From the article…
Quarterly reports will include information on beneficiaries at risk for opioid or acetaminophen overutilization based on the following 3 outlier categories:
Beneficiaries engaged in doctor and pharmacy shopping for opioids: patients without a cancer
diagnosis or receiving hospice care whose daily morphine equivalent dose (MED) exceeds 120 mg for at least 90 days, and, who used more than 3 prescribers, and more than 3 pharmacies.
Acetaminophen outliers: Beneficiaries who take more than 4 g/day of acetaminophen for more than 30 days.
Referrals from CPI: May include issues of fraud or abuse and may be based on issues other
than opioid use.
While the initial criteria has the word AND between them.. that does not mean that they will remain as AND and could be changed to OR at some time in the future when the direction of war on drugs doesn’t change course.
Between the rationing of the wholesalers and the “just say no” attitude of all too many Pharmacists.. a chronic pain pts could be easily labeled as a addict/doctor/pharmacy shopper.. thru no fault of their own.
It would seem that we now how the DEA, FDA, CMS and a number of state legislatures that are targeting chronic pain pts for continuing the war on drugs on. If you are a chronic pain pts and having trouble obtaining your medications.. you are being discriminated against and being complacent on your part is only going to allow things to get worse for you..
I suggest that you read this https://www.pharmaciststeve.com/?p=6142
Filed under: General Problems
Wait…..I thought law enforcement access to state monitoring programs required warrants…this was already decided in at least 2 states by federal courts. And I rhought also this info was HIPPA protected as well as 4th amendment protected..seems to me doesnt pass the unreasonable search and seizure smell test. How did this fly past the TN courts??? And where is the AMA on this as CMS interfering with the doctor/patient relationship??? Was the date correct in the article? it looks like they are starting retroactively with 2013.
I thought the same as the previous commenter. It IS a HIPPA violation. I wonder what the ACLU’s take on all of this is? As chronic pain sufferers, our rights are being obliterated. It’s already law in the states where medical marijuana is LEGAL, thus obtaining a red card, giving the government (DEA) the right to put you in a data base which makes it ILLEGAL for you to either possess or obtain a license for a gun. It’s like they are trying to convey to those citizens, who are lucky enough to live in one of these states, they are too dangerous to have a gun! REALLY? Bet me, Buckwheat! I refuse to give anymore of my constitutional rights away! Is this issue going to get to the point where we, in order to alleviate or in some cases hardly touch our pain, find the need to purchase our meds from the streets, thus becoming a criminal? I certainly hope not. We need to stand up and be HEARD! C’mon everyone!
Tennessee has already begun. They also give the police the right to access your medication for the past year at any traffic stop for any reason. I don’t know why a non-medically trained person would need medication records for a year. After being a chronic pain patient for over 10 years my tolerance is going to be higher than a person just beginning to need medication. Please people wake up. I did not ask or want to be disabled and in pain 24/7. I am already a DNR. Is the plan to force suicide to protect the drug dealers? This could be you or a family member in a few years.