This is a email that showed up in my inbox.. it would appear that this pt’s particular insurance company has taken upon themselves to send out the CDC dosing guidelines to prescribers… “suggesting” that “if appropriate” the opiate dose of their pts should be reduced. It is interesting that the CDC guidelines have not even been implemented yet.. just published for comments and those that pay the bills… is using them as a way to save the system money ?
IMO.. if this woman loses her job and home because of the actions of this insurance company and prescriber.. that those issues are calculable as monetary damages, besides ADA violations and other issues of malpractice and pt harm/neglect.
Hello, My name is xxxx and I have been dealing with Arachnoiditis for the past 26 years. I got it from a spinal block during child birth. Dec. 4 I was told by my doctor that my insurance company will no longer pay for my morphine at the level it was so he lowered it by 120 mg a day. On Dec 31 I had an appointment and was told the same thing again and this time it is going down 100 mg a day. He informed me that he would give me Cymbalta, lyrica, ES Injections, or a spinal stimulator. He is taking me off all of the opiates and refuses to refill any further rx’s. We are living in a state of total communism when a doctor tells you how you are feeling. Since being on this dose of medication I have been able to get my degree and go back to work. If I can not find a new doctor to help me I am going to lose my job again, and last time this happened I became homeless for over a year. Thanks for being so outspoken and on our side. We need to be one large voice.
Filed under: General Problems
we need a class action suit for all pain pts.
As someone who has practiced in long term care for many years, if these guidelines or anything CLOSE are adopted, mandated, whatever and residents pain meds are cut way down or completely off, I forsee a war between CMS, CDC and each state’s Board of Health who surveys these bulidings. I forsee several citations as far as patient care, comfort, etc being pulled during the survey resulting in not only fines on the facility but ironically withholding of Medicare/Medicaid funds and a ban on further Medicare and Medicaid admissions until the corrections are made…..with the resident and the facility stuck in the middle because of the CMS and CDC obscene guidelines on pain mangement!!!! LTC was among the reasons “Pain as the 5th Vital sign” was developed. Too many of our elderly were getting little to zero pain management and now the CDC and CMS and PROP want to return to those days….I ask each and every member of these agencies “With 100 million chronic pain patients in this country, I find it mathematically impossible NOT ONE OF YOU DO NOT HAVE A FAMILY MEMBER WITH CHRONIC PAIN (due to a war injury, a near tragic car or work accident, a doctor surgical error or an auto immune disease) and you dare to tell them they do not need ANY opiates and should just tolerate the intensity of a consistent pain level of 9/10 every day 24/7 because intensity is not important! Shameful!!!
I was reading through all the new policies last summer from CMS, (Medicare /Medicaid),HHS, the 21st Century Cures Act, State Boost Programs to fight drug abuse, etc, etc. that are slated for 2016 in co-ordination with Obama’s FY 2016 budget. They all stated that they were waiting for CDC’s guidelines to implement their programs to deal with the prescription drug abuse epidemic. It isn’t even a true epidemiological epidemic! These programs all put limit’s on dosages and CMS is concerned about all the senior citizen drug addicts (what?????) and they are using Orwellian language like tracking and mapping over-utilizers of substances of abuse, patients who are on more than 100 MEQ opioid medication, (God help those with Utlra Rapid or Poor Metabolism!), over -prescribers of substances of abuse, opioid use disorder-(patients who are over the 100 MEQ daily or have been on opioids for more than three months..etc. So these guidelines will be used, if they go forward, and it looks like they are already being used by VA and other doctors. There is no room for those who don’t fit the standardized medical model or for skilled doctors to make their own decisions! Enough of the bureaucrats between the doctor and patient. We used to be a free country. These guidelines were put together in such a shady way that they should be scrapped. We are all different and need individualized treatment plans. That people are already dying from untreated pain makes all of this just immoral. Chilling. We need to speak out loud and quickly if we all join together and speak loudly! I believe this madness can be stopped.
ES injections for someone with arachnoiditis????? OMG!
A term you will begin to hear is “legacy patient”:
https://painkills2.wordpress.com/2015/12/06/dr-shame/
In Oregon, where all these regulations have already been implemented, one doctor estimated that about 10% to 15% of chronic pain patients will be allowed to continue with their high doses — these are legacy patients.
And I find it hard to believe that this patient, with a 26-year history of chronic pain, was not one of the legacy patients.
You simply need to find another doctor. One that is in pain management! Your current doctor is on the wrong here, however he is scared for no reason and is deciding not use opiates anymore, therefore you MUST FIND A NEW DOCTOR THAT WILL. They are out there, even internal medicine doctors are pretty good about treating a certain number of pain patients. Legitimate pain will be treated with legitimate meds. GOOD LUCK
Oops no apostrophe in boards…
And didn’t the CDC specifically ask they not be implemented until they are revised? No one will punish the insurer for trying to ask that doctors implement them EARLY, but I guarantee state board’s will go after doctors for not following the supposedly voluntary guidelines once they are finalized and Boards start adopting them en mass.
My only words are, get the insurance company to say the words to you, the patient, and if true, file an appeal! Let’s stop taking everyone at their word…my doctor said the ins co said….or my pharmacist said the ins comp said, …..I know in some instances this may be true, but, we,!the patient, have got to go straight to the source of the “they” said…..I have seen too many times, others being used as the scapegoat…..and the patient just taking the word of whomever, sometimes it is not even the Dr making the statement, but someone who works in the office and then takes off from there….the first stance in being your own advocate is saying, “Really, let me double check!”
Hi Kathy Yes I would double check,,the Gide lines are not even in place yet so ,,it seems to me that someone has opened the can of worms before fishing season has even began,,God Bless You and I Pray all works out for you,,I would think that would be deadly if your dose were dropped that much at one time,,File a suit as I know there are Lawyers who would take this kind of case..You have a right to be treated Humanly according to the Constitution of the USA
No listening to the patient at all. Causes me to not even go to the doctor and I have serious health problems. I guess I’ll lose everything! My wife, job, family, house, and then probably kill myself from the pain, so when I have a heart attack, just leave me laying in the gutter! Cause I won’t even go to the er for being treated poorly. I will not go to the doctor! You are turning people away. Drs are hard to go to in the first place but when you get treated like a piece of crap, that does it for me! I hope you take into consideration that many are suffering!