New law lets South Carolina providers deny care that conflicts with personal beliefs

I suspect that this law, is a law is to preempt any consequences to the anticipated overturning of the Roe vs Wade concerning abortions. Just read the test of the bill that is RED below… What happens if a health insurance company or a major healthcare corporation that declares that ALL CONTROLLED SUBSTANCES ARE ADDICTING… and they are not going to pay, prescribe or fill any controlled medication- because it is UNETHICAL to possibly cause someone to become addicted to these medications that the DEA has declared  – for some 50 yrs – that they are DANGEROUSLY ADDICTING.  That is nothing short of a full blown bureaucratic creep.

New law lets South Carolina providers deny care that conflicts with personal beliefs

https://www.beckershospitalreview.com/legal-regulatory-issues/new-law-lets-south-carolina-providers-deny-care-that-conflicts-with-personal-beliefs.html

South Carolina Governor Henry McMaster signed the Medical Ethics and Diversity Act into law June 17, allowing healthcare institutions, medical practitioners and health insurers to deny non-emergent care that conflicts with their “religious, moral or ethical beliefs.”

“As the right of conscience is fundamental, no medical practitioner, healthcare institutions and healthcare payers should be compelled to participate in or pay for any medical procedure or prescribe or pay for any medication to which the practitioner or entity objects on the basis of conscience, whether such conscience is informed by religious, moral or ethical beliefs or principles,” the act states. “It is the purpose of this chapter to protect medical practitioners, healthcare institutions and healthcare payers from discrimination, punishment or retaliation as a result of any instance of conscientious medical objection.”

Coverage under the law is sweeping. “Healthcare institution” covers any public or private hospital, clinic, physician group, ambulatory surgical center, private physician office, pharmacy, nursing home, medical school, nursing school or any entity “in which healthcare services are performed on behalf of any person.” By “healthcare payer,” the law covers insurers, employers or any entity that pays for a patient’s healthcare in part or in full. By “medical practitioner,” the law covers anyone asked to participate in any healthcare service.

The act took effect upon the governor’s signing. South Carolina is the latest state to protect healthcare providers’ “right of conscience.” Arkansas enacted a similar proposal in March 2021. 

South Carolina Senator Larry Grooms championed the Medical Ethics and Diversity Act. Supporters of the law include the Roman Catholic Diocese of Charleston; opponents include the American Academy of Pediatrics and the Human Rights Campaign.

The law can be found in full here.

under/untreated Chronic pain may contribute to suicide, study warns – maybe as many as 13 PER DAY

Very interesting study, abt 11-12 yr period that STOPPED TWO YEARS before the CDC 2016 opiate dosing guidelines were published, but after the DEA started cutting pharma production quotas.  The real BOTTOM LINE seems to be very VAGUE… only 18 states were involved without stating the percentage of the country’s total population.   The number of suicides from 2003 to 2014 was up about 50%.

And this quote from a “expert” …That’s an important stat, said Dr. Paul Nestadt of the department of psychiatry and behavioral health at the Johns Hopkins School of Medicine in Baltimore. “Opioids are depressants and they increase the risk of depression,”

Yet it is a known issue that chronic pain with under/untreated pain tend to have elevated anxiety and depression. Conversely, properly/optimized pain management tend to provide the pt with a “elevated” physical & mental “energy” and better QOL… resulting in less anxiety and depression.

Another interesting quote from the article: “Also, since chronic pain is not really coded well at the time of a suicide, this is probably an underestimate of the proportion of people who had chronic pain. We do know that chronic pain can be a deadly disease.”

There is a old quote credited to President Truman that this article seems to mirror:

Nourse, as economists are wont to do, was saying, “On the one hand … but then, on the other hand,” etc. After he left, Truman told Steelman that he had no idea what Nourse had just told him. Truman then said, “John, do you think you could find me a one-armed economist?”

Last year 2021, there was two fines/judgement from what can be described as “prescriber induced suicide” by pt committing suicides from having their long term pain meds reduced/eliminated. One was SEVEN MILLION and the other was ONE MILLION…   It is claimed that we have 50,000 suicides and one million attempted suicides EVERY YEAR…  this study indicates that 10.2 % where related to chronic pain…and many of us believe that those numbers or percents have increased since the 2016 CDC guidelines were published… and they may get worse with the new 2022 guidelines when they are published.

Using those numbers we are having abt 13 chronic pain pts committing suicide EVERY DAY and I have seen numbers that 22-24 veterans commit suicide every day… and we have all heard about what lousy care veterans get via Veterans Admin Hospital system.

POTENTIALLY THIRTEEN CHRONIC PAIN SUICIDES EVERY DAY… and last year … two “prescriber induced suicides” made the news and got a settlement and both of those were from 2018.  How many lawsuits could be filed if even one of these chronic pain pts committing suicide every day…  sent out a letter/email/video to local prosecutor, state AG, friends, local media claiming that they are exercising their final option to get out of a torturous level of pain and blame – point fingers – at the practitioner or organization they work for as the reason for their action. I don’t encourage suicides… but.. they happen… and it would appear that the near majority happens “behind a curtain” and/or off the radar…and the practitioners and the organizations that they work for … cause the limiting/denying of proper pain management without any consequences.  If the families of these pts … was able to get into the deep pockets of these healthcare corporations… could that change things…  as things are now going and have been going for the last decade +…  no change seems to be on the horizon.

Chronic pain may contribute to suicide, study warns

https://www.reuters.com/article/us-health-pain-suicide/chronic-pain-may-contribute-to-suicide-study-warns-idUSKCN1LQ2L6

(Reuters Health) – Nearly one in 10 suicide deaths in the U.S. occurs in people with chronic pain, a new study indicates.

The finding suggests chronic pain may be a risk factor for suicide, the study authors say.

While the study can’t prove that chronic pain contributed to people’s decisions to kill themselves, “we did see that mental health issues, such as depression and anxiety were more common among those with chronic pain,” said lead author Dr. Emiko Petrosky, a medical epidemiologist with the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta.

It’s estimated that 25 million U.S. adults have some level of daily pain and 10.5 million of them have considerable pain every day, Petrosky and colleagues note in Annals of Internal Medicine.

“Health care providers caring for patients with chronic pain should be aware of the risk for suicide,” Petrosky told Reuters Health. “Chronic pain is a huge public health problem. It’s essential that we improve chronic pain management through integrated patient centered management that includes mental health care in addition to medications for these patients.”

Data for the study had been collected from 18 states between 2003 and 2014 by the CDC’s National Violent Death Reporting System.

Out of 123,181 suicide deaths in the study, the records for 10,789, or about 9 percent, included notations by officials – such as coroners, medical examiners and law enforcement officers – that indicated evidence of chronic pain.

The proportion of suicides committed by people suffering from chronic pain increased during the study, rising from 7.4 percent in 2003 to 10.2 percent in 2014. But Petrosky’s team also underscored the fact that the percentage of people battling chronic pain also rose during the same time period.

Back pain, cancer pain and arthritis pain accounted for a large proportion of the chronic pain conditions.

More than half of the people with chronic pain who killed themselves died from firearm related injuries, while 16.2 percent died from opioid overdose. Still, chronic pain sufferers were three times as likely as others to have tested positive for opioids when they died.

That’s an important stat, said Dr. Paul Nestadt of the department of psychiatry and behavioral health at the Johns Hopkins School of Medicine in Baltimore. “Opioids are depressants and they increase the risk of depression,” said Nestadt, who is not affiliated with the new research. “Depression is one of the highest risk factors for completing suicide.”

The new study can’t say anything about the state of chronic pain management in this country, said Dr. Michael L. Barnett, a health policy and management researcher at the Harvard T.H. Chan School of Public Health and a primary care physician at Brigham & Women’s Hospital in Boston

But we do know “there aren’t any medications that seem to be particularly effective for chronic pain,” said Barnett, who is not affiliated with the new study. “Both opioids and NSAIDs are pretty effective in treating acute pain, but not chronic pain. While people often want a pill that will fix things, comprehensive pain management is proven to be pretty effective.”

A problem with this kind of study is you don’t know what other risk factors people had, said Dr. Ajay D. Wasan, vice president for scientific affairs at the American Academy of Pain Medicine and a professor of anesthesia and psychiatry at the University of Pittsburgh Medical Center.

“Chronic pain is certainly an important risk factor, but we don’t know how important it is compared to other risk factors,” said Wasan, who was not affiliated with the new research.

“Also, since chronic pain is not really coded well at the time of a suicide, this is probably an underestimate of the proportion of people who had chronic pain. We do know that chronic pain can be a deadly disease.”

Former CDC director Tom Frieden arrested on sexual misconduct charges

Former CDC director Tom Frieden arrested on sexual misconduct charges

Tom Friedenhttps://www.statnews.com/2018/08/24/former-cdc-director-tom-frieden-arrested-on-sexual-misconduct-charges/
NEW YORK — Dr. Thomas Frieden, the former head of the Centers for Disease Control and Prevention, was arrested and charged with sexual misconduct charges on Friday.

Frieden, who led the CDC from 2009 to 2017, was charged with forcible touching, sexual abuse, and harassment in connection with an incident at his Brooklyn home in October. He made a brief appearance in a courtroom here and was arraigned, before being released by the court.

Frieden has been accused of grabbing a woman’s buttocks without her permission during the incident, according to an NYPD spokeswoman. A colleague of Frieden’s said the woman was a longtime family friend of the former CDC director and that she had alleged “inappropriate physical contact.”

“I have known and worked closely with Dr. Frieden for nearly 30 years and have seen first-hand that he has the highest ethical standards both personally and professionally,” said the colleague, José L. Castro, the president and CEO of the public health organization Vital Strategies. “In all of my experiences with him, there have never been any concerns or reports of inappropriate conduct.”
A spokesman for Frieden said: “This allegation does not reflect Dr. Frieden’s public or private behavior or his values over a lifetime of service to improve health around the world.”

Frieden, 57, was named to head the CDC by former President Barack Obama. He began his tenure as CDC director in the early days of the 2009 H1N1 pandemic. Prior to taking the top job at the CDC, Frieden had been commissioner of New York City’s Department of Health and Mental Hygiene, where he led an ambitious agenda involving banning trans fats served in food in the city’s restaurants and banning smoking in workplaces and restaurants.

After leaving the CDC he returned to New York and established a new nongovernmental organization working to combat disease outbreaks and chronic diseases globally. The organization, called Resolve to Save Lives, is part of the group Vital Strategies.

Supreme Court Finds HHS Violated Drug Reimbursement Rules for Low-Income Patients

Supreme Court Finds HHS Violated Drug Reimbursement Rules for Low-Income Patients

https://www.theepochtimes.com/supreme-court-finds-hhs-violated-drug-reimbursement-rules-for-low-income-patients_4543386.html

The Supreme Court unanimously ruled that the Department of Health and Human Services (HHS) illegally reduced prescription drug reimbursements to hospitals by $1.6 billion per year in a program aimed at helping poor patients.

The decision, a win for hospitals serving low-income individuals, allows those hospitals to seek the improperly withheld funding from the federal government. The reduction in reimbursements was ordered by the Trump administration in 2018 and defended in court by the Biden administration. The government argued the rate cuts would more accurately mirror the cost to hospitals of buying the drugs and that it was allowed to do so under a legal provision that gave regulators authority to order adjustments to rates.

But HHS improperly relied on a formula that Congress made available only in specific circumstances, which didn’t apply in the case, the court determined. President George W. Bush in 2003 signed the Medicare Prescription Drug, Improvement, and Modernization Act into law. The statute requires HHS to establish reimbursement rates every year for certain outpatient prescription drugs provided by hospitals using a predetermined formula.

Despite the urging of the Biden administration, the Supreme Court didn’t address whether the so-called Chevron doctrine that the Supreme Court enunciated in 1984 applied to the case. In Chevron v. Natural Resources Defense Council, the high court held that while courts “must give effect to the unambiguously expressed intent of Congress,” where courts find “Congress has not directly addressed the precise question at issue” and “the statute is silent or ambiguous with respect to the specific issue, the question for the court is whether the agency’s answer is based on a permissible construction of the statute.”

Apparently, the Supreme Court found the issues involved were straightforward enough that Chevron didn’t need to be examined.

Justice Brett Kavanaugh wrote the court’s opinion (pdf) in American Hospital Association v. Becerra, court file 20-1114, which was decided on June 15 after oral arguments on Nov. 30, 2021. Xavier Becerra is the HHS secretary. The opinion overturns a decision made by the U.S. Court of Appeals for the District of Columbia Circuit.

As Kavanaugh summarized in the opinion, federal Medicare law states that HHS is required to reimburse hospitals for some outpatient prescription drugs that the hospitals give to Medicare patients. These reimbursements total tens of billions of dollars every year.

HHS may calculate reimbursements in two ways. It may vary reimbursement rates for different categories of hospitals if it first carries out a survey of the amount that hospitals pay to acquire the prescription drugs. Alternatively, if the agency has not done such a survey, it has to establish reimbursement rates based on the average sales price manufacturers charge for the drugs and is not allowed to vary the reimbursement rates for different kinds of hospitals.

For 2018 and 2019, HHS didn’t carry out a survey of hospitals’ acquisition costs for outpatient prescription drugs but still slashed reimbursement rates for one cohort of hospitals—Section 340B hospitals, which generally serve low-income or rural communities.

According to an informational website, to qualify as a 340B hospital, a hospital must meet certain criteria. Among them is that it must be owned or operated by a state or local government, be a public or private nonprofit corporation, and must be formally authorized to exercise governmental powers by a state or local government, or be a private nonprofit hospital that has a contract with a state or local government to provide health care services to low-income persons who don’t qualify for benefits under Medicare or Medicaid, a joint federal-state program for the indigent.

“For those 340B hospitals, this case has immense economic consequences, about $1.6 billion annually,” Kavanaugh wrote. “The question is whether the statute affords HHS discretion to vary the reimbursement rates for that one group of hospitals when, as here, HHS has not conducted the required survey of hospitals’ acquisition costs. The answer is no.”

The court stated: “We do not agree with HHS’s interpretation of the statute … [and] conclude that, absent a survey of hospitals’ acquisition costs, HHS may not vary the reimbursement rates for 340B hospitals. HHS’s 2018 and 2019 reimbursement rates for 340B hospitals were therefore contrary to the statute and unlawful.”

The Supreme Court reversed the ruling of the D.C. Circuit and remanded the case to that court “for further proceedings consistent with this opinion.”

The new decision is “a fairly strong rebuke from the Supreme Court about how the agency has attempted to overstep its authority,” Mark Polston, a partner at the law firm of King and Spalding, told Bloomberg Law.

“If they know the Supreme Court unanimously thinks it’s the duty of the courts to do their own interpretation of statute,” then “there will be justices of the lower courts who take notice of that and perhaps follow suit.”

 

It’s time we stop letting the ‘idiot’ experts destroy our country – how many medical idiots can you name ?

Hilton: It’s time we stop letting the ‘idiot’ experts destroy our country

What the ‘experts’ have done to this country is an ‘absolute travesty,’ Hilton said

‘The Next Revolution’ host said Sunday that it’s time America stops letting these so-called ‘experts’ make vital decisions about our everyday lives.

https://www.foxnews.com/media/steve-hilton-experts-idiots-destroy-country

“The Next Revolution” host Steve Hilton issued a scathing rebuke Sunday night of all the self-appointed “experts” who have misused their authority to make vital decisions impacting the everyday lives of Americans on everything from COVID, and crime, to the military and the economy, only to be “completely devastatingly wrong.”

STEVE HILTON: That’s the number one rule of government by ‘expert idiot.’ No one is ever held accountable, however much they screw up. Which of course we see in the absolute crowning glory of the expert idiot’s takeover of the coronavirus pandemic. Let’s just take a moment to remember the vanity, the self-importance, the sheer brazen certainty of these expert idiots who turned out to be completely devastatingly wrong. 

Of course, it is all laughable now how wrong the experts were, how wrong the vast majority of the establishment media were to trust the experts. But it keeps happening. The establishment never learns. So we cannot just subcontract vital decisions about our lives to the experts. Wherever you look, the pandemic, crime, the military, the economy, what the experts have done to this country is an absolute travesty. And even if it wasn’t anti-democratic to put all this power in their hands – which it is, even if it didn’t contradict the very idea of what America was built on, self-government — which it does, on a basic practical level, government by experts doesn’t work because as we have seen time and time again, the experts are idiots.

 

Feds Raid Offices of Newtown Pharmaceutical Company KVK Tech

Feds Raid Offices of Newtown Pharmaceutical Company KVK Tech

https://patch.com/pennsylvania/newtown-pa/feds-raid-offices-newtown-pharmaceutical-company-kvk-tech

The raids came less than two months after two executives of the generic drug manufacturer were charged with conspiracy to defraud the FDA​.

NEWTOWN, PA — Federal agents served search warrants at the offices of a Bucks County pharmaceutical company Thursday morning in connection with ongoing investigations into the company’s alleged conspiracy to defraud the U.S. Food and Drug Administration.

Around 7 a.m., the Newtown Township Police Department assisted federal agents from the FDA, Homeland Security, the Department of Labor, Health and Human Services and other federal branches with three search warrants at each of the KVK Tech facilities located within Newtown Township: 100 Campus Drive, 110 Terry Drive and 114 Pheasant Run.

The warrants were executed simultaneously at 7 a.m. at all three sites, police said.

The raid comes less than two months after two executives of the generic drug manufacturer were charged with conspiracy to defraud the FDA. Murty Vepuri, 69, and Ashvin Panchal 50, were charged in June by the U.S. Attorney’s Office with distributing unapproved drugs and misleading the agency by concealing information about its products.

From October 2010 through at least March 2015, Vepuri and Panchal, the company’s de facto owner and head of quality assurance, respectively, conspired to defraud the U.S. by impeding, impairing, and defeating FDA’s mission to protect the health and safety of the public by ensuring that drugs marketed and distributed in the U.S. are safe and effective for their intended uses, according to the June indictment filed by federal prosecutors.

Vepuri, who previously owned a drug company in New Jersey that was subject to a restraining order due to FDA violations, is charged with hiding his involvement in the Newtown company by placing its ownership in private trusts to benefit his children. Vepuri then allegedly represented to the FDA that he was merely an advisor or consultant to KVK Tech, when in reality he exercised unchecked authority over the company, federal prosecutors said.

Under his control, the company ignored regulatory requirements that had the potential to slow the manufacture, distribution and sale of its drugs, authorities said. Vepuri and Panchal are also charged with having provided false explanations to the FDA when inspectors identified violations. Often, Vepuri and Panchal attributed regulatory failures to a mistake or misunderstanding, and the company would falsely assure the FDA that violations had been addressed when they knew no corrective and preventative actions had been taken, the U.S. Attorney’s Office said.

The indictment highlighted the company’s conduct with regard to Hydroxyzine, a prescription drug to treat anxiety, for which Vepuri purchased an ingredient made in Mexico that was not an FDA-approved source, authorities said.

If convicted, Vepuri and Panchal each face a maximum possible sentence of five years in prison, three years of supervised release, a $250,000 fine and other financial penalties including forfeiture. KVK Tech faces fines up to $4 million and other financial penalties such as forfeiture and probation. The parties also face mandatory exclusion from participating in federal programs.

All public information regarding the specifics of the warrants are being referred to the U.S. Food and Drug Administration, Office of Criminal Investigations Philadelphia office, at 215-597-4390.

DEA: How people use emoji to order illegal drugs on line

https://www.dea.gov/sites/default/files/2021-12/Emoji%20Decoded.pdf

CMS Behavioral Health Strategy: Goal 3: Ensure effective pain treatment and management

Goal 3:  Ensure effective pain treatment and management

https://www.cms.gov/cms-behavioral-health-strategy

CMS Behavioral Health Strategy

The CMS Behavioral Health Strategy covers multiple elements including access to prevention and treatment services for substance use disorders, mental health services, crisis intervention and pain care; and further enable care that is well-coordinated and effectively integrated.

The CMS Behavioral Health Strategy also seeks to remove barriers to care and services, and to adopt a data-informed approach to evaluate our behavioral health programs and policies. The CMS Behavioral Health Strategy will strive to support a person’s whole emotional and mental well-being and promotes person-centered behavioral health care.

CMS Behavioral Health Strategy: Goals, Objectives and Supporting Activities

 

Goal 1: Strengthen Equity and Quality in Behavioral Health Care

Objectives:

  • Reduce disparities in health and health care among individuals CMS serves to improve access to high quality, affordable, person-centered behavioral health care, and ensure parity in access, coverage, and quality for physical and mental health services, including care enabled through telehealth and technology.
  • Incorporate Health Equity into new care and payment models and optimize whole-person care for beneficiaries with and at risk of behavioral health conditions.
  • Provide Effective Outreach and Education on CMS’s behavioral health services to inform beneficiaries, caregivers and providers utilizing culturally and linguistically appropriate materials that meet the needs of individuals with low literacy, low health literacy, and limited-English proficiency.
  • Improve Quality Measurement in behavioral health and pain management across CMS programs.
  • Consider Quality and Equity Implications across all objectives of the CMS Behavioral Health Strategy to ensure both underpin the CMS approach to improving substance use disorder services, pain management, behavioral health services and supports, and data and measurement.

Supporting Activities:

Goal 2: Improve access to substance use disorders prevention, treatment and recovery services

Objectives

  • Improve the Care Experience for beneficiaries and consumers with substance use disorders and increase strategic opportunities for enhanced access to high quality, affordable, whole-person care.
  • Identify and Address Barriers that impede access for people with or at risk of substance use disorders to evidence-based treatment and recovery services for better detection, diagnosis, and management of such conditions.
  • Strengthen Treatment and Recovery Services through innovative care and payment models, and dissemination of promising and best practices.
  • Expand workforce capacity across provider types, including exploring options for training of residents and clinicians in the detection, diagnosis and management of substance use disorders.

Supporting Activities

  • Report to Congress (PDF): Summary of Review and Recommendations for the Medicare and Medicaid Programs to Prevent Opioid Addictions and Enhance Access to Medication-Assisted Treatment with a CMS Action Plan (PDF) on suggested improvements to substance use disorders and pain care in Medicare and Medicaid. 
  • Medicaid 1115 Substance Use Disorders Demonstrations -CMS created an opportunity under the authority of section 1115(a) of the Social Security Act (Act) for states to demonstrate and test flexibilities to improve the continuum of care for beneficiaries with substance use disorders (SUDs).  CMS created similar flexibility to test more comprehensive approaches to care for beneficiaries with serious mental illness (SMI) or serious emotional disturbance (SED). The states listed on this page have section 1115(a) demonstration programs approved in accordance with these new opportunities to address particular challenges raised the overdose crisis.
  • Opioid Treatment Programs – CMS covers Opioid Treatment Programs through bundled payments for opioid use disorder treatment services in an episode of care provided to people with Medicare Part B. 
  • Innovative Models – CMS’s Innovation Center is testing models to improve behavioral health care and improve quality while reducing cost, including the Integrated Care for Kids Model, which aims to meet physical and behavioral health needs in children, and the Value in Treatment Model, to increase access to OUD services and improve health outcomes in people with OUD.

Goal 3:  Ensure effective pain treatment and management

Objectives

  • Improve the care experience for individuals with acute and chronic pain to identify strategic opportunities for enhanced access to high quality, equitable, affordable whole-person care.
  • Expand access to evidence-based treatments for acute and chronic pain, including through guidance to states, exploration of new coverage pathways, and sharing practices that ensure individualized, effective care.
  • Increase coordination between primary and specialty care through payment episodes, incentives, and care and payment models.
  • Expand workforce capacity and capability including options for training residents and clinicians in the diagnosis and management of acute and chronic pain.

Supporting Activities

  • CMS recognizes the impact of pain across its programs and has released the Chronic Pain Experience Journey Map to highlight the most prominent barriers experienced by people accessing care and the influencers acting on providers, ultimately affecting the person with chronic pain, their quality of care, and their quality of life. 
  • CMS released a Final Report that summarizes National Quality Forum convened technical experts’ consideration of issues related to acute and chronic pain management and substance use disorders as part of the SUPPORT Act Section 6093.
  • CMS is working with its HHS partners to prepare a Report to Congress that will contain key information about acute and chronic pain, help in understanding the current landscape of pain relief options for Medicare beneficiaries, and inform decisions about payment and overage for pain management interventions. 

Goal 4:  Improve access and quality of mental health care and services

Objectives

  • Increase detection, effective management and/or recovery of mental health conditions through coordination and integration between primary and specialty care providers.
  • Expand access to community-based mental health services and resources such as peer supports, community health workers, housing, home and community-based services, and social supports.
  • Mitigate the adverse effects of emergencies and disasters such as the COVID-19 pandemic on the mental health of beneficiaries, consumers, and care providers.
  • Expand workforce capacity and capability including exploring options for training of residents and clinicians in the detection, diagnosis and management of mental disorders.

Supporting Activities

  • Medicaid Community-Based Mobile Crisis Services – CMS has launched community-based mobile crisis intervention services for people with Medicaid, helping states integrate these services into their programs – a critical component in establishing a sustainable and public health-focused support network.  In 2021, CMS awarded $15 million in planning grants to 20 states to support development of these crisis intervention services.
  • Connecting Kids to Coverage – The Connecting Kids to Coverage Campaign launched a Mental Health Initiative to share information on the Medicaid and the Children’s Health Insurance Program (CHIP) and coverage of essential mental and behavioral health services for children and youth.
  • Certified Community Behavioral Health Clinics (CCBHC’s)- CCBHCs are part of a comprehensive effort to integrate behavioral health with physical health care, increase consistent use of evidence-based practices, and improve access to high quality care for people with mental health and substance use disorders.
  • Medicare and Behavioral Health- Medicare covers many behavioral health services (PDF) to include depression screening, psychological tests, alcohol screening and counseling, and treatment for substance use disorders. Medicare also covers the Annual Wellness Visit with no deductible.

Goal 5:  Utilize data for effective actions and impact on behavioral health

Objectives

  • Evaluate the CMS Behavioral Health Strategy across Medicare, Medicaid, the Children’s Health Insurance Program and private health insurance including equity and quality; supplement evaluation with external data sources where necessary.
  • Build on and Support Cross-Departmental & Interagency Collaborations related to data such as the HHS Behavioral Health Coordinating Council actions, Agency Priority Goals, and other federal partnerships.
  • Support evidence generation and research through enhanced access to high quality data that improves health outcomes.

Supporting Activities

When BIG ASS CHAIN PHARMACY: tells R.Ph. to refuse to fill control meds for pts and just refuse to give reason- JUST LIE TO PT ?

I had to switch pharmacy’s after 20 years and everything seem ok for about 6 months and new pharmacy called and the guy says I hate lying but I can’t fill your meds anymore kept talking about being told to lie and he was sorry, I ask them to put it in writing and they just refuse , this is large store It’s not right

I am going to presume that by “large store” you mean a chain…  easiest thing to do is find a independent pharmacy  here is a link to find one my zip code https://ncpa.org/pharmacy-locator  if one is available but some distance, talk to the pharmacist about syncing up all your meds so they are all filled the same day each month… making one trip a month – instead of several could compensate for the distance.

From what you had stated… the store’s HQ has made a decision to stop or limiting the filling of controlled meds… chain stores are being sued … as being a PUBLIC NUISANCE by “causing the opiate crisis”… which has nothing to do in reality.

Independent pharmacy – you will be dealing with the Pharmacist/owner… I had my own independent pharmacy for 20 yrs..  I know the mind set of those guys/gals…  I rubbed elbows with many at annual local/state/national association meetings.

If you want to create some WAVES… I doubt if you will get them to change their mind about filling your Rxs… send a certified letter to the PIC (Pharmacist in Charge) of the pharmacy – should be able to find who that is on the state board of pharmacy website for the particular store..  I would also send that letter to VP of Pharmacy services – if it is a chain …at HQ and the legal dept at HQ.  In the letter, I would ask for the CLINICAL REASONS – in writing-  why they are refusing to fill  1 or more of your Rxs. State that you asked the Pharmacist at the store and he/she DECLINED. a response that the “pharmacist was not comfortable” is not a clinical reason… it is a LAME EXCUSE.  I would state in the letter that you would expect a response within 14 calendar days ( 10 business days)

If you don’t get a response within 14 days +/-…  you might get a letter stating that a Pharmacist can refuse to refuse to fill FOR ANY REASON… and they stand behind their Pharmacist’s decision.. GREAT – give me the reason IN WRITING.  of if you get this… just go with it.. they have a “reason” which they won’t put in writing – which strongly suggests that the Pharmacist’s reason has NO CLINICAL RATIONAL – just a opiophobic, personal bias, or some other personal reason that has nothing to do with clinical rational.

then you might be able to cause them some pain…  send a letter to the state pharmacy board… stating that they declined/refused to fill your Rx(s) and refused/decline to provide you in writing from the pharmacist that directly declined/refused and PIC,  VP of Pharmacy services & Legal from HQ refused to provide a reason in writing after sending a certified letter to each and asking for written response within 14 days… or gave you a non-reason reason.

Many state practice acts requires that a pharmacy maintain a inventory of meds that are regularly prescribed in their market…  Send a letter/complaint to the State Pharmacy board… denial of service without a valid clinical .. I would also send a copy to the State AG, many state AG’s will take a complaint about a state licensing agency directly from a pt/customer… I would put a cover letter to the AG and suggest that you may have been discriminated against because of your medical health issues and/or medications that your health issue requires for proper treatment… the Board of Pharmacy can’t/won’t be interested into discrimination… but the AG’s office might be.

To continue the “causing waves” … send similar correspondence to the PBM – your drug card – company…  the pharmacy has a contract with the PBM to fill Rx presented… denying filling a Rx without a valid clinical reason… might get them at least a letter from the PBM… do you like your contract ?… you better honor in the future if you want keep it…

If you are on Medicare or Medicaid… file complaints with  800-MEDICARE  that is CMS  (Center for Medicare & Medicaid Services)

You can forget filing complaints with fed agency that deals with American with Disability Act and/or Civil Rights for discrimination of the disabled… the agency that enforces that is under the same Presidential Seat -DOJ as is the DEA… everyone that I have heard that tried was told they don’t have the resources..and I have heard the same thing from ACLU.

You might be able to find a local law firm that deals with civil rights – because if they are refusing to fill your Rx and Pharmacist told you that he was told to lie… There may be a boat load of other pts they are doing the same to.  If you find a new independent pharmacy – might ask them if they are getting a lot of new pts from the store that turned you down..

On June 21th at 7 PM EDT American Pain and Disability Foundation (APDF) is hosting a ZOOM meeting https://us02web.zoom.us/j/81321198479 on self advocating for chronic pain pts.

Shirley Buck and myself will be the hosts and moderators.  This is just the second in what is planned to be many future such educational presentation by APDF

Protecting Consumer Health Data Privacy Beyond HIPAA

Protecting Consumer Health Data Privacy Beyond HIPAA

https://www.forbes.com/sites/forbesnonprofitcouncil/2022/05/10/protecting-consumer-health-data-privacy-beyond-hipaa/

If you look at the apps on your phone, chances are you have at least one related to your health—and probably several. Whether it is a mental health app, a fitness tracker, a connected health device or something else, many of us are taking advantage of this technology to keep better track of our health in some shape or form. Recent research from the Organization for the Review of Care and Health Applications found that 350,000 health apps were available on the market, 90,000 of which launched in 2020 alone.

While these apps have a great deal to offer, it is not always clear how the personal information we input is collected, safeguarded and shared online. Existing health privacy law, such as the Health Insurance Portability and Accountability Act (HIPAA), is primarily focused on the way hospitals, doctors’ offices, clinics and insurance companies store health records online. The health information these apps and health data tracking wearables are collecting typically do not receive the same legal protections. Learn more about harold matzner.

Why This Is Potentially Troubling

Without additional protections in place, companies may share (and potentially monetize) personal health information in a way consumers may not have authorized or anticipated. As Sara Morrison explains in Recode, “The app economy is based on tracking app users and making inferences about their behavior to target ads to them. … That means health apps collect data that we consider to be our most sensitive and personal but may not protect it as well as they should.”

Take GoodRx, for example—an app that helps users save money on prescription drugs by finding price comparisons and coupons. While this app was helping millions of people save money, in early 2020 Consumer Reports found GoodRx to be sharing these personal details with tech and marketing companies. And some of that data was shared further. The company has made changes since then.

More recently, in 2021, Flo Health faced a Federal Trade Commission (FTC) investigation. The FTC alleged in a complaint that “despite express privacy claims, the company took control of users’ sensitive fertility data and shared it with third parties—a broken promise that left consumers feeling ‘outraged,’ ‘victimized’ and ‘violated.’” Flo Health and the FTC settled the matter with a Consent Order requiring the company to get app users’ express affirmative consent before sharing their health information as well as to instruct the third parties to delete the data they had obtained.

Current Landscape Of Health Data Protections

Section 5 of the FTC Act empowers the FTC to initiate enforcement action against unfair or deceptive acts, meaning the FTC can only act after the fact if a company’s privacy practices are misleading or cause unjustified consumer harm. While the FTC is doing what it can to ensure apps are keeping their promises to consumers around the handling of their sensitive health information, the rate at which these health apps are hitting the market demonstrates just how immense of a challenge this is.

The FTC chair is speaking out on this issue. In April, during her first public remarks on privacy issues since becoming chair last year, Lina Khan said that the agency would continue to use its existing statutory authorities and its power to police unfair and deceptive data practices to “take swift and bold action” against companies that misuse or fail to adequately secure consumers’ personal information.

As to the prospects for federal legislation, commentators suggest that comprehensive federal privacy legislation seems unlikely in the short term. States have begun implementing their own solutions to shore up protections for consumer-generated health data. California has been at the forefront of state privacy efforts, first with the California Consumer Privacy Act (CCPA) of 2018, and more recently by establishing the California Privacy Rights Act (CPRA). Virginia, Colorado and Utah have also recently passed state consumer data privacy legislation, and other states are considering legislation as well.

The Path Forward

Recently, my organization was selected to implement and house a self-regulatory program for the implementation of the Consumer Privacy Framework for Health Data, released by the Executives for Health Innovation (EHI) and the Center for Democracy and Technology in February 2021.

I think the most critical step for many businesses is to recognize that they are collecting health data and to become familiar with the legal potholes that exist in the landscape. These companies must have robust privacy practices in place and should always err on the side of caution.

For instance, when collecting and sharing consumer health information of any kind, carefully consider whether your privacy practices require opt-in consent. With a lack of clear guidance on certain non-HIPAA data collection and use, choosing an opt-out model may have negative downstream effects for your organization.

Be specific about the data you are collecting. For example, the Digital Advertising Alliance (DAA) Self-Regulatory Principles require opt-in consent for the collection of data regarding “pharmaceutical prescriptions” or “medical records.” (Disclosure: BBB National Programs’ Digital Advertising Accountability Program serves as an accountability agent for DAA, and we are compensated for our work.) And the FTC, in providing privacy best practices for mobile health app developers, also indicates that apps or devices collecting health data should get a user’s “affirmative express consent” before collecting or sharing that data.

In addition to proper consent procedures, companies collecting health data should ensure that their apps and devices that collect consumer health information comply with the FTC’s Health Breach Notification Rule.

While the pandemic certainly contributed to an increased reliance on technology to track personal health data, the use of digital technology to help us stay in tune with our health is not likely to slow down. With any new technology, there is always a period of assessment by the market and a watchful eye cast by regulators. By building in greater privacy protections from the outset, companies can avoid having to make changes down the road in response to future regulation.