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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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Medicare Hospital Trust Fund to Stay Solvent Until 2036, Trustees’ Report Says
Posted on May 7, 2024 by Pharmaciststeve
Medicare Hospital Trust Fund to Stay Solvent Until 2036, Trustees’ Report Says
https://www.medpagetoday.com/publichealthpolicy/medicare/109997
Projection is 5 years longer than last year’s prediction
The Medicare Hospital Insurance Trust Fund is expected to remain solvent until 2036, 5 years longer than projected last year, the Medicare trustees said Monday in their annual report to Congressopens in a new tab or window, but they also expressed concern about low payment rates to physicians.
The longer hospital trust fund solvency is “largely due to greater income and lower expenditures than was projected last year,” a senior administration official said on a call with reporters. “Income was projected to be higher because the number of covered workers and average wages per worker were both projected to be higher than last year’s estimate.”
On the other hand, “expenditures were projected to be lower in the short-range period mainly as a result of a policy change to reduce Medicare Advantage spending,” the official said.
The long range actuarial deficit of the hospital trust fund is 0.35% of taxable payroll, “lower than last year’s estimate of 0.62%,” he said. “Two ways to reduce the deficit are to decrease outlays by 8% or increase the standard payroll tax rate” from 2.9% to 3.25%.
The trustees’ report covers two separate funds. The Medicare Hospital Insurance Trust Fund — also known as the Part A Trust Fund — pays for inpatient hospital care as well as hospice care and skilled nursing facility and home health services following hospital stays. The Supplemental Medical Insurance (SMI) Trust Fund pays for benefits under Medicare Part B — which includes physician services — and Medicare Part D, which is the prescription drug benefit.
The SMI Trust Fund is adequately financed into the indefinite future because it is financed by beneficiary premiums and federal funds that are automatically adjusted each year to cover costs for the upcoming year. In contrast, the Part A Trust Fund is financed by a variety of sources, including payroll taxes, a portion of the taxes on Social Security benefits, Part D state payments, Part B drug fees, and beneficiary premiums.
The Medicare board of trustees has six members: the secretaries of Labor, HHS, and Treasury; the Commissioner of Social Security; and two public trustees, although the public trustee positions have been vacant since 2015. The CMS administrator serves as the board’s secretary.
The Medicare trustees also found that Part B expenditures were $502.9 billion in 2023 and are expected to grow annually at an average of 7.7% for the next 5 years under current law. In 2024, the monthly Part B premium rate is $174.70 and is projected to increase to $185 in 2025, although that amount won’t be finalized until later this fall.
As for the Part D drug program, expenditures there stood at $131.1 billion in 2023 and are projected to grow at an average annual rate of 8.2% over the next 5 years, according to the report.
In comparison to the rosy overall forecast for the Hospital Insurance Trust Fund, the official warned that “uncertainty remains about adherence to current law payment updates, particularly in the long range,” adding that the concern “is more immediate for physician services, for which a negative payment rate update is projected in 2025, and updates are projected to be below the rate of inflation in all future years.”
In particular, the official told MedPage Today on the call, with a negative payment update anticipated for 2025 and 0.25% or 0.75% updates specified after that, which are “considerably lower than projected rates of inflation…, there’s a recognition that those updates are not going to meet up with expectations for provider costs, and that’s the concern that is raised.”
The trustees’ report includes an alternative scenario in which physician payment rates are raised in conjunction with the rate of increase in the Medicare Economic Index (MEI), a measure of healthcare inflation. Under that alternative — which likely would ease concerns about beneficiary access to physicians — “total Medicare expenditures would increase to 8.4% of GDP [gross domestic product] at the end of the long-range [75-year] projection period, as opposed to 6.2%” if current law doesn’t change, the official said. He noted that without changes to current law, “should payment rates prove to be inadequate for any service, beneficiary access to and quality of Medicare benefits would deteriorate over time.”
Raising physician payment rates in line with the MEI was also discussed by the Medicare Payment Advisory Commission (MedPAC) in its March report to Congressopens in a new tab or window. “Given recent high inflation, cost increases could be difficult for clinicians to continue to absorb,” the reportopens in a new tab or window said. “Yet current payments to clinicians appear to be adequate, based on many of our indicators. Given these mixed findings, for calendar year 2025, the commission recommends that the Congress update the 2024 Medicare base payment rate for physician and other health professional services by the amount specified in current law plus 50% of the projected increase in the MEI.”
“Based on CMS’s MEI projections at the time of this publication, the recommended update for 2025 would be equivalent to 1.3% above current law,” the report continued. “Our recommendation would be a permanent update that would be built into subsequent years’ payment rates, in contrast to the temporary updates specified in current law for 2021 through 2024, which have each increased payment rates for one year only and then expired.”
American Medical Association president Jesse Ehrenfeld, MD, MPH, said in a statementopens in a new tab or window Monday that “This report continues the drumbeat of recommendations that all point out that the payment system is failing patients and physicians. When physicians face a set of facts, we respond to improve the situation. It would be political malpractice for Congress to sit on its hands and not respond to this report.”
“Medicare trustees and MedPAC have teed up the issue for members of Congress who, no doubt, have heard from constituents about problems accessing healthcare under Medicare,” he added. “The AMA has plenty of reform ideas to permanently solve the problem and end this annual cycle of payment cuts and patches.”
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CDC Admits Its Opioid Prescribing Guidelines Have Hurt Chronic Pain Patients
Posted on May 7, 2024 by Pharmaciststeve
The CDC guidelines were not created by the CDC but by a dozen or so of “so-called experts” If these people on that committee were “experts” should they not have known that what they created -2016 CDC guidelines -potential to do harm? Could they be financially liable for all the harm that was caused directly & indirectly? I don’t know if the CDC paid those people on the committee – or they just volunteered to have the chance to put “their stamp/beliefs” on the chronic pain community. If they were paid… many were DOCTORS… The CSA states that no one can prescribe a controlled med without doing an in-person exam… While probably none on the committee directly treated pts, they used the perceived creditability of the CDC to convince the DEA, and VA to implement the guidelines as a standard of care and best practices and > 50% of our state legislators to codify these guidelines into law.
CDC Admits Its Opioid Prescribing Guidelines Have Hurt Chronic Pain Patients
https://themighty.com/topic/chronic-pain/cdc-opioid-guidelines-hurt-chronic-pain-patients/
On Wednesday, the Centers for Disease Control and Prevention (CDC) issued a clarification regarding the federal guidelines for opioid prescriptions that were put into place in 2016. The paper, published by CDC researchers in the New England Journal of Medicine, stated that many of the guidelines have been misapplied, causing serious harm to chronic pain patients.
The original prescribing guidelines were intended for primary care physicians treating adults with chronic pain (pain that lasts more than three months) outside of active cancer treatment, palliative care and end-of-life care.
“The guideline is intended to ensure that clinicians and patients consider safer and more effective treatment, improve patient outcomes such as reduced pain and improved function, and reduce the number of persons who develop opioid use disorder, overdose, or experience other adverse events related to these drugs,” the CDC wrote.
While many medical and health policy communities embraced the guidelines, CDC researchers said some clinicians and policy-makers have misinterpreted them, taking the recommendations too far.
The paper published this week reported that some physicians have encouraged “hard limits and abrupt tapering of drug dosages, resulting in sudden opioid discontinuation or dismissal of patients from a physician’s practice.” The guidelines have also been mistakenly applied to patients with pain associated with cancer, surgical procedures or sickle cell crises – patients who were not included in the original recommendations.
CDC researchers offered several examples of the ways in which their guidelines had been wrongly implemented. They wrote:
For example, the guideline states that ‘Clinicians should…avoid increasing dosage to ≥90 MME [morphine milligram equivalents]/day or carefully justify a decision to titrate dosage to ≥90 MME/day.’ This statement does not address or suggest discontinuation of opioids already prescribed at higher dosages, yet it has been used to justify abruptly stopping opioid prescriptions or coverage.
This misapplication can have major consequences for people with chronic pain. Researchers explained that forcing patients to abruptly taper their dosages can lead to opioid withdrawal, increased pain or other adverse psychological and physical outcomes. Too little is known about the benefits and harms of reducing high dosages of opioids in physically dependent patients for researchers to recommend this strategy to physicians.
Mighty contributor Chris Jolley was one of many people with chronic pain adversely affected by these misimplemented guidelines. In his essay “When a Doctor Forced Me to Taper Off Pain Medication,” he wrote:
I was with my pain doctor on the same medication for 20 years when the medications that control my chronic pain were stopped without my consent. …
I live in unbearable pain 24/7. I’m one of the many people in pain whose doctors have abandoned us and ignored our pleas for help. Many pharmacists profile us based on their perception of our appearance. Some will not even fill prescriptions from cancer patients.
I have disability benefits awarded by my government for intractable pain, yet I suffer discrimination and cannot get treatment for that pain. Until our government admits the epidemic is about street drugs like fentanyl and heroin and stops persecuting people in pain, there will be more and more deaths by overdose from street drugs and more pain patients suffering.
Since the CDC’s guidelines were published in 2016, the number of opioid prescriptions has decreased. In May 2018, SERMO, a social network for physicians, conducted a study of 3,000 physicians and found that seven out of 10 said they cut back on prescribing opioids or stopped prescribing them entirely in the last two years. When SERMO conducted the same study in 2016, six out of 10 doctors said they were cutting back.
Among doctors who had cut back, 22 percent said it was because there were “too many hassles and risks involved,” while 34 percent said chronic pain patients have been hurt by the reduction in opioid prescriptions.
Research has shown that limiting opioid prescriptions does not have an effect on the rates of death and addiction in the U.S. According to reports from the CDC, opioid deaths in the U.S. are rising, with a 9.6 percent increase from 2016 to 2017. But this increase is due to fentanyl, not prescription opioids.
Researchers said the CDC is examining the impact its 2016 guidelines have had on pain patients and will update them when new evidence is available. “Until then, we encourage implementation of recommendations consistent with the guideline’s intent,” they said.
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Doc Blows Whistle on Cigna
Posted on May 5, 2024 by Pharmaciststeve
Doc Blows Whistle on Cigna
https://www.medpagetoday.com/special-reports/features/109910
Cigna increased efforts to speed up claims denials using new software and performance measures that pressured medical directors to close cases without a full review, according to a ProPublica investigationopens in a new tab or window.
The insurance company reportedly pressured medical directors who fell behind in reviewing cases, and even threatened to fire them if they failed to work faster, according to Debby Day, MD, a medical director who worked at Cigna for more than 15 years.
Often, the company encouraged doctors to “cut and paste the denial language that the nurse had prepared and quickly move on to the next case,” according to Day. This practice became so common that Cigna employees took to calling the approach “click and close.”
The company reportedly measured the pace and total number of cases that each medical director closed, which involved a productivity dashboard that tracked performance. Day told ProPublica the only way to keep up with expectations was to “deny, deny, deny.”
But Day told ProPublica that she believed her work was too important to speed through. Medical directors at Cigna were given the responsibility to approve or reject payment requests for critical care such as complex surgeries. And while the insurance company was pressuring doctors to work faster, Day said the work of the nurses “was getting sloppy,” which made reviewing claims harder and more meticulous.
Cigna told ProPublica that medical directors are not permitted to “rubber stamp” nurse denials and the company expects case reviewers to “perform thorough, objective, independent, and accurate reviews in accordance with our coverage policies.”
Longevity Scientist Faces Blowback
A Harvard geneticist who became the face of the longevity movement has drawn increasingly harsh criticism for claiming his products can reverse aging, according to the Wall Street Journalopens in a new tab or window.
Last year, David Sinclair, PhD, faced backlash for posting on social media that a gene therapy invented in his lab and developed by his company, Life Biosciences, had successfully reversed aging in monkeys. He also claimed the therapy had restored vision in the monkeys.
Earlier this year, Sinclair reportedly said another company he co-founded had developed a supplement that had reversed aging in dogs, according to WSJ.
However, other longevity science experts called this an empty promise. There isn’t an accepted standard for measuring aging, let alone a definition of what it means to “reverse” it, they said. The criticism was paired with the resignations of scientists from the Academy for Health and Lifespan Research, a group that Sinclair co-founded and led. Of the roughly 60 members who resigned, one posted on social media that Sinclair was a “snake oil salesman.”
The Academy’s remaining board members called for Sinclair to step down as president, which he eventually agreed to do.
Sinclair made a name for himself by promoting scientific claims about his work that garnered interest from top-tier scientific journals as well as praise in the news and on social media. But he has increasingly drawn criticism for hyping his own research or promoting unproven products, especially when he stood to benefit financially.
“The data is not good, you’re calling it the wrong thing, and then you’re selling it,” Nir Barzilai, MD, the new president of the Academy and the director of the Institute for Aging Research at Albert Einstein College of Medicine in New York, told WSJ. “The selling is a step too far.”
Fertility Clinic Accidents
The growing fertility industry has been plagued by an opaque system that frequently hides major errors and accidents, according to a Washington Post investigationopens in a new tab or window.
Many fertility centers are not required to report errors or accidents, including lost or damaged embryos, to any government or professional oversight organization, the report found. The industry relies largely on self-policing, which means patients are rarely informed immediately after something has gone wrong.
The Post highlighted two accidents that resulted in the loss of thousands of eggs and embryos belonging to hundreds of individuals and couples. One accident in San Francisco involved the implosion of a cryopreservation tank that contained 4,000 eggs and embryos. Another incident in Cleveland resulted in the loss of 4,000 eggs and embryos after a similar storage tank failed.
Both incidents occurred over the same weekend in March 2018, the Post reported.
Industry representatives insisted that error rates are low, and experts told the Post that fertility practitioners are regulated similar to other medical disciplines. Patients are also able to use the courts to address mismanagement of genetic material, experts said.
In fact, the Alabama Supreme Court ruling that frozen embryos are children came during a dispute over the mishandling of human embryos. But experts claim that most lawsuits end in settlements with nondisclosure provisions reinforcing the secrecy around the fertility industry.
Still, Adam Wolf, a prominent attorney for fertility plaintiffs, told the Post that the “vast, vast supermajority of mistakes in fertility clinics, the public doesn’t even know about.”
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In Re: National Prescription Opiate Litigation transcript
Posted on May 3, 2024 by Pharmaciststeve
In Re: National Prescription Opiate Litigation
(Exhibit B – 3.28.24 hearing transcript)Related document(s)
It is only 160+ pages
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R.I.P. Robert Charles Foster: suicide by cop
Posted on May 3, 2024 by Pharmaciststeve
R.I.P.
Robert Charles Foster
Robert Charles Foster
Robert Charles Foster, a male from Oregon died by suicide. ‘(or as he phrased it, “suicide by cop”). Foster told the police during a previous suicide attempt, “I had been in chronic, constant pain, and was for whatever reason, not able to get the medication he needed for it.” He was 65 years old. He came out of a building with a gun, and would not drop it, on the command from the police. They shot and killed him – this was his intention.’
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Pain Management Physician Convicted of Unlawfully Distributing Opioids
Posted on May 3, 2024 by Pharmaciststeve
Notice in this DOJ press release, that they stated that individuals traveled hundreds of miles to obtain prescriptions for opioids and other controlled substances – one of those DEA RED FLAGS. Generally, RED FLAGS are policies that the DEA adopts from observing what many/addicts/diverters do. Let’s look at the simple math. Over a ~ 6-year period of time, Romano prescribed 137,000 doses of three controlled substances to 9 pts. 137,000/6 yrs = 22,833 doses given to 9 pts = 2,537 doses to each pt which equals ~ a total of 7 doses of those three meds daily – on average. That could break down to, 2 opioids a day, 4 muscle relaxants a day, and a benzodiazepine at bedtime for sleep. Not knowing the mgs of each med, this could be appropriate for many pts dealing with intractable chronic pain!
I noticed that there was no mention of any of his pts ODing/dying, and the pts were addicted to these medications. Do they know the difference between addiction and dependency when these categories of meds are appropriately prescribed long-term? It took 3 attorneys from the Criminal Division’s Fraud Section, “gin-up” 24 counts against Romano. Of course, each count could be worth 20 yrs in prison for Romano. Given Romano’s age (73 y/o), one count could end up being a LIFE SENTENCE, let alone the 480 yrs Romano is potentially looking at.
Pain Management Physician Convicted of Unlawfully Distributing Opioids
https://www.justice.gov/opa/pr/pain-management-physician-convicted-unlawfully-distributing-opioids-0
A federal jury in the Southern District of Ohio convicted an Ohio physician today for unlawfully distributing opioids from his clinic.
According to court documents and evidence presented at trial, Thomas Romano, 73, of Wheeling, West Virginia, owned and operated a self-named pain management clinic in Martin’s Ferry to which individuals traveled hundreds of miles to obtain prescriptions for opioids and other controlled substances. Romano charged $750 for an initial visit and $120 for subsequent monthly visits. The prescriptions Romano issued for opioids and other controlled substances greatly exceeded recommended dosages and were in dangerous, life-threatening combinations that fueled the addiction of the individuals to whom he prescribed. Between October 2014 and September 2019, Romano prescribed over 137,000 pills, including opioids, benzodiazepines, and muscle relaxants, to nine individuals.
The jury convicted Romano of 24 counts of unlawful distribution of a controlled substance, outside the usual course of professional practice, and not for a legitimate medical purpose to nine individuals. He faces a maximum penalty of 20 years in prison for each charge. A sentencing date has not yet been set. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
Acting Assistant Attorney General Nicole M. Argentieri of the Justice Department’s Criminal Division, U.S. Attorney Kenneth L. Parker for the Southern District of Ohio, Special Agent in Charge Orville O. Greene of the Drug Enforcement Administration (DEA) Detroit Division, Special Agent in Charge J. William Rivers of the FBI Cincinnati Field Office, and Special Agent in Charge Mario M. Pinto of the Department of Health and Human Service Office of the Inspector General (HHS-OIG) made the announcement.The DEA, FBI, and HHS-OIG, as well as the Ohio Bureau of Worker’s Compensation and Ohio Board of Pharmacy, investigated this case.
Assistant Chief Alexis Gregorian and Trial Attorneys Devon Helfmeyer and Danielle Sakowski of the Criminal Division’s Fraud Section are prosecuting the case.
The Fraud Section leads the Appalachian Regional Prescription Opioid (ARPO) Strike Force. Since its inception in late 2018, ARPO has partnered with federal and state law enforcement agencies and U.S. Attorneys’ Offices throughout Alabama, Kentucky, Ohio, Virginia, Tennessee, and West Virginia to prosecute medical professionals and others involved in the illegal prescription and distribution of opioids. Over the past four years, ARPO has charged over 115 defendants, collectively responsible for issuing prescriptions for over 115 million controlled substance pills. To date, more than 60 ARPO defendants have been convicted. More information can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit.
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Equal Protection Clause- another law on the books to protect chronic pain pts
Posted on May 2, 2024 by Pharmaciststeve
Equal Protection Clause
https://en.wikipedia.org/wiki/Equal_Protection_Clause
The Equal Protection Clause is part of the first section of the Fourteenth Amendment to the United States Constitution. The clause, which took effect in 1868, provides “nor shall any State … deny to any person within its jurisdiction the equal protection of the laws.” It mandates that individuals in similar situations be treated equally by the law.[1][2][3]
A primary motivation for this clause was to validate the equality provisions contained in the Civil Rights Act of 1866, which guaranteed that all citizens would have the guaranteed right to equal protection by law. As a whole, the Fourteenth Amendment marked a large shift in American constitutionalism, by applying substantially more constitutional restrictions against the states than had applied before the Civil War.
The meaning of the Equal Protection Clause has been the subject of much debate, and inspired the well-known phrase “Equal Justice Under Law“. This clause was the basis for Brown v. Board of Education (1954), the Supreme Court decision that helped to dismantle racial segregation. The clause has also been the basis for Obergefell v. Hodges which legalized same-sex marriages, along with many other decisions rejecting discrimination against, and bigotry towards, people belonging to various groups.
While the Equal Protection Clause itself applies only to state and local governments, the Supreme Court held in Bolling v. Sharpe (1954) that the Due Process Clause of the Fifth Amendment nonetheless requires equal protection under the laws of the federal government via reverse incorporation.
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Warren Blasts United Health CEO for Monopolistic Practices that Harm Patients
Posted on May 2, 2024 by Pharmaciststeve
CVS Health stock price drops nearly 20% in two days
Posted on May 2, 2024 by Pharmaciststeve
This could be the proverbial “canary in the coal mine”. Several major healthcare providers did not renew their contracts with a number of Medicare-C (Advantage) programs for 2025.
All insurance providers of Medicare-C and Medicare-D are FOR PROFIT. CVS stated in this article that it experienced increased Medicare utilization. If you have Medicare-C or Medicare-D insurance, you might want to carefully read the new policy you will be signing up for during open enrollment – October 15th to December 7 2024 for insurance coverage for 2025.
CVS Health drops as medical cost trends prompt guidance cut
CVS Health (NYSE:CVS) shares traded sharply lower in the premarket on Wednesday after the pharmacy chain operator reported lower-than-expected Q1 2024 financials and slashed its full-year outlook below consensus, citing medical cost trends.
While the Woonsocket, Rhode Island-based healthcare giant’s revenue for the quarter rose ~4% YoY to $88.4B, exceeding expectations, its Health Services segment, which includes its PBM unit Caremark, underperformed.
CVS’ Health Services segment added $40.3B to the topline, indicating a ~10% YoY drop due to multiple reasons, including the loss of a major client during the period.
However, the company’s Health Care Benefits segment, which houses its insurance arm Aetna, and CVS’ Pharmacy & Consumer Wellness segment outperformed, bringing in $33.2B and $28.7B in revenue with ~25% YoY and ~3% YoY growth, respectively.
Meanwhile, CVS’ bottom line fell during the quarter, with adjusted earnings per share reaching $1.31 with a ~41% YoY drop as the company’s adjusted operating income slumped ~32% YoY to $3.0B amid declines in the Health Care Benefits and Health Services segments.
In the Health Care Benefits unit, adjusted operating income decreased by ~60% YoY to $732M as the medical benefits ratio, which calculates the share of premiums spent on medical benefits, reached ~90% compared to ~85% a year ago.
CVS attributed the MBR spike to several factors, including increased Medicare utilization and the unfavorable impact of the company’s 2024 Medicare Advantage star ratings.
“We are confident we have a pathway to address our near-term Medicare Advantage challenges,” CEO Karen Lynch remarked ahead of the conference call at 8:00 a.m. EST. “We remain committed to our strategy and believe that we have the right assets in place to deliver value to our customers, members, patients, and shareholders.”
However, expecting the pressure on medical utilization to continue to impact its Health Care Benefits segment throughout the year, the company lowered its 2024 adj. EPS outlook to at least $7.00 from at least $8.30, compared to $8.27 in the consensus.
With CVS citing pressure on medical utilization, shares of other health insurers will be in focus. In January, Humana (HUM) led a selloff among health insurers such as UnitedHealth (UNH), Alignment Healthcare (ALHC), Elevance Health (ELV), and Centene (CNC) after the managed care provider set its 2024 outlook below consensus, expecting a spike in medical costs to continue this year.
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