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How scammers have sunk to a new low with an AI obituary scam targeting the grieving

Don’t fall for this heartless trick by crooks trying to take advantage of your time of sadness

https://cyberguy.com/scams/how-scammers-have-sunk-to-new-low-with-ai-obituary-scam-targeting-the-grieving/

As if scammers couldn’t sink any lower, there’s a new online scam taking advantage of grieving people. It’s a strange pirate scam that uses AI to scrape data to build fake obituary websites, exploiting the information of somebody who is deceased in an attempt to scam vulnerable victims.

We can only hope that this unfortunate situation doesn’t affect you or anyone you care about. If, unfortunately, you have passed away, there’s little you can do to prevent someone from exploiting your obituary for their own gain. However, these scammers specifically target kind-hearted individuals who are still alive and willing to assist grieving families. It’s essential to remain vigilant and protect yourself and your loved ones from such deceptive practices.

How the fake obituary or “bereavement scam” works

Have you ever been on your social media account and seen someone post an obituary page of someone they have lost? Perhaps you’ve clicked on the links to learn about the person, their impact, how they’ve passed, or to read the information regarding the funeral.

Monitoring search trends

Scammers do this by first monitoring Google search trends to determine when people are searching for obituaries after a death.

Creating bogus obituaries

Then, once the scammers find out who has died, they create bogus obituaries with the help of AI that are hosted on legitimate funeral/memorial websites.

SEO optimization

Next, the scammers optimize these pages using SEO tactics so that the scammer’s page ranks first when someone searches for a specific person’s obituary page.

The trap is set

Then, when the prospective victim goes to click on it, though, they’ll be redirected to an e-dating or adult entertainment site, or they’ll be given a CAPTCHA prompt that, unbeknownst to them, will install web push notifications or pop-up ads when clicked.

These may give fake virus warnings but link to legitimate landing pages for subscription-based antivirus software programs. Worrying that you might accidentally download a virus, innocent victims instead walk right into a scam.

The scammers profit in two ways

After this, two things can happen:

• Scammers monetize this via affiliate reward programs from software downloads people are tricked into thinking they need.
• Scammers get revenue from adverts on the page that pay per impression.

So, while they may not explicitly target you in the same fashion as other scams, they’re still quite creative. Although Secureworks Counter Threat Unit emphasizes that this scam is not currently infecting devices with malware, it is possible that this scam could evolve in that direction in the near future.

MORE:HOW TO ENSURE YOUR PASSWORDS DON’T DIE WITH YOU  

How to protect yourself from falling for an obituary scam

To protect yourself from one of these scams, there are a few questions to ask yourself if you see an obituary page:

Do you have a connection to the person who has passed away? If you’re not connected in any way to the person you see the obituary page for, don’t click on it. And, if you do know the person, make sure you click on the original link that was shared on social media from the contact you know well; don’t search it in Google, as the first option that comes up could be a fake one.

Know the fake websites. Some fake obituary websites include Nextdoorfuneralhomes.com, Memorialinfoblog.com, Obituaryway.com, and Funeralinfotime.com. But keep in mind that some scammers are using common sites, too.

Check if the person has actually passed away. This may seem obvious, but some of these scammers are writing obituaries for people who have not actually passed away!

Look out for suspicious pages. Key signs of a fake obituary include overly descriptive language and an impersonal tone. Many scammers rely on AI to write these obituaries as quickly as they can and don’t usually take the time to review them to make them sound more human. After all, they are in a rush to snag you shortly after the person has died.

MORE: SCAMMERS ARE USING FAKE NEWS AND MALICIOUS LINKS TO TARGET YOU IN AN EMOTIONAL FACEBOOK PHISHING TRAP

Kurt’s key takeaways

Many scammers prey on emotionally vulnerable people to get their way. Though this obituary scam is next level, it’s not much different than someone taking advantage of someone during a phone scam, where the victim is rushed to send over money or provide information. So, always keep your wits about you if you’re ever not sure. Before clicking on a link, opening a file, or answering that phone call, take a minute.

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HHS OIG Toolkits for Calculating Opioid Levels and Identifying Patients At Risk of Misuse or Overdose

https://oig.hhs.gov/reports-and-publications/all-reports-and-publications/hhs-oig-toolkits-for-calculating-opioid-levels-and-identifying-patients-at-risk-of-misuse-or-overdose-2/

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Abt 15 yrs ago, I was working only as a “temp/locum” Pharmacist as an independent contractor. I had signed up with several Pharmacist temp services and I was working in all kinds of community pharmacies from independent pharmacies to Big Box stores. The technician brought to me a refill for a Suboxone, which was a couple of days early, had refills, but the pt’s insurance was not going to approve paying for it a couple of days early.  The technician offered the pt the cash price for the 2-3 tablets that he needed and the cost was too much for him to afford. I walked out front to talk to him, and he was obviously very upset. He was concerned that not having those 2-3 doses, his attempt to get sober may be compromised.  I always try to be a problem solver. In talking to this young man, I mentioned that insurance companies will often pay for early refills for someone going on vacation. “Did I hear you say that you were going on vacation and that was the reason for this early refill?”.  It took the young man a couple of minutes to catch on what I was asking. I asked him if he would like to use the pharmacy’s phone to call his insurance company to see if they would provide an “early vacation refill authorization”?  He made the phone call to his insurance and they approved the early refill, we filled his Rx for the 30-day supply that he could afford and he went happily on his way. Was he able to successfully get sober and stay sober? I don’t know because I was at this Big Box pharmacy that one day and knew that my “just saying no” to his refill, may have caused him to break his path to sobriety.

Why Aren’t Pharmacies Filling My Patient’s Life-Saving Medication?

https://www.doximity.com/articles/116b245b-74d8-4068-8eb8-ebea2a24805a

I sat on the phone yesterday consoling a single mother going through heroin withdrawal. In between bouts of vomiting and dry heaving, she pleaded, “When will I be able to pick up the medication you ordered that stops all of this?” This mother had already overcome significant barriers Americans face when seeking addiction treatment, including stigma associated with treatment, affordability of treatment, and finding high quality, highly trained addiction specialists. I had prescribed an FDA-approved addiction treatment medication that reduced her chance of death from addiction by more than 50%. Seemed like it should be a happy ending. Instead, she found her local pharmacy refusing to fill the prescription.

That pharmacy’s response is just one example of a troubling, growing trend. Pharmacies across the country are refusing to fill the life-saving addiction treatment medication buprenorphine/naloxone. As a multi-state licensed addiction psychiatrist, I find myself in daily debates across the country with major retail pharmacy chains who refuse to fill this medication. The DEA and the federal Substance Abuse and Mental Health Services Administration (SAHMSA) have both issued recent policy statements urging health care practitioners and pharmacies alike to increase access to this medication with fully telehealth treatment of substance use disorders.

Why are so many pharmacies refusing to fill valid, legal, physician-issued prescriptions for the single most important and effective medication used to treat addiction? The answer, ironically, lies in recent well-meaning landmark court proceedings designed to decrease the opioid epidemic.

In late 2022, CVS, Walgreens, and Walmart were forced to pay an eye-popping $10.7 billion to settle allegations that the pharmacy chains failed to adequately oversee opioid painkiller prescriptions, thus contributing to America’s opioid addiction crisis. CVS alone agreed to pay nearly $5 billion in fines over 10 years, while Walgreens would pay $5.7 billion over 15 years. With this decision, the pharmacy chains also agreed to implement robust “controlled substance compliance programs” that required additional layers of opioid prescription reviews, mandatory state prescription pharmacy database checks, and new employee training programs on prescription monitoring oversight.

This well-meaning legislation was designed to rightfully reduce access to dangerous and addictive prescription opioid drugs like Oxycontin, Percocet, and Vicodin, among others — drugs which are gateways to opioid addiction and are often involved in opioid overdose deaths. Buprenorphine is also a controlled substance, although it contains a very low, weakened amount of a “partial” opioid to treat withdrawal and ultimately has a very different, safer chemical make up than traditional opioids. The chemical makeup is designed to prevent people from getting high on it. It also contains the opioid overdose agent Naloxone or “Narcan,” which further reduces abuse potential. These important differences make it a safe, effective, FDA-approved medication designed to treat addiction, not cause or worsen it. Despite all of these important differences, some pharmacies continue to lump it in with other opioid medications. Ironically, the very measures designed to curb addiction are now resulting in less access to our most important medications used to fight addiction.

I spend a significant portion of my days trying to convince pharmacists to fill these prescriptions. Pharmacists’ objections to refilling the meds include: “The patient lives too far away from your treatment facility,” “You did not see the patient in person,” or “There is no previous prescription for buprenorphine on file for this patient.” Pharmacists concerned with no previous prescription is puzzling. Luckily, due to increased addiction treatment access, many patients are starting to treat their opioid use disorder for the first time — and this is a good thing! It means we are broadening treatment access to more folks who need it most and saving more lives.

I’m successful in convincing the pharmacist to ultimately dispense the drug about half of the time. After an hour on the phone with the pharmacist, I addressed all of her questions and she dispensed the prescription to the single mother waiting outside in the grocery store parking lot. Many other times, my patients are forced to pharmacy hop until we find an understanding and well-informed pharmacist. It is tiring and exhausting.

What is the solution? We desperately need advocacy help from our high-profile medical stakeholders, as well as more pharmacist education and training on buprenorphine. It would be helpful if the DEA, the American Medical Society, and SAMHSA released specific policy statements encouraging all pharmacies to fill these prescriptions without geographic, mileage, or in-person requirements. If you are a pharmacist reading this article right now, please share it with as many of your colleagues as possible to spread the word: we need your help!

The best way to quickly curb the opioid epidemic is increased access to effective treatment. This is one of very few life-saving addiction treatments in our medicine arsenal. Its effects on mortality rates mean that your loved one suffering from opioid use disorder is more than twice as likely to survive with this medication. We need help reducing well-meaning but misinformed pharmacy red tape to its access. We owe this to the American public. We owe this to our friends, family members, and loved ones whose lives are jeopardized by addiction. We owe this to our children. We owe this to the more than 500,000 people we’ve lost in the U.S. in the past two decades due to overdose. Martin Luther King Jr. famously said, “The ultimate tragedy is not the oppression and cruelty by bad people but the silence over that by the good people.” Now more than ever, we need loud, passionate advocacy from you: our good people.

Dr. Lauren Grawert is a double board certified addiction psychiatrist. She received her medical degree from Medical University of South Carolina College of Medicine and has been in practice 15 years. She speaks multiple languages, including Spanish. She was Chief of Psychiatry at Kaiser Permanente of the Mid-Atlantic from 2018-2022. She is currently the Chief Medical Officer at Aware Recovery Care. She enjoys working with the media in her spare time to reduce stigma around mental illness and addiction. She has been interviewed by SAMHSA on Co-Occurring Disorders and most recently published articles in Capital Psychiatry and Northern Virginia Magazine.

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Has anyone ever reached out to ACLU about denial of care at the Emergency Dept concerning your pain? I got this from ACLU this AM.  Apparently, according to this ACLU email, only pregnant females who are denied care at a ED with long-standing protections to access necessary emergency care at hospitals are being discriminated against.

Steve, the Supreme Court is considering a second case that could devastate abortion access nationwide and make pregnant people second-class citizens in the emergency room. Anti-abortion politicians are now trying to take away people’s power to get emergency care if they are facing severe complications during pregnancy. Their claim is that pregnant people are somehow excluded from long-standing protections to access necessary emergency care at hospitals – threatening doctors with prison time for providing abortion care in a medical emergency. We don’t need to tell you how disastrous this would be. Everyone has a right to the emergency treatment they need without political interference. That’s why we’re urging Congress to act to end state bans and protect all forms of reproductive health care – including emergency care, IVF, and medication abortion. We need you with us to send a clear message: Congress must defend our reproductive freedom. Steve, federal law protects patients in emergency situations – patients experiencing medical crises should never be turned away from the emergency room. Period. But if anti-abortion activists win, doctors could face jail time for doing their medical duty – and pregnant patients could be left to suffer. It’s yet another prong of the coordinated campaign to push abortion out of reach entirely, proving that extreme politicians and the groups supporting them do not care about the well-being of pregnant people, do not care that abortion is supported by a vast majority of Americans, and does not care who they will hurt with their extreme agenda. Denying emergency care is not an accident – it’s an intentional part of their cruel vision for the world. Steve, it’s completely unacceptable – which is why we’re using every tool at our disposal to fight back. We can’t do this alone, we need you with us. Join the growing number of your fellow ACLU activists calling on Congress to protect our reproductive health care and restore our rights. Thank you for all that you do, Alexa Kolbi-Molinas Pronouns: She, her, hers Deputy Director, Reproductive Freedom Project

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If you are patronizing any pharmacy that has/will close, expect to start getting emails, letters, etc.. communication(s) from your insurance/PBM promoting moving your meds over to their mail-order pharmacy. They will tell you how convenient their mail-order service is – they won’t tell you that your medications will often be subjected to temperatures that are outside those required/recommended by the FDA, USP, and NF.  They won’t mention that trying to get a solution to any problem you might encounter, you will be interacting with a nameless, faceless person working in a pharmacy that could be 1000’s miles away. If you don’t get your meds on time, they will tell you that they will pay for you to get them filled at a “local pharmacy”, which there is none left in your town, and the closest is maybe 30-50 miles away.

Rite Aid to shutter 53 more stores across 9 states

https://drugstorenews.com/rite-aid-shutter-53-more-stores-across-9-states

Rite Aid is reportedly closing stores in California, New York, New Jersey, Maryland, Massachusetts, Michigan, Pennsylvania, Ohio and Virginia, per a report in The Hill.

Rite Aid will close 53 more store locations across nine states, adding to the approximately 200 it has closed since filing for Chapter 11 bankruptcy protection last year, per a report in The Hill.

After filing for bankruptcy protection in mid-October, Rite Aid announced the closures of more than 150 stores across 15 states. In late November, the retailer announced the closures of another 31 stores. More stores were closed at the beginning of this year.

[Read more: Rite Aid divesting majority of Health Dialog assets]

A full list of closures is outlined in court documents released this month.

California

• 1208 West Redondo Beach Blvd., Gardena, California
• 1700 W Whittier Boulevard, La Habra, California
• 15924 Bellflower Boulevard, Bellflower, California
• 16491 Lakeshore Drive, Lake Elsinore, California
• 334 South Vermont Avenue, Los Angeles, California
• 5610 Stockton Boulevard, Sacramento, California
• 37950 47th St E, Palmdale, California
• 7224 Broadway, Lemon Grove, California
• 1030 South White Road, San Jose, California
• 14727 Rinaldi Street, San Fernando, California
• 7211 Elk Grove Boulevard, Elk Grove, California
• 439 Santa Fe Drive, Encinitas, California
• 1650 Decoto Road, Union City, California
• 888 Lincoln Boulevard, Venice, California
• 35946 Winchester Road, Winchester, California
• 3941 Spring Road, Moorpark, California
• 4037 Ball Road, Cypress, California
• 2500 North 10th Avenue, Hanford, California

Maryland

• 250 Englar Road, Ste 22, Westminster, Maryland

Massachusetts

• 10 Stafford Road, Fall River, Massachusetts

Michigan

• 42481 West 13 Mile Road, Novi, Michigan
• 11743 15 Mile Road, Sterling Heights, Michigan

New Jersey

• 235 N Maple Ave, Marlton, New Jersey
• 7835 Maple Avenue, Pennsauken, New Jersey
• 480 North Beverwyck Road, Lake Hiawatha, New Jersey

New York

• 139 Ronkonkoma Avenue, Lake Ronkonkoma, New York
• 283 West Jericho Turnpike, Huntington Station, New York
• 47 Niagara Street, Tonawanda, New York
• 2047 Sheridan Drive, Buffalo, New York
• 1910 Hempstead Turnpike, East Meadow, New York
• 960 Halsey Street, Brooklyn, New York
• 459 South Transit Street, Lockport, New York
• 3249 Sheridan Drive, Amherst, New York
• 218-35 Hempstead Avenue, Queens Village, New York
• 1825 Brentwood Road, Brentwood, New York
• 95-14 63rd Drive, Rego Park, New York
• 2271 Richmond Avenue, Staten Island, New York
• 592 East 183rd Street, Bronx, New York

Ohio

• 2840 Youngstown Road SE, Warren, Ohio
• 501 East Emmitt Avenue, Waverly, Ohio

Pennsylvania

• 6744-46 North Fifth Street, Philadelphia, Pennsylvania
• 118 Eagleview Boulevard, Exton, Pennsylvania
• 6731 Woodland Avenue, Philadelphia, Pennsylvania
• 2131-59 North Broad Street, Philadelphia, Pennsylvania
• 124 South Front Street, Steelton, Pennsylvania
• 510 East Baltimore Pike, Media, Pennsylvania
• 4551 Milford Road, East Stroudsburg, Pennsylvania
• 1536 North Atherton Street, State College, Pennsylvania
• 3807 Lincoln Highway, Downingtown, Pennsylvania
• 1200 West Market Street, York, Pennsylvania
• 6201 Germantown Avenue, Philadelphia, Pennsylvania
• 120 South Mill Road, Kennett Square, Pennsylvania

Virginia

• 1808 Salem Road, Virginia Beach, Virginia

A Rite Aid spokesperson provided Drug Store News with the following statement:

“Rite Aid regularly assesses its retail footprint to ensure we’re operating efficiently while meeting the needs of our customers, communities, associates and overall business. In connection with the court-supervised process, we notified the Court of certain underperforming stores we are closing to further reduce rent expense and strengthen overall financial performance. At this time, we have not made or confirmed any decisions on additional specific store closures as part of our financial restructuring process.”

The company added:

• The decision to close a store is not one we take lightly. The Company, with the assistance of its advisors, carefully considers various factors in its decision-making, including business strategy, lease and rent considerations, local business conditions and viability, and store performance.
• For our customers, we make every effort to ensure they have access to pharmacy-based health services, whether at another Rite Aid or other nearby pharmacy, and we work to seamlessly transfer their prescriptions to ensure there is no disruption of service.
• For our associates, we strive to transfer them to other Rite Aid locations where possible. In fact, approximately 75% of our associates have accepted opportunities to transfer locations if their store has been or is part of the ongoing store closures.

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CMS finalizes 2025 Medicare Advantage rule: 11 key updates

https://www.beckerspayer.com/policy-updates/cms-finalizes-2025-medicare-advantage-rule-11-key-updates.html

CMS issued its final 2025 Medicare Advantage and Part D rule April 4, setting new standards around marketing, broker payments, and prior authorization.

Here are 11 things to know about CMS’ final rule: 

1. CMS set a fixed amount that agents and brokers can be compensated by MA plans, regardless of the plan a beneficiary enrolls in. The agency increased the final fixed amount by $100, compared to the proposed $31.
2. Personal beneficiary data collected by a third-party marketing organization for marketing or enrollment purposes may only be shared with another TPMO when prior written consent is given by the enrollee.
3. Insurers are generally prohibited from paying TPMOs volume-based bonuses for steering a certain number of enrollees to health plans. 
4. CMS is adding behavioral network adequacy evaluation standards to include providers specializing in mental health and addiction issues.
5. Plans are required to issue a mid-year notice to enrollees, informing them of any supplemental benefits they have access to in their plan that they have not used.
6. MA plans must analyze their utilization management policies and procedures from a health equity perspective, including having one member of the UM committee with expertise in health equity and an annual health equity analysis of prior authorization policies.
7. There are new restrictions on the marketing of supplemental benefits for chronically ill enrollees, requiring plans to disclose that these benefits are only available to beneficiaries with certain diagnoses, not all Medicare beneficiaries. 
8. Independent contractors will review untimely fast-track appeals of an MA plan’s decision to terminate services in a skilled nursing or outpatient rehab facility, and for home health services.
9. The rule reduces the number of plans able to enroll beneficiaries dually eligible for Medicare and Medicaid outside of the open enrollment period. This will crack down on year-round aggressive marketing of D-SNP plans, CMS said. 
10. MA plans will be limited in how much information they can request from CMS when appealing risk adjustment data validation audits.
11. Part D sponsors will have more flexibility around formulary substitutions of biosimilars with interchangeable generic products.

Read the full rule here.

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Hospitals Cash In on a Private Equity-Backed Trend: Concierge Physician Care

https://www.medpagetoday.com/hospitalbasedmedicine/generalhospitalpractice/109518

Pricey membership fees for easier access to doctors becoming more common

Nonprofit hospitals created largely to serve the poor are adding concierge physician practices, charging patients annual membership fees of $2,000 or more for easier access to their doctors.

It’s a trend that began decades ago with physician practices. Thousands of doctors have shifted to the concierge model, in which they can increase their income while decreasing their patient load.

Northwestern Medicine in Chicago, Penn Medicine in Philadelphia, University Hospitals in the Cleveland area, and Baptist Health in Miami are among the large hospital systems offering concierge physician services. The fees, which can exceed $4,000 a year, are in addition to copayments, deductibles, and other charges not paid by patients’ insurance plans.

Critics of concierge medicine say the practice exacerbates primary care shortages, ensuring access only for the affluent, while driving up healthcare costs. But for tax-exempt hospitals, the financial benefits can be twofold. Concierge fees provide new revenue directly and serve as a tool to help recruit and retain physicians. Those doctors then provide lucrative referrals of their well-heeled patients to the hospitals that employ them.

“Hospitals are attracted to physicians that offer concierge services because their patients do not come with bad debts or a need for charity care, and most of them have private insurance which pays the hospital very well,” said Gerard Anderson, PhD, a hospital finance expert at Johns Hopkins University in Baltimore. “They are the ideal patient, from the hospitals’ perspective.”

Concierge physicians typically limit their practices to a few hundred patients, compared with a couple of thousand for a traditional primary care doctor, so they can promise immediate access and longer visits.

“Every time we see these models expand, we are contracting the availability of primary care doctors for the general population,” said Jewel Mullen, MD, MPH, of Dell Medical School at the University of Texas at Austin and a former commissioner of the Connecticut Department of Public Health. She noted that concierge doctors join large hospital systems because of the institutions’ reputations, while hospitals sign up concierge physicians to ensure referrals to specialists and inpatient care. “It helps hospitals secure a bigger piece of their market,” Mullen said.

Concierge physicians typically promise same-day or next-day appointments. Many provide patients their mobile phone number.

Aaron Klein, DO, who oversees the concierge physician practices at Baptist Health, said the program was initially intended to serve donors.

“High-end donors wanted to make sure they have doctors to care for them,” he said.

Baptist opened its concierge program in 2019 and now has three practices across South Florida, where patients pay $2,500 a year.

“My philosophy is: It’s better to give world-class care to a few hundred patients rather than provide inadequate care to a few thousand patients,” Klein said.

Concierge physician practices started more than 20 years ago, mainly in upscale areas such as Boca Raton, Florida, and La Jolla, California. They catered mostly to wealthy retirees willing to pay extra for better physician access. Some of the first physician practices to enter the business were backed by private equity firms.

One of the largest, Boca Raton-based MDVIP, has more than 1,100 physicians and more than 390,000 patients. It was started in 2000, and since 2014 private equity firms have owned a majority stake in the company.

Some concierge physicians say their more attentive care means healthier patients. A study published last year by researchers at the University of California (UC), Berkeley and the University of Pennsylvania in Philadelphia found no impact on mortality ratesWhat the study did find: higher costs.

Using Medicare claims data, the researchers found that concierge medicine enrollment corresponded with a 30-50% increase in total healthcare spending by patients.

For hospitals, “this is an extension of them consolidating the market,” said study co-author Adam Leive, PhD, of UC Berkeley. Inova, a healthcare services company in Fairfax, Virginia, one of the state’s largest tax-exempt hospital chains, employs 18 concierge doctors, who each handle no more than 400 patients. Those patients pay $2,200 a year for the privilege.

George Salem, 70, of McLean, Virginia, has been a patient in Inova’s concierge practice for several years along with his wife. Earlier this year he slammed his finger in a hotel door, he said. As soon as he got home, he called his physician, who saw him immediately and stitched up the wound. He said he sees his doctor about 10 to 12 times a year.

“I loved my internist before, but it was impossible to get to see him,” Salem said. Immediate access to his doctor “very much gives me peace of mind,” he said.

Craig Cheifetz, MD, a vice president at Inova who oversees the concierge program, said the hospital system took interest in the model after MDVIP began moving aggressively into the Washington, D.C., suburbs about a decade ago. Today, Inova’s program has 6,000 patients.

Cheifetz disputes the charge that concierge physician programs exacerbate primary care shortages. The model keeps doctors who were considering retiring early in the business with a lighter caseload, he said. And the fees amount to no more than a few dollars a day — about what some people spend on coffee, he said.

“Inova has an incredible primary care network for those who can’t afford the concierge care,” he said. “We are still providing all that is necessary in primary care for those who need it.”

Some hospitals are starting concierge physician practices far from their home locations. For example, Tampa General Hospital in Florida last year opened a concierge practice in upper-middle-class Palm Beach Gardens, a roughly 3-hour drive from Tampa. Mount Sinai Health System in New York City runs a concierge physician practice in West Palm Beach.

NCH Healthcare System in Naples, Florida, employs 12 concierge physicians who treat about 3,000 patients total. “We found a need in this community for those who wanted a more personalized healthcare experience,” said James Brinkert, regional administrator for the system. Members pay an annual fee of at least $3,500.

NCH patients whose doctors convert to concierge and who don’t want to pay the membership fee are referred to other primary care practices or to urgent care, Brinkert said.

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The War on Drugs Is Also a War on Pain Patients

https://www.cato.org/blog/war-drugs-also-war-pain-patients

In a March 22 opinion column in the New York Times entitled “The DEA Needs to Stay Out of Medicine,” Vanderbilt University Medical Center associate professor of anesthesiology and pain management Shravani Durbhakula, MD, documents powerfully how patients suffering from severe pain—many of them terminal cancer patients—have become collateral casualties in the government’s war on drugs.

Decrying the Drug Enforcement Administration’s progressive tightening of opioid manufacturing quotas, Dr. Durbhakula writes:

In theory, fewer opioids sold means fewer inappropriate scripts filled, which should curb the diversion of prescription opioids for illicit purposes and decrease overdose deaths — right?

I can tell you from the front lines that that’s not quite right. Prescription opioids once drove the opioid crisis. But in recent years opioid prescriptions have significantly fallen, while overdose deaths have been at a record high. America’s new wave of fatalities is largely a result of the illicit market, specifically illicit fentanyl. And as production cuts contribute to the reduction of the already strained supply of legal, regulated prescription opioids, drug shortages stand to affect the more than 50 million people suffering from chronic pain in more ways than at the pharmacy counter.

Dr. Durbhakula provides stories of patients having to travel long distances to see their doctors in person due to DEA requirements about opioid prescriptions. However, despite their efforts, they find that many of the pharmacies do not have the opioids they require because of quotas. She writes:

Health care professionals and pharmacies in this country are chained by the Drug Enforcement Administration. Our patients’ stress is the result not of an orchestrated set of practice guidelines or a comprehensive clinical policy but rather of one government agency’s crude, broad‐​stroke technique to mitigate a public health crisis through manufacturing limits — the gradual and repeated rationing of how much opioids can be produced by legitimate entities.

In the essay, Dr.Durbhakula does not question or challenge the false narrative that the overdose crisis originated with doctors “overprescribing” opioids to their pain patients.

Unfortunately, Dr. Durbhakula’s proposed policy recommendations would do little to advance patient and physician autonomy. She would merely transfer control over doctors treating pain from the cops to federal health bureaucracies and let those agencies set opioid production quotas. For instance, she claims, “It’s incumbent on us [doctors] to hand the reins of authority over to public health institutions better suited to the task.”

No. The “reins of authority” belong in the hands of patients and doctors.

Dr. Durbhakula suggests that “instead of defining medical aptness, the DEA should pass the baton to our nation’s public health agencies” and proposes that the Centers for Disease Control and Prevention and the Food and Drug Administration “collaborate” to “place controls on individual prescribing and respond to inappropriate prescribing.” She elides the fact that these public health agencies will “respond” to doctors or patients who don’t comply with their regulations by calling the cops.

To be sure, Dr. Durbhakula has good intentions. But replacing actual cops—the DEA—with federal health agencies that can order those cops to arrest non‐​compliant doctors and patients is like rearranging the deck chairs on the Titanic. True, her proposed new pain management overlords would have greater medical expertise, but they would still reign over doctors and patients and assault their autonomy. And, as we learned during the COVID-19 pandemic, they will not be immune to political pressures and groupthink.

While her policy prescriptions may be flawed, Dr. Durbhakula deserves praise for having the courage to point out that the war on drugs is also a war on pain patients. Alas, courageous doctors are in short supply these days. Most doctors keep their heads down and follow the cops’ instructions.

After I read her essay, I wrote the following (unpublished) letter to the editor of the New York Times:

Dear Editor—

Kudos to Dr. Durhakula for speaking out against the Drug Enforcement Administration’s intruding on doctors’ pain treatment (“The DEA Needs to Stay Out of Medicine,” March 22, 2024). As my colleague and I explained in our 2022 Cato Institute white paper, “Cops Practicing Medicine,” for more than 100 years, law enforcement has been increasingly surveilling and regulating pain management.

The DEA maintains a schedule of substances it controls, and it categorizes them based on what the agency determines to be their safety and addictive potential. The DEA even presumes to know how many and what kind of controlled substances—from stimulants like Adderall to narcotics like oxycodone—the entire US population will need in future years, setting quotas on how many each pharmaceutical manufacturer may annually produce.

The DEA restricts pain management based on the flawed assumption that what they consider to be “overtreatment” caused the overdose crisis. However, as my colleagues and I showed, there is no correlation between the opioid prescription rate and the rate of non‐​medical opioid use or opioid addiction. And, of course, as fear of DEA reprisal has caused the prescription rate to drop precipitously in the last dozen years, overdose deaths have soared as the black market provided non‐​medical users of “diverted” prescription pain pills first with more dangerous heroin and later with fentanyl.

Researchers at the University of Pittsburgh School of Public Health found that overdose fatalities have been rising exponentially since at least the late 1970s, with different drugs predominating during various periods. Complex sociocultural, psychosocial, and socioeconomic forces are at the root of the overdose crisis, requiring serious investigation. Yet policymakers have chosen the lazy answer by blaming the overdose crisis on doctors treating pain.

When cops practice medicine, overdoses increase, drug cartels get richer, and patients suffer.

Sincerely,

Jeffrey A. Singer, MD, FACS

Senior Fellow, Cato Institute

When cops practice medicine, overdoses increase, drug cartels get richer, and patients suffer.

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