Let’s hope that we have reached the bottom and the only way is up !

Posted on December 30, 2015 by Pharmaciststeve

stevemailbox

This showed up in my inbox. It is my understanding that TENN had a chronic pain pt’s bill of rights which the legislature recently REPEALED… how often have you ever heard of a LAW BEING REPEALED ? Has anyone checked … have they repealed our Constitution and our Bill of Rights ? Was repealing the chronic pain pts bill of rights… tantamount to endorsing a GENOCIDE of people suffering from subjective diseases ? I can recall the names of several DICTATORS in other countries that have “wiped out” segments of their population that was declared “undesirable”… we are on a very slippery slope and may have already passed the point of no return, and we are suppose to be a civilized society. Is the definition of the term “civilized” taking a dangerous revision ?

Hi I read ur article about pharmacies refusing to fill for patients. .Here in TN we have a very very big epidemic with pain medication and addiction. . I volunteer with drug treatment here in TN and I’m seeing patients daily relapse ,over dose ,even die due to pharmacies turning them away .. ANY type of buprenorphine product suboxone subutex bunavail it does not matter they r turning these patients away .. not one pharmacy EVERY PHARMACY. I saw a veteran last month over dose the day he got into drug treatment because he spent all day driving through 5 counties stopping at every pharmacy he saw and being told no they won’t fill suboxone for him … a schedule 3 drug !! For drug treatment. . He over dosed that night ..because he CLD not get this life saving medication .. they give up at a point of being as low as they can get begging for help ..finally reaching out asking for help and getting into a program all to be turned away and the help become unobtainable. .BECAUSE THE PHARMACIES. .it’s horrible TN needs help ..even on a federal level president Obama just addressed the nation explaining that medication assisted treatment wld be the way the nation handles drug addiction and patients seeking help .. the old ways were failing and M.A.T. programs r seeing higher success rates… yet here in TN we can’t even get patients medication filled. .even those who have used the same pharmacy for 5 YRS r still being told NO. . there has to be a way to stop this and fix this situation ?? Would you know of anything or anyone I can reach out to?

Filed under: General Problems | 3 Comments »

700,000 died in 2015 from drug resistant infections , 23,000 in USA alone !

Posted on December 29, 2015 by Pharmaciststeve

Another killer could top cancer by 2050—and we’re to blame

http://www.foxnews.com/health/2015/12/29/another-killer-could-top-cancer-by-2050-and-were-to-blame.html?intcmp=hpffo&intcmp=obnetwork

We’ve already been warned about an “antibiotic apocalypse.” Now a new study says medicine-resistant infections will take more lives annually than cancer does by 2050 unless action is taken, CNBC reports.

According to the Review on Antimicrobial Resistance, deaths caused by drug resistance will rise from 700,000 in 2015 to an estimated 10 million per year in 2050.

The problem: People around the world are taking more antibiotics, rendering them less effective, while global food production uses at least as many, the Guardian reports.

Meanwhile, fewer new antibiotics are being made. In time, the study says, we may no longer be able to treat diseases that are now curable. “The problem is straightforward,” writes Jim O’Neill, who chairs the Review, in the Guardian.

“As valuable as scientific breakthroughs may be, it takes a lot of work to turn them into marketable drugs. And … antibiotics generally produce low—and sometimes even negative—returns on investment for the pharmaceutical makers that develop them.” So he’s calling on philanthropists and governments to create an R&D fund to create new antimicrobial drugs.

He estimates a cost of less than 0.1% of global GDP, far less than the alternative: “$100 trillion in lost production by 2050 and 10 million lives lost every year.” (Here’s the latest food chain to go antibiotics-free.)

This article originally appeared on Newser: New Killer to Top Cancer by 2050—and We’re to Blame

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Doc has license suspended for treating/maintaining ONE ADDICT..

Posted on December 29, 2015 by Pharmaciststeve

Libby doctor’s license suspended for over prescribing

http://www.nbcmontana.com/news/Libby-doctor-s-license-suspended-for-overprescribing/37139038.

HELENA, Mont. (AP) –

The state Board of Medical Examiners has indefinitely suspended a Libby physician’s license after finding he overprescribed pain medication to a patient.

Another physician filed the complaint against Clyde Knecht in August after a former patient of Knecht’s sought treatment for her hydrocodone addiction.

The board says the complaining physician searched the Montana Prescription Drug Registry and found that between March and August the woman was prescribed nearly 2,500 doses of hydrocodone-acetaminophen.

Knecht told regulators that he had tried to refer the patient for treatment of her narcotic addiction. He also argued that prescribing narcotics was preferable to a dependence on alcohol or street drugs.

Knecht has 20 days to request a hearing. He did not return a phone call seeking comment.

 

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TURF BATTLE between #FDA and #CDC forming ?

Posted on December 29, 2015 by Pharmaciststeve

Editorial: New drug guidelines should be a top priority

http://www.herald-dispatch.com/opinion/editorial-new-drug-guidelines-should-be-a-top-priority/article_644bdae3-6331-5457-ae4e-f1d91c2b6434.html

A federal agency’s effort to help curb the deadly impact of opioid use by the American public has run into a sizable obstacle – one that we hope won’t become permanent.

At issue were new prescribing guidelines for potent opioid painkillers such as OxyContin, Vicodin and Percocet, the type of drugs linked to alarming increases in overdoses and overdose deaths. The Centers for Disease Control and Prevention has worked to develop the guidelines and was scheduled to finalize them next month.

But then came the pushback from the companies that make those drugs and from lobbying groups funded by those companies. Even some officials from the U.S. Food and Drug Administration apparently began feeling a little territorial and also criticized the CDC for its proposed guidelines, according to a report by The Associated Press.

The result? The CDC recently dropped its January target date. Now, the CDC will open its proposals for public comment for 30 days, prompting advocacy groups pushing for the guidelines to worry that the proposal may be abandoned altogether.

Let’s hope that won’t be the case.

The CDC’s proposed guidelines, which would not be binding upon physicians, calls for doctors to prescribe opioid drugs only as a last choice for chronic pain, after first having patients try non-opioid pain relievers, physical therapy and other options. The proposal also calls upon doctors to prescribe initially the smallest supply of the drugs possible, just enough for a few days to handle acute pain.

Considering how addictive these painkillers are and their potentially harmful effects, the proposed guidelines make perfect sense. But not to those who stand to make a lot of money; total sales of these pain medications amounted to more than $9 billion last year, the AP reported.

The groups opposed to the guidelines say they were developed in secrecy and have criticized the CDC for not making public the names of people and organizations involved. That may have been a tactical blunder by the CDC, but not sufficient cause to abandon the guidelines.

Nor is the criticism last month from FDA officials and other health agencies at a meeting of pain experts. They described the guidelines as “shortsighted” and relying on “low-quality evidence.”

It’s unclear exactly what kind of evidence those FDA officials were looking for, but Tri-State residents see repeated evidence of what the current climate for prescribing opioid painkillers has done. West Virginia has the highest drug overdose death rate in the nation, and the Huntington region has been hit particularly hard this year by overdoses and more than 90 overdose deaths. A majority of those deaths are linked to opioid painkillers, while most of the others are tied to heroin use. And as CDC Director Dr. Tom Frieden has noted, the widespread availability of opioid painkillers means more Americans are “primed” for herion use.

West Virginia’s senior U.S. senator, Joe Manchin, is unhappy about the delay, particularly FDA officials’ resistance to the proposed guidelines. In a letter to U.S. Department of Health and Human Services Secretary Sylvia Mathews Burwell, he cites the alarming statistics showing a 16 percent increase in prescription-opioid deaths between 2013 and 2014, and the deaths of nearly 19,000 people due to prescription drugs last year alone. He urged Burwell’s agencies, including the FDA, to get behind what he called a unified effort to reduce the abuse of opioid drugs.

If those agencies truly have the public’s interest at heart, they will side with responsible guidelines for prescribing opioids rather than the companies who are making billions off the sale of these deadly drug

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Bold bid to rein in painkiller prescriptions hits roadblocks

Posted on December 29, 2015 by Pharmaciststeve

Bold bid to rein in painkiller prescriptions hits roadblocks

http://bigstory.ap.org/article/136b3db7f6fe42bd8836880e91bf9ac9/bold-bid-rein-painkiller-prescriptions-hits-roadblocks

WASHINGTON (AP) — A bold federal effort to curb prescribing of painkillers may be faltering amid stiff resistance from drugmakers, industry-funded groups and, now, even other public health officials.

The Centers for Disease Control and Prevention was on track to finalize new prescribing guidelines for opioid painkillers in January. The guidelines — though not binding — would be the strongest government effort yet to reverse the rise in deadly overdoses tied to drugs like OxyContin, Vicodin and Percocet.

But this highly unusual move — the CDC rarely advises physicians on medications, a job formally assigned to the Food and Drug Administration — thrust the agency into the middle of a longstanding fight over the use of opioids, a powerful but highly addictive class of pain medications that rang up over $9 billion in sales last year, according to IMS Health.

 

Critics complained the CDC guidelines went too far and had mostly been written behind closed doors. One group threatened to sue. Then earlier this month, officials from the FDA and other health agencies at a meeting of pain experts bashed the guidelines as “shortsighted,” relying on “low-quality evidence.” They said they planned to file a formal complaint.

The CDC a week later abandoned its January target date, instead opening the guidelines to public comment for 30 days and additional changes.

Anti-addiction activists worry the delay could scuttle the guidelines entirely.

“This is a big win for the opioid lobby,” said Dr. Andrew Kolodny, co-founder of Physicians for Responsible Opioid Prescribing, a group working to reduce painkiller prescribing.

CDC Director Dr. Tom Frieden said politics did not play a role and the guidelines remain a priority.

“We want to make sure we don’t go so fast that there are questions about our process, but we certainly don’t want to see any further delay,” Frieden told The Associated Press.

Frieden said the FDA and other agencies support his effort, despite the negative comments from some officials. The Department of Health and Human Services, which oversees both the CDC and the FDA, said the guidelines are critical to “tackling the opioid epidemic.”

Frieden acknowledged the limited evidence comparing various treatments. “But there is no way we can wait for better evidence while so many people are dying.”

Under the proposed guidelines, doctors would prescribe these drugs only as a last choice for chronic pain, after non-opioid pain relievers, physical therapy and other options. The CDC also wants doctors to prescribe the smallest supply of the drugs possible, usually three days or less for acute pain. And doctors would only continue prescribing the drugs if patients show significant improvement.

The CDC’s logic: Reshaping how primary care doctors use painkillers would result in fewer prescriptions and, therefore, fewer deaths. By its estimation, deaths tied to these drugs have surged more than four-fold since 1999.

But industry-funded groups like the U.S. Pain Foundation and the American Academy of Pain Management warn that the CDC guidelines could block patient access to medications if adopted by state health systems, insurers and hospitals. Such organizations often look to the federal government for health care policies.

The CDC decision to delay its guidelines followed months of lobbying by physician and patient groups aligned with the pharmaceutical industry, who have almost always had a seat at the table in federal discussions on painkillers. As a result, they have had far more influence over federal policy than addiction activists, according to experts.

“They’re very well-funded and they have a lot of pharma money behind them,” said Dr. Lewis Nelson of New York University, an FDA adviser who is also advising the CDC on its guidelines. “And then you have the anti-addiction groups on the other side, which is clearly much less funded and organized.”

___

THE PAIN DEBATE

Behind the CDC controversy is a decades-long debate over the use of opioids, which include medications like morphine and codeine and illegal narcotics like heroin.

For most of the 20th century, doctors reserved opioids for severe, short-term pain — such as after surgery — or chronic pain from deadly diseases like cancer.

But in 1990s that changed, as some specialists argued the drugs could be used safely to treat common ailments like back pain and arthritis. The message was amplified by multimillion-dollar promotional campaigns for new, long-acting drugs like OxyContin, which was promoted as less addictive.

That drug’s maker, Purdue Pharma, later agreed to plead guilty and pay over $600 million in fines for misleading the public about OxyContin’s risks. But prescriptions continued to rise — along with deaths.

Purdue declined to comment for this story.

Deaths linked to misuse and abuse of prescription opioids climbed to 19,000 last year, the highest figure on record, according to the CDC. Heroin and opioid painkillers caused 28,650 fatal overdoses in 2014, or 61 percent of all drug-related overdose deaths.

CDC’s Frieden says more Americans are “primed” for heroin use because of their exposure to painkillers.

Pain care advocates say they were blindsided, though, when the CDC moved to create formal guidelines without first consulting them.

“It looks to us like they had a pretty good idea of what they wanted these things to say, and they wanted to minimize feedback that was contrary to that,” said Dr. Robert Twillman of the American Academy of Pain Management, a group which represents pain physicians and receives funding from painkiller manufacturers such as Purdue and Teva Pharmaceuticals.

Twillman’s group has asked Congress to investigate the CDC’s handling of the guidelines, including an expert panel of advisers, which it says is “studded with a number of individuals who are publicly on record as opposing the use of opioids.”

The CDC had not publicly disclosed the panel’s membership, but Twillman and other pain advocates identified several members, including two who are leaders with Physicians for Responsible Opioid Prescribing, a group working to reduce painkiller prescribing. That group is backed by Phoenix House, a network of rehabilitation clinics.

The Washington Legal Foundation — a conservative group which frequently represents pharmaceutical interests in court — says CDC is in “blatant violation of federal law” for not disclosing its advisers. The foundation wants the CDC to scrap its current guidelines and start over.

___

BATTLE FOR INFLUENCE

Many of the patient and physician groups opposing the CDC guidelines are part of a larger coalition called the Pain Care Forum, which meets monthly in Washington to strategize on pain issues. Officials from the White House, the FDA, NIH and other agencies have met with the group over the years, according to documents obtained by The Associated Press under the Freedom of Information Act.

The Pain Care Forum presents itself as a leaderless collective that does not take formal positions. But most members receive funding from drugmakers, including OxyContin-maker Purdue, whose chief lobbyist helped found the group and remains at its center.

Anti-addiction advocates worry that outside pressure from such groups led the CDC to re-open its guidelines for comment.

“Opening a docket will tack months on to the process and increases the likelihood that the guideline might never be released,” said Kolodny, an addiction therapist.

It’s a process advocates say has played out before at the FDA, which as the nation’s top drug regulator writes the prescribing labels that accompany prescription drugs.

In 2009, the FDA announced it would develop “risk management” plans to ensure extended-release opioids were used safely. The agency’s initial ideas included mandatory certification for doctors who prescribe drugs like OxyContin and a national registry to track patients taking the drugs.

But industry pushed back. The Pain Care Forum developed its own “consensus guidelines,” which opposed any measures creating “new barriers” to medication. At the same time, the group’s members generated a 4,000-signature petition opposing registries, saying they would stigmatize patients.

Instead of the tough measures initially floated, the FDA in 2012 put in place modest changes: drugmakers would fund physician training programs, but they would be optional. Additionally, patients would receive a pharmacy pamphlet about opioid risks.

“We were stunned,” Kolodny said.

An FDA spokesman provided information about the development of risk plans in response to inquiries for this story.

If the final CDC guidelines emerge intact, they may push physicians to reconsider alternate treatments like physical therapy, counseling or modifying patients’ routines. Experts say those methods proved effective before the rise of painkillers.

“As a civilization we somehow managed to survive for 50,000 years without OxyContin and I think we will continue to survive,” agency adviser Nelson said.

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Prescription label mix-up: Racism or a mistake?

Posted on December 29, 2015 by Pharmaciststeve

Prescription label mix-up: Racism or a mistake?

http://fox11online.com/news/nation-world/prescription-label-mix-up-racism-or-a-mistake

FRESNO, Calif. (KMPH) – Is it a case of racism or a simple mistake?A Laotian family from Fresno wants an apology.Family members claim a CVS Health Pharmacy technician changed their real address on a prescription bottle to an address on China Avenue.The family believes it was jab at them.The family says they argued with the pharmacy technician about whether the hospital faxed over the prescription paperwork.

Linda Phommaseng says, “He said, ‘No, they gave you guys a hard copy prescription and you guys need to bring that in.’ I said, ‘No, they didn’t. They told us to come on down and just pick it up and they are faxing it over.’ He just seemed a little mad and angry. He finally made the call to Community Hospital. They told him they would send it over as soon as the doctor signed it. He asked for my husband’s ID. He then entered it in the computer and said it could take a few hours.”

The next day, Phommaseng says she picked up the pain pills.

A few days later, she was about to throw the receipt away when she saw her street address on the prescription had been changed to China Avenue.

She call the store to get some answers.

Phommaseng says, “The same guy picked up the phone. I asked if the patient’s address is on the prescription when it’s being sent over. So, he just asked for our date of birth. I gave it to him and I just told him as he was looking it up that this is pretty racist. He said, ‘How is this racist?’ I said, ‘Our street address–that is not the correct street address.’ He said, ‘Oh, would you like to update it to Turner Avenue?’ I said, ‘That is pretty racist, I didn’t even give you my street address. How did you know that was the correct one?'”

She says the technician just stayed quiet and then she hung up.

KMPH Fox 26 News Investigative Reporter Erik Rosales contacted the CVS Health Corporate office.

A CVS Health spokesman sent KMPH Fox 26 News the following statement:

These allegations are not in keeping with our company’s values and commitment to serving our customers. CVS/pharmacy has firm nondiscrimination policies that are rigorously enforced throughout the company and we are strongly committed to creating an environment that fosters diversity across all areas of our business. We do not tolerate any practices that discriminate against any of our customers or employees and we are actively investigating this matter.

 

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federal government’s lax enforcement of the HIPAA law

Posted on December 29, 2015 by Pharmaciststeve

Few Consequences For Health Privacy Law’s Repeat Offenders

http://www.gpb.org/news/2015/12/29/few-consequences-for-health-privacy-laws-repeat-offenders

NPR —

When CVS Health customers complained to the company about privacy violations, some of the calls and letters made their way to Joseph Fenity. One patient’s medication was delivered to his neighbor, revealing he had cancer. Another was upset because a pharmacist had yelled personal information across the counter.

Fenity worked on a small team that dealt with complaints directed to the company president’s office, assuring customers their situations were rare. “I sincerely apologize on behalf of CVS Health,” Fenity says he’d respond. “This is not how we handle things. The breach of your protected health information was an isolated incident and we’ll do better.”

In fact, Fenity learned partly from battling CVS over the privacy of his own medical information that was “a lie.”

CVS is among hundreds of health providers nationwide that repeatedly violated the federal patient privacy law known as HIPAA between 2011 and 2014, a ProPublica analysis of federal data shows. Other well-known repeat offenders include the U.S. Department of Veterans Affairs, Walgreens, Kaiser Permanente and Walmart.

And yet, the agency tasked with enforcing the Health Insurance Portability and Accountability Act took no punitive action against these providers, ProPublica found.

In more than 200 instances over those four years, that agency, the Office for Civil Rights within the U.S. Department of Health and Human Services, reminded CVS of its obligations under the law or accepted its pledges to improve privacy protections. (CVS did pay a $2.25 million penalty in 2009 for dumping prescription bottles in unsecured dumpsters.)

To be sure, the organizations with the most HIPAA violations are all large health care providers with many locations that serve millions of patients each year. In statements, they said they take privacy seriously. (Walmart declined to comment.)

“CVS Health is strongly committed to protecting the privacy of our patients’ health information,” CVS spokesman Mike DeAngelis wrote. “We have established rigorous privacy policies and procedures throughout the Company to safeguard patient information.”

Over the course of this year, ProPublica has reported on loopholes in HIPAA and the federal government’s lax enforcement of the law. A story earlier in December detailed how the Office for Civil Rights only rarely imposed sanctions for small-scale privacy breaches that caused lasting harm.

The data analyzed for this story shows the problem goes beyond isolated incidents, carrying few consequences even for those who violate the law the most.

“The patterns you’ve identified makes a person wonder how far a company has to go before HHS recognizes a pattern of noncompliance,” said Joy Pritts, a health information privacy and security consultant who served as chief privacy officer for HHS’ Office of the National Coordinator for Healthcare Information Technology until last year.

Pritts said the government is supposed to take into account a health provider’s prior track record of following the law when deciding whether to pursue fines for privacy violations. “You have to ask whether that’s happening,” she said.

The VA was the most persistent HIPAA violator in the data. Time and again, records show, VA employees snooped on one another and on patients they weren’t treating. One employee accessed her ex-husband’s medical record more than 260 times. Another employee peeked at the records of a patient 61 times and posted details on Facebook. A third improperly shared a vet’s health information with his parole officer.

All told, VA hospitals, clinics and pharmacies violated the law 220 times from 2011 to 2014. For this story, ProPublica counted as violations those complaints that resulted in either corrective-action plans submitted by a health provider or “technical assistance” provided by the Office for Civil Rights on how to comply with the law.

The VA has never been called out publicly by the Office for Civil Rights or sanctioned for its string of violations.

The VA would not make an official available for an interview, but said in a written statement that it “takes veteran privacy and the privacy of medical or health records very seriously.”

“The challenges VA is facing are similar to those experienced across public and private sectors, and we are continuously striving to better protect veteran data,” its statement said, adding that it provides training to staff, investigates complaints and conducts audits of who accesses health records.

Some privacy problems–whether inadvertent or the deliberate acts of rogue employees–are to be expected. But repeated complaints may signal organizational failures, experts say.

“I don’t think it’s a defense to just say, ‘We do a billion prescriptions a year,'” said Mark Rothstein, chair of law and medicine and the founding director of the Institute for Bioethics, Health Policy and Law at the University of Louisville School of Medicine. “They need to be more assertive to try to figure out what’s wrong. It may be true that you can’t get down to zero, but you need to make a really good faith effort to follow up on the complaints that were filed.”

OCR has broad latitude in deciding how to handle complaints. It can resolve them privately and informally, as it has chosen to do in the vast majority of instances. It also has the authority to impose fines of up to $50,000 per violation, with an annual maximum of $1.5 million. In the most egregious cases, the agency can file criminal charges against violators. It is also free to post complaints online, if it protects patients’ identities.

Deven McGraw, deputy director for health information privacy at the Office for Civil Rights, said the agency’s top priority has been investigating breaches that affect at least 500 people, which providers are required by law to report promptly. “Often, when we take a look into those breaches, what we find is that they were not accidents,” she said. “What contributed to the breach of thousands, if not tens of thousands of records, was systemic noncompliance…over a period oftentimes of years.”

Still, McGraw acknowledged, more can be done about health providers with multiple HIPAA violations.

“I don’t like the idea of repeat offenders not being called to task for that behavior and I would like to see us doing more in this regard,” she said, adding that the office’s case management system in the past was an impediment but is now being fixed to proactively flag them.

Although the Office for Civil Rights receives thousands of complaints a year nearly 18,000 in 2014 it issues only a handful of financial penalties. The agency posts details online about the fines violators have agreed to pay (fewer than 30 since 2009), as well as a listing of large breaches. But that represents a tiny share of the incidents investigated by the office; the rest has been hidden from the public.

Asked why the office did not post details of repeat violations online, spokeswoman Rachel Seeger wrote in an email: “Entities who are the subject of complaints are not necessarily guilty of a crime or a civil wrong. Our office makes public details of cases that result in settlements and formal corrective action agreements or civil monetary penalties on our website.”

Despite the VA’s status as the top serial HIPAA violator in ProPublica’s analysis, McGraw said, “that doesn’t mean that we treat them any differently in terms of our overall enforcement philosophy.”

Using data provided by OCR under the Freedom of Information Act, ProPublica is launching a new tool, HIPAA Helper, which allows users to look up reports of privacy violations by provider for the first time. OCR’s material often referred to the same entities by multiple names. CVS was listed as “CVS,” “Pharmacy, CVS,” “Caremark, CVS,” “CVS Caremark” and more. Kaiser Permanente was identified as “Kaiser Foundation Hospital,” “Kaiser Hospital,” “Kiaser Permanente,” and even “KP.” We have standardized organizations’ names to make searching easier.

The database also includes the large breaches self-reported by health providers to the Office for Civil Rights, privacy incidents logged separately by the VA and violations cited by the California Department of Public Health, which can impose its own fines against hospitals for failing to protect patient privacy. (Read our methodology.)

Two reports issued this fall by the HHS inspector general faulted the Office for Civil Rights’ case-tracking system for its inability to track repeat offenders.

The Office for Civil Rights said it is taking steps to fix those problems.

To gain a better understanding of the nature of the complaints received by OCR, ProPublica requested dozens of letters sent by the office to health providers detailing the allegations and how they were resolved.

In the case of CVS, common complaints included giving drugs to the wrong patients, speaking too loudly when discussing health information in front of customers, and faxing medical information to the wrong places (including to random strangers).

Many of the letters culminate with the admonition: “Should OCR receive a similar allegation of noncompliance against CVS in the future, OCR may initiate a formal investigation of that matter.”

But that doesn’t seem to have happened.

DeAngelis, the CVS spokesman, said the company’s 200,000 employees who work in pharmacies, medical clinics and call centers are required to complete privacy training when they are hired and every year afterward. That’s in addition to regular on-the-job-training on privacy practices, he wrote.

Walgreens ranked third for the number of privacy complaints resolved with corrective actions or technical assistance, ProPublica’s analysis showed. Spokesman Jim Graham said in an email that the company “takes the privacy and security of our customers’ information very seriously. Walgreens thoroughly investigates any concern about privacy regardless of how it is brought to our attention and will voluntarily improve practices if necessary.”

Beyond the cases in OCR’s data, there have been other incidents indicating that Walgreens sometimes struggles with patient privacy. In 2013, an Indiana jury ordered the company and one of its pharmacists to pay $1.44 million because the pharmacist looked in a patient’s prescription records and told her ex-boyfriend that she had stopped taking birth control pills before becoming pregnant. The verdict was upheld by the Indiana Court of Appeals.

Nicolas Terry, a professor and executive director of the Hall Center for Law and Health at Indiana University’s law school, said the Office for Civil Rights has moved more aggressively in recent years to impose fines against health providers that have had large-scale breaches or have done “dumb things,” such as a cardiology group that used a publicly accessible online scheduling system. Still, he said, the agency could do more.

“If you see the same offender continuing along the same line of conduct, then at some point, you’ve got to ramp up and say, ‘You are not taking the hint that we are dropping,’ ” Terry said.

For patients whose medical information is exposed, the effects can be far-reaching.

The breach involving Fenity occurred in September 2014, when he couldn’t refill a prescription for a controlled substance a medication to treat Attention Deficit Hyperactivity Disorder at a CVS pharmacy and called the company’s helpline (as required) for permission to get the drug elsewhere.

All CVS employee calls were routed to the center in San Antonio where Fenity worked, and he soon discovered that a co-worker who assisted with the call hadn’t kept his inquiry confidential. Walking down a hall a couple of days later, Fenity heard the co-worker mention his name and the medical lingo used to describe controlled substance overrides.

Deeply shaken, he told a supervisor and, after investigating, the company fired the co-worker and counseled two others who were told the information. Fenity remained so anxious and embarrassed by the incident that he took a leave of absence. (He was terminated this August for not returning.)

“It was incredibly difficult for me to reassure members that we would appropriately handle their [personal health information] or take accountability by working to avoid any additional HIPAA violations when I was experiencing the complete opposite,” he said in an email.

After trying to resolve the issue within the company, he filed a privacy complaint against CVS with the Office for Civil Rights. He said he believes the company’s systems for protecting his health data were and still are inadequate. It is pending.

CVS’s DeAngelis said the company investigated Fenity’s complaint promptly and fired the employee to blame.

DeAngelis also noted that employees can request that their calls be routed to a single employee who “would be the only representative authorized to access their prescription account. In fact, following Mr. Fenity’s incident, this option was offered to him and he accepted.”

Fenity can still recall the chill of realizing the information about his medication was out.

“It’s like feeling your clothes have been ripped off in the middle of work,” he said. “That’s what it feels like. You feel so exposed.”

This story is part of a yearlong examination into how secure medical privacy is. Has your medical privacy been compromised? Help ProPublica investigate by filling out a short questionnaire. You can also read other stories in our Policing Patient Privacy series.

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To access the MISS PMP, law enforcement officials don’t need a subpoena or a court order

Posted on December 28, 2015 by Pharmaciststeve

fishing

Lawsuit: Brandon PD violated HIPAA

http://www.clarionledger.com/story/news/2015/12/28/brandon-pd-lawsuit/77979540/

A federal lawsuit filed this month alleges a Brandon Police Department investigator accessed a man’s prescription history without probable cause, a subpoena or a court order, in violation of the Health Insurance Portability and Accountability Act.

The investigator accessed the information through the state Board of Pharmacy’s Mississippi Prescription Monitoring Program, which allows law enforcement officials and licensing boards access to certain prescriptions without a court order, according to the lawsuit.

In January, Brandon Maddox, 45, went to the emergency room for shoulder problems and received a prescription for pain medication. A doctor there told Maddox to visit his own physician the next day if he needed additional medication or treatment, said attorney Donald Boykin, who is representing Maddox in the lawsuit.

The next day, he received a prescription for oxycodone from Dr. Kurt Johnson that would lead to his arrest about six months later.

In July, Brandon Police Investigator Chris Bunch saw Maddox’s back-to-back prescriptions on the Mississippi Prescription Monitoring Program. The lawsuit claims Bunch accessed the information without probable cause to do so or a court order.

Brandon Police Chief William Thompson and Brandon Mayor Butch Lee didn’t return requests for comment.

Bunch questioned Johnson, who told the investigator he was unaware Maddox had received a painkiller prescription the day before he treated him. Johnson also gave Bunch some of Maddox’s medical records, again without a court order or other document that would grant the police department access, according to the lawsuit.

Maddox was later arrested on a prescription fraud charge, court records show. After the arrest, Johnson and his nurse practitioner wrote that they had actually known he’d received a prescription the day before, Boykin said, and that the information they gave to the Brandon Police Department was incorrect. Johnson did not return a request for comment.

Thompson and Bunch received the statements but said they’d already submitted the case to District Attorney Michael Guest for presentation to a grand jury.

“They told me … it was out of their hands, and I seriously questioned that,” Boykin said. “I think all they had to do was call the district attorney’s office and say a mistake was made.”

Guest chose not to prosecute Maddox, and the charges were remanded for lack of evidence, court records show.

To access the Prescription Monitoring System, which requires physicians and pharmacists to report controlled substance prescriptions, law enforcement officials don’t need a subpoena or a court order. They just need to be authorized database users, according to court records. The lawsuit argues this policy violates HIPAA and individuals’ right to privacy.

“It gets back to the business of how far can big brother go to look into your personal information,” Boykin said. “And I’m sure there are many people who would say law enforcement agencies should have access to it to help prevent crime. Well, that’s unquestionable, but the means by which they get it is very questionable.

“If somebody were posed the question, ‘Do you want your local police officer to be able to, in effect, look in your medical records?’ — nobody would want that.”

Contact Mollie Bryant at (601) 961-7251 or mbryant2@gannett.com. Follow @MollieEBryant on Twitter.

Filed under: General Problems | 1 Comment »

Stunningly, the DEA has repeatedly gone on record denying that it is part of the problem.

Posted on December 28, 2015 by Pharmaciststeve

The DEA’s crackdown on pain meds

Federal authorities are facilitating a proxy war between doctors and pharmacists, and patients are caught in the middle

http://america.aljazeera.com/opinions/2015/12/dea-crackdown-on-pain-meds.html

Over the summer, a federal appeals court in Washington state ruled that pharmacies do not have a right to refuse to fill a patient’s prescription on moral grounds. The plaintiffs in the case, Stormans v. Wiesman, were three pharmacists who denied emergency contraceptives to dozens of female customers, saying that doing otherwise would violate their Christian principles.

While the ruling served as an important test case for the Religious Freedom Restoration Act, the likelihood of a religious fanatic trying to come between you and your medication is minuscule compared with the threat posed by well-meaning public officials who think the best way to prevent people from getting addicted to prescription drugs is to make them harder to get for everyone.

I wrote about the ancillary impact the war on drugs is having on patients back in 2013. We now have a clearer picture of the scope of that collateral damage, and it’s worse than even I expected.

Over the past four years, reports of pharmacists refusing to honor valid prescriptions for controlled substances have grown considerably as blame for America’s opioid addiction crisis has fallen increasingly on health care providers.

Media reports such as the recent “60 Minutes” segment “Heroin in the Heartland” have helped stoke the hype against narcotic medications without adding necessary context. But federal drug policy has done the most damage. For the past five years, the Drug Enforcement Administration has been orchestrating a high-stakes proxy war between physicians and pharmacists, creating tens of thousands of opioid refugees in the process.

“Opioid refugee” is the term doctors, pharmacists and patient advocates use when referring to pain patients who have been left adrift by physicians who no longer want to deal with the hassle of writing prescriptions for narcotic pain medication and by pharmacies so fearful of sanction that they will use any excuse they can not to fill them.

As usual, poor, minority and elderly patients, many of whom already suffer from inadequate access to opioid analgesics, have been the hardest hit. An investigative report that an Orlando, Florida, news station aired this year determined that some pharmacists now go so far as to flag prescriptions for controlled substances by ZIP code — the equivalent of medical redlining. Many of these patients are now forced to travel miles and visit multiple pharmacies each month is search of medication. Others are subjected to regular trips to hospital emergency rooms during gaps in medication availability.

From patient to ‘drug seeker’

The opening salvo in the DEA’s campaign can be traced to 2010, when it issued a decision that greatly expanded the guidelines for corresponding responsibility — a decades-old federal mandate that requires drug dispensers to ensure that prescriptions for controlled substances be issued for a “legitimate medical purpose.”

Connecting the dots between federal drug enforcement efforts and the opioid refugee problem is easy.

The decision codified a list of red flags that pharmacists dispensing controlled substances could be held responsible for ignoring. One of these red flags vaguely targets medication orders that include “combinations generally known in the medical and pharmacy profession as being favored by drug-seeking individuals.”

In theory, the policy is designed to add another check in the process of preventing drug abuse and diversion. In practice, it means that after your physician diagnoses your condition and writes you an order for medication, you may be subject to a second diagnosis delivered across a counter by a virtual stranger who won’t so much as take your pulse before determining the validity of your prescription.

Since instituting its crackdown on pharmacies, the DEA has filed actions against hundreds of retail and wholesale drug dispensaries. In some cases, they shut down legitimate pill mills that were operating virtual narcotics drive-throughs. But in most cases, pharmacies and wholesalers are targeted for exceeding what the DEA considers average dispensing numbers for certain types of drugs.

Exactly how these averages are determined and what it takes to show up on the DEA’s radar are unclear. (I’ve filed a Freedom of Information Act request in an attempt to find out.) But the bulk of federal efforts have focused on the Deep South — which has suffered from an epidemic of opioid abuse but also happens to account for among the highest rates of cancer diagnoses, cancer deaths and hospice patients in the nation. In other words, these states are home to an above-average number of sick people.

Meanwhile, at least three major drug wholesalers have responded to aggressive federal enforcement efforts by establishing arbitrary monthly rations that limit the amounts of controlled medications that each pharmacy may purchase. According to one survey from 2013, three-quarters of pharmacies experienced three or more delays or issues caused by stopped shipments of their controlled substances over the past 18 months. In more than two-thirds of those cases, pharmacists could not obtain replacements from alternative suppliers.

Implausible deniability

Stunningly, the DEA has repeatedly gone on record denying that it is part of the problem.

But connecting the dots between federal drug enforcement efforts and the opioid refugee problem is easy. For example, in 2014 — less than a year after Walgreens was fined a record $80 million by the DEA over accusations it overdispensed painkillers, including oxycodone and hydrocodone — a concerned Walgreens pharmacist leaked a secret internal checklist the company had begun using that included exceedingly strict guidelines for dispensing.

Among other things, the rules required pharmacists to deny prescriptions if the person filling it was on their medication for more than six months, had never been to the store before or paid cash for their medicine (which, as a freelance writer, I did for years before acquiring health insurance this year under the Affordable Care Act).

A recent federal audit further undermines the DEA’s claim that it’s not getting in the way of legitimate patients and their medicine. In July the Government Accountability Office issued a report on DEA policies on prescription drug abuse and found that while the agency’s enforcement actions have helped decrease prescription drug abuse and diversion, they have also helped decrease actual medical treatment.

How many more innocent people need to suffer before we realize that the war on drugs is a failed strategy, no matter where we choose to point the cannon?

“Over half of DEA registrants have changed certain business practices as a result of DEA enforcement actions or the business climate these actions may have created,” the report stated, adding that these changes have “affected their ability to supply drugs to those with legitimate needs.”

Rationing of care

The blowback has been devastating. Scores of local and national media reports over the last 18 months have described the living hell that patients are being subjected to as a result of artificial drug shortages facilitated by federal policy.

One pharmacist from Jacksonville, Florida, told a reporter for Kaiser Health News in August that he sometimes turns away 20 patients a day because of dispensing thresholds imposed on him by the DEA. “We’re being asked to act as quasi-law-enforcement people to ration medications,” he said. “I have not had training in the rationing of medications.”

Some states now appear ready to double down on the war on patients. In October, Massachusetts Gov. Charlie Baker proposed a bill to the legislature that would prohibit physicians from prescribing more than 72 hours’ worth of pain medication. Doctors and patient advocates have blasted the measure, and the American Medical Association has warned it could have “unintentional consequences to the patient-physician relationship.”

That plan may be terrible policy, but it addresses what by all accounts is a legitimate issue. More people are abusing narcotic painkillers, and more people are dying from them. But fundamental misunderstandings of the nature of the problem are leading us down a path we can’t afford to take.

One of the biggest is the all-too-common myth that drug dependency, a physical condition, is the same as drug addiction, an obsessive-compulsive disorder that may or may not include physical dependency. All patients who receive regular doses of opioid painkillers will become physically dependent over time; only a minority will ever fit the diagnostic criteria for addiction.

Unfortunately, to get to that minority, we’re forcing more and more people into real danger. Sick people denied proper care are inclined to self-medicate. In the case of opioid refugees, this frequently means turning to adulterated street heroin — a far more nefarious substance than prescription pharmaceuticals. We have a better chance of saving their lives if we let doctors take the lead rather than armed federal agents.

We are currently in the midst of one of the most conscientious dialogues in decades about the sensibility of U.S. drug control policy. Yet instead of a real shift in strategy, there is ample evidence that we’re simply diverting resources to another front. How many more innocent people need to suffer before we realize that the war on drugs is a failed strategy, no matter where we choose to point the cannon?

Christopher Moraff is a freelance writer who covers policing, criminal justice policy and civil liberties for Al Jazeera America and other media outlets. He was recognized in 2014 with an H.F. Guggenheim reporting fellowship at John Jay College

The views expressed in this article are the author’s own and do not necessarily reflect Al Jazeera America’s editorial policy.

 

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FRAUD ALERT !!!!

Posted on December 28, 2015 by Pharmaciststeve

robotwarning

I received a email from a pt after the pt got questioned by their prescriber after running a PMP report on the pt.  After the pt did some investigation, it would seem that the Pharmacist first filled the controlled Rx and decided that it was not enough money from the insurance company and reversed the claim and told the pt that the insurance wouldn’t pay for the Rx, but he could fill it for cash… which the pt agreed… and the Pharmacist re-ran the Rx thru their computer system as a cash Rx… which in turned a SECOND submission to the state’s PMP database… showing that the pt got TWICE the doses that the prescriber wrote for… one being billed to the insurance and a second one for cash.

Unfortunately, everyone believes that these PMP are INFALLIBLE and could be so far from the truth. With fake driver licenses being presented and Pharmacists deciding after the Rx has been processed by a technician that he/she is not going to fill it…. for whatever reason.

This patient has contacted his/her insurance company and verified that the claim was submitted and reversed and has talked to the pharmacy – not the Pharmacist that processed the Rx – and was told that the Pharmacist reversed the claim because he didn’t think that he was being paid enough.

The representative from the pt’s insurance company suggested that the pt contact their fraud/abuse dept and file a complaint.

The potentially larger issue is what liability to pharmacists/pharmacies that do such things including auto refills that are not picked up and returned to stock… when another healthcare professionals run a PMP reports and refuse service or discharge them from a practice because of these erroneous entries in the PMP database.  Because it is unlikely that anyone is going to make phone calls to confirm/deny what the PMP reports.

 

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