Klobuchar Requests Update on Drug Enforcement Administration Efforts to Monitor Controlled Substance Providers

http://www.klobuchar.senate.gov/public/news-releases?ID=60B7C2EC-3BE3-4F3B-9874-F3D630FE1B35

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Hospital pharmacists can help reduce opioid prescriptions

http://pharmacytoday.org/article/S1042-0991(16)30505-9/fulltext

 

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The Fallout of Workers’ Comp ‘Reforms’:
5 Tales of Harm

Injured workers share their stories, revealing the real-life impact of rollbacks that have been spreading across the country.

https://www.propublica.org/article/workers-compensation-injured-workers-share-stories-of-harm

An investigation by ProPublica and NPR earlier this month detailed how states across the nation have been dismantling their workers’ compensation systems, with disastrous consequences for many of the hundreds of thousands of people who suffer serious injuries at work each year.

In some states, the cuts have been so drastic that injured workers have plummeted into poverty, losing their cars and even their homes. In others, workers spend years battling insurance companies for the surgeries, prescriptions and basic help their doctors recommend.

The five case studies below are emblematic of the bewildering labyrinths injured workers have to navigate as a result of these cutbacks. As attorneys for injured workers are fond of noting, it’s no coincidence that Franz Kafka — known for his tales of suffering at the hands of faceless bureaucracies — was once a clerk in the workers’ comp bureau of Bohemia.

22 States Now Set Arbitrary Time Limits on Injured Workers’ Temporary Wage Benefits

Gary Fury was working at a Simonton Windows factory in West Virginia in July 2012 when a large two-window unit slipped to the floor. Fury bent to help a coworker slide it back onto a cart.

“When I went to pick it up,” he recalled, “I felt something pop.”

Fury, then 49, had torn his rotator cuff and ruptured his bicep. After trying less invasive treatments, his doctor recommended surgery and warned of poor results if it was delayed.

Instead of approving it, Sedgwick Claims Management Services, an insurance claims administrator hired by Fury’s employer, sent him to its own doctor for a second opinion six weeks later, according to workers’ comp court records. That doctor also said surgery should be authorized immediately and warned that delays could lead to permanent impairment.

But in West Virginia, time is on the insurer’s side. In 2003, the state passed a law capping wage benefits for temporary injuries like Fury’s to two years — even if the worker hasn’t recovered yet. Several other states, including California, Oklahoma and North Dakota, have recently capped payments at two years. Today, 22 states set arbitrary time limits on temporary wage benefits, according to data collected by the Workers Compensation Research Institute.

Despite the recommendations of two doctors, Sedgwick waited another five weeks before approving surgery — a delay that a workers’ comp judge said was “especially unwarranted” after Sedgwick’s own physician said he needed it “ASAP.” By the time Fury finally got surgery, it was January 2013.

“They just don’t know how much pain I sat for six months in waiting to get surgery,” he said.

As the doctors had warned, Fury still had pain and limited range of motion after the surgery and was unable to return to regular work. Now, his doctor has recommended additional treatment and possibly another surgery.

But since Fury’s two years of wage benefits have run out, if he gets the surgery, his employer doesn’t have to pay him while he recovers — even though a state workers’ comp judge said Sedgwick is “at least in part responsible” for his medical problems.

After his injury, Fury initially survived on two-thirds of his wages, which are provided by workers’ comp, tax-free. But when the payments stopped, Fury has at times had to rely on food stamps and Medicaid.

“It got down to the point where I had to go get help, like from what they call welfare,” Fury said. “That was so embarrassing for me. You know, you’re used to working all your life. I raised two kids and never had to be on there. Sometimes, it really degraded me to go to a grocery store and you had to pull out your card instead of pulling out your cash — all because you’re an injured worker.”

Sedgwick and Simonton declined to comment about what happened to Fury.

After hearing the details of the case, Chris Stadelman, communications director for Gov. Earl Ray Tomblin — who was state senate president when the workers’ comp reform passed — said the governor’s office was “comfortable with the changes that were made” and has not heard complaints from injured workers.

Fury is now applying for Social Security Disability Insurance and watching his life savings slowly drain away.

Meanwhile, Tomblin recently announced a boon to West Virginia employers: Workers’ comp insurance rates would be cut for the 10th year in a row.

10 States Since 2003 Have Expanded Their Use of Outside Medical Reviewers to Assess Injured Workers’ Doctors’ Recommendations

Nicolas Mercado, a 54-year-old quadriplegic, sits in a long-term care facility waiting to return to his home in San Bernardino, California, to return to the smells of home-cooked Mexican food and the giggles of his granddaughter. Home to the same street corner where he and his wife met as teenagers.

Mercado has not lived there since December 2011, when the tanker truck he was driving to collect kitchen grease flipped over on an exit ramp, leaving him paralyzed from the neck down.

In March 2013, his doctors said that his medical condition had stabilized and he could go home as soon as modifications were made to accommodate his wheelchair. Under state law, home modifications are covered by workers’ comp.

The California Insurance Guarantee Association (CIGA) — which took over the claim when the original insurer went bankrupt — sought a second opinion from another doctor, who approved some modifications and rejected others. Then CIGA ignored many of its own doctor’s recommendations and insisted a new state-mandated medical review process allowed it to delay the fixes.

A 2012 law in California put medical disputes between the workers’ doctors and insurers into the hands of “independent medical reviewers” who remain anonymous and make decisions based solely on medical records. California is one of 10 states since 2003 to expand its use of such outside doctors, who have the power to say an injury isn’t work-related or deny recommended medical care after only a brief exam or paperwork review.

In Mercado’s case, CIGA approved a wheelchair lift, but it didn’t fix the doorway it leads to, which has a step and is too narrow for Mercado’s chair.

CIGA argued that the “prudent and responsible” course was to wait until the new medical review process was complete before doing any further modifications.

Judge Paul DeWeese, a workers’ comp judge in Anaheim, rebuked CIGA, saying it was insisting on “form over substance” and that the medical review process was never intended for cases like Mercado’s.

“That assertion is outrageous,” DeWeese wrote in his May 2014 opinion. “The ‘prudent and responsible course,’ not to mention the legally required course and the only moral and humane one, is to assist Mr. Mercado in returning home forthwith.”

For Mercado’s wife, Linda, it’s been especially wrenching to leave her husband at the long-term care facility month after month, when he could be home.

“When I leave him over there and I see him through the window, and I wave bye and I throw him a kiss and he throws me a blessing, and I give him a blessing, it just tears my heart,” she said. “I don’t like to let him see me crying, but once I leave that parking lot, everything comes out.”

The independent medical reviewer, who is supposed to have the final word under the new law, denied the additional home modifications. In October, the state Workers’ Compensation Appeals Board ruled in Mercado’s favor and ordered CIGA to finish the job. But the insurance company appealed once again.

After a local TV station aired a story about Mercado’s case in January, CIGA agreed to make the home modifications.

“I took a look at what had happened in terms of the case and determined we could have probably gone down a different path,” Wayne Wilson, CIGA’s executive director, said in an interview.

10 States Since 2003 Have Increased Use of Pre-Existing Conditions to Limit or Deny Care After Workplace Injuries

Brenda Albright spent 16 years as a forklift driver hauling rolls of paper to make cardboard boxes for Smurfit-Stone Container in Fargo, North Dakota.

One day in June 2010, she squatted down to remove a tag from one of the rolls. As she stood back up, she suddenly felt what she describes in workers’ comp records as an “extremely ungodly pain.”

Her husband, who was Smurfit-Stone’s plant superintendent, rushed her to the emergency room, and she was diagnosed with a herniated disc.

Two doctors for North Dakota’s Workforce Safety & Insurance agency (WSI), including its medical director, reviewed Albright’s records and agreed that despite prior back problems, her herniated disc was due to the incident at work and not a pre-existing condition, according to court records. The agency, which insures North Dakota businesses, accepted the claim.

Or so it seemed.

Then Albright came face to face with a growing trend in workers’ comp — the aggressive effort to pin workplace injuries on pre-existing conditions. In recent years, North Dakota and several other states have increasingly allowed insurers to deny claims by saying that work injuries only aggravated existing conditions caused by aging, prior injuries or the structure of workers’ bodies.

Since 2003, insurers in 10 states have moved in this direction. In one case in Kansas, an insurer refused to cover carpal tunnel surgery for a hand packer at a warehouse, asserting that her thin body frame made her susceptible to repetitive stress injuries. Florida lawmakers have added a twist: Insurers there can cite pre-existing conditions to require workers to pay up to 49 percent of their medical costs even when work was the primary cause of their injuries.

In 2008, employees at North Dakota’s WSI told auditors that their bosses were directing them to look for reasons to deny claims. They reported a recent “shift in management focus to a more aggressive and in-depth search for prior injuries or pre-existing/degenerative conditions, which could possibly reduce WSI liability for the injury.”

According to her claims adjuster’s notes, Albright’s employer, Smurfit-Stone, was “not happy” with WSI’s decision to accept her claim. The agency agreed to reconsider — a decision a judge later described as “bowing to pressure from the employer” — and hired an independent medical reviewer to look over Albright’s records.

Without examining Albright, that doctor said her back problems were the result of a degenerative condition unrelated to work. Using the new opinion, the agency denied the claim.

Albright’s own doctor was dumbfounded, according to a letter he wrote WSI. While Albright had problems in her neck and lower back, an MRI from a few years before showed she didn’t have any problems in her lower middle back, where the herniated disc was, he wrote. Any pre-existing condition, he said, was most likely caused by the repetitive twisting and jarring she experienced driving the forklift.

“Clearly, the single event at work led to her herniated disc,” he wrote in his letter. Millions of Americans had her back problem, he noted, but it didn’t mean they were all doomed to have herniated discs in the future.

A judge in Albright’s case called the agency’s medical reviewer a “professional witness” who had “only read about” the tissues and intervertebral discs that Albright’s neurosurgeon “once held in his hands.”

The judge ruled in her favor, but the North Dakota Supreme Court overturned that decision, noting that the legislature has restricted the courts’ oversight of the workers’ comp agency to cases where no “reasoning mind” could have come to the same conclusion.

In an interview, WSI director Bryan Klipfel stood by the decision, saying work didn’t cause Albright’s injury.

“I’ve got bad back issues also,” he said. “But if I’m at work and I bend over to pick up a paper clip or something and my back goes out, it’s maybe caused at the job, but my job didn’t cause the injury.”

RockTenn, which owns Smurfit-Stone, said the case was handled appropriately.

Albright, 57, remains out of work and on programs funded by taxpayers. The Social Security Administration awarded her disability benefits immediately, listing the onset date as the day she felt the “ungodly pain” at work.

37 States Now Restrict Injured Workers’ Ability to Choose Their Doctors

Christopher Carter’s left foot was mangled when it got sucked into a conveyor belt at a gravel pit in Great Falls, Montana, in July 2012.

The 43-year-old mining equipment mechanic went to a podiatrist who recommended a simple, inexpensive remedy: a cortisone injection to reduce inflammation and alleviate the pain, according to medical records.

His workers’ comp claim could have ended there. But Carter soon learned that something as basic as choosing your own doctor is no longer guaranteed in workers’ comp. A 2011 Montana law gave employers and insurance companies the right to pick workers’ doctors after accepting their claims and to transfer their care to another doctor at any time.

Eighteen states now allow employers to select the physician who treats their injured workers at least initially, according to the Workers Compensation Research Institute. And another 19 states require many workers to choose from a list of doctors — sometimes as few as four — approved by their state, insurer or employer.

After Carter saw the podiatrist, his employer’s insurer, the Montana Contractor Compensation Fund, sent him to an independent medical examiner, who also recommended a cortisone shot.

Instead of approving the treatment, the insurer changed his treating physician. Same result: The new doctor also recommended the shot, referring Carter back to the podiatrist he’d seen to begin with.

Carter’s insurer wouldn’t authorize him to see the podiatrist who initially cared for him or even another recommended by the new treating doctor. Instead, the insurer inexplicably sent Carter for another exam, this time bringing in an orthopedic surgeon from Missoula, 170 miles away. She recommended a similar injection.

Two years after his injury, Carter still hadn’t received approval for an injection, although four doctors had recommended it. His insurer just kept sending him to more doctors.

Mel Pozder, senior claims examiner for the contractors’ fund, declined to comment, citing health privacy laws.

Out of frustration, Carter settled his case with the Montana Contractor Compensation Fund last spring for $46,250 to cover his unpaid medical bills and future wage loss. He has struggled to find work to support his three children, ages 11 to 15, and now works at a relative’s auto body shop.

“I think that my foot and ankle could have been healed by now, or greatly improved, if Montana law allowed me to choose my treating physician,” he wrote to a state legislative committee studying workers’ comp last year.

“I’m 43,” he said in an interview, “and I walk like I’m 80.”

California Now Uses New, Stricter Guidelines to Reassess Old Cases and Deny Care

In 1997, Frances Stevens was the editor and publisher of Curve, one of the best-selling lesbian magazines in the country. She was in incredible shape and training for the Golden Gloves boxing tournament.

One day in October, she and her staff were carrying boxes of the magazine’s latest issue to a storage closet. Stevens, 30, tripped over an area rug and broke a bone in her foot. She was put in a cast and had surgery.

The bone healed, but the fall damaged her nerves, leaving her with excruciating, unexpected pain, often affecting both feet.

More than 17 years later, Stevens can’t walk and gets around in a motorized wheelchair. At night, the simple brush of a bed sheet over her feet will send her screaming in pain. She can’t take a shower without submerging her feet in a bucket of water so that the stream won’t touch them directly.

“It’s like that nerve pain that just zings through your whole body like an ice pick,” she said.

California’s workers’ comp system once paid for a home health aide to help Stevens during the day. But in 2013, a new law took effect, subjecting old cases like Stevens’ to a greater emphasis on narrow guidelines that, among other things, severely limited home health care for people injured at work. When Stevens needed to replace her aide, her insurer, the State Compensation Insurance Fund, used that request to decide that an aide was not medically necessary.

Under the new law, Stevens’ only recourse was to appeal to an independent medical reviewer chosen by a company hired by the state. But that doctor never needed to see her, didn’t have to be licensed in California, would remain anonymous and could only be challenged under limited circumstances.

 

She was supposed to get an answer in 30 days, but instead the process took nearly seven months. The medical reviewer upheld the insurance company’s decision to deny the aide.

Now, Stevens is challenging the constitutionality of that process. In a petition recently accepted by the 1st District Court of Appeal in San Francisco, she argues that allowing medical decisions to be made by anonymous doctors who don’t examine the patients and can’t be questioned violates the rights of injured workers.

California workers’ comp issued a warning to insurance companies last week that the new law shouldn’t be used to revisit existing agreements for home health care.

The State Compensation Insurance Fund said the request for the aide was denied based on medical evidence. In documents filed with the appeals court, it argued that workers have adequate avenues for appeal and that the legislature acted appropriately to try to create a “faster and cheaper” process that would “promote better health.”

“The legislature’s motivation was to help both employers and injured workers,” it wrote.

Having been both an employer and injured worker has given Stevens a unique perspective on a system she only thought about when she paid her insurance premiums.

“I had just turned 30. I was an athlete. I had a job that I loved, a life that I loved. I couldn’t ever imagine this happening to me, and in a second, my life changed,” Stevens said. “If people don’t stand up and start noticing how broken the system is, by the time you figure it out, it’s going to be too late.”

Correction: An earlier version of this story said that Christopher Carter was sent by his employer’s insurer for an independent medical exam in Missoula, Montana. Instead, the insurer brought the Missoula physician to Great Falls for the exam.

 

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Getting a Painkiller from a Doctor Is About to Get Harder

The government set new guidelines for primary care physicians on prescribing medicines for chronic pain.

http://www.usnews.com/news/articles/2016-03-15/cdc-issues-guidance-on-prescription-painkillers

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National Guard, DEA, State Police Raid Elderly Cancer Patient Over 4 Pot Plants

 

www.mintpressnews.com/national-guard-dea-state-police-raid-elderly-cancer-patient-4-pot-plants/219155/

In a gross display of wasted taxpayer dollars, dozens of Massachusetts National Guard personnel, operating under a grant from the DEA, alongside Massachusetts State Police, descended into the backyard of an 81-year-old cancer patient in a raid last week — to protect society from the dangers of his four marijuana plants.

Paul Jackson, 81, of Martha’s Vineyard, grows cannabis to make medicine. His plants, along with several other plants, became the target of law enforcement last week in a crackdown on hardened criminals who’d dare to grow a plant that helps them.

Jackson was in his backyard last Tuesday when plainclothes men and a helicopter descended on his property. With no warrant, and without showing identification, these heroes ripped Jackson’s plants from the ground.

“They just come charging through and start cutting it down,” Jackson said in an interview with the The MV Times.

According to the The MV Times, Mr. Jackson, a lifelong Islander and renowned organic gardener with over 300 ribbons from the Martha’s Vineyard Agricultural Fair, expressed both bewilderment and disgust when he spoke to The Times on Friday.

“I told them they don’t know what they’re doing, they’re destroying it and it could be used for good purposes,” he said. “I know because I went through it before. You wrote about it in The Times. I had the article framed, took it out to show them; I said, ‘This is proof of what it does,’ but they didn’t want to hear it.”

As The Times reports, Mr. Jackson was referring to a February 2013 article,” Love, life, and death: A Martha’s Vineyard marijuana story,” in which he described how cannabis tea had helped Mary, his wife of 53 years, through the pain of pancreatic cancer and the ravages of chemotherapy. Mr. Jackson said they forsook the morphine prescribed by her doctors, and substituted cannabis tea for pain management.

“I never ever saw pain in her face,” he said. “She was eating and happy, right up until she died. You had to see it to believe it. People don’t understand it. It’s a beautiful plant and it works beautifully.”

For years, Jackson has been growing this beneficial plant to help his wife, himself, and other friends in the area.

“There’s another fellow I’ve given it to, his wife has cancer bad,” he said. “They mix it with her food and it’s really helping her. Another fellow had a tube down his stomach and his wife would pour [tea] down his tube for the pain. And it worked. At least there’s no damn pain in it. I gave another guy some, he was taking seven different pills a day. I talked to him a month later and he said he’d gotten rid of three of those pills. It works on all kinds of different things.”

However, these poor people will now suffer thanks to the public service provided by the government in their attempts to stamp out this miraculous plant.

While medical marijuana is legal in Massachusetts, to a certain extent, Jackson says he grows his own because it’s far healthier.

“The people that are selling it are using chemicals that react with the chemotherapy,” he said. “Mine is much better because it’s organically grown. I saw it with my own eyes, I couldn’t believe how well it worked.”

In the interview, Jackson noted that he doesn’t smoke the plant and will continue to consume it, in spite of the immoral laws that prohibit it.

“I don’t like smoke and I don’t like dust,” he said. “We just make tea out of it. But if I need to make the tea, I’ve got it. I don’t sell it. I will continue to have a certain amount in case somebody close to me needs it.”

When word began to spread about this embarrassing action to eradicate a beneficial plant, spokesmen from the agencies involved in the raid began denying they had a hand in it.

After their heroic mission to rid Martha’s Vineyard of cannabis, Colonel James Sahady, Public Affairs Officer for the Massachusetts National Guard, said in an email to The Times, “The order was initiated by the DEA and Massachusetts State Police as part of pre-planned eradication missions throughout the year.”

However, Sahady later issued another statement claiming that the DEA was not involved.

On top of the National Guard’s flip-flop, The Times reports:

On Tuesday, two Massachusetts State Police spokesmen checked into the matter and said there was no evidence of State Police involvement. “It was not us,” Officer Tom Ryan told The Times.

In a follow up email received on Thursday, State Police spokesman David Procopio said the operation was initiated by the State Police. “We routinely request the assistance of the National Guard in these operations,” Mr. Procopio said in an email to The Times. “Our Narcotics Inspection Section conducts these operations regularly across the state. We utilize a trained spotter in a helicopter to search for marijuana grow sites. Once one is located, the spotter directs ground units to the plants, which are confiscated and taken by State Police for eventual destruction. These seizures occasionally result in criminal prosecutions, but many times do not, if the plants are seized from rural or wooded areas that can be accessed by many people (as opposed to just growing in some homeowner’s backyard).”

Mr. Procopio said State Police seized 392 plants, “which are slated for destruction as part of our next narcotics burn.”

Although the helicopter was parked at Martha’s Vineyard Airport last Tuesday night, there are no records of landing fees or fuel purchases paid by a government agency, according to airport manager Ann Crook.

“The idea we’re so frivolously spending money on marijuana interdiction, especially now when it’s about to be rolled back, is extremely frustrating. How many books or school lunches could have been bought instead of having these plants ripped up?” Bill Downing, spokesman for MassCan/NORML said to The Times.

Downing’s sentiment is a very real concern as the war on drugs has spent upwards of a trillion taxpayer dollars since its inception. Every one of those dollars spent ruining the lives of otherwise entirely innocent people.

At any one time, 59,300 prisoners charged with or convicted of violating marijuana laws are behind bars. Of those, 17,000 are behind bars for possession ONLY, not trafficking.

Enforcing marijuana laws costs an estimated $10-15 billion in direct costs alone — not to mention the sustained costs of incarceration of the individual who has done nothing to harm anyone. It is estimated that the money spent enforcing useless marijuana laws is double what we spend on education in this country.

Countless lives are ruined every year as the state locks people away or worse, for possessing a plant. The time is now to end this violent ridiculousness before another innocent life is ruined or taken in the name of controlling what people can put in their own bodies.

---

Matt Agorist is the co-founder of TheFreeThoughtProject.com, where this article first appeared.

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Hearings Begin In Journalist’s Freedom Of Information Lawsuit Against DEA

http://ripr.org/post/hearings-begin-journalists-freedom-information-lawsuit-against-dea

 A judge in U.S. District Court in Rhode Island began hearings Wednesday in a lawsuit against the Federal Drug Enforcement Agency, spurred by a local journalist.

Providence-based writer Phil Eil, says he’s fought for more than five years to obtain access to thousands of pages of public evidence from a pill-mill trial, about which he plans to write a book.

“I think it’s long overdue that the press and the public have access to the evidence, and I hope the judge will agree with that and say this has gone on long enough,” said Eil. 

The ACLU of Rhode Island is representing Eil. ACLU Director Steve Brown said the DEA has unfairly denied Eil the documents he requested.

“We’re not saying he’s entitled to all of them. We do recognize that there are privacy concerns,” said Brown. “But the DEA has really engaged in a wholesale denial of literally thousands of documents.”

The case in question involves a Chicago doctor found guilty of distributing millions of opioids at clinics across Ohio. The physician, Dr. Paul Volkman, was sentenced to four consecutive life sentences, one of the lengthiest criminal sentences for a physician in U.S. History.

Eil requests documents related to the case as part of his research for a book he was hoping to write.

One of Eil’s attorneys told Esquire Magazine that the DEA refused to release the bulk of the documents due to concerns involving medical privacy.

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Mud slinging – political style

I sense a HIDDEN AGENDA by those – mostly in the “Republican Establishment” that are refusing to support the candidate of the party that they are suppose to belong to.

There seems to be a solid resentment because those who are part of the “old guard” of the Republican party .. like JEB Bush.. even after spending tons of money on advertising .. never got traction. Marco Rubio said that he was not going to run for reelection to his FL Senate seat.. but.. guess what.. HE’S RUNNING…

It is almost as if the ole guard of the Republican party does not want anyone that could disrupt the reigning establishment. What if Trump won and starting looking at the Fed bureaucracy as a businessman would and start cutting the budgets for the next fiscal year – Oct 1, 2017 ?  Going after a balance budget… vetoing bills that have a massive amount of “pork” attached to them ?

It would be heresy to the establishment to start running the Fed government with a balanced budget… to start pulling back on individual agencies budgets to force many/all agencies to keep their activity to their core authority.

No more DEA going after prescribers, pharmacies and wholesalers…. CDC no more opiate dosing guidelines or other things outside of their authority under the law.

After all what is 4-8 yrs of relinquishing the White House to the Democrats so long as the rest of the “establishment” that both parties have put so much time/trouble developing over the last 240 yrs of our country’s history..  remains intact… After all there is another election in four years.

As long as the status quo remains intact. IMO.. this suggests that there is really not that much philosophical differences between the two parties.

Both parties have conventions to chose a candidate.. both .. establish their individual platforms…  but.. after the election… does any of the members of Congress even look at those platforms when they are voting on bills that are on their way to becoming laws ?

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Business Groups Sue U.S. Government Over Tax-Inversion Rules — Update

http://www.nasdaq.com/article/business-groups-sue-us-government-over-taxinversion-rules–update-20160804-01162

BY LAW… the USA President is the final authority if laws, regulations are enforced.. Congress is suppose to be the only entity within our three separate/distinct parts of our Federal government that can pass laws. Which our President can sign or veto and Congress can with a “super majority vote” can override the veto.  Doesn’t this sound similar to CDC passing opiate dosing guidelines – not laws – and then creating on-line instruction for prescriber in how they are to implement these guidelines in their practices.  How the DEA has reinterpret existing laws to meet their new agenda. As I have stated before … Congress appears to be impotent and/or our President has turned a “blind eye” to the actions of various parts of the Federal government and/or has indirectly encouraged various parts of the Federal government to go “off the reservation ” and push the envelope as far as possible in “fundamentally changing America”  If you notice the apparent ONLY PATH FOR A RESOLUTION… is going thru the courts.  As I have suggested before… many of the things being done by the States and the FEDS are unconstitutional .. but.. until someone challenges their actions in the courts… the will continue to be enforced.

The U.S. Chamber of Commerce and a Texas business group sued the federal government on Thursday, alleging that the Treasury Department’s rules limiting tax-motivated inversion transactions violate the law.

The lawsuit charges that the government rewrote the Internal Revenue Code itself after Congress wouldn’t go along with President Barack Obama’s proposed legislative changes to limit inversions.

Those April 4 rules attacked “serial inverters,” companies such as Allergan that had grown to their current size through other inversions. The rules would disregard three previous years of those deals when calculating the size of the two companies, and that matters because the tax rules are tied to the relative size of companies that merge and take a non-U.S. address.

The U.S. Treasury Department didn’t immediately respond to a request for comment.

The lawsuit points to statements in 2014 by Treasury Secretary Jack Lew in which he emphasized the limits to administrative action and said the government would be doing more if it could.

The suit also says “it was widely understood” that Treasury had written the rule to stop the Pfizer-Allergan merger. Treasury officials have said repeatedly that they didn’t target any particular deal.

Normally, lawsuits over tax regulations occur after a company has filed a tax return and been audited. In this case, the chamber and the Texas Association of Business are asserting that the rules violated the Administrative Procedure Act, which governs federal rule-making. They say the government didn’t provide adequate reasons for the rules and failed to explain why it made the rules effective immediately.

“But for this Rule, Allergan would actively explore merger opportunities with large U.S. pharmaceutical companies, and Pfizer would actively explore merger opportunities with foreign pharmaceutical companies that have recently acquired U.S. corporations or may acquire such corporations,” the lawsuit says.

Both companies are members of the U.S. Chamber of Commerce, according to the lawsuit.

Mark Marmur, a spokesman for Allergan, declined to comment. A Pfizer spokeswoman referred to April comments by Chief Executive Officer Ian Read, in which he wrote that the government’s “ad hoc and arbitrary attempt to single out and damage the growth opportunities of companies operating within the current law is unprecedented, unproductive and harmful to the U.S. economy.”

Write to Richard Rubin at richard.rubin@wsj.com

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Nearly a year ago another chronic pain pt and myself trying to raise a legal “war chest” to help with lawsuits against various entities. Our goal.. we thought .. was rather modest… to get abt 1% of the chronic pain community to donate – one time – the cost of a fast food meal – $5.00.  That would have created a FIVE MILLION DOLLAR fund to move forward… After abt one month.. upwards of a couple of dozen people had made donations … totaling some $600 and change … including two people contributing $100 each.  The project was dropped and the donations were refunded to those who had donated.

Then there is the article that I published today:

If you are disabled…your life is not worth enough for attorneys when harmed by the medical system

That suggested that unless you are a high income person and experience a disability or death from a medical error… your chances of finding an attorney to take your case on a contingency basis is between SLIM & NONE. And we know from a survey published several months ago 90% of families with a chronic pain pt.. either the disease itself – pt can’t work – or the cost of treating the disease… caused a financial hardship on the family.

Maybe there is a “money trail” here that is unseen..  The anti-opiate group is positive that there is a connection between prescribing opiates and abuse/addiction to opiates.  They fail to see the lack of connection of opiate Rxs peaked in 2012 and OD’s continue to increase.. so the DEA in 2014 moved Vicodin type products to C-II and the OD’s continue to increase.. so in 2016 we have CDC opiate guidelines and we will have to see their next move in 2018 as OD’s continue to climb.

Many of these new CDC and State guidelines have non-opiate therapy recommendations… many which is not covered by insurance and pts cannot afford.. so being non-compliant with these non-opiate therapies as a reason to DISCHARGE THE PT FROM THE PRACTICE ?

Shifting therapy to non-covered therapy, lowering the daily opium limits, anticipating less people with “opiate abuse disorder”… all of it costing the system – Medicare/Medicaid/insurance companies money.

While there seems to be no direct “death panels” as feared with Obamacare.. there is definitely is the evolution of “denial of care panels”… 

At CVS: “HEALTH IS EVERYTHING” … Cuts Coverage of Dozens of Drugs in Exclusion Expansion

This is the 3rd – 4th year in a row that CVS Health, Express Scripts and other PBM’s have removed dozens of medications that they will no longer pay for.

Vote for whoever you want – things won’t change ! OMG !

Then this article suggests that there is a “closed door Federal government” ran by un-elected bureaucrats/regulators… so you can vote in/out of office all you want and you can sign all the petitions… it would appear that either no one  is paying attention or the ones that are paying attention have no ability to effect change.

It is reported that 200 million deaths each year are caused by medical errors, but you don’t hear much about this EPIDEMIC because they are the chronically ill and who’s life – according to our legal system – has little value ?

Maybe those with chronic diseases should divert some of the money they are collecting to find a cure… and put it into a “legal war chest” to start addressing the denial of care that is a growing problem..  Maybe it is just a “thinning of the heard of  what is considered ‘takers’ ” and take the burden off of the “makers”

If you don’t read the “road signs”.. you may end up being “road kill” 🙁

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