https://youtu.be/ao8L-0nSYzg
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During the years drug firms poured millions of highly addictive pain pills into West Virginia amid a rise of overdose deaths, the U.S. Drug Enforcement Administration had a shortage of leadership in the state, according to a DEA official.
“We had no leadership in West Virginia. We had none,” said Karl Colder, special agent in charge of the Washington, D.C., field office, which covers Virginia, Maryland, the District of Columbia and West Virginia.
Between 2007 and 2012, drug wholesalers shipped 780 million hydrocodone and oxycodone pills to West Virginia, while 1,728 people fatally overdosed on those two powerful painkillers, the Gazette-Mail reported in December.
Before 2013, the highest-ranking DEA agent in West Virginia was a group supervisor, Colder said. Now, the DEA has a Charleston-based assistant special agent in charge who reports directly to Colder. The agency also has hired more agents and set up tactical diversion squads in Clarksburg and Charleston.
“In the past, they were just supervisors, and they had to run enforcement operations,” Colder said. “You had no leadership in West Virginia. This is the first time the community has seen the special agent in charge.”
Colder, who became special agent in charge in 2013, and four other DEA officials were in Charleston last week to announce the agency will spend $500,000 on a program that aims to reduce heroin and prescription drug abuse in Kanawha, Putnam and Cabell counties. West Virginia has the highest drug overdose death rate in the nation.
The night before their press conference in Charleston, the DEA agents talked about recent national reports that revealed agency lawyers had put the brakes on enforcement actions against drug distributors, starting in 2013.
Following the reports, the DEA announced drug giant McKesson agreed to pay $150 million to settle a case, and wholesaler Cardinal Health agreed to pay $44 million in fines.
“We also were targeting their DEA numbers, their registration numbers, but, unfortunately, if you read The Washington Post, you’ll know, unfortunately, there was some pressure,” said Ruth Carter, the DEA’s diversion program manager. “We were told … you know.”
Five former DEA supervisors told The Post they were frustrated by the sharp drop in enforcement actions. The former head of the diversion office, Joseph T. Rannazzisi, said he was summoned to a meeting in 2012 during an investigation of Cardinal Health. Rannazzisi told the The Post he was chastised for “going after industry.”
Carter said a Department of Justice lawyer, whom she didn’t name, directed agents to halt an ongoing investigation against Cardinal Health, the nation’s second-largest drug wholesaler.
“One DOJ official told us we could not pursue Cardinal any further,” Carter said. “That’s the only thing I know that’s true. Yes, they did. But those people aren’t at DOJ anymore. Everyone at DEA, we want to do the right thing.”
“We were told not to go any further,” she said. “‘You’ve done enough investigating. Let’s just process the case.’”
Last month, Cardinal Health and wholesaler AmerisourceBergen abruptly agreed to settle a four-year legal battle with the state of West Virginia, which had accused the companies of fueling the state’s prescription drug problem. Cardinal Health and AmerisourceBergen paid a combined $36 million — the largest pharmaceutical settlement in state history. The money will go to drug treatment programs that help West Virginians addicted to opioids.
The DEA agents also answered questions last week about a new law — passed by Congress last spring — that allows drug distributors to submit corrective action plans to persuade the DEA to stop investigations against the companies. The law also raises the bar for the DEA to temporarily suspend their licenses, according to a Los Angeles Times report.
“They can submit those to us,” Carter said. “That’s part of the reason some of these settlements have been slower. That is happening, yes, but if it’s a continual, ongoing, egregious thing, that’s a whole different story.”
Colder said drug distributors hire an army of lawyers to fight the DEA when the agency investigates the companies and tries to sanction them.
“Taking action against them is more complicated, and it’s going to be harder because you’re dealing with very high-priced attorneys,” he said. “They’ll hire four or five law firms to represent them.”
In a follow-up story, The Washington Post reported the nation’s largest drug distributors have hired more than 40 former DEA agents over the past decade. The Post article described the hires as a “revolving door.”
“It’s the carousel,” Colder said. “You have some of our retirees who go on and work for these companies. They’re going to pay the big dollars, and whoever has the experience, that’s who they go after. Hopefully, they’re going in there to train people how to do things the right way.”
Colder said there’s nothing nefarious about DEA agents going to work for drug wholesalers.
“It just so happens we have truly qualified people,” he said.
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INDIANAPOLIS — A team of doctors initially accused of operating a “pill mill” is suing the city of Carmel and a Drug Enforcement Agency agent for false arrests they say destroyed their careers.
The physicians include Dr. George Agapios, who had a Pendleton family practice and was working part-time for a Carmel opiate addiction treatment clinic when he was charged in 2014 with five felonies involving dealing in a controlled substance. The charges, filed by the Indiana Attorney General’s office, were dismissed in Hamilton County Superior Court in December 2015.
Charges against three other doctors were either dropped or ended in acquittal.
The new complaint is against DEA agent Gary Whisenand, the city of Carmel and Carmel police officer Aaron Dietz.
In Carmel, the group’s clinic was operated as the Drug & Opiate Recovery Network (DORN) where Suboxone, used to manage pain and relieve opioid dependency, was often prescribed but not dispensed, court documents said.
DORN’s main clinic was in downtown Carmel.
The lawsuit claims “The presence of a clinic specializing in the treatment of opioid dependency in Carmel, Indiana, was in visible contrast to the political position of the Carmel city administration that there was no significant opioid drug addiction problem in Carmel, Indiana, that would require such a facility.”
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http://northwestcannacast.com/deas-marijuana-eradication-program-in-washington-state/
SEATTLETIMES.COM – It’s a scene that continues to unfold in Washington state: A helicopter hovers low over the trees, deep inside a park in the Cascade Mountains a SWAT team dressed in Kevlar rappels from the chopper to the ground other officers, federal agents and state environmental officials move toward the site on foot, alert for armed guards, booby traps and razor fencing.
The targets of these taxpayer funded efforts aren’t terrorism suspects or dangerous fugitives they are marijuana plants.
The Drug Enforcement Administration (DEA) has for decades poured millions of dollars into a nationwide marijuana eradication program, and the effort continues even in Washington, where the drug was legalized for recreational use in 2012. Financial documents obtained from the DEA show that in fiscal year 2016, Washington was the nation’s fourth largest recipient of eradication funding, at $760,000. According to the most recent data, each plant the state destroys costs taxpayers $26.49, over six times the national average.
Washington’s funding has fallen 28 percent over the last three fiscal years, from about $1.1 million. But funds for the DEA’s marijuana eradication program have seen larger cuts in other states where the drug has been legalized, according to the financial documents. Colorado’s funding dropped to zero over the past two fiscal years. Oregon’s budget has been slashed by 80 percent from $1 million to $200,000 during the same time.
Upon release of the DEA’s financial documents, a bipartisan group of eight members of Congress sent a letter in October to the U.S. Government Accountability Office that called the program’s roughly $18 million annual cost wasteful.
“While the DEA’s Cannabis Eradication Suppression Program has been in effect nationwide for three decades, the recent trend in state laws to legalize and decriminalize the production, distribution or consumption of marijuana calls into question the necessity of such a program,” the letter states.
One of the letter’s signees, U.S. Rep. Ted Lieu, D-Calif., proposed legislation last year that would have cut the eradication program’s funding in half. The effort failed.
Lieu, in an interview with The Seattle Times before the November election, said that legalization of recreational marijuana in California the nation’s top cultivator would force the DEA to reassess the feasibility of trying to suppress the country’s supply. The election saw voters in California, Maine, Massachusetts and Nevada approve measures to legalize marijuana for recreational use. Voters in Arkansas, Florida, Montana and North Dakota approved the drug for medical use.
Legalization will accelerate discussions of whether the drug’s national prohibition can be maintained, Lieu said.
“I don’t believe the arguments that this program is needed. From a taxpayer’s standpoint, it doesn’t make any sense that Washington state is still spending so much money on marijuana eradication,” Lieu said. “There are so many more worthwhile uses for it.”
Lt. Chris Sweet of the Washington State Patrol has managed the state’s eradication program since 2013, mainly by requesting and administering federal funds. Sweet said that when he attends law-enforcement conferences, he’s frequently asked how he can operate a marijuana-eradication program in a state where the drug is legal.
“I hear it all the time: ‘You guys still have an outdoor-eradication program when you’re a legalized state? How does that make sense?’ ” Sweet said.
Eradication remains a law-enforcement priority because Mexican drug cartels may have moved their marijuana-growing operations north of the border, where the climate produces higher-quality plants, Sweet said. These organizations tend to operate on swaths of public land, often in mountainous regions, where detection of large crops is difficult.
The abundance of good growing terrain along the eastern slopes of the Cascades has led the Sinaloa Cartel of Mexico — considered the world’s most powerful drug-running operation — to operate in that region for some time, according to a recent joint report from the DEA and Department of Justice.
The presence of Mexican drug cartels might explain why Furadan, a pesticide banned in the United States and “only made south of the border,” has been found on Washington’s illicitly grown marijuana crops, Sweet said. California authorities have also cited the pesticide as evidence of Mexican involvement in grow operations there. Starting this year, Sweet said, officers removing illegal marijuana plants must wear protective suits and be accompanied by Department of Ecology agents.
The DEA’s eradication program gained national attention in September after a helicopter, a bevy of police vehicles, state police officials and National Guard troops descended upon the home of an 81-year-old Massachusetts woman to haul off a single marijuana plant growing in her garden.
However, small growing operations are not typically targeted by the program. The average size of a Washington crop bust in 2015 was 609 plants; the average size nationally was 519, according to DEA records.
There have been roughly 57,000 plants eradicated in Washington so far this year, a 63 percent increase over 2015’s total haul. Sweet believes the involvement of Mexican drug cartels helps explain the rise in plant discoveries this year.
“No one had a crystal ball about how legalization would affect our outdoor growing, but with the spike this year, we’ll have to see what the coming years bring,” he said. “Is it a freak thing? It’s too early to tell.”
But the DEA’s records show that the number of plants found in Washington this year is almost identical to the number found two years ago, and down significantly from the 346,484 plants eradicated five years ago. Nationwide, the records show a nearly 70 percent decrease in the number of grow sites eradicated between 2010 and 2014.
Morgan Fox, communications manager of the Marijuana Policy Project, the largest U.S. nonprofit dedicated to marijuana reform, said the best way to limit the impact of drug cartels is to “eliminate the illicit market, and make it not worth it economically. That’s what we see legalization doing.”
“Law-enforcement organizations are loath to give up on funding sources, so there are times there is a concerted effort to tell a dramatic story,” Fox said. “Marijuana eradication is just playing whack-a-mole.”
In justifying the program’s continued existence in Washington, Sweet cited the need to fight Mexican gangs, and to mitigate the environmental damage caused by grow operations. The fact the program has been slashed in Colorado and Oregon is ominous to him, he said.
“We’ve seen the proposals in Congress, and the public perception, and the adage that this is money that can be used for other programs, like education and treatment,” Sweet said. “That’s definitely a big concern.”
For Fox, the fact eight more states legalized pot this November illustrates the program’s increasing irrelevance. After alcohol’s prohibition, he said, a criminal element remained in the industry for a while but diminished as the legal market established itself.
“We don’t see illicit criminal organizations planting secret vineyards on national parks when the market has been made legal for wine,” said Fox. “There’s still some illegal moonshine stills around the country, but it’s not a big issue. This is where we’re headed as a country.”
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http://www.knowyourleak.com/Pharmacist-Wins-Walmart-Lawsuit-228428.html
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http://bnlawatlanta.com/wp-content/uploads/2014/05/Healthcare-Whistleblowing-April-14.pdf
This was sent to me by a middle aged Pharmacist who has just gotten toss to the curb because of nebulous issues of corporate policies and procedures being theoretically broken.
Any employee that works for a business that deals with receiving Federal money, could learn a lesson from this primer from a law firm in Georgia.
Document what “wrong doings” that your employer is doing like tomorrow is going to be your last day on the job.
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Hey folks, here’s an opportunity to maybe change the dialog on opioid hysteria. NPR has a sunday morning program called the “Call In Show” and next week the question is “How has the opioid epidemic effected you?” We should all call in- dial 202-216-9217 with full name, where you are calling from and your story! Maybe if they hear from enough of us they will start showing how this is hurting chronic pain patients and our abilities to receive adequate pain relief…
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Humana has already announced that they will no longer participate in Obamacare in 2018 and the CEO of Aetna recently stated that “they had not made the decision yet about 2018 ” If both of these very large ACA providers are not participating in 2018, that means that there will be a lot of areas that will not have the first insurance company to sell policies and competition in a lot of areas will be limited to just one provider… basically NO COMPETITION.
All Congress has to do is repeal/rescind the premium subsidies and the ACA will collapse under its own weight… when people are expected to pay the “full rack rate” for their health insurance premiums.
Insurance can’t even approach an “affordable level” unless all that expect/need coverage participate. Below is a table of per-cent of drivers that are uninsured per state.. from a low of 3.9% (Mass) to a high of 25.9% (OK). Every state has MANDATORY VEHICLE INSURANCE.
http://www.carinsurance.com/Articles/uninsured-motorist-coverage-state-averages-of-uninsured-drivers.aspx
Estimated percentage of uninsured motorists by state
State Uninsured Rank (2) State Uninsured Rank (2)
Alabama 19.6% 7 Montana 14.1% 15
Alaska 13.2 21 Nebraska 6.7 44
Arizona 10.6 29 Nevada 12.2 23
Arkansas 15.9 11 New Hampshire 9.3 34
California 14.7 13 New Jersey 10.3 30
Colorado 16.2 9 New Mexico 21.6 4
Connecticut 8.0 41 New York 5.3 49
Delaware 11.5 27 North Carolina 9.1 35
D.C. 11.9 24 North Dakota 5.9 47
Florida (3) 23.8 2 Ohio 13.5 17
Georgia 11.7 26 Oklahoma 25.9 1
Hawaii 8.9 37 Oregon 9.0 36
Idaho 6.7 45 Pennsylvania 6.5 46
Illinois 13.3 20 Rhode Island 17.0 8
Indiana 14.2 14 South Carolina 7.7 43
Iowa 9.7 32 South Dakota 7.8 42
Kansas 9.4 33 Tennessee 20.1 6
Kentucky 15.8 12 Texas 13.3 19
Louisiana 13.9 16 Utah 5.8 48
Maine 4.7 50 Vermont 8.5 39
Maryland 12.2 22 Virginia 10.1 31
Massachusetts3.9 51 Washington 16.1 10
Michigan 21.0 5 West Virginia 8.4 40
Minnesota 10.8 28 Wisconsin 11.7 25
Mississippi 22.9 3 Wyoming 8.7 38
Missouri 13.5 18
I would suspect that you will find similar numbers of people driving cars that don’t have a driver’s license.
It is estimated that the USA has a 1-2 TRILLION/yr underground economy and the income taxes evaded on that money… would close the annual deficit in the Federal budget… about 600 billion/yr
Congress has mandated that hospital have to treat/stabilize anyone walking thru their doors… seeking treatment. Also medical bills are the largest single reason for personal bankruptcies. Meaning that a lot of “small businesses” – doctors, pharmacies, hospitals end up “eating” those $$$ wiped clean with a person declaring bankruptcy.
Let’s approach this issue of providing healthcare in a business like manner.. even though Obamacare has abt 20 million people with coverage.. we still have abt 30 million that still doesn’t have any health insurance.
Lets start with a 5% sales tax very soon and beginning with 2018 let everyone enroll into Medicare in their birth month. Like most sales taxes… food, medication, rent, utilities will be exempt. Phase out Obamacare in the same manner. Everyone will have a deductible of maybe 5% of their gross income, and will pay 20% after the deductible. There will be no more prior authorizations, quantity limits, step therapy and the rest of the BS that insurance companies have put in place in order to “save the system money”,but has done more to establish their dictatorship over our healthcare and help “pad their bottom line”. Those currently on Medicaid or getting some sort of subsidy will continue to get some sort of subsidy.
The sales tax rate will be adjusted annually based on one year back actual cost per capita to provide healthcare to our citizens. No system will ever be perfect, but we need to strive to improve upon what we have failed to do to date. The transition will be neither painless nor transparent, but there are no quick fixes.
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From Susan Ash Director of The American Kratom Association
Folks, we have a new bill in West Virginia to add kratom to their controlled substances list (its been included under the misconception that its contributing to the existing opiate problem there). But we are on top of the situation and there is no need to panic. Let’s let our lobbyists continue to work behind the scenes and give us direction on what we can be doing after the weekend. Thanks
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The nation’s largest pharmacy benefit manager is defending itself against accusations that it’s partly to blame for high drug prices.
Express Scripts Chief Executive Tim Wentworth delivered a strongly worded response to such claims during an earnings call Wednesday.
“Let me first say that in my nearly 20 years in the PBM business, I have never been prouder of the results we create, but I’ve never seen more misinformation and absence of facts in the dialogue about our role.”
Express Scripts negotiates the cost of drugs directly with pharmaceutical companies and provides prescriptions to about 85 million Americans each year through employer-based coverage.
“Let me start with the facts,” Wentworth said during Wednesday’s call. “Drug companies set drug prices, and over the last eight years, those list prices have increased by more than 200 percent. If not for us, our clients and patients would be left to pay those costs. Drugmakers set prices, and we exist to bring those prices down to ensure patients can access the drugs they need and that payers can afford them.”
Rebates are one of the most popular tools used to lower drug prices. Wentworth said Express Scripts’ clients received 89 percent of the rebates the company negotiated with drug manufacturers. Express Scripts had not shared that figure in recent years.
Express Scripts has a national preferred formulary, which is a list of drugs it covers. Because Express Scripts filled 1.4 billion prescriptions last year, manufacturers want to have their drugs on that formulary. To get listed, they agree to rebates.
That timing can expose some patients, especially those with high deductibles, to the full cost of a drug, said Rachel Sachs, an associate professor of law at Washington University. She focuses on health law and food and drug regulation.
PBMs serve a function, Sachs said, but they are partly to blame for high drug costs. Ultimately, she said, there’s not a lot of transparency in how the rebates are passed through to patients.
Express Scripts tried to provide more information on Wednesday’s call.
Wentworth said Express Scripts sometimes passed the entire rebate through to its client, which is an employer or health insurance company, and the client decides what to do with the money.
“One hundred percent of the time, our clients determine how to share rebates,” Wentworth said.
Sometimes clients share the rebate with Express Scripts, and sometimes Express Scripts keeps all of it.
“To suggest that our creating competition and the resulting rebates is why prices go up is uninformed and simply wrong,” Wentworth said.
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