When healthcare providers end up really being healthcare deniers

Posted on January 13, 2024 by Pharmaciststeve

I got the email below on Jan 1, 2024.  This pt’s story is not a unique issue. Another example of bureaucrats and politicians attempting to “solve” our fabricated opioid crisis by creating a “one size fits all” on pain management.

After having this blog for 12-13 yrs, I have developed a fairly sizeable network of chronic pain pts, chronic pain advocates, and numerous healthcare practitioners.  I shared this woman’s email with a couple of select people that I believed might be able to STEP UP. And one did:

When a pt’s long term medical records mean nothing when seeing a new practitioner

When everything seemed to start to fall into place for this young lady. This young lady’s pharmacist and the mid-level practitioner who was forcing her to reduce her pain meds had to step in to make sure that things were not going to change the way that this mid-level practitioner wanted things to happen. Here is a video this young lady sent that she personally explains what has happened.

Hi Steve,

I have sent you my story before. I am a single disabled palliative care sick patient in Maine. In September of 2021, my doctor and I were targeted by the assistant attorney general, Michael Miller. We think it was for 2 reasons-he was very effective at getting patients disability, testings, procedures, equipment, etc and because I require a high dose of opiates to physically and mentally function. Dr. Lommler believes Michael Miller made a deal with the insurance companies and profited somehow for taking him out. Michael Miller used at least 2 agencies to target, harass, and destroy us. They suspended Dr. Lommler’s license for going over the 100 MME limit on my prescription. However, Maine has a palliative care exemption that allows people (like me) to have access to opiates for pain control and disease treatment options. It also allows us to go over the 100 MME limit. They refused to lift the suspension unless he transferred to a “board approved” facility. He chose to retire because he wanted to stay at his independent office with his 200 complicated and unique patients. They gave neither one of us any due-process! They used backdoor methods and I believe they were illegal! There was a covering LNP seeing me for a year. We tried to find a doctor everywhere in Maine to see me but because of the Opiate Task Force and doctors getting red-flagged for going over the 100 MME limit and being dragged in front of the board, no one would see me. I was forced to transition to the hospital where all of my specialists are. You see, Maine and New Hampshire were the 2 states prescribing the most Opiates so they created a New England Opiate Task Force and sent them to work with the Governor Mill’s administration to red-flag doctors prescribing over the 100 MME limit and drag them in front of the board of medicine! They have forced independent providers to either retire or transfer to a “board approved” facility. These “board approved” facilities all have anti-opiate one-size-fits-all policies. The hospital that I am at has an anti-opiate provider masquerading as a “pain specialist.” She believes Opiates are life threatening and dangerous to everyone. She is force tapering me off all my pain medication! I am complicated and unique-I have multiple health conditions. I had an original medical nightmare that left me with life altering physical deformities and severe debilitating pain. I have Crohn’s disease, vitamin and bone deficiencies, and neuropathy-all of these cause malabsorption so I have to take double doses of all of my medication! I cannot have the conventional pain management treatments because I am allergic to everything and sensitive to anything and I have a prosthetic heart valve. I have Scoliosis and severe Osteoporosis with dangerously low Scores. I am 46 in an 86 year old’s body.
They are stereotyping anyone on opiates as addicts and forcing them off pain medication. The only option they give you is Suboxone-I cannot take this because the side effects would be catastrophic to my body. I had nothing but recovery and progress with my 8 1/2 year stable pain regimen. I was able to semi function independently with a decent quality of life. Since this provider has been force tapering me, I can no longer function independently at all and I have zero quality of life! According to Maine’s own definition and standards, what this facility and provider are doing to me is disability abuse! I tried to contact patient services for an advocate but was told there wasn’t one. The woman I spoke with for 2 minutes, asked me what my concerns were. I explained to her what was happening to me. 2 days later I received a letter stating my concerns were forwarded to the Medical Director and Operations Manager and they agree with the provider force tapering me. They also said there was no medical justification for my pain medication. I filed a public accommodation discrimination complaint with the Maine’s Human Rights Commission but haven’t heard a word since intake months ago! The letter gave an 800 number to call if you disagreed with their decision. It was the board of licensure telling you to submit a complaint. I already filed a complaint with the board of medicine and nurses months ago. So, you have to go to the same people that are red-flagging and harassing doctors going over the 100 MME limit. I won’t hold my breath! These are the same people that asked Dr. Lommler how he didn’t know that I was taking half of my pain medication and selling the other half! Dr. Lommler provided them with 7 1/2 years worth of passed urine screens and passed frequent random pill counts! I wasn’t even allowed to attend or participate into the investigation into my opiate use-I could’ve answered that question myself-I have never misused my pain medication! In fact, I did everything that I was supposed to do! How in the world can I trust they will help me!
Since this provider has been forcing me off my pain medication, I have had sky high blood pressures-202/129, severe bloody noses, I have been discharged from aquatic therapy-which I needed to get into my Crow Walker boot, I am completely dependent on my sons, I have had to quit tutoring for supplemental income, I can no longer walk on my crutches so I am trapped in my wheelchair, and I cannot mentally or physically function! My counselor and former providers have tried talking with this provider but she refuses to listen because she knows best. I had to spend my Christmas in the ER and I am now watching my right leg and foot do exactly what my left leg and foot did in my original medical nightmare. When my body is in severe stress, my multiple conditions play off of one another and wreak havoc on my body. Last time, the severe stress was an allergic reaction to hardware (we didn’t know why at the time, it took years to figure it out). This time, it is force tapering my pain medication! This time, it’s the providers choice to force taper me because of her personal feelings about a medication! Medical providers are supposed to do what is in the best interest of the patient, not what is in the best interest of their personal feelings! I have cellulitis in my right leg and foot with ulcers everywhere! I maintain my left leg and foot with Cuban for compression. I tried to wrap my right leg and foot but it’s not used to being wrapped, and I get continuous Charley Horses. They are intolerable with all of my pain medication being taken away! I have severe PTSD and zero trust in doctors from my original medical nightmare! I never ever wanted to go back to that sick person trapped in a wheelchair, I thought I left it behind for ever! This time, I don’t have a heart valve to lose! I am petrified and profoundly devastated because I worked so hard for 8 1/2 years to recover and progress and now that has been destroyed! I see people helping doctors that have been arrested but what about people, like me, who have been targeted, harassed, discriminated against, and literally going through disability abuse-who tells our story and helps us?
My counselor gave me a brochure for adult protective services and she told me to call because what they are doing to me is discrimination and disability abuse. I called and the lady said there is no process for this situation. She told me that it does qualify but the only thing I can do is file a complaint with the board of medicine and nurses because they are the only entities that have authority and jurisdiction over medical providers. I told her that I already filed complaints but it will take months because they only meet one day a month! I told her my body won’t make it that long and I asked her, “what if I die in the meantime?” She said, “let’s hope it doesn’t come to that but good luck!” WHAT? It’s like a nightmare that I cannot wake up from! I have contacted every politician in Maine and asked for their help. Crickets…I requested assistance from Governor Mills but she doesn’t even think she has to answer to her constituents. I have reached out to every volunteer lawyer’s projects and disability rights groups but they all claim no to have the resources to help me. I have documented, taken pictures, recorded videos, screenshot messages from my portal between her and I, audio recorded my video appointments exposing her discrimination and disability abuse! I cannot find an attorney in Maine to help me. This provider only saw me one time in person! She never looked at any areas causing my pain, she’s not monitoring my vitals or everything that is happening to me, she doesn’t even have the correct MRI’s-she’s going by a 2008 one when I was a normal person and could walk on my own, and she’s retaliating against me for filing a complaint! I need help and I don’t know where or who to go to! I even have an appointment with cancer care, January 23rd. I have MGUS and the blood work markers and symptoms all point to it turning into Multiple Myeloma. I asked her to please pause the force taper until I can get into my appointment. She said, “Oxycodone will not cure Multiple Myeloma so the force taper will continue!” How cruel is that!
I was hoping that you may have some direction or advice to help me. If I knew how to file a civil lawsuit against the hospital and provider, I would do it myself. Since September of 2021, I have had to be my own advocate, case manager, and attorney!
I already missed about 6 years of my sons’ lives because of my original medical nightmare! I can do no physical activity without my pain medication! I really don’t think my body will make it through this force taper! Opiates are literally life saving for me! They knew that I wouldn’t be able to find another doctor to see me and Michael Miller and the board of medicine took 2 doctors from me! The provider force tapering me filed a complaint against the LNP that saw me for a year. In it, she said that she felt compelled because Kaye endangered my life by prescribing these life threatening and dangerous medications. She also accused me of bribing Kaye in her complaint. That is ludicrous-I have never bribed anyone! Kaye made it very clear in her response that no one forced or bribed her. She also made it clear that I was the only patient she ever prescribed narcotics for in her entire medical career! I have been accused of selling half of my pain medication and bribing doctors! I am a law abiding Mainer and American just trying to live my life!
Thank you for taking your time to read my email. You can reach me any time at xxx.xxx.xxxx

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most societies/communities have 1 or more agitators, disruptors, false prophets, scammers, traitors, saboteurs and cult leaders

Posted on September 11, 2022 by Pharmaciststeve

Some believe our country is on the verge of a Civil War, they may be right, but it won’t be a bilateral war like our last Civil War..  Our society has voluntarily divided itself in – for lack of a better description – TRIBES.

The chronic pain community is not all that different from our country of as a whole.

Recently a fellow chronic pain pt who had been advocating for end stage pediatric pts in a large hospital system that has a “no opiate” policy.  All of a sudden the advocated was told that he was no longer permitted to advocate for these end of life pediatric cancer pts.  I suppose that this major hospital system will return to treating these pediatric pts with NSAIDS and Acetaminophen and let them live the rest of their lives in a torturous level of pain.

There are rumors as to who said what and to whom… I am not going to elaborate. However, they know who they are and what was said to cause this to happen.  One can only imagine the deprived mental status of those who have been involved in this.

Some have told me that this tribe of malcontents have monetized chronic pain pts’- personal information  and several other covert processes. I started my blog in 2012 and have tried to motivate and educate chronic pain pts in some ways that they can navigate their way to getting their pain management back.  Some chronic painers have told me that I should charge for my advice.  My Pharmacy degree, license and career has provided for Barb and myself a comfortable retirement.

After this issue with these end of life pediatric pts,  Going forward… I am going to ASK of people that want my advice to make a contribution to one of the four national charities listed below, these are all about THE KIDS… and charities we support.  Maybe in some small way, my advice can help more than just one person/family. 

 

https://www.stjude.org/ St. Jude Children’s Research Hospital – deals with kids dealing with cancer and/or life threatening health issues

https://lovetotherescue.org/ Shriners Hospital – deals with kids, born with “broken bodies” and birth defects

https://rmhc-kentuckiana.org/ Ronald Mc Donald House – this is near us and just a few blocks from a very large regional pediatric hospital ,3 other major hospitals within blocks, one being a teaching hospital and having the only LEVEL ONE TRAUMA CENTERS for 100 miles and part of a medical university and  helps provide housing for families with kids in the hospital

https://t2t.org/ Tunnel to Towers Foundation – helps get handicapable housing for veterans, first responders with “broken bodies” , families with spouse/parent killed in the line of duty and Gold Star Families

 

 

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Compounded Semaglutide (GLP-1) Overdoses Tied to Hospitalizations

Posted on July 26, 2024 by Pharmaciststeve

Compounded Semaglutide Overdoses Tied to Hospitalizations

https://www.medscape.com/viewarticle/compounded-semaglutide-overdoses-tied-hospitalizations-2024a1000dte

Patients are overdosing on compounded semaglutide due to errors in measuring and self-administering the drug and due to clinicians miscalculating doses that may differ from US Food and Drug Administration (FDA)–approved products.

The FDA published an alert on July 26 after receiving reports of dosing errors involving compounded semaglutide injectable products dispensed in multidose vials. Adverse events included gastrointestinal effects, fainting, dehydration, headache, gallstones, and acute pancreatitis. Some patients required hospitalization.

Why the Risks?

FDA-approved semaglutide injectable products are dosed in milligrams, have standard concentrations, and are currently only available in prefilled pens.

Compounded semaglutide products may differ from approved products in ways that contribute to potential errors — for example, in multidose vials and prefilled syringes. In addition, product concentrations may vary depending on the compounder, and even a single compounder may offer multiple concentrations of semaglutide.

Instructions for a compounded drug, if provided, may tell users to administer semaglutide injections in “units,” the volume of which may vary depending on the concentration — rather than in milligrams. In some instances, patients received syringes significantly larger than the prescribed volume.

Common Errors

The FDA has received reports related to patients mistakenly taking more than the prescribed dose from a multidose vial — sometimes 5-20 times more than the intended dose.

Several reports described clinicians incorrectly calculating the intended dose when converting from milligrams to units or milliliters. In one case, a patient couldn’t get clarity on dosing instructions from the telemedicine provider who prescribed the compounded semaglutide, leading the patient to search online for medical advice. This resulted in the patient taking five times the intended dose.

In another example, one clinician prescribed 20 units instead of two units, affecting three patients who, after receiving 10 times the intended dose, experienced nausea and vomiting.

Another clinician, who also takes semaglutide himself, tried to recalculate his own dose in units and ended up self-administering a dose 10 times higher than intended.

The FDA previously warned about potential risks from the use of compounded drugs during a shortage as is the case with semaglutide. While compounded drugs can “sometimes” be helpful, according to the agency, “compounded drugs pose a higher risk to patients than FDA-approved drugs because compounded drugs do not undergo FDA premarket review for safety, effectiveness, or quality.”

Medscape Medical News recently reported on how some endocrinologists are addressing the ongoing shortage.

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Does This Single Fact Signal Our Imminent Financial Collapse?

Posted on July 26, 2024 by Pharmaciststeve

https://americanliberty.news/economics/does-this-single-fact-signal-our-imminent-financial-collapse/phouck/2024/07/

Interest on the federal debt in June was equivalent to 76% of all personal income collected, which is the Treasury’s largest revenue source, with three-quarters of it being used solely for interest.

The current state of dollar value destruction:

The fact 76% of all personal income tax collected last month was allocated to servicing the $34 trillion national debt has profound implications for America’s financial security. Analyzing different aspects of fiscal policy, economic stability and future financial planning is essential to understand the consequences.

Financial Security Concerns

  1. Reduced Fiscal Flexibility
    • Impact on Budget Allocation: With the majority of personal income tax revenue being used to pay off debt, less money is available for other essential government services and programs. This can lead to underfunding in critical areas such as healthcare, education, infrastructure and social services.
    • Increased Borrowing: The need to service such a large debt may force the government to borrow even more, creating a vicious cycle of debt dependency. Increased borrowing can lead to higher interest rates, further exacerbating the debt crisis.
  2. Economic Stability Risks
    • Investor Confidence: High levels of debt and significant portions of tax revenue going towards debt servicing can undermine investor confidence. If investors perceive the national debt as unsustainable, they may demand higher interest rates for government bonds, increasing the cost of borrowing.
    • Inflationary Pressures: Large-scale borrowing and debt servicing can lead to inflation if the government resorts to printing more money to meet its obligations. This devalues the currency and erodes purchasing power, impacting the overall economy.
  3. Long-term Financial Health
    • Intergenerational Equity: High debt levels burden future generations with repayment obligations, potentially limiting their economic opportunities and financial security. This raises ethical concerns about intergenerational equity and the responsibility of current policymakers.
    • Potential for Austerity Measures: To manage the debt, the government might implement austerity measures, including cuts to public spending and increased taxes. Austerity can slow economic growth and lead to social unrest, as seen in other countries with high debt burdens.

 

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CenterWell to open 23 senior primary care centers at Walmart locations in four states

Posted on July 26, 2024 by Pharmaciststeve

CenterWell to open 23 senior primary care centers at Walmart locations in four states

https://drugstorenews.com/centerwell-open-23-senior-primary-care-centers-walmart-locations-four-states

The centers will be located in a clinical office space formerly occupied by Walmart Health.

CenterWell, the health care services business of Humana plans to lease clinical space and open senior-focused primary care centers at 23 Walmart Supercenter retail stores in Florida, Georgia, Missouri and Texas. 

The centers will operate under the CenterWell Senior Primary Care and Conviva Care Centers brand names and will provide seniors in these communities with greater access to primary care services designed specifically for older adults. 

The new centers will be conveniently located next to Walmart stores in clinical office space that was formerly occupied by Walmart Health. CenterWell expects the centers to be equipped, staffed and opened no later than the first half of 2025. Financial terms of the agreement were not disclosed.

“CenterWell is committed to providing seniors with high quality health care that is accessible, comprehensive, and most of all, personalized. We are excited by the unique opportunity to lease space from a world-class community partner such as Walmart and offer seniors in these four states greater access to our integrated approach to care,” said Sanjay Shetty, president of CenterWell. “These nearly two dozen primary care centers are specifically designed for seniors, and each location’s design, including dedicated entrances and easy parking, offers patients the access that they have come to expect at our clinics across the nation. We are eager to expand on our mission to help patients lead happier, healthier lives.”

“We are looking forward to welcoming CenterWell into these purpose-built healthcare spaces to offer quality care to communities in four states,” said Brian Setzer, executive vice president of Walmart Health & Wellness. “Leasing these spaces to a well-known and successful healthcare delivery organization is a win for customers and patients, as we continue to focus on our core health & wellness business of Pharmacy and Optical.”

CenterWell Senior Primary Care, along with its sister brand Conviva Care Centers, represents the largest, fastest-growing senior-focused, value-based primary care provider in the country. Together, the businesses comprise Humana’s Primary Care Organization, delivering care to about 318,000 seniors in nearly 300 centers across 15 states as of March 31, 2024.

CenterWell Senior Primary Care and Conviva Care Centers locations are designed specifically with the needs of seniors in mind, and include a staff of board-certified physicians, nurse practitioners and medical assistants that coordinate care alongside care coaches, social workers, behavioral health specialists and clinical pharmacists. These teams are dedicated to treating the unique medical and social needs of seniors and take the time to listen to and partner with patients on their healthcare journey, collaborating on a care plan that is evidence-based and centered on the patient. 

[Read more: Pharmacy Innovator of the Year 2021: Walmart connects with communities]

CenterWell Senior Primary Care and Conviva Care Centers locations accept patients on many different Medicare Advantage health plans, as well as those who have Original Medicare.

In connection with this lease agreement, CenterWell plans to open senior-focused primary care centers adjacent to Walmart Supercenter locations in the following metropolitan areas:

  • Tampa/St Petersburg
  • Orlando
  • Jacksonville
  • Atlanta
  • Dallas/Fort Worth
  • Kansas City

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Greater than 50% of Honeymoons end in divorce

Posted on July 25, 2024 by Pharmaciststeve


This blog post is not about a particular politician but about the TERRIBLE financial state that all politicians have put our country in – THAT IS NOT TALKED ABOUT!

In 2009 when Pres Obama came to office, our country had amassed a 9 trillion dollar national debt since our founding in 1776 – (233 yrs). https://www.usdebtclock.org/ When Obama left office we were nearly 20 Trillion in debt and when Trump left office, we were 25 Trillion in debt, we are now 35 TRILLION in debt. In 16 yrs – abt 6% of our entire timeline history – our national debt has nearly QUADRUPLED. In 12 of those 16 yrs, There is a common denominator in 75% of this time, Joe Biden was part of the administration. In 2008 our interest on our national debt was $380 billion.

Next year (2025) the interest on our national debt is projected to approach ONE TRILLION.  https://www.pgpf.org/budget-basics/what-are-interest-costs-on-the-national-debt

And it is projected that within the next decade, our national debt may exceed 50 TRILLION.

Just watch the first video and this presidential candidate is promising all sorts of benefits to just about every segment of our population and a “promise of freedom” with our society being shackled to that much increasing national debt and increasing interest payments that we have to make on that debt?

Please watch the second video starting at ~ 3 minutes with a scrolling part of the screen with all the things that have happened in spending money we don’t have.

Please watch the third video at 7:30 where there seemed to be support of a 70%-80% federal tax level to help pay for all these promises.

When will this honeymoon be over and when irreconcilable differences between promises and reality come home to roost?

 

 

 

 

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Pharmacists & techs – urgent request to speak with a national reporter!

Posted on July 25, 2024 by Pharmaciststeve

Pharmacists & techs – urgent request to speak with a national reporter!

 

Dear pharmacists and technicians, especially chain pharmacists. I have a one day deadline on this one. It’s a tough one, but I’ll ask. I’ve had CVS pharmacists from locations across the nation say that they also get medications hot to touch that are coming from hot UPS and USPS trucks from central fill locations to the local pharmacies.
These medication are then put on shelves and given to patients without considering the impacts on heat. Is there anyone who is willing to speak to a reporter on this issue? I can ask for anonymity from the public for those who are willing to speak.
Sadly, some of the pharmacists or techs ask me to report to the state boards, but I know most state boards already know this is happening and turning their heads. Some also want to see a better future of medication handling but some are afraid to speak to a reporter. Will you be brave with me?
Maybe, I’ve almost sadly given up home especially here in Missouri.
I have more hope in reporters sharing the stories of patients and pharmacists to apply the pressure on state boards over many (not all) state boards doing the right thing and ensuring safe temperature storage on their own.
If you’re willing to speak message me or email loretta@uniteforsafemeds.com

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Trauma Patients Without Insurance Taken Off Life Support Sooner, Study Finds

Posted on July 24, 2024 by Pharmaciststeve

Clinicians must “uncomfortably” examine bias in life-and-death decisions, says expert

https://www.medpagetoday.com/criticalcare/generalcriticalcare/111230

Critically injured trauma patients without insurance had a higher risk of being taken off life-saving care sooner than their insured counterparts, according to findings from a retrospective cohort study of more than 300,000 U.S. adults.

After adjustment for patient and hospital characteristics, those without insurance had significantly earlier withdrawal of life-sustaining therapy (WLST) when compared with Medicaid recipients (HR 1.53, 95% CI 1.45-1.62) or the privately insured (HR 1.57, 95% CI 1.49-1.65), reported researchers led by Graeme Hoit, MD, of the University of Toronto.

In contrast, no such difference in time to WLST was observed between the Medicaid and privately insured groups (HR 1.03, 95% CI 0.98-1.08). Unadjusted numbers showed mean times to WLST of 6.5 days in the uninsured group, 8.9 days in the Medicaid group, and 7.8 days for the privately insured group.

“Our study suggests that a patient’s ability to pay may be associated with a shift in decision-making for WLST,” the group wrote in JAMA Network Openopens in a new tab or window.

This would appear to go against the Emergency Medical Treatment and Labor Act, which requires that all critically ill patients in hospitals receive optimal care regardless of insurance status or financial means.

But more than two-thirds of uninsured trauma patients are at risk of catastrophic health expenditures, noted Hoit and colleagues, and if these patients are unable to pay, the financial responsibility may shift to the institutions caring for them. One study from 2013opens in a new tab or window estimated a $2.8 billion annual tab for uninsured trauma care in the U.S.

Under ideal circumstances, the decision to WLST involves a shared decision between clinicians and a patient’s surrogate or substitute decision-maker (SDM), the researchers pointed out.

“However, the nature of severe traumatic injury means that trauma patients are typically younger, less likely to have preexisting care directives, more likely to be estranged from their families and SDMs, and more likely to belong to marginalized social populations compared with the general critical care population,” they wrote. “These factors complicate WLST decisions and may increase the likelihood of practitioner, caregiver, or institutional biases impacting decisions and timing.”

The new findings, said Hoit and colleagues, build on prior trauma studies linking uninsured status with increased mortality.

“When presented with decisions about whether or not to proceed with tests, procedures, or care continuation, institutions and/or SDMs may both have concerns with the cost of care and be less likely to pursue extensive measures, resulting in earlier mortality,” they wrote.

In an accompanying commentaryopens in a new tab or window, Zara Cooper, MD, MSc, a trauma surgeon at Brigham and Women’s Hospital and Harvard Medical School in Boston, said “it is incumbent upon individual clinicians and health systems to closely and uncomfortably examine how bias either creeps or marches into the life-and-death decisions we make for everyone under our care.”

In fact, she suggested, meaningful differences between the study groups — namely alcohol or substance use and mental health disorders — may have influenced WLST decisions. Self-inflicted injuries, for example, were associated with a greater risk of earlier WLST (HR 1.54, 95% CI 1.36-1.73), “suggesting that even though depression is a treatable disorder, comorbid depression may have biased clinicians and surrogates toward WLST.”

But Cooper added that “one of the more important findings in this study is that having any insurance vs no insurance is more important than having public vs private insurance in terms of risk of treatment withdrawal.”

An estimated 12% of American adults ages 18 to 64 do not have insurance, according to recent CDC dataopens in a new tab or window, with the highest rates among Hispanics, those of lower income, and people living in non-Medicaid expansion states (all but 10 states — mostly in the south — have expanded Medicaid accessopens in a new tab or window under the Affordable Care Act).

Compared with injured adults in non-expansion states, noted Cooper, people in expansion states “are more likely to survive hospitalization, have shorter hospitalizations, and are more likely to receive rehabilitation postdischarge.”

The study from Hoit’s team included 307,731 critically ill trauma patients ages 18 to 64 admitted to an intensive care unit (ICU) in the U.S. from 2017 to 2020. Data were captured from level I and level II trauma centers participating in the American College of Surgeons Trauma Quality Improvement Program (TQIP) registry. Analyses excluded patients who died on arrival or in the emergency department, as well as individuals with a “do not resuscitate” order.

Mean age was 40 years, three-fourths were male, about two-thirds were white, and 19% were Black. The most common mechanism of injury was motor vehicle collision (35%), followed by falls (22%), firearms (12%), and motorcycle (10%) or pedestrian (9%) accidents. More than three-fourths of the injuries were unintentional, while 15.8% were related to assaults and 2.8% were self-inflicted.

A majority (52%) of the cohort had private insurance, while 19% were uninsured, and the rest were insured through Medicaid.

Uninsured patients tended to be younger than those with private insurance (37.8 vs 41.7 years); were more likely to be male (82.6% vs 73.2%), have a history of substance abuse (12.5% vs 0.8%), and be victims of assault (24.2% vs 7%); they were less likely to be white (56.1% vs 73.8%) and generally had lower rates of chronic illness. The uninsured population was more similar to the Medicaid group.

Hoit’s team noted that TQIP defined life-supporting interventions as ventilator support (with or without extubation), kidney replacement therapy, medications to support blood pressure or cardiac function, and surgical, interventional, or radiological procedures.

Overall, 12,962 patients (4.2% of the total cohort) underwent WLST during their ICU admission, including 5% of those without insurance, 4.2% of those with Medicaid, and 3.9% of those with private insurance. Overall, the average time to WLST was 7.8 days.

Besides self-inflicted injuries, another variable associated with earlier withdrawal of care was firearm injuries (HR 2.01, 95% CI 1.79-2.27). WLST was less common in Asian, Black, and Hispanic patients (as compared with whites) and for those treated at teaching or for-profit hospitals.

Study limitations cited by the authors included a lack of variables captured in the TQIP registry — including income, religious/spiritual beliefs, marital status, language ability, and education level — that may have influenced decisions related to WLST. Also, researchers did not assess the types of care that had been provided before it was withdrawn.

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Texas Lawsuit to Stop Optum PBM Audit Termination

Posted on July 24, 2024 by Pharmaciststeve

Texas Lawsuit to Stop Optum PBM Audit Termination

https://www.healthlawalliance.com/blog/health-law-alliance-files-emergency-texas-lawsuit-against-optum-pbm-audit-termination

When is the last time you took a stand on something that you believed in? Here, at HLA, we stand up everyday for clients across the country who we believe in and who are in serious need of help, whether that be against PBMs, payors, the federal government, or some other industry giant looking to crush them and their livelihood. It’s not easy, and anyone who promises specific results should not be taken at their world. With us, however, you can be assured that we will represent you fiercely at every turn. It’s just who we are and what we do based on decades of experience at the highest levels of industry. Today’s lawsuit is one example of that commitment.

optum pbm lawsuit

Texas Lawsuit to Stop Optum PBM Audit Termination

PBMs like Optum have motivations behind their audits that are not always apparent. However, our founding partner, Anthony Mahajan, previously served as the Chief Compliance Officer of United Health, with oversight over both Optum and United Healthcare. We used to work for them, now we fight for you.

You can read HLA’s complaint HERE, a summary of the relief requested HERE, and our legal arguments HERE. Among other claims, we allege that our client was selected for termination because Optum wanted to reverse or transfer to its internal, mail-order pharmacy claims for beneficiaries of United Healthcare plans. The lawsuit alleges that United Health is losing money on its Part C Medicare Advantage capitated plans given rising medical loss ratio, and therefore is particularly incentivized to audit and recoup on prescription claims using its corporate affiliate, Optum Rx.

Alleged Violations of Texas PBM Audit Reform Laws

We have many clients in the great State of Texas who have been targeted by Optum and other PBMs as a result of their relationship with telemedicine providers. In our client’s case, the pharmacy was targeted for termination due to “mailing on a retail contract.” Nonetheless, in addition to the waiver on mailing arising from the pandemic, Texas has specific PBM reform laws, enacted under Governor Abbott, that expressly prohibit payors and PBMs from barring mail-order delivery in their provider contracts.

With HLA, providers can hold PBMs like Optum accountable to their legal obligations because our PBM audit lawyers have decades of experience litigating federal and state laws.

Alleged Violations of Federal and Texas “Prompt Pay” Laws

PBMs often refuse to reimburse providers for claims that are submitted during the pendency of an audit. This results in a difficult choice for many: should you continue serving patients in good faith, or should you change course to avoid the possibility of the PBM recouping on everything owed.

However, Texas and federal laws prohibit PBMs from refusing to reimburse “clean claims” within certain time periods. These laws may also prohibit PBMs from extending the “look-back” period for claims audits. In addition, certain laws impose significant monetary penalties on PBMs who do not comply.

HLA’s lawsuit alleges that Optum refused to timely reimburse the pharmacy for hundreds of thousands of dollars in clean claims even though Optum’s final audit findings were far lower. If a PBM is refusing to pay reimbursement due and owing, you should understand your rights under these “prompt pay” laws.

Texas PBM Audit Attorneys Fighting for You

If your pharmacy is facing unjust termination from a PBM’s network, or other PBM audit abuses, HLA can help you level the playing field. Our PBM audit defense team has successfully resolved PBM audits across the country because we have a reputation as trial lawyers with the dedication to win.

Contact us today to learn more about how we can advocate for your rights and fight for your continued ability to serve your pharmacy patients.

 

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PAIN PATIENTS Washington State!

Posted on July 23, 2024 by Pharmaciststeve
PAIN PATIENTS Washington State!
On Friday July 19th the Washington Medical Commission held their regularly scheduled meeting.
During this meeting was continued discussion about changes being made to the opioid prescribing rules/laws in Washington State.
With the help of Kat Hatz & APDFoundation I submitted a Petition to the WMC requesting more explicit changes to the rules/laws.
At the beginning of this meeting several patients made public comments. There were also written comments. These can be heard at approximately 1.33 (1 minute 33 seconds) into the recording.
At 1:55 (1 hr 55 minutes) The commission begins discussing my Petition and changes to the prescribing law, it was great to hear their support!!
Please know that this was an extremely positive meeting and the commission has agreed that changes need to be made to stop harms to chronic pain patients.
You can also read the transcript on the YouTube video and please also feel free to comment on YouTube BUT be sure to send in your testimony directly to WMC
PLEASE continue to send comments to:
Amelia.boyd@wmc.wa.gov
There will be a hearing in October to discuss comments and changes!
OUR VOICES HAVE BEEN HEARD but I NEED MORE!!
Thank you everyone!! Via email (above) contact Maria Higginbotham for details 🥰

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Is this what the chronic pain community needs?

Posted on July 23, 2024 by Pharmaciststeve

Presidential candidate VP Kamala Harris brings to DC the experience of a PROSECUTOR for THREE DECADES. The above video is her first campaign stop where she states that she is going to get women to be allowed to make their own decisions about their bodies and medical decisions and keep the government out of medical decisions- but apparently when it only involves abortion!

Does this mean that no pts- especially those who are dealing with medical disabilities – do not have the right to be involved in their medical care – especially subjective diseases – like pain, depression, and anxiety?

Just ask chronic pain pts in Florida, where they elected a state Attorney General who is married to a DEA AGENT!

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CVS LIES UNDER OATH over their PBM’ jacking up Rx prices

Posted on July 23, 2024 by Pharmaciststeve

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