Opinion: Aetna’s behavior is unacceptable

www.salinapost.com/2019/08/23/opinion-aetnas-behavior-is-unacceptable/

In the state of Kansas, the media has quietly reported about issues with Aetna Better Health of Kansas. Aetna BH is a Kansas Medicaid Contractor with a $1 billion a year contract. They serve approximately 100,000 Kansans.

Since 7/1/2019, all payments have ceased for many local providers. This includes behavioral health providers as well as medical. Long story short, Aetna can’t get their stuff together and providers are not being paid for services rendered. The Kansas Department of Health and Environment gave notice to Aetna at the end of July that they had 10 days to get their act together. Aetna did submit a plan, which KDHE shot down as not good enough. I have yet to hear a new plan or a deadline.

I am one of those providers in Salina. To put it in perspective, consider your monthly income being cut in 1/2, but you still put in the hours of work. Imagine being told day in and day out the issues are “escalated” and “we are trying to fix this.” I hear it every day, “we cannot tell you when you will get paid.” I, like most other providers, have done nothing wrong and essentially are working for free due to inefficient, incompetent, and unknowledgeable staff and leadership at Aetna that our tax dollars fund. Why is this important and how does it impact me? You are paying into the funds that in turn pay me. You continue to pay into that fund, but no money is paid out. So where is the money? We aren’t talking just a few dollars. My clinic has not been paid thousands, nearing the $10,000 mark.

There has been such an encouragement for mental health care over the last few years and this is fabulous. Along with the push for better access to mental health care comes the challenge of finding providers that accept Medicaid. If this situation continues, many Medicaid providers will likely be forced to close their doors or will stop accepting Medicaid period. My specialty is victims of severe trauma, foster children, and early childhood. They deserve the best care possible, and I am one of those experienced, educated, and skilled clinicians able to treat these patients. But not free. At the end of the day, I am running a business that has expenses. I’d also like to be able to take care of my family.

You can help by contacting our local representatives Randall Hardy and Diana Diercks. Tell them this is unacceptable and that you support the local Medicaid providers. You can call KDHE and the Governor’s office to also offer support. Perhaps with a united effort, providers will be rewarded for their tireless work.

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Consumers like their pharmacies, but CVS trails rivals in survey

https://www.healthcaredive.com/news/consumers-like-their-pharmacies-but-cvs-trails-rivals-in-survey/561314/

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DEA warns of national methamphetamine comeback

https://www.abc12.com/content/news/557138522.html

As the opioid epidemic swells in the United States, there’s another deadly drug that’s making a comeback.

“We’re talking super labs,” said former Drug Enforcement Administration Agent Kevin Hartmann. “Super labs that can produce multi hundred kilograms of methamphetamine.”

In 2005, Congress passed the Combat Methamphetamine Epidemic Act which regulated the sale of legal drugs, like Sudafed and cough suppressants, which were used to manufacture meth locally.

It worked for a while. Officials say, it almost eliminated the production of meth in the U.S.

“That’s the good news,” said Hartmann. “The bad news is that these producers of meth ramped up operations in Mexico and now they have these super labs that provide the majority of meth to the United States.”

The drug enforcement administration says meth seizures have increased 255 percent since 2012. Last year, agents in the Omaha Division took more than 1,600 pounds of the synthetic drug off the streets.

Now, Hartmann is calling on Congress to grant officers more authority to intercept cartel communications. Republican Sen. John Thune of South Dakota believes the solution is to strengthen border security.

“That’s a combination of technology and drones and manpower,” said Thune. “Because one of the best ways to shut that down is to make sure it never gets to South Dakota in the first place.”

According to the DEA, methamphetamine is 71 percent cheaper than it was in 2005.

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New Survey Data Confirm That Opioid Deaths Do Not Correlate With Pain Pill Abuse or Addiction Rates

www.reason.com/2019/08/21/new-survey-data-confirm-that-opioid-deaths-do-not-correlate-with-pain-pill-abuse-or-addiction-rates/#comment-7904072

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Class Action LawSuit

www.doctorsofcourage.org/class-action-lawsuit/

CLASS ACTION LAWSUIT
Needed: Victims’ stories

A law firm has shown interest in class action for chronic pain patients who have suffered damages as a result of being denied their medications by a chain pharmacy. That would be such places as CVS, Walgreens, Walmart, Rite Aid, Kaiser Permanente (HMO), or mail order chains.

What they need to establish a realistic case are legitimate, verifiable stories of how legitimate patients have been denied their medications without just cause. They also need to know how this action caused damages. There are the worst cases of suicide, unintentional death, heart attacks, loss of job, but there are also damages accepted by the court that would be less drastic, such as inability to go to work, loss of quality of life, stress over being able to provide for the family, PTSD, anxiety, depression, costs of other medications for related conditions, etc.

We want to start with a presentation of 100 cases. To show how widespread this is, I would like to pick 2 from each state. Eventually all cases received would be shared, so please contribute your case, even if your damages were mild. As their interest is piqued, they will be asking for more cases and we want to have an armamentarium to just reach in and pull out.

Do not worry about sending us what happened to you. For the investigation phase, we will redact all names from the report given to the law firm. We will not share your personal information, but we will need to be able to contact you once the case is accepted. We do need your name, location, email address, and phone number for contact.

An example of other people’s horror stories can be found at https://pbmabuses.org/. Feel free to also add your story there.

This is something that all pain patient advocacy groups should advocate for. Please ask them to put this notice on their home page of their website, and post it on every facebook page, twitter account, Instagram that you have access to. Make this go viral.

Send your story to:

lindacheek@doctorsofcourage.org

There will also be a place on DoctorsofCourage.org for you to send your story through a message box.

This has the potential to be bigger than the tobacco law suits, so get on board and let’s hit a homer.

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Prosecutors: former DEA agent Chad Scott is a liar; defense says witnesses are tainted

https://www.nola.com/news/courts/article_e0071a16-c28f-11e9-8e43-e30b1d68b458.html

For nearly two decades, Chad Scott helped push criminal cases through federal courtrooms as a decorated field agent for the Drug Enforcement Administration, eventually leading a multiagency task force based on the north shore, where he patrolled the heavily traveled drug corridor of Interstate 12.

But for the second time this year, Scott sat Monday at the defense table in a federal courtroom in New Orleans and listened to a special team of prosecutors describe him as an out-of-control liar who leveraged his job as a way to coerce drug dealers to give him what he wanted.

His defense attorneys countered that Scott was an outstanding agent who is being railroaded by resentful drug dealers and convicted cops looking to get a better deal from the feds.

The arguments kicked off Scott’s retrial on seven counts of perjury plus obstruction of justice and falsification of government records. Earlier this year, a jury deadlocked on the charges against Scott, and U.S. District Judge Jane Triche Milazzo was forced to declare a mistrial.

U.S. Department of Justice special prosecutor Charles Miracle’s opening presentation Monday sought to build a stronger foundation and narrative than the government did in the first trial.

During his half-hour opening statement, Miracle told the newly empaneled jury of seven men and five women that Scott’s case was about “honesty and integrity” and that Scott had repeatedly lied to get things he wanted.

“These are not minor lies,” Miracle said. “These lies had consequences.”

Miracle told the jury that Scott had betrayed the trust of his employers and the entire criminal justice system.

He acknowledged, in an effort to head off what will be a focus of the defense’s presentation, that the witnesses against Scott are not innocent men: Three of them are admitted drug traffickers who moved scores of kilograms of cocaine and heroin; two others are former drug task force officers who have since pleaded guilty to federal crimes.

“A number of witnesses in this case have criminal backgrounds,” Miracle said, but the evidence they will present “fits together with common sense and logic.”

Specifically, Miracle said, the prosecutors will show that Scott ordered Frederick Brown to buy him a truck like the one Brown himself drove. Brown did so, and Scott picked it up in Houston while there for a water skiing tournament. Days later, Scott turned in the truck at his Metairie DEA office with forms that said Brown had surrendered it in Metairie as part of his role as an informant for Scott. He also told Karl Newman, a task force officer who is slated to testify against Scott, to say they had gotten the truck in Metairie, Miracle said.

The truck was later allocated to Scott to use as his undercover vehicle.

In the perjury counts, Scott is accused of lying on the stand about the relationship between Brown and a trafficker named Jorge Perralta. Scott also faces an obstruction of justice charge for allegedly trying to convince Brown and a man named Edwin Martinez to say that Brown knew Perralta. Brown will testify that he never met Perralta, Miracle said.

Scott’s attorney, Matthew Coman, signaled the defense’s intention to attack the government’s case even more aggressively than it did the first time, spending the first few minutes of his own opening statement scoffing at the government’s witnesses.

Perralta, one of the drug traffickers who is expected to testify, “will admit he supplied kilo after kilo of heroin to this conspiracy that made its way to Hammond, Louisiana,” Coman said. “From Houston to our hometown.”

Despite those admissions, Coman noted, Perralta will walk in and out of the court a free man because he has been granted immunity in return for his testimony against Scott. Similarly, Martinez faced life in prison, Coman said. But because of a deal with prosecutors, he could be released next year.

Newman refused to tell the government what it wanted to hear until prosecutors added new charges to his indictment, Coman said. Then, faced with the possibility of 30 years in prison, Newman caved and agreed to testify as prosecutors wanted, Coman argued.

“This is the government’s case: people that sold drugs and have something to gain,” he argued.

“On the other side of the ledger, Chad Scott is a 20-year veteran of the DEA who put his life on the line on a regular basis” and is innocent, Coman said.

The trial is expected to last about two weeks.

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Isn’t it about time the pts started to embarrass them ?  The post linked below… is what I am talking about… this pt’s embarrassment was posted in a local OHIO newspaper

Stark has filed a complaint with the Ohio Board of Pharmacy against Walgreens’ Pharmacist, refusing to fill meds she had taken for EIGHT YEARS

Want to share your embarrassing story with all those on the web ?…  I will publish them – minus  your personal information..

Tired of a pharmacy telling your that “they are not comfortable” filling your prescription/medication to treat your health condition ? Maybe -you – the pt needs to make them really feel uncomfortable… share your story with me… I will post it… name names… if it is a chain pharmacy…. give me the name of the pharmacist…. give me at least the town they are in…

Let’s see how comfortable they are when their chains start getting BAD PR because of their actions/decisions

Filed under: General Problems | 5 Comments »

I was involved in a interesting conference call tonight… on the call was a person who has contacts with some of the very large law firms.  According to contacts within these law firms put it simply how law firms think…. when it comes to taking on a class action law suit… first is MONEY and second is JUSTICE.

It has been stated that all that is needed is abt ONE HUNDRED DENIAL OF CARE HORROR STORIES involving a large healthcare/insurance corporation to peak the interest of these major class action law firms.

There ia a handful of chain pharmacies that control >50% of the community pharmacies

There is three Prescription Benefit Managers (PBM) that control abt 80% of all prescriptions filled

There is a handful of insurance companies that control the majority of health insurance business and if – or not – pts get certain therapies paid for.

Who is ready to TAKE A STAND… share your denial of care horror story… about these entities basically practicing medicine without a license.

Those involved with the conference call came away with the idea of collecting those horror stories – confidentially – until we reached or exceeded that magical ONE HUNDRED NUMBER …  Then share these HORROR STORIES with the law firm – while initially redacting the person’s personal information.

OR … do you just wish to continue to call/write  your member of Congress ?  – THAT GOES NO WHERE

Continue to sign petition that GOES NO WHERE

Whine, Bitch, Moan to each other on hundreds or thousands of Face Book pages… or keep sending out tweets expressing your dissatisfaction of some employee of one of these healthcare entities that really could care less if you are being thrown into cold turkey withdrawal every month for a few days.

OR you could continue to “LIKE” a Face Book or Twitter post BUT NEVER SHARE A POST.  A post WILL NEVER GO VIRAL without being SHARED !

You need to decide if you will continue to “cut bait” or ready to GO FISHING ?

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Patient Horror Stories

www.pbmabuses.org/horror-stories/

PBMs have very real and negative impacts on patients with cancer and our entire health care system. Read for yourself just how horrific PBMs are in the following collection of real stories. While these stories are real, we changed personal details to protect the privacy of patients.

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https://l.facebook.com/l.php?u=http%3A%2F%2Fwww.sanduskyregister.com%2Fstory%2F201908150028%3Ffbclid%3DIwAR1TmBZegIyp6sMKmKq1_2JlUh9MEPDs_LpoxGOZKKvqK3O1XlkrQe1zlME&h=AT3pQP1_GUy39YO3VS8ta72h6LIyA2YakUQ6-CXLLZxclmnPQ6IIrbq5bbvN-29iFE3QC9voIEQ64-RWDYYYcBDdRgE1iB2c3rI20GwmPzjtEIO289qp4-mvmKqVY6CmC6JoMcGRgNlk

SANDUSKY — Chronic pain patient Awna Stark used the same prescriptions, from the same doctor, at the same pharmacy, for more than eight years when the Walgreens pharmacy in Fremont suddenly ended their service to her.

Stark, 45, a Sandusky resident, said the Walgreens would not fill her pain prescriptions and even refused to fill her seizure medications, which aren’t a controlled substance.

A patient of local pain specialist Dr. Bill Bauer, Stark has filed a complaint with the Ohio Board of Pharmacy, alleging the pharmacy failed to meet its professional obligations. She’s also filed a complaint under the Americans With Disabilities Act, alleging that she’s a disabled person who was denied service.

Neither complaint has been resolved yet, Stark said.

Stark, who said she was denied service at the Fremont Walgreens at the end of May, is a former nurse who said she smashed her toe in 2008 on a concrete barrier in a Chicago parking lot.

A doctor hit a nerve while performing surgery. She now has nerve problems all through her body.

After trying a variety of technologies and drugs but never managing to “get ahead” of the pain, she said, she now takes morphine, oxycodone and fentanyl patches. It’s a trio of medications that allow her to cope and function. She also takes anti-seizure medication.

Stark met her husband, Sandusky native Shawn Stark, in downtown Sandusky.

“He bought me a drink. We were married six months later,” she said.

The couple, now together 20 years, have a blended family with four children.

Stark had knee surgery a few days ago, and she’s been trying to take care of him.

“He’s taking care of me more than I’m taking care of him. I’ve had 14 surgeries now. He’s a good guy,” she said.

The Starks say they are very aware there’s an ongoing drug epidemic. Shawn Stark’s mother died of a drug overdose, and one of the Starks’ children has battled addiction.

But Shawn Stark said it’s unfair to punish pain patients because of the drug epidemic.

“It’s heartbreaking on a daily basis to see my wife go through this,” he said.

“I’ve seen her where she can’t have a fan blowing on her, it hurts too much,” he said. “To see those lumped together infuriates me. I want to see legitimate patients who have problems get their medicine.”

Stark said the pharmacist who cut her off refused to talk to her. The Register called the Fremont Walgreens and was told the pharmacist is on vacation.

The Register also contacted a spokeswoman for Walgreens.

Walgreens spokeswoman Molly Sheehan responded, “We support our pharmacists in exercising their professional judgment while also trying to balance patient access to medication.”

Ali Simon, a spokeswoman for the Ohio Board of Pharmacy, said she cannot comment on cases being investigated by the board.

Simon said a pharmacist is not required to fill every prescription that comes in.

“Based upon information obtained during a prospective drug utilization review, a pharmacist shall use professional judgment when making a determination about the legitimacy of a prescription. A pharmacist is not required to dispense a prescription of doubtful, questionable, or suspicious origin,” Simon said.

She noted a patient can transfer a prescription to another pharmacy — which is what Stark did.

The Register has published stories about other local chronic pain patients. In June, the Register published an article about a cancer patient, Tina Bango, who was refused medication at a Rite Aid on Perkins Avenue. The local pharmacy and the Rite Aid company both refused to comment for the article.

“That’s the one that ticked me off. I started crying with that one,” Awna Stark said. “That was the same week I had the first issue dealing with all of this.”

Stark’s doctor, Bauer, said Stark stands out because she is trying to fight back after being denied medication. Many are busy dealing with their illness or don’t know what to do, Bauer said.

Bauer said he’s frustrated pain patients who are denied medication aren’t getting more attention. Bauer recently launched a petition at Change.org to speak up for chronic pain patients.

“For some reason, the country’s more interested in Epstein than they are these people,” Bauer said.

Coming in Tuesday’s Register: Do doctors in Ohio face sanctions if they refuse to treat pain patients?

What a bunch of BOGUS EXCUSES …   Walgreens spokeswoman Molly Sheehan responded, “We support our pharmacists in exercising their professional judgment while also trying to balance patient access to medication.”

AND 

Ali Simon, a spokeswoman for the Ohio Board of Pharmacy, said she cannot comment on cases being investigated by the board.

Simon said a pharmacist is not required to fill every prescription that comes in.

“Based upon information obtained during a prospective drug utilization review, a pharmacist shall use professional judgment when making a determination about the legitimacy of a prescription. A pharmacist is not required to dispense a prescription of doubtful, questionable, or suspicious origin,” Simon said.

If the pt had been taking the same medications for EIGHT YEARS written by the same doctor and filled at the same WALGREENS… the pharmacist’s judgement is more likely based on some personal phobia or biases…

Stark said the pharmacist who cut her off refused to talk to her.

My money is on the fact that the Pharmacist refused to talk to her because she could not come up with a VALID REASON for the denial of filling her prescriptions… and didn’t/couldn’t justify her actions.   With the trio of opiates that Stark was taking, she was going to be thrown into some very serious – possible life threatened – cold turkey withdrawal… not to mention the elevated pain.. From the description of the onset of the cause of her pain… she may be suffering from RSD … and that disease on the McGill pain scale is near the top of the list of severity and often referred to as a “suicide disease” because the intensity of pain is claimed to be more intense than child birth… except it is 24/7 situation.

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