Sooner or latter the healthcare providers FIGHT BACK to low ball reimbursement for services from insurance companies

Posted on June 13, 2022 by Pharmaciststeve

Healthcare System Sues Cigna Over Emergency Care Reimbursements

https://www.lexology.com/library/detail.aspx?g=a1c5223f-0d66-40a1-8d43-078765fafa0a

Tenet Healthcare and nineteen of its hospitals filed a complaint against Cigna Health and Life Insurance Company in Connecticut Superior Court, alleging that Cigna had reimbursed its claims at unfair and unreasonable rates. The plaintiffs also allege that Cigna wrongfully denied claims for emergency medical services, although they are legally obligated to provide Cigna plan members with emergency medical care.

Cigna immediately removed the suit to Connecticut District Court, where it remains pending. The District Court has issued the standard scheduling orders for civil cases. Cigna has not yet filed its formal response to Tenet’s complaint.

In its complaint, Tenet claims Cigna reimburses its claims according to a unilateral payment methodology, resulting in steeply discounted payments. Tenet alleges that it did not agree to discounted payments, which bear no relation to the reasonable and fair value of the medical services provided to Cigna plan members. Tenet further alleges that Cigna has arbitrarily denied many claims of its members for emergency services rendered by Tenet and its hospitals.

As a result of its action, Tenet accuses Cigna of violating its common law right to payment for the fair and reasonable value of its services. It also claims that Cigna violated the legal obligation of health insurers to cover emergency medical services for its members and pay reimbursements in the amount of the fair market value of those services. Finally, Tenet alleges that Cigna violated the Connecticut Unfair Trade Practices Act.

Tenet claims that Cigna also refuses to add its hospitals to its roster of in-network providers, leaving plan members with no place to seek in-network non-emergent medical care in their geographical areas. According to Tenet, this refusal allows Cigna to continue unilaterally defining the level of reimbursement for services that Tenet provides to Cigna plan members.

Tenet’s complaint details allegations specific to various hospitals in different states, including Arizona, Florida, Tennessee, Alabama, Massachusetts, and South Carolina. Each hospital alleges state law claims and violations of the Emergency Medical Treatment and Labor Act (EMTALA).

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chuckle of the day 06/13/2022

Posted on June 13, 2022 by Pharmaciststeve


Nuts. Fruit. Cookies and pound cake. Even potato chips. You don’t have to look hard to find things that are coated in chocolate. But people? Never. But that’s what happened last week in Lancaster County, Pa., at the Mars Wrigley plant. Two plant employees were rescued after getting trapped in a large tank of chocolate and were taken to a local hospital. Here’s a song about falling into a vat of chocolate.

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Red flag laws have worked so well for chronic pain pts – just imagine when they are applied to our 2nd Amendment rights

Posted on June 12, 2022 by Pharmaciststeve

I don’t normally step on the “third rail”… how many times have we seen practitioners “taken out” with the FACTS from the DEA that they violated some “red flags”… none of which are defined in the controlled substance act and more often than not… the DEA uncovered these “red flag violations” by data mining the various states’ PDMP ?

Just imagine, if the ATF starts down the path of the DEA.. after all they are also part of the DOJ..  and starts data mining Electronic Medical Records and/or all prescription records – after all the PBM industry pays for some 90% of all prescriptions and with pharmacies filling some FOUR BILLION Rx per year… the PBM’s have huge databases… and the PBM’s are all about generating revenues and profits…  just let the ATF to go on a “fishing expedition” thru their databases. Find a person who has meds prescribed by a Psychiatrist, has a anti-depressant or some other “mental health med” prescribed/filled,  someone who is a chronic pain pt and taking opiates…  RED FLAGS of potential “mental instability” … under the “influence of opiates”…  Compare those names with the national gun register and could a person find someone from the local law enforcement or ATF… at their front door wanting to confiscate their guns ?

Of course, those people in possession of guns, that they have obtained thru break-ins, robbery, bought off the street and the like – don’t have to worry… there is no record of them buying/owning a firearm.

Just look at this recent case Dr. Bauer reports to prison Thursday 85 y/o doctor sent to jail for 5 yrs on the ALLEGATIONS by the DEA of “not adhering to good medical practices”  which I have never seen the DEA DEFINE, and THOUSANDS of his chronic pain pts were tossed to the curb. All those pts having to suffer thru cold turkey withdrawal, committing suicide, having to live/exist in a torturous level of pain and a untold number of premature deaths from their untreated pain.   I guess that all those “bodies” left in the wake of the DEA actions, will be just unfortunate collateral damage.

Fortunately or unfortunately, my two INDIANA SENATORS are not part of the 10 Republican Senators that have abandoned the party’s platform, I have no one to write to hoping they will change their vote.  Probably most/all are not up for re-election this Nov and figure that “all will be forgotten” the next time they run for re-election.

Senate Republicans Betray Base, Join Democrats on Gun Crackdown

DEVELOPING STORY: While you were attending church this morning, a bipartisan group of U.S. senators were conspiring to take away your constitutional rights.

The lawmakers, including enough Republicans to overcome the chamber’s “filibuster” rule, on Sunday announced an agreement on a plan that would curtail the right to bear arms.

“This is the ultimate betrayal of conservative voters,” said nationally syndicated radio host Todd Starnes. “Senate Republicans are more interested in being accepted at Georgetown cocktail parties than they are keeping their word to constituents.”

The bill included support for state “red flag” laws, tougher background checks for firearms buyers under 21 and a crackdown on a practice called “straw purchases.”

“Our plan saves lives while also protecting the constitutional rights of law-abiding Americans,” the group, led by Democrat Chris Murphy and Republican John Cornyn, said in a statement. “We look forward to earning broad, bipartisan support and passing our commonsense proposal into law.”

Ten Republicans signaled their support for the preliminary deal, indicating the measure potentially could advance to a vote on passage and overcome roadblocks by other Republicans who oppose most gun control measures.

The senators include: Chris Murphy, John Cornyn, Thom Tillis , Kyrsten Sinema, Richard Blumenthal, Roy Blunt, Cory Booker, Richard Burr, Bill Cassidy, Susan Collins, Chris Coons, Lindsey Graham, Martin Heinrich, Mark Kelly, Angus King, Joe Manchin, Rob Portman, Mitt Romney, Debbie Stabenow, and Pat Toomey.

President Biden specifically thanks Sen. John Cornyn (R-TX) and Sen. Thom Tillis (R-NC) for their help in weakening the Second Amendment.

I want to thank Senator Chris Murphy and the members of his bipartisan group—especially Senators Cornyn, Sinema, and Tillis—for their tireless work to produce this proposal. Obviously, it does not do everything that I think is needed, but it reflects important steps in the right direction, and would be the most significant gun safety legislation to pass Congress in decades. With bipartisan support, there are no excuses for delay, and no reason why it should not quickly move through the Senate and the House. Each day that passes, more children are killed in this country: the sooner it comes to my desk, the sooner I can sign it, and the sooner we can use these measures to save lives. 

White House

Biden had called for banning the sale of assault weapons and high-capacity magazines, or, if that were not possible, raising the minimum age to buy those weapons to 21 from 18. Biden also pressed for repealing the liability shield that protects gun manufacturers from being sued for violence perpetrated by people carrying their guns.

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A New Injectable Gel May Greatly Reduce Chronic Low Back Pain

Posted on June 11, 2022 by Pharmaciststeve

A New Injectable Gel May Greatly Reduce Chronic Low Back Pain

https://neurosciencenews.com/hydrogel-back-pain-20785/

Summary: Hydrafil, an experimental injectable hydrogel appears to be safe and effective in reducing chronic lower back pain associated with degenerative disc disease.

Source: Society of Interventional Radiology

An experimental formulation of a hydrogel, injected into spinal discs, proved safe and effective in substantially relieving chronic low back pain caused by degenerative disc disease (DDD), according to new research to be presented at the Society of Interventional Radiology Annual Scientific Meeting, in Boston.

Hydrogels have been used for a number of years to treat DDD, but the current study is the first test of this particular gel in humans.

After six months, all participants in this small study reported significantly less low back pain—declining from an average self-reported pain level of 7.1 down to 2.0 on a scale of zero to 10. They also experienced greatly improved physical function, with average scores falling from 48 to 6 on a questionnaire to gauge the impact of low back pain in preventing patients from the ability to perform normal activities.

“If these findings are confirmed in further research, this procedure may be a very promising treatment for chronic low back pain in those who’ve found insufficient relief from conservative care,” said lead author Douglas P. Beall, MD, FSIR, chief of radiology services at Clinical Radiology of Oklahoma. “The gel is easy to administer, requires no open surgery, and is an easy procedure for the patient.”

The gel used in this study, Hydrafil™,  is a second-generation hydrogel developed by ReGelTec, Inc. In 2020, it received FDA’s breakthrough device designation, which allows expedited review when early evidence suggests an experimental product may provide more effective treatment than current options for treating a serious condition. Dr. Beall is a medical advisor to the company.

The research team enrolled 20 patients, aged 22 to 69, with chronic DDD low back pain. Each described their pain as four or higher on the 10-point scale. None had found more than mild relief from conservative care, which includes rest, analgesics, physical therapy, and back braces.

Patients were sedated for the procedure, and the gel was heated to become a thick liquid. Guided by fluoroscopic imaging, researchers used a 17-gauge needle to inject the gel directly into the affected discs, where the gel filled in cracks and tears, adhering to the disc’s center and outer layer.

This shows a cartoon of a woman rubbing her back
After six months, all participants in this small study reported significantly less low back pain—declining from an average self-reported pain level of 7.1 down to 2.0 on a scale of zero to 10. Image is in the public domain

“We really have no good treatments for degenerative disc disease, aside from conservative care,” said Dr. Beall.

“Surgery is statistically no more effective than conservative care and can potentially make things worse; nerve ablation is appropriate for only a few patients; and existing hydrogels are inserted through an incision as a soft solid, which can pop out of place if you’re not highly skilled in placing it.”

“Because this gel is injectable, it requires no incision, and it augments the whole disc, restoring its structural integrity, which nothing we have currently can do,” he said.

Degenerative disc disease is the leading cause of chronic low back pain, one of the world’s most common medical conditions. Healthy discs cushion the spine’s vertebrae, facilitating movement and flexibility. With normal aging, though, they can become dry, thin, cracked or torn, causing pain or loss of motion. By age 60, most people have at least some disc degeneration.

 

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Should those in the chronic pain community pay attention to this

Posted on June 11, 2022 by Pharmaciststeve
About 40,000 people showed up in D.C., according to organizers, and protests were also planned through the day in major cities including New York, Chicago, Las Vegas and Los Angeles. About 300 people showed up to protest in West Melbourne, Florida, and some 400 people marched through Old Town in Fort Collins, Colorado.
The March for Our Lives events come four years after the organization was founded by teens who survived the 2018 Marjory Stoneman Douglas High School shooting that killed 17 people in Parkland, Florida. That year, more than 1 million people rallied in Washington.

This is suppose to be a picture of a protest TODAY (06/11/2022) in DC… estimated 40,000 showed up and their first protest, FOUR YEARS ago … claimed to have ONE MILLION people to show up.  This protest is about gun violence..  In the years between the first protest in 2018 and today… I have not seen anything done about gun violence.

The largest protest/demonstration by any chronic pain group – anywhere in the country – amounted to about SEVEN DOZEN people showing up. If a MILLION PEOPLE show up and there is no real change in anything that will compromise our 2nd amendment.

In our country’s nomenclature the killing of 4 or more people is considered a MASS SHOOTING..   So those four that were murdered and one suicide in St Francis Healthcare in Tulsa, was considered a MASS SHOOTING… but more than four people are shot/killed in Chicago each weekend, but because they are mostly individual shooting/killing… Chicago has very few mass shooting, but in 2021, Chicago had 797 homicides.

It is just my opinion, but I think that members of Congress can be more likely to be influenced by $$$ into their re-election campaign fund… Maybe that is why the lobby industry spend more than NINE MILLION PER DAY to influence the 535 members of Congress to get them to pass bills that will favor those who hire those lobbyists.

Maybe we need to look and follow what the “rich cats do”   Zuckerberg’s election spending was ‘carefully orchestrated’ to influence 2020 vote: ex-FEC member

A former federal election official on Thursday called the $400 million-plus that Mark Zuckerberg spent to help finance local elections a “carefully orchestrated attempt” to influence the 2020 vote

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Monetary deception ?

Posted on June 10, 2022 by Pharmaciststeve

This appeared to really starting to happen with the Tobacco settlement in 1998… in which 46 state AG’s and some law firms suited the 4 major tobacco manufacturers and 4 states settled outside of the lawsuit and in the first 20 yrs there was abt 135 BILLION dollars shared with those states.. I tried to read the details of the settlement and the details are so convoluted that at the end of 25 yrs of the settlement, the states are to share 9 BILLIONS/yr in perpetuity – think ” until hell freezes over”  The states didn’t put any taxpayers’ money at risk, the private law firms took all the fiscal risks.  The various states could only WIN or NOT WIN… they could NOT LOSE ANYTHING.

Here is a link  https://www.cagw.org/thewastewatcher/smoke-what-happened-tobacco-master-settlement-agreement-money and especially a quote from that link

The Tobacco Master Settlement Agreement simultaneously represents one of the most egregious examples of a government shakedown of private industry and offers a case study of the problems that stem from big government and big business scratching each other’s backs. It has turned the largest tobacco companies into an indispensable cash cow for politicians and bureaucrats, enabled irresponsible state spending, and, amazingly, has resulted in less money for public health and tobacco control while propping up a declining industry. As is the case with discriminatory tobacco taxes, the incentives of the MSA are perverse: the more people smoke, the more money the government gets to spend on whatever it wants. The biggest losers are those with tobacco-related diseases and smokers trying to quit.

Apparently the lesson learned by the various state AG’s from this lawsuit – over suing companies that manufactured a legal product…  and we are seeing now with the lawsuit over the fabricated “opiate crisis”…is that they did not sue not only the manufacturers, but also the wholesaler and retailers.  Apparently they realized that they left a lot of money on the table with the tobacco lawsuit that they were not going to let them happen again as they proceeded to sue companies who manufacturer and sell a legal product.

Civil Asset Forfeiture act.  It has been stated that some city/state bureaucracies are able to cover up to half of their annual budget with the $$ collected using this law.   Anyone questioning this just do a web search on “Civil Asset Forfeiture Act ” and/or here is very interesting website  https://ammo.com/articles/civil-asset-forfeiture-policing-for-profit

Then there is social security…the first check was sent out the first of Feb 1940 – for $22.54 and when SS was started there was abt 25 employees for every recipient and in 1940 < 50% of all people would die before reach 65 y/o and draw the first penny from SS.  When I graduated in 1970, SS was 4.3% on the first 10,000 of income – which the employer paid an equal amount. In 2022 the income limit subject to SS & Medicare is 147,000 and combined tax is 7.65% and employer contributes the same.

In the last week or so it was announced/stated that if the COLA/CPI had been properly calculated from 2000 the average SS check would be $500+ more per month. This week it was announced that SS & Medicare would be unable to meet full promised commitment in the later part of the next decade.  Just as Gen-X become eligible for SS & Medicare and the last of the baby boomer generation will be entering their 70’s. Medicare & SS really doesn’t have much of a cash reserve, it depending entirely on cash flow to pay the bills and it is estimated that required payments in the latter part of next decade. Cash flowing into Medicare & SS will be LESS than what has to be paid out.  There has been estimates that all benefits will be reduced some 20%-25% when this happens.

the cost of treating pain is claimed to be second to the cost of treating Diabetes, however… there are 3-4 times more chronic painers than the number of diagnosed/undiagnosed diabetic  Does this suggest how GROSSLY UNDER TREATED CHRONIC PAINERS ARE ?

We have seen the DEA raid a office practice and confiscate all the prescriber’s assets and throw all the pts in the practice to the curb and confiscate all the pt’s records and some pts have reported to still be trying to get a copy of their medical records – THREE YEARS after the office was raided. it is well known that pts are less likely to be accepted in a practice without existing medical records.  So what is the game plan, the DEA doesn’t really know which pts that they claimed were being treated without valid medical necessity – because it is all done with data managing – so they CYA themselves because it might be uncovered that there were no pts in a practice that didn’t have a valid medical necessity ?

It is pretty well known that all the pts in a practice will be thrown into cold turkey withdrawal <30 days of the office being raided.  They could suffer a stroke or heart attack while going thru withdrawal.  Without medical records, pt is unlikely to find a new provider, end up being in a hypertensive crisis which could cause stroke, heart attack, kidney/eye damage, premature deaths and/or suicide.

Now we have hundreds or 1000+ pts who can’t get accepted to a new practice, the DEA has at least clawed-back all the monies paid to Medicare or Medicaid for medical services that were claimed not medical necessity.  Pt that will not incur little/no charges to Medicare going forward, because no office practice will accept them.  And may end up dying from complications of under/untreated pain. How many hundreds or millions of dollar is Medicare/Medicaid not going to not expend on these pts going forward ?

 

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Bump in Non-Opioid Pain Prescriptions Following CDC’s 2016 Guidelines – pt outcomes of no concern ?

Posted on June 10, 2022 by Pharmaciststeve

Bump in Non-Opioid Pain Prescriptions Following CDC’s 2016 Guidelines

https://www.medpagetoday.com/painmanagement/painmanagement/99183

Non-opioid pain medication prescribing increased after the CDC published guidelines on opioids for chronic pain in 2016, according to a cohort study using insurance claims data.

Among over 15 million individuals, logistic regression models showed that the odds of non-opioid pain prescriptions were higher following the release of the “Guideline for Prescribing Opioids for Chronic Pain” compared with pre-guideline pattern-based estimates:

  • 3% higher in the first year (95% CI 2.6-3.3)
  • 8.7% higher in the second year (95% CI 8.3-9.2)
  • 9.7% higher in the third year (95% CI 9.2-10.3)

“This finding aligns with language in the 2016 CDC guideline advising caution when initiating opioids and avoiding their use as a default first-line therapy,” wrote Jason E. Goldstick, PhD, of the University of Michigan in Ann Arbor, and colleagues in JAMA Network Open.

The magnitude of the post-guideline differences from the pre-guideline pattern varied by several clinical characteristics, including chronic pain, recent opioid exposure, anxiety disorder, and mood disorder, the authors noted.

Of note, there were greater increases in odds of non-opioid prescribing over the post-guideline years among those with opioid exposure versus those without exposure:

  • Year 1: OR 1.06 (95% CI 1.05-1.06) vs OR 1.02 (95% CI 1.02-1.02), respectively
  • Year 2: OR 1.11 (95% CI 1.10-1.12) vs OR 1.08 (95% CI 1.08-1.09)
  • Year 3: OR 1.12 (95% CI 1.11-1.13) vs OR 1.09 (95% CI 1.09-1.10)

Similarly, those with chronic pain, anxiety disorder, and mood disorders showed larger relative increases in prescribing odds of non-opioids compared with those without these factors, Goldstick and team said. For instance, those with chronic pain had a 14.9% higher prescribing rate during the third year compared with the pre-guideline pattern estimates.

In addition, non-opioid medications were more likely to be prescribed for women versus men, and those with Medicare Advantage compared with those with commercial insurance plans.

Across the study period from 2011 to 2018, opioid prescription rates notably decreased throughout the full cohort, from 23.1% in 2012 to 17.6% in 2018. Non-opioid prescriptions were steady through 2015 (20.1%), but increased in each following year, rising to 22.2% by 2018.

“Identifying the best way to tailor treatment options and delivery to the individual is a new area of investigation. Innovations in clinical research, including pragmatic and adaptive clinical trials; stepwise treatments; responder analyses; and machine learning approaches to predictive modeling of the interaction of biopsychosocial factors in response to various treatments are poised to revolutionize the field,” noted Stephanie A. Eucker, MD, PhD, of Duke University School of Medicine in Durham, North Carolina, and colleagues, writing in an invited commentary. “Until we collectively prioritize pain management to include comprehensive multimodal, person-centered treatments, the problem of chronic pain will continue to grow.”

For their study, Goldstick and colleagues constructed seven annual cohorts using claims data from the Optum Clinformatics Data Mart Database for January 2011 through December 2018. The cohorts included adults with commercial insurance or Medicare Advantage plans, no cancer or palliative care claims, and 2 years of continuous insurance enrollment. Patients were allowed to be included in more than one cohort, and each cohort covered a 2-year period.

The first year in each cohort was considered the baseline period, used to measure opioid exposures and other clinical characteristics, while the second year was the follow-up period in which prescribing outcomes were measured. Out of the seven cohorts, four were studied before the 2016 guideline was published, and three were studied after.

Goldstick and team acknowledged some limitations to their study. The requirement of continuous enrollment in an insurance plan meant that participants likely fell within a particular socioeconomic range. The study was also unable to account for pain management for those without insurance, those on Medicaid, those using over-the-counter medications, and those with a secondary insurance plan.

In addition, any comorbidities prior to a participant’s insurance coverage, as well as specialty clinic care, were not included. Some non-opioid pain medicines, such as skeletal muscle relaxants and lidocaine, were also left out of the study, they noted

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can’t always judge a book by its cover ?

Posted on June 10, 2022 by Pharmaciststeve

Chronic pain groups, wow!!! Just wow!!
Many claim to be advocates and the upper management boasts about all their accomplishments when actually they do little to nothing to actually make a difference. I joined DPPR – Don’t Punish Pain Rally National &  state level after a parent passed away suddenly when their medication was discontinued after their doctors office was raided. In the beginning, I found the members very supportive; however very quickly after watching multiple live meetings that Claudia Merandi did, I became very concerned. These live meeting were filled with vulgar language and disparities about other advocates. She also insisted on supporting many doctors that the evidence against them clearly indicated they were not appropriately prescribing.
The group had a lot of back biting amongst members, hatefulness and it became clear to me that this was not a cohesive group. The group actually has a few that were actually trying to make a difference, but some members treated them badly, they had private chat groups that they shared info gossiping about others within the group.
I support American Pain & American Pain & Disability Foundation they have many programs including support group, blessing page, advocacy education, etc. They are boots on the ground actually helping pain patients, vets, children to obtain necessary pain treatment.
No group will ever get along 100% of the time, they will have struggles and sometimes feelings might get hurt; however my experience with APDF is that they go above and beyond to do the very best they can as a group, it’s not about individual or group recognition. They are not looking for a pat on the back or fame & fortune; they truly care about the pain patients they are trying to help.
With all that said, I am disgusted and outraged by the recent remarks and outright lies that Claudia Merandi has been spewing about APDF and Bob Sheerin. If you want to be apart of a pain group and that truly cares, dump DPPR and join APDF.

Here is a recent post that I made on my blog  https://www.pharmaciststeve.com/i-heard-it-through-the-grapevine/ that came to me from what I consider to be a fairly reliable source and the people/entities that are referenced, they know who they are and most people should be able to recognize who is being referenced.

Collecting and monetizing personal information based on specific pt health issues, would be a violation of  HIPAA, but none of the individuals collecting and monetizing pt health information, are  healthcare professionals/practitioners… the HIPAA law does not apply and is not violated.

Sharing is NOT ALWAYS CARING !!

FULL DISCLOSURE: I am “officially” the unpaid/volunteer Pharmacist consultant for the APDF, and I routinely have chronic pain pts reach out to me for a consult.  I have never charged a pt for my advice and have always declined to accept payments from chronic pain pts that has sought out my advice. Anyone who claims that I do – or have – charged pts for my advice – IS A LIAR.

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Walgreens Sues Hospital Over New In-House Pharmacy

Posted on June 9, 2022 by Pharmaciststeve

Walgreens Sues Hospital Over New In-House Pharmacy

https://www.medpagetoday.com/special-reports/exclusives/99119

Retail pharmacy giant says it will suffer “substantial, immediate, and irreparable harm

Walgreens has filed a lawsuit against Hagerstown, Maryland-based Meritus Health after the community hospital and health system opened an independent pharmacy in the lobby of its flagship medical center.

The retail pharmacy giant alleged that by opening an 1,800-square-foot pharmacy inside Meritus Medical Center (MMC), the health system is in violation of its lease agreement, which promised no other pharmacy would be established on the Robinwood medical campus, where MMC is both located.

But Meritus claimed the 2013 lease agreement is no longer valid, since the unit currently leased by Walgreens was sold to another company and is no longer part of the Meritus portfolio.

Maulik Joshi, DrPH, president and CEO of Meritus Health, told MedPage Today that the company opened its own pharmacy for better continuity of care, to ensure that patients who are discharged can get any medications before they leave the building.

“Our mission is to improve the health of our community,” Joshi said. “We’re doing this for our community.”

In its complaint, filed May 13, Walgreens argued that selling the unit “was a bad faith attempt by Meritus to avoid having to comply with the exclusivity obligation imposed by the [lease contract].” It alleged that Meritus sold the unit to Water Street Investments LLC, whose “managing member … is a physician affiliated with Meritus.”

Joshi said the physician “to which we believe the complaint refers … is a community physician (not employed) with Meritus medical staff membership. Almost all the community physicians have medical staff membership and/or privileges at the hospital.”

In a press release shared with MedPage Today, Joshi called the lawsuit a “tough pill to swallow.” The release noted that “Walgreens is one of the largest for-profit corporations in the country, and, according to their Q2 2022 SEC filing, had Net Earnings of over $4.3 billion for the six months ending February 28, 2022.”

Joshi said Meritus is a 100-year-old independent, non-profit community organization, with the 327-bed MMC as its flagship facility on the Robinwood campus. The system is the sole provider for Washington County, Maryland, which has more than 150,000 residents.

Walgreens argued in its complaint that it will suffer “substantial, immediate, and irreparable harm” due to the new pharmacy. “The operation of the Meritus Pharmacy poses a significant and substantial threat to Walgreens’ business because it directly competes with and is substantially similar to the Walgreens Pharmacy,” the complaint stated.

A spokesperson for Walgreens declined to comment for this story, given the pending litigation.

Meritus has since filed a motion to dismiss the lawsuit, alleging that Walgreens’ claims fail essentially because Meritus has been released of any obligations as landlord when the unit was sold.

“Meritus had the absolute unfettered right to sell [the unit] to a new owner without the consent of Walgreens and did so, and, upon that sale and transfer of the ownership of [the unit] to a new owner, Meritus was relieved of all obligations thereafter arising expressed in the Lease or implied by law,” the filing stated.

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Dr. Bauer reports to prison Thursday

Posted on June 9, 2022 by Pharmaciststeve

Doctor is “convicted”  ON ALLEGATIONS of over prescribing & NOT FOLLOWING GOOD MEDICAL PRACTICES.  From what I have heard about a person being taken to FEDERAL COURT that 90%-95% will be FOUND GUILTY… Apparently in our federal court system, the DOJ/DEA can take a doc to federal court and can get them convicted over JUST ALLEGATIONS.  Using the words in this article the EVIDENCE was ALLEGATIONS that the doc did not follow “good medical practices”  – what the hell is the DOJ/DEA’s definition of “not good medical practices” ?

From what I have concluded, the DOJ/DEA’s opinion of  “good medical practices” is based on 2016 CDC opiate dosing guidelines, which has claimed was developed by a number of “so called medical experts” and it has been stated that the studies that they used… were mostly rated on a credibility scale of 3 to 4. Where “1” was EXCELLENT and 3 to 4 were poor/crappy.

They created a “one size fits all” formula for treating pain, based on the MME system https://www.acsh.org/news/2022/03/01/true-story-morphine-milligram-equivalents-mme-16154 which this article strongly suggests that system is not supported by VALID SCIENCE nor   any double blind clinical studies and totally ignored any variation of a pt’s particular disease issue and/or pt’s pharmacogenomics DNA testing- which would isolate those pts who are fast/ultra fast metabolizers and required higher singular doses and/or higher mgs/day in hopes of providing proper pain management for a individual chronic pain pt.

I have notice lately that the DOJ/DEA have went after “clawing back” Medicare/Medicaid monies, I guess a lot easier than using the civil asset forfeiture act… the former involves all CASH and the latter involves various assets, and the need to acquire the asset and liquidate of non-liquid assets – like various personal property/assets that many in multiple states and liquidation value may be less than the net proceeds of liquidating the asset.

I like Dr Bauer’s comment: he refused to abandon chronic pain patients and that he did what was necessary to help patients in severe pain and he remains concerned over the fate of thousands of chronic pain patients: people who suffer from substance abuse disorder and people who need mental health treatment. They are not getting the help them need and can’t defend themselves.

Pathetic that it has been state by the CDC that last year 70K-75K people died from illegal fentanyl – from China & Mexico – POISONING/RESPIRATORY ARREST and the DOJ/DEA continues with the hypothesis they started with in 1973 when the DEA was placed in charge to fighting the war on drugs/pts. Opiate Rxs causes addiction and OD’s.  One has to ask, how many of these pts of Dr Bauer, will end up committing suicide because they cannot find another practitioner to treat their chronic pain, how many will end up trying to treat their chronic pain using “street drugs” and may end up ODing or how many will just end up trying to exist/live in a TORTUROUS LEVEL OF PAIN and end up with a premature death… because of their untreated pain ?

So much for what our founding Fathers promised us… the unalienable rights which the Declaration says have been given to all humans by their Creator, and which governments are created to protect….  Life, Liberty and the pursuit of Happiness

Bauer reports to prison Thursday

https://sanduskyregister.com/news/390903/bauer-reports-to-prison-thursday/

SANDUSKY — Dr. William Bauer, a local doctor convicted in federal court of over  prescribing pain medications, will report to federal prison on Thursday, when he’ll begin serving a five-year prison term.

Bauer, 85, was convicted of multiple charges in a federal trial in Toledo over allegations that he over prescribed pain medications and committed fraud on federal health care programs by not following good medical practices.

A jury convicted Bauer of 76 counts of distribution of controlled substances and 25 counts of health care fraud.

Many law enforcement and regulatory authorities contend that over prescribing pain pills has contributed to the opioid epidemic. Critics of the policy argue that deaths have soared because of the “war on drugs” approach.

Bauer contends that he refused to abandon chronic pain patients and that he did what was necessary to help patients in severe pain. Many of his patients continue to defend him.

“I’ve been following the sentence I’ve been given, but I firmly believe I can defend my position,” Bauer said Tuesday.

Bauer said he remains concerned over the fate of thousands of chronic pain patients: people who suffer from substance abuse disorder and people who need mental health treatment. They are not getting the help them need and can’t defend themselves, he said.

On March 10, U.S. District Judge Jack Zouhary sentenced Bauer to five years in prison. Bauer also was told to pay $464,099 in restitution, which includes $253,300 paid to Medicare and $210,798 to Medicaid.

In addition, Bauer was ordered to pay $100,000 in community restitution. It was recommended he give that payment to the Mental Health and Recovery Services Board of Seneca, Ottawa, Sandusky and Wyandot Counties.

On Thursday, Bauer will report to the Federal Correctional Institution in Morgantown, West Virginia.

It’s a minimum-security federal prison that has sometimes been nicknamed “Club Fed” because of its amenities. It is commonly used to house white-collar, nonviolent inmates.

Bauer is appealing his conviction to the U.S. Sixth Circuit Court of Appeals in Cincinnati. The grounds for the appeal will become public in a few weeks when his appeals brief is filed. Bauer said only that he believes his attorney will be able to file a strong appeal.

Bauer practiced in Sandusky and lived in the Port Clinton area.

About two weeks ago, his daughter, Catherine “Cate” Whiddon, helped Bauer and his wife move to the Dallas-Fort Worth area in Texas. Bauer was able to attend his grandson’s wedding before preparing to report to prison.

The grounds for the appeal will become public in a few weeks when his appeals brief is filed. Bauer said only that he believes his attorney will be able to file a strong appeal.

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