Pain-clinic patients worry as DEA moves toward revoking doctor’s registration
http://www.seattletimes.com/seattle-news/freaking-out-pain-clinic-patients-worry-as-dea-steps-up/
Since it is estimated that there is between 1.9 and 2.1 million serious opiate addicts in the USA… which .. if 25,000 pts of these eight clinics have been “thrown to the curb”… either means that these clinics were providing opiates to 12.5 % of all the addicts in the USA or there is a lot of legit chronic pain pts that are being thrown into cold turkey withdrawal… subject to having a hypertensive crisis, stroke and death. I may have missed it… but I see no allegation or proof of deaths from opiates that had been provided to pts. Another case of guilty without proof ?
Federal Drug Enforcement Administration officials are taking steps to revoke the DEA registration of Dr. Frank Li, medical director of Seattle Pain Clinics, whose license was suspended by state officials last week.
The agency is seeking to pull the DEA registration of Dr. Frank D. Li, 48, who runs Seattle Pain Centers, a group of eight clinics that serve an estimated 25,000 patients across Washington, Jodie Underwood, a DEA spokeswoman, said Monday.
The move would halt Li’s ability to prescribe and dispense all controlled substances, including opiate painkillers. It comes as patients began to learn Monday that they’d need to find other sources for their drugs.
Li is already banned temporarily from prescribing drugs after officials with the Washington state Medical Commission on Thursday suspended his medical license amid allegations of Medicaid billing fraud and the deaths of at least 18 patients between 2010 and 2015.
But Mark Bartlett, a Seattle lawyer representing Li, said the commission’s decision was made “in error.”
“We strongly disagree with the state’s action,” Bartlett said. “We have every confidence that the decision will be reversed after a full hearing.”
Li has 20 days from the suspension to respond to the state charges and request a hearing, which must be held within 14 days.
Commission officials also revoked the agreement that allows five physician assistants to practice under Li’s authority and said they would investigate or file complaints against more than 40 other health-care providers who have worked for Li since 2013.
Saying an investigation showed signs of “classic ‘pill mill’ behavior,” officials alleged that Li and providers who worked for him failed to follow state guidelines governing pain management.
“The records demonstrate repeat violations of the standard of care for safe opioid prescribing and medical care of patients,” the suspension order says.
Among other practices, Li and his colleagues are accused of ignoring evidence that patients were addicted or using opiates improperly. Instead, they continued to prescribe the powerful drugs.
Providers sanctioned by the DEA are asked to voluntarily surrender their registration to prescribe controlled substances. If they don’t, the DEA can use an administrative process to revoke it.
“A revocation of a DEA registration would prohibit the registrant from ordering, manufacturing, distributing, possessing, dispensing, administering, prescribing or engaging in any other controlled substance activity whatsoever,” Underwood said in an email.
A man who answered Li’s cellphone number hung up when a reporter called for comment on Monday. Bartlett said Li chose not to voluntarily give up his DEA registration because he expected the suspension of his medical license to be only temporary.
At the same time Li’s license was suspended, officials with the state agency that oversees Washington’s Medicaid program terminated Li’s core-provider agreement, which allows him to bill for clinic services. The Health Care Authority (HCA), which runs Apple Health, halted payment for clinic visits immediately.
But the agency will pay for prescriptions written by Li and his physician assistants through midnight Monday and for those written by Seattle Pain Centers providers who have intact licenses for at least 30 days, HCA spokeswoman Amy Blondin said.
“We take this issue very seriously and are expediting everything we can with regards to Dr. Li,” said HCA spokeswoman Cassandra Hockenson.
State health officials are bracing for possible fallout from the near-closure of the clinics in eight cities — Seattle, Tacoma, Olympia, Poulsbo, Vancouver, Renton, Everett and Spokane.
They’ve urged primary-care providers, pharmacists and others to assist patients who need care for legitimate pain. Patients have been urged to call their health-care providers and their insurance companies for assistance.
Dr. Nathan Schlicher, president of the Washington chapter of the American College of Emergency Physicians, said he and his colleagues are poised to help.
“The ERs cannot stand in the shoes of the pain clinics, but we care deeply that patients have access to care,” he said.
But Reiten said she and other patients could find it difficult, if not impossible, to get drugs. Reiten said she takes hydromorphone and methadone to fight fibromyalgia, chronic back pain and foot problems, including neuropathy.
“They’re taking patients who are being responsible and following the rules and they’re screwing us, basically,” she said. “There are tens of thousands of patients like me. We don’t abuse our medication. It improves our quality of life.”
Filed under: General Problems
Scapegoating.
Nothing but.
From the nejm article just posted:
” . Alternatively, heroin market forces, including increased accessibility, reduced price, and high purity of heroin appear to be major drivers of the recent increases in rates of heroin use.46,56, “
I posted a similar recounting of this unbelievable use of a supposedly “benign” law that “doctors don’t need to fear” on my website http://www.doctorsofcourage.org. Now the federal government is approving similar laws to use against any physician in the country that prescribes even one Lortab, if they so choose. EVERYONE–fire your senators and congressmen. Then tell the new legislature to enact a law exempting physicians from criminal charges based on patient treatment. The CSA originally stated that doctors seeing patients were exempt. The Justice Department has been working illegally, and needs to be held accountable.
I agree about “firing” our Congressmen if they participate in this imaginary and over exaggerated war on opioids. However, make sure you look at their record and stance. Also send correspondence to find out what any candidate who is running has stated their beliefs or stance on this issue.
Also begin writing or emailing the us attorney general and the Secretary of Health Services in your state and in Washington, as well as your current legislators (state & federal), and the members of the House Energy & Commerce Committee, the Senate Finance committee, and the joint Obiate Abuse Review Committee… We need to send our info out in droves. Most people think they need to write a book but I work from a few basic facts and don’t go into my personal history w chronic pain, my treatments, diagnosis’, etc. I say if you would like to speak by phone, video conferencing, or in person to please let me know.
Would this b a case of forced patient abandonment since there is a time limit less than 30 days against Washington state medical board and the DEA if patients could prove harm was/is caused?
Do you know if there is the standard 30 days of care requirement in Washington as a law? Or if there is a list for all 50 states that show what the standard care for Rx’s (mo has a 30 day law as does Ohio)?
https://www.pharmaciststeve.com/?p=15358… post on pt abandonment
I had read that article but was asking if in your opinion this would qualify under those standards and also if you knew of a list that shows what the standard of care regarding number of days your physician would be required to issue medication until u were able to reestablish care w another physician?
Example is in Missouri, Drs must provide 30 days of medication per state law and must see you in their office if needed for 30 days regarding termination of care.
I have often heard the 30 day transition rule… I am not sure that it is a state law or considered a ethical issue to avoid being charged with pt abandonment… of course, if you are being referred out to a pain clinic that has a 6 months waiting list to get an appt.. other than providing for a weaning down period to avoid the worse of withdrawal issues… is there still a ethical issue about causing a pt to be without necessary medication for five months… should that still be considered abandonment ?
I definitely believe it to be an ethical issue as even if you wean down a CPP they are still in pain and in crisis due to increased risk of increased pain, higher blood pressure, stroke, and myraid of other complications while waiting to establish care w another pm.
For those who saw this dr or were treated by associates in this clinic they didn’t even get the compassionate care to be stepped down from their medications.
If I work on a list for the states regarding laws for continued care (ie 30 days of meds and visits w the actual law), would you be willing to post a link to it or upload it to your blog? It would definitely be a great tool for many if not all CPP to have on hand as this attack gets worse.
I believe you have my email and we have two or three sample letters to go to Congress, & the White House if you might be interested in them as well. If so, please let me know.
Thank you for all you do!