Day: 05/18/2015

States Where the Most People Work for the Government

http://247wallst.com/special-report/2015/05/12/states-where-the-most-and-least-people-work-for-the-government/2/

3. New Mexico

More than 20% of New Mexico’s workforce was employed by state and local governments, the third highest proportion in the country. The relatively large public sector workforce was likely necessary to provide services for the state’s widely dispersed population. There were just 17 people per square mile in the state, the sixth lowest population density nationwide. Rural populations also do not have the same economic advantages cities provide, and public sectors tend to be larger in areas with relatively small private sectors. At just $39,825, New Mexico had one of the lowest GDPs per capita in the country. New Mexico’s nearly 22% poverty rate also may have strained state and local public services. Like several other states with large shares of the labor force employed by state and local governments, just over 50% of the state’s population 16 years and older had a job, one of the lowest proportions in the country. The presence of several large government research facilities also raised the the concentration of federal jobs, which accounted for nearly 4% of the workforce, the fifth highest such share in the country.

Representations Of Mental Health On TV

http://www.huffingtonpost.com/2015/05/18/mental-health-empire_n_7183356.html

As Andre Lyons on “Empire,” actor Trai Byers’ portrayal of a character with bipolar disorder is not perfect. In general, mental health representation needs a lot of work across pop culture. But to see such a studied, nuanced portrayal on a broadcast network is progress in a realm so severely lacking.

It’s important that Andre is shown managing his illness and taking his meds, something especially rare for fictional characters with chronic mental illness. There is also a misconception that people with mental illness can’t be successful, lending a myth-busting element to the fact that Andre is a graduate of a competitive university who is largely responsible for the business success of Empire Enterprises…

Hillary Clinton Campaign Begins Drafting Policy Solutions To Heroin Epidemic

http://www.huffingtonpost.com/2015/05/18/hillary-clinton-heroin_n_7309930.html

WASHINGTON — After hearing story after story from voters on the campaign trail about heroin’s toll, Hillary Clinton instructed her policy team to draw up solutions to the burgeoning opiate epidemic.

A Clinton aide told The Huffington Post that the Democratic presidential candidate decided to make mental health and drug addiction a major campaign issue after stops in Iowa and New Hampshire, where she kept hearing from people that the problem needs more attention. It’s the type of issue that may not get much attention inside the Beltway and on Sunday talk shows, but opiate addiction has become a devastating problem.

Clinton brought it up on Monday during a stop in Iowa, telling supporters that she wants to “end the stigma against talking about it.” …

Under comments:

Kathy Kokotis · Top Commenter · Indiana University
I am not surprised at the heroin overdose issue. The DEA made it almost impossible to get pain control medications for those in pain with their new rules. My 81 year old mother who has rheumatoid arthritis has a terrible time getting pain control. We have pee tests, drug contracts, CVS never has stock so we drive [from] CVS to CVS. The hurdles to keep my mom to some extent pain free are gigantic. I told her at some point heroin is the next step if we legally cannot get pain medications. I have read that many have turned to heroin as they no longer can get pain medications for chronic pain.

Thinking of you, James Brown

http://www.huffingtonpost.com/2015/05/18/soldier-james-brown-dies-jail-video_n_7309716.html?utm_hp_ref=world&ir=WorldPost

Sgt. James Brown was an active-duty soldier who had served two tours of duty in Iraq.

But he didn’t survive a two-day DWI sentence in 2012.

New graphic video from El Paso County Jail in Texas shows the confusing and terrifying last minutes of Brown’s life, KFOX reports. Brown, who reportedly suffered from post-traumatic stress disorder, can be seen thrashing in his cell as officers in riot gear subdue him. About 35 minutes later, he repeatedly tells officers he can’t breathe and loses consciousness…

Why weren’t emergency medical personnel called until after Brown lost consciousness, 35 minutes after the incident began? …

Brown may have been suffering from a sickle cell crisis, KFOX reports. Brown’s lawyer said the usually dormant condition may have been triggered by dehydration and stress…

http://kfor.com/2015/05/15/graphic-video-shows-moments-before-26-year-old-soldiers-death-in-jail/

“When a 26-year-old man checks into jail for a court imposed sentence on a Friday, and he leaves Sunday in a casket, something went horribly wrong there,” said B.J. Crow.

Brown had no criminal record and toxicology reports show he had no illegal drugs in his system.

The autopsy results cited sickle-cell crisis as the cause of death…

Brown’s attorney says he apparently suffered more stress in jail than coming under fire in combat twice, which Brown did…

Researchers find how to make morphine and other painkillers at home

http://www.dailymail.co.uk/sciencetech/article-3086478/Discovery-opens-door-homemade-morphine-painkillers.html

For the past decade, various groups of researchers have hacked the DNA of yeast to mimic poppies, in hopes of creating cheaper and less addictive pain relievers. So far, the yeast strains created can only perform the last steps of a long process that can lead to morphine and other narcotic drugs. A team led by researchers at UC Berkeley discovered the missing piece — the first step in the process — and published the findings Monday in the journal Nature Chemical Biology…

With technology advancing, some point out that there could come a time when brewing morphine may be as simple as brewing beer. In a commentary published in the journal Nature, a group of researchers from the Massachusetts Institute of Technology and University of Alberta in Canada called for restricting genetically modified yeast strains to licensed facilities so that they won’t fall into the wrong hands.  They also want current laws to be extended to make such yeast strains illegal to distribute…

Pretty soon, we won’t need doctors at all. 🙂

Fighting Medicare fraud is important, right?

But when you see so many cases like those listed on this website, especially for mental health care, you begin to wonder…  Who’s deciding whether the health care and/or prescribed drugs were reasonable and medically necessary or not?  What happens to the patients when the government shuts down all these doctors and clinics?

After paying these fines, will providers/hospitals change their behavior and refuse to treat some patients?  And by the way, where does all this money go?  Not back to the patients who may have been victims, that’s for sure.

https://oig.hhs.gov/fraud/enforcement/criminal/

May 6, 2015:  A Houston doctor and a group home owner were arrested on charges related to their alleged participation in a $5.2 million Medicare fraud scheme involving false claims for mental health treatment.

May 14, 2015:  PharMerica Corporation has agreed to pay the United States $31.5 million to resolve a lawsuit alleging that they violated the Controlled Substances Act by dispensing Schedule II controlled drugs without a valid prescription and violated the False Claims Act by submitting false claims to Medicare for these improperly dispensed drugs, the Justice Department announced today.

May 7, 2015:  Sixteen Hospitals to Pay $15.69 Million to Resolve False Claims Act Allegations Involving Medically Unnecessary Psychotherapy Services.  The Justice Department announced today that 16 separate hospitals and their respective corporate parents have agreed to collectively pay $15.69 million to resolve False Claims Act allegations that the providers sought and received reimbursement from Medicare for services that were not medically reasonable or necessary, the U.S. Department of Justice announced today.

May 1, 2015:  Settlement With Accredo Health Group Over Kickback Scheme Involving Prescription Drug.  Preet Bharara… announced yesterday a $60 million settlement of a civil fraud lawsuit against ACCREDO HEALTH GROUP (“ACCREDO”) concerning a kickback scheme with NOVARTIS PHARMACEUTICALS CORP. (“NOVARTIS”) involving the prescription drug Exjade… In connection with the scheme, the defendants understated the serious and potentially life-threatening side effects of Exjade when promoting the drug’s benefits to patients.

Big Pharma understates the side effects of medications every day in commercial after commercial.  Should pharmaceutical companies overstate the side effects?  Seems like a pretty fine line to end up somewhere in between understate and overstate.  And because of the long list of side effects for every drug, I don’t think Americans even pay attention to that stuff anymore.

There’s no doubt that Medicare fraud happens every day, but no one in law enforcement ever considers the consequences of their actions for the patients.  All they’re concerned with is who they think is committing fraud, and saving money for Medicare

Conviction Of Doctor And Owner Of Bronx Clinic

http://www.justice.gov/usao/nys/pressreleases/May15/LoweKevinVerdictPR.php

Preet Bharara, the United States Attorney for the Southern District of New York, announced the conviction of KEVIN LOWE, the owner of “Astramed,” a purported medical clinic with multiple locations in the Bronx, New York, and from which more than five million tablets of the prescription painkiller oxycodone were unlawfully distributed over a three-year period…

LOWE capitalized on that black market for oxycodone by employing Board-certified, state-licensed doctors who were willing to write medically unnecessary prescriptions for large quantities of oxycodone in return for cash. LOWE’s clinics, which accepted no insurance from patients seeking oxycodone prescriptions, typically charged $300 in cash for “doctor visits” that usually lasted just a minute or two, involved no actual physical examination, and consistently resulted in the issuance of a prescription for large doses of oxycodone, typically 180 30-milligram tablets, or a daily dosage of six 30-milligram tablets.

LOWE’s clinics bore little resemblance to a standard medical office. For example, on a daily basis, crowds of up to 100 people gathered outside the Astramed office on Southern Boulevard (the “Clinic”) clamoring to see one of the doctors at the clinic in order to obtain a prescription for oxycodone. Virtually none of these individuals had any medical need for oxycodone, or any legitimate medical record documenting an ailment for which oxycodone would be prescribed. Instead, most of these individuals were members of “crews” – that is, they were recruited and paid by high-level drug traffickers, oxycodone distributors (the “Crew Chiefs”), to pose as “patients” in order to receive medically unnecessary prescriptions from the Doctors. The Crew Chiefs then arranged for and oversaw the filling of the resulting prescription at various pharmacies and took possession of the oxycodone pills to be resold on the street. Crew Chiefs also paid the Clinic’s employees hundreds of dollars in cash at a time to get their Crew Members into the Clinic to see one of the Doctors.

In total, between approximately January 2011 and February 2014, Astramed Doctors issued 34,925 medically unnecessary prescriptions for oxycodone, comprising nearly 5.5 million oxycodone tablets with a street value of more than $165 million. LOWE alone collected more than $7 million in cash for these sham “doctor visits” during this time period…

It’s very hard to believe that none of these people suffered from chronic pain — that they were “virtually” all scammers.  And what happens to the legitimate patients?  Are they now also labeled as criminals because of their association with these clinics?

Dentists now part of the drug war

http://www.cda.org/news-events/role-of-dentists-in-reducing-prescription-drug-abuse

5/14/2015, Role of dentists in reducing prescription drug abuse

Bundy said 12 percent of all of the immediate-release opioid prescription drugs are written by dentists in the U.S., just slightly less than family physicians. Part of Bundy’s presentation was to make sure dentists know what to do to prevent being taken advantage of by drug abusers, yet make sure their patients receive the medications necessary to alleviate discomfort following dental procedures. Bundy offered a few recommendations…

Bundy also advised dentists to maximize the amount of nonopioid medications to the patient’s benefit, noting that studies have shown that much of the time this approach is better than opioid medication.

“The last time I checked, most of the pain that is involved in dentistry involves some degree of inflammation,” Bundy said.

Because most postoperative dental pain has an inflammatory component, NSAID (nonsteroidal anti-inflammatory drugs) such as ibuprofen therapy is essential and often superior to opioids for pain control…

Another tip he offers dentists is to not prescribe anything prior to the patient’s procedure…

Park said pharmacists are not immune to the changing environment either, as the Board of Pharmacy is cracking down on pharmacists more now, too…

Park also reminded dentists in attendance of the lecture that they must register to be able to access the CURES system by Jan. 1, 2016 (go to pmp.doj.ca.gov and register as a “Practitioner”). All dispensed controlled substance prescriptions are recorded in CURES, which allows prescribers to look up a patient’s controlled substance current usage and past history…

If you’re a chronic pain patient, do not expect treatment for the additional pain from a dental procedure.  Do not believe that most dental pain comes from inflammation — we’re talking about bone pain, which is some of the worst kind.

Since TMJ makes my dental appointments excruciating, and the lack of range of motion in my jaw joints makes it impossible for dentists to work on me without anesthesia, I have to pay extra to be put under.  My last dental bill was almost $10,000 (none of which is covered by Medicare). Needless to say, I haven’t been to the dentist in quite awhile.  And now, with dentists added to the drug war, I think I’ll just let all my teeth fall out and wait to pay for dentures.  If I’m lucky, a dental infection will travel to my brain and kill me before that happens.

Patients wrongfully labeled by Ameritox drug tests

http://www.abovetopsecret.com/forum/thread1067106/pg12

Ameritox Urine Drug Test has destroyed my doctor/patient relationship… literally.

When I asked why the sudden change.. She told me the DEA told the Doc he no longer had to take insurance if he didn’t want to.. Mongths later I still haven’t gotten a clear answer..but my yearly doc expenses went from $600 to $2,400.. Not including medicine costs..

My insurance has been covering my health care (office visits, blood-work, mammograms, scripts, etc) for years without too much grief, but it sure did put the $1300 Ameritox charge in the ‘not covered’ category…

a reply to: annoyedpharmacist
My doctor had to have another doctor shadow him for six months because he was being punished for not giving patients enough warning that the medication they’re taking could lead to addiction. I was floored.who doesn’t know that in this day and age? He admitted it would affect his prescription writing habits in the future. We made a joke about it but I felt really bad for the stress it clearly put him under. He said he would have to stop assuming his patients are rational thoughtful adults. How does a town handle losing that many doctors?

From a court case in 2012: Millennium Labs vs. Ameritox

Ameritox’s nearly decade-long practice of using false claims and advertising practices to mislead physicians into believing they could use the Rx Guardian service to determine whether their patients were taking the proper dosage of their prescribed medications, leading to damaging outcomes for patients and their physicians.”

Essentially, the two Rx Guardian systems did not do what Ameritox claimed and, consequently, patients could have been wrongfully labeled as adherent or nonadherent based on quantitative Rx Guardian ranges. In some cases, patient test results could have been erroneously recorded in physicians’ records as reflecting aberrant behaviors, when in fact the patient was taking medications exactly as prescribed…

He was asked, “Dr. Leider, you would agree with me that Rx Guardian cannot determine the dosage of a medication that a patient has taken; isn’t that correct?” He answered, “Yes.”
Leider was then asked, “And you would agree with me that Rx Guardian cannot determine the frequency with which a patient actually is taking a prescribed medication; isn’t that correct?” he answered, “Yes.”

Moreover, Dr. Leider conceded that patients who were excluded from Ameritox’s “Compliance Database” could in fact be compliant with their regimens, while those abusing or misusing their medications could actually be included…

(5/15/2015) tigertatzen said:  Talked to one of my friends who’s an ER doc last night and he said there have been so many people being dumped by their physicians that it’s starting to impact ED medicine in a very significant way. Patients have nowhere else to go get seen. He said there has been talk of certain Schedule II meds not being authorized for dispensation by ERs or 24-hour clinics anymore and Adderall is one of them. He said they’re also being told that Tramadol is probably going to be reclassed as a narcotic too…far too many people over-prescribing and prescribing for long-term use when it was not meant to be a maintenance med. He said they’re cracking down on Phenergan too. Good grief!

Pain doctors paid to overprescribe Fentanyl spray Subsys

http://sirf-online.org/2015/04/24/the-new-killing-it/

On the evening of July 1, 2014 Carolyn “Suzy” Markland, a 58-year old Jacksonville, Florida resident suffering from a degenerative disc disease, took her prescribed medicine—a 400 microgram dose of a Fentanyl spray called Subsys— and went straight to bed.

Despite regular pain, Subsys was not an everyday drug for Markland. She had had the prescription filled for several months but almost never took the stuff; her longtime family doctor and pharmacist had expressed plenty of no holds barred skepticism to her about it. On the three occasions she took Subsys, her family noticed that its sedative and respiratory effects were noticeably sharper than those of another strong painkiller she took, Exalgo [extended-release hydromorphone].

The next day, July 2, Markland went to Dr. Orlando Florete, her pain management physician for the previous five years, for a scheduled injection in her lower spine. As part of her pre-procedure anesthesia mix, she received another Fentanyl dose. Unlike previous procedures however, she wasn’t up and moving around 20-30 minutes afterwards; this time it would take about hour to where her oxygen levels would allow her to be safely released.

Markland was tired for the balance of the day, and headed in to bed early, skipping her usual cup of pre-bed decaf.

She would never wake up…

The medical examiner’s report of the lethal combination of the stream of Fentanyl and other drugs in Carolyn Markland’s blood is both puzzling and sad, seemingly emblematic of a strain in modern American medicine where solutions for pain can be as scarce as the medication of the pain is abundant.

In another sense, Dr. Orlando Florete also represents a parallel strain of American medicine: the physician as compensated endorser. According to the Center for Medicare & Medicaid Services’ Open Payments database, which covers just the last five months of 2013 (2014’s figures are slated for release in June), Florete was paid $18,874.03 by the makers of Subsys, a small but rapidly growing pharmaceutical company called Insys Therapeutics Inc., to travel and speak to fellow doctors.

Additionally, the 16 Subsys prescriptions written by Dr. Florete between January 1, 2013 and May 31, 2103 , according to Freedom of Information Act documents obtained by SIRF, cost TRICARE, the U.S. military’s primary health insurance plan, $133,770.36…

Like Dr. Florete’s speaking engagements, another unremarked upon issue was the nature of Carolyn Markland’s Subsys prescription: a drug indicated solely for breakthrough cancer pain was prescribed for a bad back…

Like Dr. Florete, Insys Therapeutics is doing pretty darn well. The company has had a remarkable level of financial success and its soaring stock price has made it a darling on Wall Street.

But that level of growth ought to warrant a raised eyebrow; going to over $222 million sales from about $15.5 million in just two years without inventing something like a better search engine is no mean feat. Fentanyl, after all, has been around for many years and while Subsys is the only spray version available, several of Insys’s competitors are well-established and better capitalized, with sales forces that reach all 50 states…

But Insys grew north of 100%, implying that whatever organic growth they are getting is being aided by a whole lot of doctors who have grown profoundly fond of an expensive drug that brings an acre of governmental red-tape with it and that one of the largest pharmacy benefit managers will no longer touch…

SIRF asked him about the reality of a former exotic dancer pitching a restricted drug to board-certified oncologists. He said she was more effective with pain management physicians who appreciated what he referred to as her “empathy.” …

Adding that there is a “sense that prescribing [Subsys] is something for hospice” among oncologists, Burlakoff said most oncologists that he and his colleagues deal with are happy “to refer pain treatment out” to pain management doctors so they could focus on the cancer treatment…

Insys’s assertions about serving the cancer patient aside, the company’s bread is buttered by pain management and physical rehabilitation doctors, according to TRICARE’s reimbursement and prescription data (the range is the most recent available, from January 1, 2013 to May 31, 2014) obtained by SIRF…

SIRF attempted to contact Dr.’s Xiulu Ruan and Patrick Couch, partners in a Mobile, Alabama practice, and the leading Subsys prescription writers by an impressive margin, to discuss this, as well as their ownership of C&R Pharmacy, which dispenses the drug to their patients. (About 50% of the Subsys dispensed in the U.S. is handled by Linden Care, a Long Island, New York-based specialty pharmacy, owned by Bell Health Ventures, a private-equity fund.) …

I refuse to just exist, I want to live!

http://www.healthcentral.com/chronic-pain/c/317/108819/pain-patients/

Jerry loyd
Jan. 07, 2015

I have congenital spinal stenosis,sciatica and severe arthritis in my back ankles knees and hips. I take gabapenten Mobic and until 6 months ago norco. Now I have no norco. Why? Because I tried some marijuana last April after a day when I spent 10 hours in a car. The pain was unbearable and the weed helped. I’m 57 years old and haven’t played with marijuana since my teens, but when I tested positive the doctor said that she could no longer prescribe my meds per the federal government mandate. Why is the federal government involved in my healthcare? Because the evil weed though legal for med marijuana patients in my state( and yes I did have a Drs rx, though I hadn’t used it yet)is a schedule 1 drug the same as heroin. So here I am with the same physical problems as before and now unable to work because of the chronic pain that I can no longer get adequate relief for.ive already been approved for disability. So thanks to our 1930s era drug policies I’m now a drain on the system. We should all be voicing our opinions on this outdated policy to our elected officials. I know I’m not the only one to fall into this idiotic loophole.

Dye59
Jan. 09, 2015

New York, chronic pain, whole back thing. Yesterday after 8 years of giving me my meds for pain. I was cut off. His reason, I did not op on you. No the doc that did twice left the office. This doc took over. 8 years your done, what about withdrawals and pain. Been just a great 24 x hours. Never took anything else or too much. Do not really know what to do, I wll not beg! But I will grow some great weed, that eaten really helps. Sad government, has made me enemy number one instead of terrorists.

leblancnorma13
Jan. 23, 2015

I haven’t seen anyone bring up the statistics of how many people were dropped from their pain management due to a bogus urinalysis. Not only is it embarrassing but there is very little you can do to dispute it. Medical records are permanently tarnished, and the likelihood of finding another pain doctor for treatment is difficult. It seems to me that long term chronic pain patients who are unwilling to undergo surgery are no longer wanted by doctors when they can make so much more money doing surgeries. One way or another they will find a way to get rid of you even if you did nothing wrong.

teschej
Mar. 22, 2015

How many chronic pain patient have died because they were medically mistreated because they take pain medicine. I almost died because of the prejudice. They thought I was overdosing on my pain medicine, put me on the drug addict floor when it was sepsis from an undiagnosed UTI that became pyelonephritis (kidney infection). By the time I got to my family doctor’s care, I was semi-comatose…

jlmp1961
Apr. 02, 2015

I suffer from chronic pain am in my early 30’s – I have 5 screws in my ankle, recent knee surgery and severe back pain. I am also depressed and the same doctor who prescribed my pain meds put me on Zoloft. I recently had to do a urine test. Well it came up positive from some benzo drug that I am not even taking. After a few minutes of online searching I find that Zoloft can show up as positive for the benzo things. So guess what the doctor that prescribed me these meds has now dropped me as a patient. What am I to do now. Any suggestions

kodella600
Apr. 26, 2015

I’ve been disabled for 15 yrs and on opiates, muscle relaxers, anxiety meds. I was cutoff in Dec 14 because no drugs were in my system. I know ppl throwing out those costly contracts and buying street drugs. My Dr. Wanted me to go to a mental health pro also to get my tramadol n zanax!! Someone has to start listening to us , we know our pain level, what works and how much we need. I refuse to just exist, I want to live! Neither the DEA nor my Dr, is going to make me live that way. I don’t need a mental health pro, I need adequate pain control.

Manager/Owner of Pain Clinic Sentenced to 15 Years in Federal Prison

http://www.justice.gov/usao/co/news/2015/may/5-4-15.html

DENVER — Keith A. Schwartz, age 47, of Silverthorne, Colorado, was sentenced last week by Senior U.S. District Court Judge John L. Kane to serve 180 months (15 years) in federal prison for conspiracy, distribution of a controlled substance and money laundering, United States Attorney John Walsh announced…

According to the indictment and evidence presented at trial, Schwartz, in conjunction with co-conspirators, all of but one of whom have previously pled guilty, knowingly conspired and agreed to dispense and distribute, or facilitate the dispensing and distribution of controlled substances, to patients at times and in circumstances outside the usual course of professional medical practice. He then laundered the proceeds from the patients through bank accounts in his wife’s name. The patients didn’t have a sufficient medical necessity for the prescription of the controlled substances. The primary prescription drug involved in the case was Oxycodone, with over one half million dosage units prescribed in an 18 month period.

Specifically, Schwartz, using an alias, approached a pain doctor named Kevin Clemmer in May of 2011, who at the time was housed in the Federal Detention Center in Englewood, Colorado after his indictment for the unlawful prescription of controlled substances. Schwartz offered to purchase the list of Clemmer’s patient lists, most of whom received substantially more narcotic or other controlled substance medication than was medically necessary…

The relationship among the co-conspirators began in the summer of 2009, when Schwartz recruited Dr. Ferrara to write medical marijuana recommendations to support Schwartz’s marijuana growing in his house. During 2009 and 2010, the medical marijuana business expanded to include travel throughout the state of Colorado, where Dr. Ferrara wrote medical marijuana recommendations. In May of 2011, the conspiracy shifted its primary focus to distribution of prescription controlled substances while also maintaining the medical marijuana recommendation business…

Director speaks out on pain clinic’s future after DEA, FBI raid

http://www.wvva.com/story/28562016/2015/03/19/fbi-dea-and-wv-state-police-conduct-search-at-beckley-pain-clinic

BEAVER, W.Va. (WVVA) – The director of the Hope Pain Clinic weighs in on the building’s future following an DEA, FBI raid.

Mark Radcliff said the clinic has extensive procedures when it comes to screening patients and is cooperating fully with investigators. “It was a surprise, but we cooperated fully and I believe very professionally. There were no charges filed. The special agent in charge was very professional. He told us we could reopen as soon as they finished the search warrant,” said Radcliff.

Radcliffe said patients have to go through background checks just to be seen by a doctor at the Hope Clinic. “Some of the technology we’ve developed are the biometrics. We fingerprint all of our patients. If you think about it, if you go to Disney World and go through the main gates, they’re going to fingerprint you to stop people from defrauding Disney World. We believe if patients are going to gain access to schedule 2 narcotics, they should be willing to cooperate with us and get fingerprints.“

Radcliffe said it is standard procedure at the Hope Clinic to take patients’ pictures, scan their driver’s license, and record their history. “We track our patients. We track our good patients and the ones we catch doing bad things. When we do catch patients mis-selling, we turn them over for prosecution.“

Radcliffe said another less extensive search warrant was executed last week at their location in Wytheville, Virginia…

The Hope Pain Clinic is one of three chronic pain management offices shutdown earlier this month by the WV Dept. of Health for not complying with a state law created to reduce substance abuse. Its branch in Charleston, WV was also forced to close along with Med-Surg Group in Beckley…

Electronic Prescribing

http://perspectives.ahima.org/electronic-prescribing-improving-the-efficiency-and-accuracy-of-prescribing-in-the-ambulatory-care-setting-2/#.VVnuVPlViko

The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 proposed that healthcare professionals throughout the United States have access to EHRs [electronic health records] and use them meaningfully according to standards set by the Centers for Medicare and Medicaid Services (CMS)…

As mentioned previously on my blog, patients should be aware that anything entered into your EHR cannot be removed, whether it’s correct or not.  For instance, if a doctor believes a chronic pain patient is a “drug seeker,” and enters that information into the patient’s EHR, that label is there forever.

An important factor in the quality of patient care is whether medical errors are present. In the United States, an estimated 200,000 deaths occur yearly from preventable medical mistakes and hospital infections. Errors in medication prescribing and filling are some of the most common types of medical errors. Medication errors have been defined by the National Coordinating Council for Medication Error Reporting and Prevention as preventable events that may cause or result in inappropriate use of medications or harm to patients while the medication is being used by a healthcare professional, patient, or consumer. These errors can occur in any part of the medication use process, which includes mistakes from prescribing to dispensing of the drug and monitoring of how it is taken. The ambulatory care setting is the most common place for prescribing errors to occur. (See Table 1.)

An adverse drug event (ADE) can be the result of preventable or non-preventable medical interventions related to medications. ADEs are considered preventable if they are caused by medication errors, and potential ADEs are errors that could result in harm to the patient. The Institute of Medicine has estimated that 1.5 million preventable ADEs occur in the United States each year and more than 7,000 patient deaths can be linked to poor handwriting and prescription filling errors…

Through the EHR incentive program, CMS has provided incentive payments of $44,000 for Medicare-eligible providers demonstrating meaningful use of EHRs through 2014; then, starting in 2015, eligible providers failing to demonstrate meaningful use will receive Medicare payments reduced by 1 percent, with penalties increasing to 5 percent in 2020. Though these efforts have helped to increase the use of e-prescribing from 38 percent of prescriptions dispensed in 2011 to 44 percent in 2012, most prescriptions are still sent to pharmacies outside of an electronic system…

Legal issues arise when providers need to prescribe controlled substances. On March 31, 2010, the DEA made a final ruling on e-prescribing of controlled substances that took effect on June 1, 2010. The rule made it legal to transmit controlled substance prescriptions electronically, though the many standards contained in the ruling make it cumbersome to implement…

This would not include certain controlled substances, like the recent changes for hydrocodone, which require a handwritten prescription (like oxycodone).