Here is a definition  of extortion:https://legaldictionary.net/extortion/ 

This DOJ action seem very similar to the DOJ recent action against CVS

Biden’s DOJ taking its last swing for the fences

In Settling Fraud Case, N.Y. Medicare Advantage Insurer, CEO Will Pay Up to $100M

https://www.medpagetoday.com/practicemanagement/medicolegal/113546

It’s one of the first to accuse a data mining firm of helping a health plan overcharge

A western New York health insurance provider for seniors and the CEO of its medical analytics arm have agreed to pay a total of up to $100 million to settle Justice Department allegations of fraudulent billing for health conditions that were exaggerated or didn’t exist.

Independent Health Association of Buffalo, which operates two Medicare Advantage plans, will pay up to $98 million. Betsy Gaffney, CEO of medical records review company DxID, will pay $2 million, according to the settlement agreement. Neither admitted wrongdoing.

“Today’s result sends a clear message to the Medicare Advantage community that the United States will take appropriate action against those who knowingly submit inflated claims for reimbursement,” Michael Granston, a Department of Justice (DOJ) deputy assistant attorney general, said in announcing the settlement on December 20.

Frank Sava, a spokesperson for Independent Health, said in a statement: “The assertions by the DOJ are allegations only, and there has been no determination of liability. This settlement is not an admission of any wrongdoing; it instead allows us to avoid the further disruption, expense, and uncertainty of litigation in a matter that has lingered for over a decade.”

Under the settlement, Independent Health will make “guaranteed payments” of $34.5 million in installments from 2024 through 2028. Whether it pays the maximum amount in the settlement will depend on the health plan’s financial performance.

Michael Ronickher, an attorney for whistleblower Teresa Ross, called the settlement “historic,” saying it was the largest payment yet by a health plan based solely on a whistleblower’s fraud allegations. It also was one of the first to accuse a data mining firm of helping a health plan overcharge.

The settlement is the latest in a whirl of whistleblower actions alleging billing fraud by a Medicare Advantage insurer. Medicare Advantage plans are private health plans that cover more than 33 million members, making up over half of all people eligible for Medicare. They are expected to grow further under the incoming Trump administration.

But as Medicare Advantage has gained popularity, regulators at CMS have struggled to prevent health plans from exaggerating how sick patients are to boost their revenues.

Whistleblowers such as Ross, a former medical coding professional, have helped the government claw back hundreds of millions of dollars in overpayments tied to alleged coding abuses. Ross will receive at least $8.2 million, according to the Justice Department.

Ross said that CMS “created a bounty” for health plans that added medical diagnosis codes as they reviewed patients’ charts — and whether those codes were accurate or not “didn’t seem to bother some people.”

“Billions of dollars are being paid out by CMS for diagnoses that don’t exist,” Ross told KFF Health News in an interview.

Data Mining

DOJ’s civil complaint, filed in September 2021, was unusual in targeting a data analytics venture — and its top executive — for allegedly ginning up bogus payments.

DxID specialized in mining electronic medical records to capture new diagnoses for patients — pocketing up to 20% of the money it generated for the health plan, according to the suit, which said Independent Health used the firm from 2010 through 2017. DxID shut down in 2021.

Gaffney pitched its services to Medicare Advantage plans as “too attractive to pass up,” according to the Justice Department complaint.

“There is no upfront fee, we don’t get paid until you get paid and we work on a percentage of the actual proven recoveries,” Gaffney said, according to the complaint. Timothy Hoover, an attorney for Gaffney, said in a statement that the settlement “is not an admission of any liability by Ms. Gaffney. The settlement simply resolves a dispute and provides closure to the parties.”

‘A Ton of Money’

CMS uses a complex formula that pays health plans higher rates for sicker patients and less for people in good health. Health plans must retain medical records that document all diagnoses they highlight for reimbursement.

Independent Health violated those rules by billing Medicare for a range of medical conditions that either were exaggerated or not supported by patient medical files, such as billing for treating chronic depression that had been resolved, according to the complaint. In one case, an 87-year-old man was coded as having “major depressive disorder” even though his medical records indicated the problem was “transient,” according to the complaint.

DxID also cited chronic kidney disease or renal failure “in the absence of any documentation suggesting that a patient suffered from those conditions,” according to the complaint. Past conditions, such as heart attacks, that required no current treatment, also were coded, according to the DOJ.

The suit alleges that Gaffney said renal failure diagnoses were “worth a ton of money to IH [Independent Health] and the majority of people (over) 70 have it at some level.”

Ross filed the whistleblower case in 2012 against Group Health Cooperative in Seattle, one of the nation’s oldest managed-care groups.

Ross, a former medical coding manager there, alleged that DxID submitted more than $30 million in disease claims — many of which were not valid — on behalf of Group Health for 2010 and 2011. For instance, Ross alleged that the plan billed for “major depression” in a patient described by his doctor as having an “amazingly sunny disposition.”

Group Health, now known as the Kaiser Foundation Health Plan of Washington, denied wrongdoing. But it settled the civil case in November 2020 by agreeing to pay $6.3 million. The DOJ filed a second complaint in 2021, against Independent Health, which also used DxID’s services.

Ross said she lost her job after her suit became public in 2019 and was unable to secure another one in the medical coding field.

“It was rough at times, but we got through it,” she said. Ross, 60, said she is now “happily retired.”

False Claims

Whistleblowers sue under the False Claims Act, a federal law dating to the Civil War that allows private citizens to expose fraud against the government and share in any recovery.

At least two dozen such suits, some dating to 2009, have targeted Medicare Advantage plans for overstating the severity of medical conditions, a practice known in the industry as “upcoding.” Previous settlements from such suits have totaled more than $600 million.

The whistleblowers have played a key role in holding health insurers accountable.

While dozens of CMS audits have concluded that health plans overcharged the government, the agency has done little to recoup money for the U.S. Treasury.

In a surprise action in late January 2023, CMS announced that it would settle for a fraction of the estimated tens of millions of dollars in overpayments uncovered through its audits dating to 2011 and not impose major financial penalties on health plans until a round of audits for 2018 payments, which have yet to be done. Exactly how much plans will end up paying back is unclear.

“I think CMS should be doing more,” said Max Voldman, an attorney who represents Ross.

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An insurance CEO was gunned down. Malignant health care system in Kansas explains reaction.

https://coloradonewsline.com/2024/12/23/an-insurance-ceo-was-gunned-down-malignant-health-care-system-in-kansas-explains-reaction/

I remember the room so clearly. It was a small conference space in the Concord Monitor newspaper office in New Hampshire, scarcely big enough for two people. I had ducked into the room to make a phone call to a mail-order pharmacy, one of the “conveniences” required by my health insurance company.

My voice shook, and I could barely contain my emotion.

Do you understand that I need this drug to live? I told the person on the other side. Do you understand that without this medicine I will die?

If you want to understand why so many Americans of disparate political ideologies have cheered on Luigi Mangione, the man accused of killing UnitedHealthcare CEO Brian Thompson, you might look to that moment, one that I’m confident has been shared by countless people in recent decades. The exact medicine I was talking about doesn’t matter in the grand scheme of things — some folks depend on EpiPens, others on asthma inhalers, others on insulin, others on antiretroviral therapy, still others on chemotherapy drugs.

Until you find yourself on that call, begging our nation’s health care cartel to keep you alive, you don’t know what it’s like.

The shame grinds at you.

But at least there’s some sort of coverage underneath it all. You’re not one the approximately 172 Kansans who died this year because of the Legislature’s blinkered refusal to expand Medicaid. Imagine their friends and families, reeling from preventable carnage.

We have numbed ourselves, I think, to the shocking cruelty of it all, to the everyday horror of begging for medicine, for medical care, for someone to listen. Insurers and the dubious shell companies they spawn (take a look into pharmacy benefit managers sometime) enjoy record profits. Meanwhile, everyday folks grit their teeth and persist.

Those a rung or two lower on the social ladder? Forget about it.

Mangione has been apprehended and will face justice. Murder and violence, no matter the motivation, are wrong. Killing Thompson not only wounded his loved ones and friends, but it arguably makes efforts to improve the system more difficult. No CEO wants to appear as though fear has changed their behavior.

Yet when so many feel powerless as a system runs roughshod over them, we should not be surprised that some number (perhaps larger than we imagine) will condone horrifying violence.

Consider that the Kansas Legislature passed Medicaid expansion — yes, passed it — a mere seven years ago. Then-Gov. Sam Brownback vetoed the bill, and lawmakers couldn’t override him. Each year, advocates trek to the Statehouse in Topeka and make their case. Each year, think tanks issue papers showing how many more parents and children would be covered. Each year, the news media points out the clear good that such a move could make.

One year, demonstrators even unfurled banners covered with red handprints, declaring the legislators had blood on their hands. Others have tried mildly disruptive tactics, anything to seize the attention and make the case.

We know the cost — you can calculate it with publicly available numbers. Once 2024 ends in a couple of weeks, some 1,720 Kansans will have died over 10 years.

Yet nothing happens.

Writ large, the same story has played out across the nation. Despite the Affordable Care Act’s success in covering more Americans, the law did not prevent for-profit insurance companies from playing the angles to maximize their take. It has not meaningfully lowered prices. Mangione’s manifesto points out — entirely accurately — that we spend more money on health care in the United States than any other nation yet see poor health outcomes.

Mangione faces first-degree murder charges in New York. If found guilty, he will face punishment from society. We punish those who commit acts of violence against others — as long as they do it one-on-one. The German philosopher Friedrich Engels described a different kind of murder in 1845. He called it “social murder,” described it as occurring when society’s elites created conditions for the poor that inevitable prove fatal.

“When society places hundreds of proletarians in such a position that they inevitably meet a too early and an unnatural death, one which is quite as much a death by violence as that by the sword or bullet; when it deprives thousands of the necessaries of life, places them under conditions in which they cannot live – forces them, through the strong arm of the law, to remain in such conditions until that death ensues which is the inevitable consequence – knows that these thousands of victims must perish, and yet permits these conditions to remain, its deed is murder just as surely as the deed of the single individual,” he wrote.

Engels also helped create communism with Karl Marx, so skepticism might be warranted. Yet he precisely defines the socially excused violence that threatens our state and nation.

The political process, if working correctly, should reform the mechanisms that create such suffering. Successive generations of reformers, from Teddy Roosevelt to Franklin Roosevelt to Lyndon Johnson, created a web of safety nets. Untold numbers of lives were saved.

Yet that process has solved fewer and fewer problems of late. Americans feel in their bones that something is amiss, that something has gone wrong and needs fixing. Conservatives blame liberals, while liberals blame conservatives. Neither want to blame actual culprits, the wealthy, because they underwrite each party’s existence.

Extremism flourishes when officials close off everyday avenues of social and government change.

I fear it, from any party or ideology. Once lit, certain fires can be difficult to extinguish. We have witnessed the results of popular uprisings over the past 150 years, and they do not fill one with confidence. Revolution often ends poorly. Dictators and strongmen rise, while the ultra-wealthy flee to stable fortresses elsewhere.

We know what we need to do. Create a responsive government at the state and national levels. Lower health care costs without sacrificing coverage or quality. Reorient society from a win-at-all-costs mindset to the neighborliness of an earlier age. Show others the caring we would hope they show us.

Yet how can we plausibly achieve these goals? Ideological chasms yawn. Many have abandoned hope, drawn into black holes of nihilism. Those of us who dare to imagine better outcomes wonder if we lead others astray by doing so.

We are all locked in that room together now, still on that phone call, begging for our lives.

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From this interaction between this pt and this pharmacist – which is really the MOST UNCOMFORTABLE? I am going to share – again- the graphic that explains the potential comorbidity complication – or cause additional comorbidity issues – from under/untreated pain. One of the very basic functions of the practice is the starting, changing or stopping a pt’s therapy. Does this pharmacist’s action – and many other Pharmacists that “we” never hear about – are potentially practicing medicine without a license?

Here is something – are these Pharmacists violating the oath that we all took – JUST LOOK AT THE FIRST LINE (PROMISE) of the Pharmacist’s Oath!

Should pts and prescribers start filing complaints with respective state Boards of Pharmacy with this Pharmacist Oath enclosed/attached?  If the pharmacy boards gets enough complaints – will some of them become UNCOMFORTABLE?

In case someone takes issue with the fact that the Pharmacist Oath was recently revised. I found a version where the revisions are in COLOR

Oath of a Pharmacist: Final revised draft

I will consider the welfare of humanity and relief of suffering my primary concerns.

I will apply my knowledge and experience to advance health equity to assure optimal outcomes for all patients.

I will respect and protect all personal and health information entrusted to me.

I will accept the responsibility to improve my professional knowledge, expertise, and self-awareness.

I will champion diversity and inclusion, respect the perspectives of others, and mitigate my personal biases.

I will hold myself and my colleagues to the highest principles of our profession’s moral, ethical and legal conduct.

I will embrace and advocate changes that improve patient care.

I will utilize my knowledge, skills, experiences, and values to prepare the next generation of pharmacists.

I take these vows voluntarily with the full realization of the responsibility with which I am entrusted by the public.

Edits to existing statement

New statement

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As Drugstores Close, Older People Are Left in ‘Pharmacy Deserts’

https://www.nytimes.com/2024/12/21/health/drugstore-closures-seniors.html

Shuttered drugstores pose a particular threat to older adults, who take more medications than younger people and often rely on pharmacies for advice.

Filed under: General Problems | 3 Comments »

In this day and age, most healthcare professionals are just employees of a large corporation. They have little/no say over staffing levels. Patients that are in charge of caring for can get possible good or bad care .. depending on the staffing levels. Generally, these attorneys/bureaucrats go after “deep pockets”.  The got after the pharmas, the drug wholesalers, the physicians – they all have deep pockets.

I had never really thought about it until now, but when it comes to hospitals and nursing homes. The attorneys/bureaucrats seem to go after the employees of those entities. Could it be that “they” believe that going after the employees of those corporations will be perceived as a “warning” to the corporation to straighten up in staffing levels and/or the quality/training of the staff so that pts are more properly cared for?

I am not an attorney, but I counted 38 different counts stated in the video and I presume that each one of the 18 staff of the nursing home had 38 charges against each of them. for a GRAND TOTAL OF 684 charges collectively.

It was stated within those 18 staff members, there was the administrator and a nurse, so that state of Virginia is going to after least financially bankrupt the administrator and the nurse and the balance of those charged will need the state to provide them with legal counsel (Public Defender). Will this cause the Nursing Home Industry in Virginia to get their act together?

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This video was done on Dec 3, 2024 and as typical of me, I was little late to the party, since I just watched it today. You would not believe all the links to some video that can be a ONE HOUR+ that are shared with me.  Unfortunately, I have to pick and chose which ones that I have to carve out the time to watch.

One of the most poignant info was from Attorney Kate Nicholson, who stated that just trying to make change only at the state or federal level, success will be fairly limited. Her statement is toward the end of the video.

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I talked to a practitioner a few days ago, this practitioner had a high intensity, intractable chronic pain pt who had been filling a opiate Rx at a local grocery store pharmacy for some time.  All of a sudden, the pt was informed by a Pharmacist at the pharmacy that he “was not comfortable” to continuing filling the pt’s C-2 and this was just a few days before the pt was get a new C-2 filled. In fact, the practitioner had already electronically sent the C-2 Rx to the pharmacy.

The pt had been taking 135 MME/day for some time. I have often stated that one of the basics of the practice of medicine, the starting, changing, stopping a pt’s therapy. In reality, “I’m not comfortable” is not a valid clinical reason for stopping a pt’s therapy and it would suggest that this Pharmacist is totally indifferent to intentionally throwing this pt into a cold turkey withdrawal and within days of Christmas.

I don’t know if this pt was intending to travel to be with family or the pt was planning on having family at their house for Christmas?

IMO, this Pharmacist should be taken before the state pharmacy board for unprofessional conduct and lack of empathy for the cold turkey withdrawal and torturous level of pain the Pharmacist’s action was intentionally causing for this patient.

I wonder what a State Board Pharmacy actions would  take – if any- against a Pharmacist, if a pt would file a formal complaint?

I went out to www.perplexity.ai and asked the following question:

what could be the consequences to a pharmacist that intentionally cut a legit chronic pain patient off their pain meds and intentionally throws the patient into cold turkey withdrawal. Could the pharmacist be charged with practicing medicine without a license

If a pharmacist intentionally cuts a legitimate chronic pain patient off their pain medications, leading to cold turkey withdrawal, the consequences can be severe and multifaceted. Here are some potential outcomes:

## Professional and Legal Consequences
– The pharmacist could face disciplinary action from their professional licensing board, including the suspension or revocation of their license. This is because such actions would violate the standards of professional practice and potentially harm the patient[1][6][8].

## Criminal Charges
– While the pharmacist would not be charged with practicing medicine without a license, as pharmacists are licensed to dispense medications, they could face other charges. For example, they might be charged with negligence, reckless endangerment, or other crimes related to the harm caused to the patient[5].

## Civil Liability
– The pharmacist and the pharmacy could be held liable in a civil lawsuit for any harm or suffering caused to the patient. This could include damages for physical and emotional distress, medical expenses, and other related costs[5].

## Health Consequences to the Patient
– Abruptly stopping opioid pain medications can lead to serious withdrawal symptoms, uncontrolled pain, psychological distress, and even thoughts of suicide. Patients may also seek other sources of opioids, including illicit substances, which can further exacerbate the situation[1][4][6].

## Ethical and Regulatory Violations
– Such actions would violate FDA guidelines and other regulatory standards that emphasize the importance of gradual tapering of opioid doses to avoid serious harm to patients. This could result in regulatory penalties and further disciplinary action[1][6].

In summary, while the pharmacist would not be charged with practicing medicine without a license, they could face severe professional, legal, and civil consequences for their actions. The primary issue would be the violation of professional standards and the potential harm caused to the patient.

Citations:
[1] https://www.fda.gov/drugs/drug-safety-and-availability/fda-identifies-harm-reported-sudden-discontinuation-opioid-pain-medicines-and-requires-label-changes
[2] https://www.davidrankinlaw.com/former-pharmacist-arrested-for-practicing-health-care-without-a-license/
[3] https://www.govinfo.gov/content/pkg/FR-2018-04-30/html/2018-09020.htm
[4] https://www.nbcnews.com/health/health-news/cdcs-new-opioid-guidelines-little-late-chronic-pain-patients-rcna74248
[5] https://www.criminaldefenselawyer.com/resources/practicing-medicine-without-a-license.htm
[6] https://www.npr.org/sections/health-shots/2019/10/10/768914092/dont-force-patients-off-opioids-abruptly-new-guidelines-say-warning-of-severe-ri
[7] https://www.mbc.ca.gov/Download/Publications/pain-guidelines.pdf
[8] https://en.wikipedia.org/wiki/Practicing_without_a_license

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Walgreens’ Woes: Retail Pharmacy Giant Reportedly Weighing Private Equity Sale to Sycamore Partners

https://www.doximity.com/collections/890523eb-6a52-412a-8533-fb6bbf3abd1b

After a tumultuous run which included making major investments into healthcare delivery assets (most notably VillageMD), Sycamore Partners is reportedly taking Walgreens private as scooped by the Wall Street Journal.

In November, Walgreens parted ways with VillageMD CEO Tim Barry.

It has been a tough few years for the beleaguered retail pharmacy player, and Walgreens has been brought to its knees in 2024. The knockout punch was coming. How did we get here?

Walgreens has been hit hard by uncontrollable secular shifts in consumer behavior. Amazon and others are eating Walgreens’ retail lunch.

The retail side of Walgreens’ business is stagnant and oversaturated with stores, as more consumers shift to online shopping. This challenge is two-pronged. The pharmacy business traditionally operated like a “gas station” model—drawing foot traffic that would lead to retail sales. But as patients increasingly choose online prescription refill services for convenience, fewer people are visiting physical pharmacy stores, resulting in decreased retail shopping at these locations.

So when retail sales sagged, Walgreens needed to make a move in a big way. The big plan involved embarking on an ambitious business transformation journey into healthcare delivery .

This journey jump-started in 2021 with VillageMD as Walgreens cobbled together the below healthcare footprint to sell a healthcare transformation story, including diving into value-based care headfirst.

Execution, however, didn’t go as planned. As Hospitalogists reading this breakdown know, healthcare is hard. Primary care is hard. Value-based care is hard. This dynamic isn’t unique to Walgreens and VillageMD, either.

Unfortunately this assemblage of assets no longer seems to be industry leading.

Plain and simple, Walgreens was desperate and overpaid for what it got in a low-interest rate environment. In its 2024 full year earnings release Walgreens incurred an $8.6B net loss on $12.7B in goodwill impairment charges (meaning they overpaid for these companies and the current earnings/economics could not support the acquired valuation, more or less). VillageMD performance weighed down the healthcare story given acute pressures in Medicare Advantage and changes to risk adjustment, along with significant capital and timeline required to build out an appropriate risk-bearing primary care player.

Unfortunately, unlike CVS, Walgreens lacks some of the most important assets to execute on the strategy (at least so far) to make the flywheel…fly – the PBM and the health insurance plan (side note that CVS isn’t doing particularly well either but for its own reasons).

Despite its own struggles, CVS holds a believable narrative to tell investors. From Q3:

But I digress. This is Walgreens’ share performance since acquiring a majority stake in VillageMD for $5.2B in late 2021, then proceeding to attach Summit Health for $9B in late 2022. At its peak, Walgreens held a $100B+ market cap in 2015.

Today it sits at $8B:

In Walgreens, Sycamore is acquiring a struggling giant, but with a vast revenue base and operating footprint – $147.7B in revenue. While not being an accountant, the impairment charges are largely addressed in 2024, so Sycamore probably thinks there’s significant value to unlock over time as a private company – and tax savings to boot. I’m inclined to agree. Walgreens holds some bright spots. Without being under the gun of quarterly investors Walgreens will have more freedom to reduce its debt load and continue billions of dollars in cost-cutting initiatives (1,200+ store closures in the coming years, capex reductions, working capital reductions). Expect to see Walgreens continue this trajectory but also focus on growing service lines like specialty pharmacy – probably its best acquisition to date.

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FDA Says Compounded Tirzepatide Must Exit the Market

Compounders only have 2 to 3 months left to copy injectable

https://www.medpagetoday.com/endocrinology/obesity/113478

The shortage of the diabetes and obesity injectable tirzepatide (Mounjaro, Zepbound) has been resolved, the FDA announced

As a result, compounders will have a grace period of 60 to 90 days to wrap up production and distribution of the combination GIP/GLP-1 receptor agonist during which the FDA won’t take legal action against them, “to avoid unnecessary disruption to patient treatment and to help facilitate an orderly transition,” the agency noted in a letter to maker Eli Lilly

Compounders are only allowed to make copies of a drug when it’s on the FDA shortage list, meaning the demand or projected demand of that drug exceeds the U.S. supply.

First added to the shortage list nearly 2 years ago, the agency initially determined that the tirzepatide shortage was resolved on Oct. 2, prompting it to be removed from the drug shortage list.

But just 5 days later, the FDA was sued by compounders, and as part of a court order, the agency had to reevaluate its decision to remove tirzepatide from the shortage list — a decision that has now been confirmed.

As part of its reevaluation, the agency concluded that the supply is “currently meeting or exceeding demand for these drug products, and that Lilly has developed reserves that it now holds in its finished product inventory, plus significant units of semi-finished product, and has scheduled substantial additional production over the coming months, such that supply will meet or exceed projected demand.”

But even after a shortage is considered resolved, patients and prescribers could still face intermittent localized supply disruptions as products move through the supply chain from the manufacturer and distributors to local pharmacies, the agency noted in their letter.

Furthermore, the 60- to 90-day grace period doesn’t preclude the FDA from taking action for other violations, including in cases of substandard quality or safety concerns.

Approved in 2022 for type 2 diabetes and in 2023 for chronic weight management along with diet and exercise, tirzepatide is the only once-weekly dual GIP/GLP-1 receptor agonist on the market and is arguably the most effective weight-loss injectable

As of today, three other GLP-1 receptor agonists remain on the FDA’s shortage list: semaglutide (Ozempic, Wegovy), dulaglutide (Trulicity), and liraglutide (Victoza, Saxenda). All have been reported as “available” by their respective manufacturers, but the FDA hasn’t formally declared their shortages to be resolved yet.

The agency said it will continue to monitor supply and demand for these products, including tirzepatide.

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As you read the accusations of the DOJ on CVS, notice the words they use accused of … alleges …  dangerous and excessive quantities of opioids… trinity cocktails… especially dangerous and abused combination of drugs made up of an opioid, a benzodiazepine and a muscle relaxant…. “known ‘pill mills.”…  bearing the hallmarks of abuse and diversion… invalid prescriptions with red flags… what it called CVS’ unlawful practices and to prevent future violations…

THIS IS SUCH BS !!!  Their allegations are nothing but the DOJ doing some statistical number crunching and them “counting” the number of  “statistical out-liars”  as determined by the DOJ or DEA.

There is no mention of a time frame, numbers of prescriptions or any other specific numbers

This year the SCOTUS overturned the Chevron Doctrine which means that federal agencies do not have the statutory authority to create new interpretations of the laws they are in charge of enforcing. In regards to the DEA, think about all the RED FLAGS that they have created during the last 5 decades.

How many prescriptions for opioids/opiates were filled over the last decade

Citations:
[1] https://www.cdc.gov/mmwr/volumes/66/wr/mm6626a4.htm
[2] https://www.cvshealth.com/news/pharmacy/cvs-health-fighting-national-opioid-abuse-epidemic-with-enterpri.html
[3] https://jamanetwork.com/journals/jamapediatrics/fullarticle/2781107
[4] https://www.cnn.com/2024/12/18/business/doj-cvs-opioid/index.html
[5] https://www.nature.com/articles/s41598-024-52032-4
[6] https://www.cdc.gov/overdose-prevention/data-research/facts-stats/opioid-dispensing-rate-maps.html

CVS knowingly dispensed ‘massive’ amount of invalid opioid prescriptions: DOJ lawsuit

https://www.newsbreak.com/news/3722553226577-cvs-knowingly-dispensed-massive-amount-of-invalid-opioid-prescriptions-doj-lawsuit

The largest pharmacy chain in America is accused of “unlawfully dispensing massive quantities of opioids and other controlled substances to fuel its own profits at the expense of public health and safety,” according to a civil lawsuit filed by the Justice Department, which was unsealed Wednesday.

The DOJ lawsuit alleges that CVS has, for more than a decade, knowingly filled sometimes-dubious prescriptions for controlled substances that lacked a legitimate medical purpose, or were not valid.

Those prescriptions included “dangerous and excessive quantities of opioids” and “trinity cocktails” — a blend of “especially dangerous and abused combination of drugs made up of an opioid, a benzodiazepine and a muscle relaxant,” the suit stated.

The suit also accuses the company of filling “at least thousands of controlled substance prescriptions” penned by “known ‘pill mills.'”

In a statement to ABC News, CVS spokesperson Amy Thibault called the suit “misguided” and said company officials “strongly disagree with the allegations and false narrative” described in the DOJ suit and will “defend ourselves vigorously.”

DOJ’s lawsuit says CVS “contributed to the opioid crisis, a national public health emergency with devastating effects in the United States.” The suit went on to say: “These included illegitimate prescriptions for extremely high doses and excessive quantities of potent opioids that fed dependence and addiction, as well as illegitimate prescriptions for dangerous combinations of opioids and other drugs.“

The suit accuses CVS of ignoring sometimes “egregious red flags” about prescriptions “bearing the hallmarks of abuse and diversion.” The lawsuit points to performance metrics and incentive compensation policies that allegedly pressured pharmacists to “fill prescriptions as quickly as possible, without assessing their legitimacy” and corporate policies that allegedly prioritized speed over safety.

The suit claims CVS refused to implement compliance measures recommended by its own experts to reduce the number of invalid prescriptions with red flags “primarily due to fear that they would slow the speed of prescription filling and increase labor costs,” according to the suit.

The government is seeking civil penalties, injunctive relief and damages to address what it called CVS’ unlawful practices and to prevent future violations.

In her statement, Thibault, the CVS spokesperson, said the company has been an industry leader in fighting opioid misuse.

“Each of the prescriptions in question was for an FDA-approved opioid medication prescribed by a practitioner who the government itself licensed, authorized, and empowered to write controlled-substance prescriptions,” Thibault’s statement said.

She said the DOJ lawsuit “intensifies a serious dilemma for pharmacists, who are simultaneously second-guessed for dispensing too many opioids, and too few.”

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