The Montana Medical Board has been chasing Mark Ibsen for nearly 10 yrs. Their first attempt was a complaint from a Chiropractor who worked in Mark’s “doc in a box” practice. The AG of Montana at the time, I got the impression that he would have been happy if Montana were a “opioid desert”. I am told that the Chiropractor filed a complaint with the board that he was prescribing too many opioids. Many other practices were being raided and shut down, and Mark was trying to help those pts, who had been thrown to the curb. He was trying to lower or wean their doses down, but he found that ~ 20% were ultra-fast metabolizers. Mark spent a lot on legal fees and kept pushing the medical board back. The Medical Board’s aggressive posture cost Mark so much in legal fees that he ended up closing his practice.

A couple of years ago, Mark decided to provide pain management to what he called “opioid refugees”. Using the rules that the DEA created during the COVID-19 pandemic, virtual office visits would be permitted, and prescribers could prescribe controlled medications under those guidelines.

Now the Medical Board has an attorney – probably the State AG to call for a Grand Jury to investigate Mark. The date of this Grand Jury is July 23, 2025. Of course, it is claimed that a Grand Jury could indict a “ham sandwich”. That may be because a Grand Jury is just a judge, a jury, and the prosecuting attorney. 

IMO, if this Grand Jury finds “probable cause” that Mark is violating some law by treating these “opioid refuges “, and pulls his medical license. It will be a “death sentence” to all the intractable chronic pain pts that Mark has been trying to manage their intractable chronic pain pts and optimize their QOL.

How many patients will die from being thrown into cold turkey withdrawal, or commit suicide? It is anyone’s guess. But the primary function of all medical boards is to protect the public’s health & safety. Unfortunately, no one is involved in how this all shakes out, will not have any culpability for the adverse outcomes of their decisions.

1. https://www.justice.gov/jm/jm-9-11000-grand-jury
2. https://www.mololamken.com/knowledge-What-Exactly-Is-a-Grand-Jury
3. https://www.findlaw.com/criminal/criminal-procedure/how-does-a-grand-jury-work.html
4. https://www.santacruzcountyca.gov/grndjury/gjfunction.htm
5. https://en.wikipedia.org/wiki/Grand_jury
6. https://www.uscourts.gov/court-programs/jury-service/types-juries
7. https://www.nyjuror.gov/pdfs/hb_grand.pdf
8. https://courts.ca.gov/courts/jury-service/civil-grand-jury
9. https://www.tdcaa.com/journal/grand-jury-where-the-community-meets-the-law/
10. https://miamisao.com/wp-content/uploads/2020/12/Florida-Grand-Jury-Handbook.pdf
    

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At one time, Rite Aid had abt 5,000 stores, and soon they will be down to ZERO! Walgreens 10-15yrs ago was worth 100 billion dollars, and now there are rumors that they are selling the entire chain to a private equity firm. Years ago Walgreens had ~ 11,000 stores, and now they are down to abt 8500 stores. Typically, these private equity firms buy distressed companies, and they start selling off parts that are not as profitable as they would like or should be. They will cut the operating cost overhead to the bare bones and sell what is left for 2-3 times what they paid for the chain.

Most likely, whoever buys the Rite Aid stores will close them, and move the Rx files to one of their nearby stores, and close the Rite Aid stores.  In two or three years, we will probably see similar things happening to what is left of the Walgreens chain.

How many more pharmacy deserts will be created by all this “consolidation”?

Arkansas has passed a new law that prohibits PBM from owning pharmacies. CVS which owns the largest PBM Caremark, is threatening to close 23 stores they have in Arkansas.

Pres Trump is going after our Rx meds so that our Rx meds are the lowest prices sold to any nation on the planet. The term for this is “favored nation status”.

We have so many middlemen within our healthcare system that a lot of other countries don’t have. Since the 5 largest PBM are owned by the 5 largest insurance companies. This is going to be one hell of a legal battle between TWO GOLIATHS.

Rite Aid offloads more than 1,000 pharmacies to former rivals

The pharmacy chain is undergoing a bankruptcy process to sell “substantially all of its assets.”

https://www.retailbrew.com/stories/2025/05/19/rite-aid-offloads-more-than-1-000-pharmacies-to-former-rivals

After filing for bankruptcy earlier this month for the second time in less than two years, Rite Aid Corporation is offloading more than 1,000 pharmacies to rivals such as CVS and Walgreens as well as grocery chains such as Albertsons and Kroger.

In a press release, Rite Aid CEO Matt Schroeder said that the goal of transactions is to ensure continuity of care during the bankruptcy process; the company emphasized that all pharmacies will remain open through the transition to provide prescription refills and immunizations without interruption. 

“These agreements ensure our pharmacy customers will experience a smooth transition while preserving jobs for some of our valued team members,” he said.

Warm welcomes: On the receiving end of the deal, Albertsons is giving Rite Aid customers a warm welcome—as well as a coupon. New customers are set to receive a “$15 off” coupon for their next grocery purchase, plus another coupon for every five subsequent prescriptions.

“As a community health partner, our dedicated pharmacists are committed to providing our customers with timely, safe and convenient access to medications and essential vaccines,” Anthony DalPonte, president of pharmacy and health at Albertsons, said in a statement.

CVS similarly promised it was working toward a “seamless” transition for Rite Aid customers in a blog post.

The US Bankruptcy Court will hold a hearing on Wednesday to approve the sales.

All or nothing: While Rite Aid’s first bankruptcy in 2023 aimed to optimize the chain’s footprint and restructure its debt, the Chapter 11 bankruptcy initiated on May 5 will help facilitate the sale of “substantially all of its assets.” Anything not sold during this process, per bankruptcy steward Kroll, will no longer be owned or operated by Rite Aid.

The bankruptcy comes as a difficult time for the pharmacy business. Earlier this spring, private equity firm Sycamore Partners took Walgreens private in a $23.7 billion after a rocky run on public markets.

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This is another situation with the DOJ making ALLEGATIONS, and the settlement amount is based on Walgreens’ ability to pay. Maybe because all these ALLEGATIONS and settlements with DOJ and the PBMs’ low-balling reimbursements, Walgreens is most likely on the verge of declaring bankruptcy. 10-15 yrs ago Walgreens’ stock was worth ~100 billion, but they are in talks to sell the company to Sycamore Partners, a private equity firm, for ~ 10 billion.

The SCOTUS ruled in July 2024 https://www.pharmaciststeve.com/is-the-overturning-of-the-chevron-doctrine-a-good-or-bad-thing/    that federal agencies cannot create new interpretations of laws they are in charge of enforcing. It is also illegal for people/pts to obtain controlled substances under false pretenses, but there is nothing in this article of any of these people, who DOJ stated had illegal Rxs filled, being charged? What about all those illegal prescriptions? Walgreens didn’t fill them; their employee pharmacists filled them. I can’t count the number of pts that have told me that a chain pharmacist refused to fill a controlled med Rxs, and they filed a complaint with the chain HQ and were told, “We can’t force a Pharmacist to fill a Rx.”

Here is what perplexity.ai says about an allegation vs filing charges against someone/company. Maybe that is because it is a known fact that 90 – 95 %+ of people/companies taken to federal court will be found GUILTY! 

An allegation by the Department of Justice (DOJ) that a company has violated a law is not the same as formally charging the company with violating that law.

An allegation is an assertion or claim that a company has engaged in illegal conduct. It is essentially an accusation, which may be made during the course of an investigation or in public statements, but it does not in itself initiate formal legal proceedings against the company

. The DOJ may make such allegations as part of a civil investigation, in a press release, or in correspondence with the company.

A charge, on the other hand, is a formal legal action. In the context of criminal law, this typically involves the filing of an indictment, information, or criminal complaint, which are official documents that initiate a criminal case and set out the specific laws the company is accused of violating

. Only after such a document is filed does the company face formal criminal prosecution. For civil matters, a charge may take the form of a lawsuit or civil complaint.

The process generally works as follows:

• The DOJ (or another law enforcement agency) investigates and may make allegations based on evidence gathered.

• If the DOJ believes there is sufficient evidence, it may proceed to formally charge the company, which involves filing official documents in court

In summary, an allegation is a claim or accusation, while a charge is a formal step in the legal process that brings the accused company into court to answer the alleged violation

Walgreens to Pay $300 Million in Unlawful Opioid Prescriptions Settlement

https://jamanetwork.com/journals/jama/fullarticle/2834868

Walgreens has agreed to pay the US government $300 million in a settlement of allegations that the pharmacy chain illegally filled millions of invalid prescriptions for opioids and other controlled substances, the Department of Justice (DOJ) announced.

The civil lawsuit against Walgreens and its subsidiaries, filed in January, alleges that the drugstore chain violated the Controlled Substances Act and False Claims Act by accepting invalid prescriptions and seeking payment for them from federal health care programs including Medicare. According to the complaint, pharmacists allegedly dispensed prescriptions despite “clear red flags”—including opioid prescriptions filled significantly early, in large quantities, and in regularly abused combinations—and faced pressure from the company to fill prescriptions quickly without taking time to ensure legality.

The settlement amount is based on Walgreens’ ability to pay, the DOJ stated. If the company is sold, merged, or transferred prior to 2032, it will owe the US an additional $50 million. On top of the monetary payments, Walgreens has entered into agreements with the Drug Enforcement Administration and the Department of Health and Human Services Office of Inspector General to ensure future compliance with laws regulating the distribution of controlled substances.

A similar lawsuit against pharmacy giant CVS is still pending.

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What Medicaid Cuts Mean for Chronic Pain

Untreated childhood pain follows to adulthood

https://www.medpagetoday.com/opinion/second-opinions/115803

As pediatric pain psychologists, we often wish we had a magic wand that could wave away the suffering that children and their families bring into our offices. However, we know that good pain management for kids isn’t magic. It’s science. And it depends first and foremost on access to consistent, high-quality healthcare.

People are often shocked to learn that they have probably known a child with chronic pain. In fact, one in five children and adolescentsopens in a new tab or window suffer with chronic pain during their youth, making chronic pain one of the most common and overlooked disorders in childhood. Yet, for these millions of children with recurring pain, there are less than 60 pediatric pain centersopens in a new tab or window in the U.S. Pain scientists and clinicians have worked tirelessly to build these truly lifesaving programs. Still, even with years of effort, the scale of need so vastly outweighs the available resources that most families will never gain access. And now, proposed cuts to Medicaid threaten to make the situation even worse.

We meet the families that are lucky enough to access care in clinic every day. Children often arrive to their first appointments with limited physical functioning and must relearn how to move their bodies. Some show up with mobility devices and a goal of walking without assistance; others are striving to re-learn how to socially function, regulate pain-related fear, or just develop habits that help their bodies learn to sleep well at night again. Pain science has made all of these goals realistic for the majority of kids who can access good care.

Without Medicaid support, however, many children will continue to have limited functioning and difficulty returning to their lives. For the fortunate families who are able to access pediatric pain treatment centers, the results are often observed by parents to be miraculous.

For example, consider a 16-year-old female athlete who arrived at her first appointment in a wheelchair. She had difficulty getting out of bed and walking independently. She described her pain as unbearable — a feather touch to the skin yielding fiery discomfort. She had missed more school than she had attended over the past year. Her parents had to shift job schedules to take care of her. Basketball team texts became MyChart appointment reminders. The family’s whole life was engineered to fit the agenda of pain. Fortunately for this family, they were able to access an interdisciplinary team of trained pain specialists, including pain medicine physicians, pain psychologists, physical therapists, and occupational therapists. As a team, these providers were able to offer evidence-based treatment to help this athlete return to the classroom, to her sports, to her friends, and ultimately, to herself. The family could rebuild their life after 6 months of pain rehabilitation.

This is just one example of the many children we see whose lives have been twisted beyond recognition because of a chronic pain syndrome. For the family mentioned above, they were able to receive early intervention and make steady progress. However, this is not the case for families who get access to the right care too late, or never get access at all. When patients do not receive early intervention, they can develop severe chronic pain. Treatment becomes a slow and arduous march, sometimes taking months to years of therapies before a child and their family can recover functioning. It is our collected decades of experience working in the trenches with these children and families that drives our plea to ensure pediatric pain treatment is not luxury care. It is evidence based, life-altering recovery.

Children’s lives and futures are at risk right now. Without Medicaid, children will lose access to treatments like ours that quite literally give them their lives back. The proposed federal budget cutsopens in a new tab or window to Medicaid will deepen the gap between what kids need and what families can access. If we allow that to happen, we aren’t just ignoring suffering — we’re ensuring it.

Here’s the rub: ensuring childhood pain isn’t only about kids; it ensures another generation of adults with serious pain conditions. That is a reality we are intimately familiar with in this country. Childhood pain that goes untreated or undertreated is one of the strongest predictors of chronic pain in adulthood. We’ve lived through one opioid epidemic — one born in part from our failure to offer strong, early solutions for pain. If we cut off access now, we’re not just abandoning children in pain — we may be setting the stage for some version of an Opioid Epidemic 2.0. And with it, an even larger burden on our future workforce, healthcare system, and economy.

To be sure, children with private insurance will still have access to high-quality pain care, but Medicaid is the backbone of all pediatric healthcare in the U.S., covering nearly half of all childrenopens in a new tab or window. Approximately 37 million childrenopens in a new tab or window in the U.S. are enrolled in Medicaid or the Children’s Health Insurance Program (CHIP), and Medicaid accounts for more than $4 billionopens in a new tab or window in pediatric pain-related healthcare per year. In many pediatric pain programs, Medicaid is the most common payor. While Medicaid is administered through the individual states, federal funding matches at least 50%opens in a new tab or window of what states contribute. Without federal funds, fewer children will have access to pain care; though their symptoms will remain, and likely amplify over time.

We are asking you to please call your legislators. Urge them to protect Medicaid funding and remove cuts. Pediatric pain care isn’t optional. For the children and families we serve — some of whom may also be your patients, or perhaps even your children, grandchildren, nieces, nephews, and neighbors, and the youth who will one day be charged with carrying forward our society — it’s essential, life-changing care.

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The article below is just the first page of a 5-page article, and the hyperlink below will bring up the entire article

2011.12 InterRights Bulletin Article_only

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Citations:

1. https://www.neurologylive.com/view/fda-approves-vertex-pharmaceuticals-suzetrigine-acute-pain-management
2. https://www.biopharmadive.com/news/vertex-pain-non-opioid-drug-fda-approval-journavx/738721/
3. https://www.nbcnews.com/health/health-news/fda-approves-new-type-nonopioid-painkiller-acute-pain-rcna189871
4. https://www.biospace.com/drug-development/vertexs-journavx-changes-the-pain-treatment-landscape-but-opioids-here-to-stay
5. https://icer.org/news-insights/press-releases/institute-for-clinical-and-economic-review-publishes-final-evidence-report-on-treatment-for-acute-pain/
6. https://rsds.org/a-new-pain-killer-on-the-market-the-good-and-the-not-so-good-on-journavx/
7. https://psyclarityhealth.com/hopeful-new-non-addictive-pain-relief-by-vertex/
8. https://www.biopharmadive.com/news/pain-drug-vertex-opioid-price-insurance-journavx/738856/
9. https://www.pharmexec.com/view/fda-approves-vertex-pharmaceuticals-first-class-non-opioid-journavx-moderate-severe-acute-pain
10. https://www.fda.gov/news-events/press-announcements/fda-approves-novel-non-opioid-treatment-moderate-severe-acute-pain
11. https://www.drugs.com/journavx.html
12. https://cen.acs.org/pharmaceuticals/drug-development/FDA-approves-new-nonopioid-pain-medication-hailed-a-triumph/103/web/2025/01
13. https://www.statnews.com/2025/01/30/vertex-pain-drug-journavx-wins-fda-approval-non-opioid/
14. https://www.cnbc.com/2025/01/30/fda-approves-vertex-non-opioid-painkiller-drug.html
15. https://news.vrtx.com/news-releases/news-release-details/vertex-announces-fda-approval-journavxtm-suzetrigine-first-class
16. https://investors.vrtx.com/news-releases/news-release-details/vertex-announces-advancements-suzetrigine-vx-548-acute-and
17. https://www.definitivehc.com/resources/healthcare-insights/most-common-pain-medication
18. https://www.thepharmaletter.com/icer-evidence-report-on-vertex-new-treatment-foraacute-pain
19. https://www.vrtx.com/stories/state-pain-america/
20. https://www.reddit.com/r/ChronicPain/comments/1japyo2/ive_got_journavx_suzetrigine_in_my_hand_filled/
21. https://www.biopharmadive.com/news/vertex-pain-drug-data-lumbosacral-radiculopathy-lsr-stock/736055/
22. https://www.statnews.com/2024/12/19/vertex-chronic-pain-sciatica-suzetrigine/
23. https://www.thepharmaletter.com/vertex-phase-2-suzetrigine-study-disappoints

Answer from Perplexity: pplx.ai/share

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Does anyone other than me care that AARP endorses UnitedHealth as its primary company that offers various health insurance to its members?

Here is a video of Senator Eliz Warren at a Senate committee hearing last year, appearing to “rip” the President of UnitedHealth over their policies. https://www.pharmaciststeve.com/warren-blasts-united-health-ceo-for-monopolistic-practices-that-harm-patients/

Now, this article that is coming out is about a questionable policy that appears to “bribe” nursing homes to implement some policies that could allow UnitedHealth to increase its profits.

‘Outright murder’: UnitedHealth pressured nurses to DNR patients who didn’t want to die

https://wegotthiscovered.com/news/outright-murder-unitedhealth-pressured-nurses-to-dnr-patients-who-didnt-want-to-die/

It’s safe to say UnitedHealth isn’t the most beloved company out there. The for-profit insurance company has ruined (and ended!) countless lives, been embroiled in many controversial denials of care, has faced SEC investigation for fraud, fought legal action for overbilling Medicare, and routinely humiliates those who rely on it for medical treatment.

All of which meant that when Brian Thompson was executed on the streets of New York on Dec. 4, 2024, few shed a tear. Now the Guardian has released a shocking new investigation that indicates the company has expanded its scope from run-of-the-mill cruelty to outright murder.

The article details how UnitedHealth secretly paid nursing homes massive bonuses to “slash hospital transfers for ailing residents”, effectively denying them hospital treatment to save the insurer a few bucks. The reporting found that many of those denied transfer suffered long-term medical issues, with one patient receiving permanent brain damage.

But wait, it gets worse! One of the most horrifying tactics details is that United Health monitored the rates of “do not resuscitate” (DNR) and “do not intubate” (DNI) orders for nursing home patients. These permit doctors to allow someone to die if their heart stops beating, or if they are intubated in case of a medical emergency.

Nursing homes considered to have low numbers of DNR/DNI patients were then pressured to boost their numbers. The article reports that multiple current and former nurses claim that (as per the article): “UnitedHealth managers pressed nurse practitioners to persuade Medicare Advantage members to change their “code status” to DNR even when patients had clearly expressed a desire that all available treatments be used to keep them alive.”

Patients with DNR/DNI orders on their files are much more profitable for UnitedHealth as, once they’re dead, the company doesn’t need to continue paying for their medical care. As you might imagine, jaws are on the floor. Comments include “good lord”, “speechless”, and “savages”. And, as you can probably predict, many references to one Mr Luigi Mangione.

Perhaps we shouldn’t be surprised. Binding medical care to shareholder value is a recipe for a mile-high stack of corpses: the less treatment UnitedHealth has to pay for, the more profit they make. Shareholders demand annual growth, so what better way to achieve that than gradually tightening the metaphorical noose around their customers’ necks?

Even knowing all that, this is monstrous behavior from UnitedHealth. How do these people sleep at night?

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