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

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

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

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

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

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

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

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

The process generally works as follows:

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

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

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

Walgreens to Pay $300 Million in Unlawful Opioid Prescriptions Settlement

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

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

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

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

A similar lawsuit against pharmacy giant CVS is still pending.

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What Medicaid Cuts Mean for Chronic Pain

Untreated childhood pain follows to adulthood

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

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

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

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

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

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

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

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

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

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

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

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

2011.12 InterRights Bulletin Article_only

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Citations:

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

Answer from Perplexity: pplx.ai/share

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

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

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

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

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

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

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

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

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

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

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

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

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

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RFK Jr. Releases Much-Anticipated MAHA Report

https://www.medpagetoday.com/publichealthpolicy/washington-watch/115723

Report raises concerns about vaccines, foods, and prescription drugs

A government report released on Thursday covering wide swaths of American health and wellness reflects some of the most contentious views on vaccines, the nation’s food supply, pesticides, and prescription drugs held by HHS Secretary Robert F. Kennedy Jr.

The much-anticipated “Make America Healthy Again (MAHA)” report calls for increased scrutiny of the childhood vaccine schedule, a review of the pesticides sprayed on American crops, and a description of the nation’s children as overmedicated and undernourished.

While it does not have the force of a law or official policy, the 69-page report will be used over the next 100 days for the MAHA commission to fashion a plan that can be implemented during the remainder of President Donald Trump’s term, Kennedy said in a call with reporters. He refused to provide details about who authored the report.

“We will save lives by addressing this chronic disease epidemic head on, we’re going to save a lot more money in the long run — and even in the short run,” Kennedy said.

Increased scrutiny of childhood vaccines — credited with saving millions of people from deadly diseases — figures prominently in the report. It poses questions over the necessity of school mandates that require children to get vaccinated for admittance and suggestions that vaccines should undergo more clinical trials, including with placebos.

Kennedy, a long-time vaccine criticopens in a new tab or window who previously led a nonprofit that has made false claims about the shots, has continued to raise doubts about the safety of inoculations even as a measles outbreak has sickened more than 1,000 Americans. This week, Kennedy’s health department moved to limitopens in a new tab or window U.S. access to COVID-19 shots.

Other contentious parts of the report are creating factions within the Trump administration’s MAHA commission, even as it strained to appease opposing forces within the politically diverse coalition that Trump and Kennedyopens in a new tab or window have fostered.

The report makes dozens of references to dietary guidelines and standards in Europe but Environmental Protection Agency head Lee Zeldin promised it would not yield more rigorous regulations. Instead, he described a system where companies will be encouraged to comply when presented with new “gold-standard science.”

“This cannot happen through a European mandate system that stifles growth,” Zeldin said in a call with reporters.

Despite numerous studies and statements throughout the MAHA report that raise concerns about American food products, Trump Cabinet officials insisted that the nation’s food supply is safe.

The report mentions that glyphosate, a commonly used chemical sprayed on crops, may cause serious health problems, including cancer.

On Thursday, however, Agriculture Secretary Brooke Rollins insisted: “The food supply is 100% safe.”

Farmers and Republican lawmakers had houndedopens in a new tab or window the Trump administration leading up to the report’s release, worried it would criticize the chemicals they use. Kennedy’s MAHA supporters, too, have been concerned that he would bend to pressure on the issue.

Ultraprocessed foodsopens in a new tab or window — industrially made products high in refined grains, sugar, saturated fats, and additives like artificial dyes that now make up two-thirds of the diet for U.S. teens and children — are also hammered in the report. Such products have been linked to a host of poor health outcomes, though documentingopens in a new tab or window how they cause those problems has been notoriously difficult and time-consuming.

The MAHA commission report “is a pretty accurate depiction of the nutrition crisis facing our country,” said Dariush Mozaffarian, MD, DrPH, an expert in nutrition and policy at Tufts University.

The report focuses not only on ultraprocessed foods, but also how too few fruits, vegetables, legumes, nuts, seeds, and fish are present in U.S. diets, he noted. But the report leaves out excess salt, which causes harm, even in young children.

The MAHA report calls on the NIH to execute sweeping, nationwide studies of ultraprocessed foods, even as the White House has called for $18 billionopens in a new tab or window to be axed from the agency’s budget. An extra $500 million has been requested from Congress for Kennedy’s MAHA initiative.

The report raises concerns about other environmental and chemical research results, funded by corporations and industry, being skewed.

But the MAHA commission’s call for more neutral research comes as sweeping budget and staff cuts propelled by Trump’s Department of Government Efficiency have resulted in 20,000 jobs lostopens in a new tab or window at the nation’s health department and billions of dollars rescinded for research studies. The Trump administration also gutted the Environmental Public Health Tracking Programopens in a new tab or window in its cuts of health-tracking programs.

The report also raises concerns about lack of physical activity among children and their prescription drug use, including antibiotics and medications used to treat attention deficit disorders.

Trump is expected to speak about the report Thursday afternoon at the White House.

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Interesting in how the number of suicides have increased and decreased over the last decade with references to 2016 – CDC first opioid dosing guidelines and 2020 the start of Covid-19 and 2022 the 2nd CDC opioid dosing guidelines.

Citations:

1. https://www.kff.org/mental-health/issue-brief/a-look-at-the-latest-suicide-data-and-change-over-the-last-decade/
2. https://www.lifespan.org/be-well/rise-suicide
3. https://nchstats.com/us-suicide-rates/
4. https://wmich.edu/suicideprevention/basics/facts
5. https://www.cdc.gov/suicide/facts/data.html
6. https://www.cdc.gov/nchs/products/databriefs/db464.htm
7. https://www.pewtrusts.org/en/research-and-analysis/articles/2023/03/03/youth-suicide-risk-increased-over-past-decade
8. https://medicine.yale.edu/news-article/youth-suicide-is-on-the-rise-yale-aims-to-save-lives/
9. https://afsp.org/suicide-statistics/
10. https://www.nimh.nih.gov/health/statistics/suicide

Answer from Perplexity: pplx.ai/share

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UPDATE 

Dear Steve;
Thank you so much for getting back to me. I had your email on the ready when I went to pick up my prescription-I called up to Walmart and was told it was filled and the pharmacist needed to speak to me when I picked it up. She apologized profusely for what the other pharmacist told me on the phone, and that the prescription was NOT on whatever list they have requiring notes every six months. I believe she said that pertained to schedule 2 controlled substances. So she said I should have no more problems after today.
I also learned from my primary doctor, when I called to tell her that I got my script, that pharmacies can now only fill scripts for a certain number of customers for lorazepam now. So what the tech at ShopRite told me was true. This is bizarre to me!
Again, thank you so much for the information. I always research things and was just lucky to have found your link.

Dear Steve; I came across an article you wrote when
I was Googling about an issue I am having with Walmart filling my Lorazepam prescription. My PCP has me call her office every month for a new script to be sent to Walmart for my 1mg
tablet that I take at night for anxiety. (I want to add here that I suffer from chronic pain due to serious issues with my cervical and lumbar spine, and was also diagnosed with Chiari Malformation at age 60) I had had no problems with my Lorazepam being filled for many years with Walmart until about 7 months ago. My script got sent in by my doctor as usual, and it was showing as delayed online when I checked. At that point I had already taken my last dose and called Walmart to ask why the delay. I was told by the pharmacist that they dropped the ball with me and I should have been providing them with a recent office visit note from my PCP. And that this is a DEA rule. Every six months a report is required from the doctor, and it isn’t the responsibility of the pharmacy to request that from the doctor to fill the script. The doctor should know this. So I called my PCP and apparently they sent the note because my script was filled. That note was sent in March 2025. When my doctor sent in the script for my May refill, again it comes up delayed. I called Walmart and was rudely told by the pharmacist that I have been on this medication for a long time, and a report or phone call from my doctor is required before they will fill it. So I contact my PCP again about this. At this point on May 20th, I have been two days without my medication. My PCP told me that the pharmacist is WRONG and the doctor sends a script in because the patient requires whatever the medication is. (I understand that Lorazepam is now considered a controlled substance. I also know that I do not EVER get a script from my doctor with refills on it for Lorazepam.) Are my doctor and myself wrong in thinking that my prescription should be filled without my personal medical reports be sent to them? That they should fill this script because it’s a new one every month? Your advice on this would be greatly appreciated. By the way, I also filed a complaint with Walmart through the corporate complaint line. I was told by the representative that the pharmacist is wrong. I will see today if the script is filled or not.

I do not know which state this pt lives but I have heard about any LAW that requires such procedures to get a C-4 refilled, so I ask www.perplexity.ai. It would appear that this particular Pharmacist is making up his own “rules” , and telling the pt that IT IS THE DEA LAW!

Citations:

1. https://www.dea.gov/press-releases/2025/01/16/dea-announces-three-new-telemedicine-rules-continue-open-access
2. https://www.nixonpeabody.com/insights/alerts/2025/01/27/dea-announces-proposed-regulations-on-telemedicine-prescribing-of-controlled-substances
3. https://www.singlecare.com/blog/is-lorazepam-a-controlled-substance/
4. https://www.fenwick.com/insights/publications/understanding-the-deas-new-telemedicine-rules-faq-for-healthcare-providers-and-telehealth-companies
5. https://www.deadiversion.usdoj.gov/GDP/(DEA-DC-071)(EO-DEA226)_Practitioner’s_Manual_(final).pdf
6. https://www.hklaw.com/en/insights/publications/2025/01/dea-extends-access-to-telehealth-treatment-with-new-rules
7. https://www.drugs.com/medical-answers/rules-controlled-substance-prescription-refills-3572555/
8. https://www.aha.org/news/headline/2025-01-15-hhs-dea-release-rules-related-telemedicine-prescribing-controlled-substances
9. https://apps.deadiversion.usdoj.gov/guidance
10. https://titangroupdea.com/dea-controlled-substance-regulations/
11. https://www.mcdermottplus.com/insights/dea-extends-telemedicine-flexibilities-for-controlled-substance-prescribing-through-december-31-2025/
12. https://telehealth.hhs.gov/providers/telehealth-policy/prescribing-controlled-substances-via-telehealth
13. https://www.in.gov/dhs/files/DEA_Practicioner_Manual.pdf
14. https://www.dea.gov/press-releases/2023/02/24/dea-announces-proposed-rules-permanent-telemedicine-flexibilities
15. https://www.dea.gov/sites/default/files/2023-02/Controlled%20Substance%20Guidance.pdf
16. https://www.deadiversion.usdoj.gov/GDP/(DEA-DC-046R1)(EO-DEA154R1)_Pharmacist’s_Manual_DEA.pdf

Answer from Perplexity: pplx.ai/share

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