Below (IN BLACK) is the second email that I have received in the last couple of days from chronic pain pts where their “pain clinic” has decided to CAVE to the CDC guidelines… SCREW … practicing medicine… just care for pts “BY THE NUMBERS”.. That is NOT PRACTICING MEDICINE… that is just filling in the blanks on a bill and collecting money for doing so.. A grade schooler could do that … Apparently we have another epidemic going on… pain specialists and prescribers that are becoming SPINELESS and BALL-LESS.
Below is my response to this pt (IN BLUE) ..might save me having to answer a number of similar emails that I presume it is just a matter of time before they start flooding my email inbox. Feel free to share this to the far corners of our country.
Medicare/Medicaid/Medicare Advantage have a new Star Rating System and the less STARS a healthcare provider ends up for the year ( hospitals, prescribers, pharmacies , Part D, Medicare Advantage provider, etc ) the less they get reimbursed the following year… and if they don’t have ONE YEAR out of three getting at least a THREE STAR RATING… they could be toss out of being a Medicare/Medicaid provider. They lose STARS by pts filing GRIEVANCES with www.cms.gov (800-MEDICARE) for “PISS-POOR CARE”. Here is a recent post 769 Hospitals Penalized For Patient Safety In 2017: Data Table where 769 hospitals are getting REDUCED REIMBURSEMENTS in 2017 because pts FILED GRIEVANCES with www.cms.gov… if pts don’t SPEAK UP when they are provided poor/bad care.. they will continue to receive poor/bad care. Most healthcare providers don’t want their reimbursements lowered….nor.. do they wish to get booted from the Medicare/Medicaid provider network. Over 200,000 people die every year from medical errors….but … the general public hears very little about this… IT IS A BIG SECRET !! That is like 800 commercial airliners FALLING OUT OF THE SKY EVERY YEAR and everyone on board DYING… If that happened… how many people would continue to fly …but we keep going to hospitals and healthcare providers !!!!
Get you a copy of the CDC guidelines and point out to them that pts who are terminal, cancer, Hospice or require palliative care are EXEMPT from the dosing limits… Here is the World Health Organization’s definition of palliative care https://palliative.stanford.edu/overview-of-palliative-care/overview-of-palliative-care/world-health-organization-definition-of-palliative-care/
The idiots who wrote the CDC guidelines.. apparently believed that palliative is part of Hospice but in reality palliative care can be its own singular stand alone modality and is not totally inclusive of Hospice. There are two ICD10 codes (diagnostic codes) that are to be used for a pt needing palliative care… IMO.. most/all chronic pain pts can easily have the ICD10 palliative care code added to their lists of diagnoses.
Have they performed the CYP450 enzyme testing on you to determine if you are a fast/ultra fast metabolizer ? https://www.practicalpainmanagement.com/treatments/pharmacological/opioids/cytochrome-p450-testing-high-dose-opioid-patients Looking at the two particular enzymes 2D6 & 2C9 for abnormalities. This should also help justify your higher than CDC dosing limits.
If this does not budge them.. and you have a spouse or significant other there is always suing them for your significant other suing them for loss of consortium and companionship. https://www.pharmaciststeve.com/?p=12615 These type of lawsuits normally have a 300,000 – 400,000 limit on damages and should be large enough for an attorney take a case on …on a contingency basis… they take a per-cent of award. Since this appears to be more than a single prescriber practice… and this is a decision of all the prescribers and the practice itself… might find an attorney to go after class action… surely a pain clinic has a fair number of pts that fit in the same mold that you do. I just looked up DNA Advanced Pain Treatment Center and they have TEN PRESCRIBERS listed on their website… that is a lot of deep pockets for a law firm to go after…
If they still insist on pulling your dose back … especially if they fail to do the CYP 450 testing and/or they do and you are a fast/ultra fast metabolizer… presuming that you are on Medicare/Medicaid/Medicare Advantage you should file a GRIEVANCE with www.cms.gov ( 800-MEDICARE) for failing to follow standard of care and pt/senior abuse.. because cutting back your dose will make you house/chair/bed confined and unable to do personal care items… take a bath, brush your teeth, prepare meals etc… I would also file a grievance with the state medical licensing board for the same. Once the new AG/head of DOJ gets into place.. I would file similar grievances with Americans with Disability act.
Hi Steve, well I received the infamous letter from the pain clinic I have been going to for 7 years. It states”DNA Advanced Pain Treatment Center will be following the CDC recommendations & policies on the dispensing of controlled substances including opiate medications. Because of these policies, there will be adjustments made to your medications that will result in a result in a reduction in your dosage. If this is not satisfactory to you we can provide you with a list of providers that may be willing to continue your medication. If you would like to discuss the changes with your practitioner, we would be happy to schedule an appointment to give you an opportunity to do so….Steve I would appreciate anything you could suggest to fight this uphill battle as u hav in the past made suggestions. I hav had 4 hip surgeries & am in chronic pain & unable to walk very well or live life to it’s fullest extent. I am om opana er 40mg tid & oxymorphone 10 IR QID prn opana 15mg ER prn bid. These meds hav made life so much easier to get the activities of daily living done along wth being more apt to socialize. Can you suggest what to do to reclaim my existence again? I would so appreciate your help Steve.
Filed under: General Problems
This is me too, but a little different. I moved from NH to KY and my new pain management doctor said that he follows the CDC guidelines regardless of diagnosis or any other reason. No more than 90 mme. I was on 110-120 mme at my former pain clinic, so at least my medication isn’t cut by half or more like so many others. I am having many many many more bad days than good now.
What if your not on Medicare/Medicaid/Medicare advantage? Is there any place for those of us on private insurance to file? I was forced by the practice I use (not a pm clinic) to drastically reduce my pain medication
If your insurance is thru employers > 50% of employers are self-funded (ERISA plan)… can take your complaint to employer that is paying the bills. Trying to get provider tossed from the insurance company’s network. They are using the LAWS (guidelines) to harm pts… and it may take using the legal system to “get even” … if a practice is doing this “cookie cutter” type of approach – then they are -IMO – no longer practicing medicine… just prescribing “by the numbers”… that would mean that there is a lot of pts in the same boat and a law firm – especially one that deals with class action lawsuits…because the docs are not following “best practices”… the larger the practice – the more “deep pockets” in the practice and the more pts that are being harmed. While attorneys claim to be in it all for “justice” but the vast majority are in it FOR THE MONEY..
Criminal neglect
Abandonment
Malfeasance
Ethical violation
Hippocratic violation
Public health crisis.
Human rights crisis.
Damm!