. But 49 percent of family-reported errors and 24 percent of family-reported adverse events were not documented in the medical record.

Hospital incident reports were also unreliable. Family-reported error rates were five-fold higher than hospital incident report rates, and adverse event rates reported by families were nearly three-fold higher.

“Our results suggest that whether we are talking about safety surveillance research or operational hospital quality improvement and safety tracking efforts, families should be included in safety reporting,” said lead study author Dr. Alisa Khan, a researcher at Harvard Medical School and Boston Children’s Hospital.

While health care providers are ultimately responsible, families can help identify events that might be missed by traditional safety surveillance methods, Khan added by email.

The researchers examined survey data from 717 parents and caregivers of children and teens hospitalized in 2014 or 2015.

During interviews with researchers, participants detailed any safety incidents that occurred during those hospital stays.

Then, researchers reviewed and classified incidents as medical errors, bad reactions to treatment, other quality issues, or situations that weren’t safety problems.

Overall, 185 families, or 26 percent, reported a total of 255 incidents. Researchers classified 132 incidents as safety concerns, 102 as quality issues unrelated to safety, and 21 involving other problems.

Family reports included eight otherwise unidentified adverse events, including multiple needle sticks, inadequate suctioning and medication side effects.

Only one of these was preventable, however.

Families also reported a number of safety concerns that didn’t occur on the unit where their child received care, such as the emergency department or surgery department, and researchers excluded these cases from their analysis.

“We cannot draw large conclusions about overall hospital safety from this study since the primary research question was how to improve error detection, reporting and formal cataloging and the authors do not draw conclusions on overall hospital safety from their results,” said Dr. Irini Kolaitis, a researcher at the Ann and Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine.

“The key finding from this study is that both clinicians and parents accurately recognize medical errors and adverse events, but the use of hospital reporting systems lags behind,” Kolaitis, who wasn’t involved in the study, added by email.

SOURCE: http://bit.ly/2lYS8kZ JAMA Pediatrics, online February 27, 2017.

More FAKE NEWS: The Accidental Addict

Illustration by Robert NeubeckerThe Accidental Addict

Morning Rounds: Can marijuana ease chronic pain?

Morning Rounds: Can marijuana ease chronic pain?

Vote the bums out !

The voice on the Phone is Senator Joe Manchin (D-WV).. this is the Senator that has proposed a ONE CENT per Mg opiate tax to pay for the funding for treating addiction. Which I believe would be a first for a certain population with a chronic disease (chronic pain) would be taxed to pay for treating another population group suffering from a different chronic disease (mental health – addictive personality disorder).

On this phone call, Senator Manchin seems a little arrogant about this ability to continued to get re-elected… for which he is up for re-election in 2018…  After Trump carried the state by 68% in the 2016 election and after Trump has revoked a lot of Obama’s rules that caused a lot of the rules that caused a lot of WV coal miners to becoming unemployed.

 

 

Trump Pick for CMS Would Ease Up on Physicians

Trump Pick for CMS Would Ease Up on Physicians

http://www.medscape.com/viewarticle/875992?

Regulations: “Patients and their physicians should be making decisions about their healthcare, not the federal government,” Verma said. “We want to identify regulations that might motivate providers not to participate [in Medicare and Medicaid].”

Seema Verma, MPH, President Donald Trump’s choice to head the Centers for Medicare & Medicaid Services (CMS), has mixed feelings about electronic health record (EHR) systems.

It’s just one example of how she’s on the same page with many physicians regarding healthcare.

“My doctor…is staring at her computer instead of looking at me,” the healthcare policy consultant told the US Senate Committee on Finance during her confirmation hearing yesterday.

Verma’s comment came in response to a question about the future of the CMS incentive program for meaningful use of EHRs, much criticized by physicians for turning them into data entry clerks. She also recounted seeing signs in physician waiting rooms that apologized for schedule delays due to EHR implementation. Yet another tech challenge she cited was the lack of EHR interoperability, which prevents different programs from freely exchanging data.

“We need to make sure [EHR technology] is fulfilling its promise and not being more burdensome,” said Verma.

 
Seema Verma, CMS administrator nominee for President Trump, smiles during a Senate Finance Committee confirmation hearing in Washington, DC, on Thursday, February 16, 2017. Source: Pete Marovich/Bloomberg/Getty Images

If confirmed, Verma would play a major role in Republican efforts to repeal and replace the Affordable Care Act (ACA) as a lieutenant of US Department of Health & Human Services Secretary Tom Price, MD. Like Dr Price, she wants the federal government to ease up on physicians in a number of ways as it enacts a Republican version of healthcare reform:

Regulations: “Patients and their physicians should be making decisions about their healthcare, not the federal government,” Verma said. “We want to identify regulations that might motivate providers not to participate [in Medicare and Medicaid].”

Mandatory Medicare pilot projects: Congressional Republicans and medical societies have complained about Medicare experiments in healthcare delivery and payment that make physician participation required instead of voluntary. Verma said she was on their side. Innovation is important but “we need to make sure we’re not mandating individuals to participate.

Medicare financial risk: The new reimbursement system established by the Medicare Access and CHIP Reauthorization Act holds the most rewards for physicians who assume significant financial risk — that is, the possibility of a revenue cut — for not meeting quality and cost targets in so-called advanced alternative payment models. It’s all a part of moving Medicare from fee-for-service to pay-for-performance. However, some medical societies argue that the government’s financial-risk requirements are unrealistically high for some medical practices. Verma agrees.

“I don’t know that rural providers and small [practice] providers would want to take on risk at all,” Verma told lawmakers. “They don’t have the large financial reserves that big systems have.”

State Medicaid Programs Need More Leeway to Innovate, Says Verma

Many of the questions that lawmakers posed to Verma yesterday centered on Medicaid, which stands to change dramatically as the ACA is repealed and replaced. Besides undoing Medicaid expansion in 31 states and Washington, DC, the Trump administration and Congressional Republicans want to give states more leeway in designing their own programs. As a consultant to states on Medicaid policy, Verma fits right in.

 

She is the architect, for example, of a “consumer-directed” Medicaid program called Healthy Indiana Plan (HIP), which gives beneficiaries there something akin to a health savings account — a Personal Wellness and Responsibility (POWER) account — to apply toward a $2500 deductible. Verma also helped create HIP 2.0, which expanded Medicaid coverage in the state under the ACA with the help of federal dollars.

Launched in 2015 when Vice President Mike Pence was Indiana’s governor, HIP 2.0 requires beneficiaries to contribute 2% of their income to their POWER account each month. That skin-in-the-game entitles them to extra benefits such as dental and vision coverage.

Verma told the Senate Finance Committee that sicker individuals in HIP 2.0 were more likely to contribute to their POWER accounts, obtain preventive care, take their medicines, and experience better outcomes. “What we found is that when we gave [beneficiaries] choices, they made good choices,” Verma said.

 

It took Indiana 5 years to receive a waiver from CMS to expand Medicaid through HIP 2.0, Verma said. An “inflexible system” stands in the way of other states making similar reforms.

Congressional Republicans believe they can loosen things up by converting now open-ended federal contributions to state Medicaid programs into either a giant block grant, or a “per capita cap,” a fixed amount for each beneficiary. Either way, states would have more say-so on how to spend the money. Democrats counter that states will end up with less money to spend on Medicaid, forcing them to either kick people off the rolls, reduce benefits, or reduce provider reimbursement.

When Sen. Maria Cantwell (D-WA) asked Verma if she supported Medicaid block grants, Verma suggested that it could be an option in the pursuit of better health outcomes.

 

“What I support is the program working better, whether that’s a block grant or a per capita cap — there are many ways to get there,” she said. “The status quo is not acceptable. This is the United States of America. We can do better for these vulnerable populations.”

Under the status quo, she said, one state now may spend almost four times as much per Medicaid beneficiary as another, “but can we show the outcomes are better? Can we show that the individual is receiving accessible, high quality care? One third of doctors aren’t taking Medicaid patients.”

Pinning Down the Nominee

Senate Democrats expressed consternation at times that they couldn’t pin down Verma on policy matters like Medicaid block grants.

 

When Sen. Debbie Stabenow (D-MI) asked if Medicare should be allowed to negotiate drug prices with manufacturers, Verma said, “We need to do everything we can to make drugs more affordable for seniors.” Marketplace competition, she explained, was the key to lowering prices. Stabenow then asked if Verma favored preserving the ACA provision that eliminated the out-of-pocket expense called the “doughnut hole” in the Medicare Part D drug program.

“I support seniors having access to affordable medicines,” Verma said.

Sen. Robert Menendez (D-NJ) fumed. “I can’t vote for someone to be [CMS] administrator…if I can’t glean from you in an open session under oath what your answers are to these questions.”

 

Verma was more forthcoming on another drug issue — government outlays for Mylan’s EpiPen for emergency allergy treatment. Mylan’s classification of EpiPen in the Medicaid program as a generic as opposed to a branded product translated into significantly smaller rebates that the manufacturer paid to the federal program. Verma called that “disturbing” and said she would like to review the classification process to ensure that the government received the drug rebates it was entitled to.

While Senate Democrats appeared vexed at times with Verma, Republicans, who control the Finance Committee, praised her. “We have an outstanding nominee in front of us,” said Sen. Michael Enzi (R-WY). “You haven’t just studied Medicaid and Medicare; you’ve done things.”

“You have acquitted yourself very well,” added Sen. Orrin Hatch (R-UT), the committee chair.

The next step in the confirmation process is for the committee to send Verma’s nomination to the full Senate for a final vote.

How many bureaucratic agencies have “ILLEGAL OFF THE BOOKS” revenue sources ?

ATF Busted for Illegally Selling Millions of World’s Deadliest Drug

How do 700 tobacco farmers uncover a highly secretive criminal operation generating millions of dollars in fraudulent cigarette sales? By going into business with the Bureau of Alcohol Tobacco, Firearms and Explosives (ATF), as they sold millions of dollars of cigarettes, the number one cause of preventable death, that’s how. And the operation may be as scandalous and controversial as the famed Fast and Furious gun running program with which the ATF was also involved.

Raleigh-based U.S. Tobacco, a group of farmers who operate small farms from Virginia to Florida, was looking to expand its operations by purchasing a distributor, someone with a warehouse and the means to supply retailers with their cigarette brands Wildhorse, Traffic, and 1839. They negotiated a deal with Big South Wholesale and its owners, Jason Carpenter and Christopher Small. Big South had a network of retailers and held out promise for U.S. Tobacco to be able to distribute their own brands.

Because Big South was able to make purchases on behalf of U.S. Tobacco, the distributors had access to U.S. Tobacco funds. The parent company quickly began to notice irregularities in various business transactions. According to the New York Times, Big South bought tobacco for, “$15 a carton and sold it to U.S. Tobacco at $17.50. The profit, about $519,000, went into what was known as a ‘management account.’ That account, while controlled by Mr. Carpenter and Mr. Small, helped pay for A.T.F. investigations.”

That’s right. According to a lawsuit filed by U.S. Tobacco, who is suing its own distributor, the ATF was running a cigarette purchasing operation disguised as a tobacco distributor, all allegedly in an effort to generate black market currency with which the ATF could then use to fund its other off-books operations.

READ MORE:  9/11 Scam: More than 100 NYC Police and Firefighters Indicted in Despicable Fraud

The arrangement U.S. Tobacco had with Big South created an internal conflict of interest. Not knowing that Big South was actually a cigarette-running ATF operation, the parent company turned in the distributor to the Justice Department for investigation. But apparently, since the ATF is a part of the Justice Department, nothing happened as a result of the case. However, a federal judge, after discovering ATF’s involvement within Big South, added the federal government as a defendant in U.S. Tobacco’s case against Big South.

Since the company filed a complaint with the Justice Department, instead of finding a resolution, U.S. Tobacco said they then became the target of a Treasury Department inquiry. In other words, it appears as though the federal government is punishing the cooperative of small time farmers, for seeking damages they say they’ve sustained as a result of the federal government’s involvement in their tobacco business. The amount of money lost, the parent company claims, amounts to 24 million dollars.

 

Big South, the Times writes, isn’t your typical distributorship. “Its assets included more than two dozen vehicles, including expensive S.U.V.s and a fleet of Mercedes, BMW, Audi, Lexus and Jaguar sports cars,” the Times describes. Carpenter and Small, Big South’s owners, weren’t hapless participants in the ATF’s scheme. According to heavily redacted documents related to the case, writes the Times, they’ve been serving within the government across various agencies, for years, yet their true employer remains an enigma.

Stuart Thompson, U.S. Tobacco’s CEO, began to question the financial movements at Big South in 2012 when he took over the company. That’s when he met Brandon Moore, Big South’s warehouse manager, who was ready to tell Mr. Thompson all he knew. According to the Times;

 

The arrangement began to break down in late 2012, when Mr. Thompson joined U.S. Tobacco as the chief financial officer. He was curious why his warehouse was placing so many orders for a brand of cigarette that competes against U.S. Tobacco. He could not get a straight answer, the company said in court documents.

 

In March 2013, Mr. Moore picked up the phone, called Mr. Thompson and explained what was happening. “I did what I did because of the ethics of it,” Mr. Moore said recently. “What was happening there was wrong.”

image: http://pixel.watch/qut7

 

Once U.S. Tobacco discovered the bookkeeping irregularities, it reported them to the Justice Department, which investigates white-collar crime and government misconduct. Records show that the Justice Department, which includes the A.T.F., investigated some aspects of the case but no charges were filed.

 

“We voted unanimously to give everything we had to the government,” said Charlie Batten, a U.S. Tobacco board member whose family has worked the same North Carolina soil for generations. “We thought they would take it and run with it. What happened was, they’ve fought us tooth and nail.”

 

Because of the sealing order, Mr. Thompson, Mr. Batten and others are prohibited from discussing what happened to the money — even with their own farmers.

Even with the revelations the ATF was running an illegal operation inside of their company, and with the Justice Department being aware, U.S. Tobacco has been unable to divorce itself from Big South. That’s because the federal government now wants its tax revenue from all of the secret tobacco transactions the ATF initiated at Big South. “Those secret tobacco sales, it turns out, should have been taxed. And the government wants its money,” writes the Times.
Read more at http://thefreethoughtproject.com/atf-caught-illegally-selling-millions-worlds-dangerous-drug/#3DxrdPHAVjO7YG04.99

The Call-In: The Opioid Epidemic And How Opioids Have Affected Your Lives

The Call-In: The Opioid Epidemic And How Opioids Have Affected Your Lives

http://www.npr.org/2017/02/26/517305305/the-call-in-the-opioid-epidemic-and-how-opioids-have-affected-your-lives

The opioid epidemic is growing. Lulu Garcia-Navarro speaks with Jim Barnum, whose brother died after an opioid addiction and Chuck Rosenberg, acting administrator of the DEA.

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