Man character need help. Vector flat cartoon illustration
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CDC launches new forecasting center for infectious diseases
Posted on April 19, 2022 by Pharmaciststeve
CDC launches new forecasting center for infectious diseases
https://abcnews.go.com/Health/wireStory/cdc-launches-forecasting-center-infectious-diseases-84163365
The new Center for Forecasting and Outbreak Analytics launched Tuesday. Its leaders say predicting the course of the COVID-19 pandemic in the U.S. has been hampered by data-collection problems.
In contrast, the United Kingdom uses regular population sampling with swab tests and blood draws to get a clearer picture of who’s been infected, said Marc Lipsitch, the new center’s science director. He said similar sampling should be considered in the U.S.
And the Centers for Disease Control and Prevention needs to have better access to data from state governments and hospitals, said Caitlin Rivers, the center’s associate director.
CDC has been granted temporary authority for COVID-19 data collection, but the agency broadly relies on voluntary reporting and complex data agreements with states, Rivers said.
The center is housed at CDC. Its initial $200 million in funding came from the 2021 coronavirus relief package. The center has awarded $21 million to academic institutions to develop modeling and forecasting methods.
It looks like the CDC is going to have to find a way around the 14th Amendment – you know that pesky “unreasonable search and seizure ” A few years ago the then AG of Indiana, decided that he was going to have better control of the opiate crisis… and he FORCED the state licensing board to pass as an emergency rule making process …. the proposed regulation was NOT POSTED, NO COMMENT PERIOD… just made a NEW MANDATE…
That mandate was that anyone prescribed > 15 MME of a opiate on a daily basis – was to have their urine tested MONTHLY… WELL… the ACLU took the Medical Licensing Board to COURT over violation of the 14 th Amendment… and I don’t remember if there was a actual trial, mediation or summary judgement. BUT the court told the Indiana Medical Licensing Board to immediately rescind that ILLEGAL regulation. That no bureaucracy can mandate a person to submit to any test without the pt’s consent… so called “unreasonable search and seizure ” that the 14th Amendment protects.
It appears that the CDC also believes that they are more powerful than any judge… since a “Trump appointed judge” did revoke the mask mandate that the Biden Administration put into affect and that is what the ABC video is all about
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“DEA practicing Medicine without a license requires a DEA Congressional Oversight Hearing”
Posted on April 18, 2022 by Pharmaciststeve
“DEA practicing Medicine without a license requires a DEA Congressional Oversight Hearing”
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Health System on the Hook for $22M Over Unnecessary Spine Surgeries
Posted on April 18, 2022 by Pharmaciststeve
UNNECESSARY PROCEDURES… how many pts have been forced into getting ESI (Epidural Spinal Inj) in order to have the physician to write the a Rx for oral opiates, when the ESI provide the pt little/no relief. The FDA and the Pharma ( Upjohn) that makes the corticosteroid DOES NOT RECOMMEND that corticosteroids should be used in ESI. There is already a couple of COUNTRIES that make those ESI ILLEGAL.. Apparently this hospital system didn’t get in trouble until a WHISTLE BLOWER that two surgeons were provided POOR CARE and care that was not appropriate (necessary). Providing ESI involving corticosteroids and the pt doesn’t get any/much relief… then that is unnecessary medical care and billing insurance … is INSURANCE FRAUD. It may also be a violation of a part of the Sherman Antitrust Act – called Tying commerce – where a person/entity is forced to buy something that they don’t want in order to be able to buy something that they do want. Doesn’t that describe what happens when a practitioner REQURIES/FORCES a pt to have a EDI procedures involving corticosteroid in order to have the practitioner to provide the pt a prescription for oral opiates ?
Health System on the Hook for $22M Over Unnecessary Spine Surgeries
https://www.medpagetoday.com/special-reports/exclusives/98247
Providence Health & Services agreed to pay $22.7 million to settle allegations that two of its neurosurgeons falsely billed federal healthcare programs for medically unnecessary spine surgeries, in the largest-ever healthcare fraud settlement in the Eastern District of Washington, according to the Department of Justice (DOJ).
The health system, the U.S. federal government, and the state of Washington reached a joint settlement Tuesday following a whistleblower complaint, which alleged that two spine surgeons employed at Providence St. Mary’s Medical Center in Walla Walla provided poor care and committed billing fraud from 2013 to 2018.
Providence, a large health system that has 51 hospitals in seven states, paid neurosurgeons based on a productivity metric, which gave them a financial incentive to perform more surgeries of greater complexity, the DOJ alleged. From 2014 to 2017, one of the surgeons in question earned between $2.5 and $2.9 million a year based on this metric, according to the settlement agreement.
The health system admitted that during the time period that the spine surgeons were employed, other medical staff expressed concerns that they endangered patients, performed surgeries that resulted in complications, conducted surgeries on patients when they were not appropriate, and did not adequately document their procedures.
Providence also acknowledged that while it did eventually place both of these surgeons on administrative leave, it allowed both doctors to resign while on leave, and did not take any action to report them to the National Practitioner Data Bank or the Washington State Department of Health.
“Ensuring that surgical procedures are medically appropriate and properly performed is critical to building safe and strong communities here in the Eastern District of Washington,” said U.S. Attorney Vanessa Waldref in a press release.
“Patients with back pain and spinal injury deserve top-notch care from a provider who puts the patient first and is not improperly influenced by how much he can bill for the procedure,” Waldref said. She added that Providence’s failure to ensure that its physicians were performing safe and necessary procedures, despite repeated warnings, “put patients’ lives and safety at serious risk.”
In a statement to MedPage Today, a spokesperson from Providence said that the events in question have prompted an internal investigation of policies, practices, and procedures to ensure the delivery of high-quality care.
“We are committed to taking specific, concrete actions to ensure this isolated incident in Walla Walla does not happen again,” the spokesperson stated. “Providence has strong existing protocols and safeguards to ensure we deliver quality care and make continuous improvements that further enhance those protocols and safeguards.”
In January 2020, a whistleblower had filed a complaint stating that two spine surgeons at Providence St. Mary’s Medical Center — Dan Elskens, MD, and Jason Dreyer, DO — provided substandard care from 2013 to 2018. Elskens and Dreyer were not named in the settlement agreement.
The whistleblower, also a neurosurgeon, had found that Elskens committed several surgical errors upon an internal review, the complaint stated, including operating on incorrect spinal sections requiring emergency remedial surgery.
The whistleblower allegedly reported these concerns to Providence’s chief medical officer, recommending that Elskens be terminated. However, Providence rejected that initial recommendation. The whistleblower then discovered that Elskens allegedly botched an additional surgery — nearly paralyzing the patient — before Providence placed Elskens on a suspension.
During this time, the whistleblower also began to review the work of Dreyer, who studied under Elskens. His review found that Providence billed the federal government for procedures that Dreyer never performed. In addition, he complained that Dreyer was “fabricating patient diagnoses and treatments to justify complex operations and to increase the reimbursement of both himself and Providence.”
Some of the incidents caused the federal government to pay amounts exceeding $150,000 for unnecessary and underperformed procedures, the complaint stated. The whistleblower reported these concerns in November 2017 and again in May 2018 before Providence suspended Dreyer, they alleged.
Both Elskens and Dreyer resigned during their suspensions, according to the complaint. Elskens’ medical license has been restricted in Washington and Michigan, but remains active in Indiana and Ohio. Dreyer’s medical license remains active in Washington and Michigan, and no actions have been taken by state medical boards.
The whistleblower will receive approximately $4 million as a result of the settlement.
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Andrew Kolodny: BELIEVES that the pharmas collaborated to increase prescriptions for opioids across America
Posted on April 16, 2022 by Pharmaciststeve
I find it very interesting that the “expert” ( Andrew Kolodny) for the plaintiff “broke down how HE BELIEVES that the companies named – among others – collaborated in the 1980’s and 1990’s to increase prescriptions for opioids across America and ESPECIALLY IN WEST VIRGINIA.”
So the plaintiff appears to be totally counting on and basing their case on the OPINION of this “expert”. My understanding is that any measurable perceived “opiate crisis” did not really again any traction until after Purdue Pharma introduced Oxycontin – which wasn’t until 1995-1996 and another potential stimuli was the Decade of Pain Law that was passed and signed into law in 2000.
Generic Vicodin first became available in 1983 and typically once a pharma loses a patent on a brand name med and the generic becomes available. The pharma does less promotion of the brand name, because most all states have mandatory generic substitution – unless brand name is specified by the prescriber, but most PBM/insurance will not pay for the brand name and/or charge a very large copay when a brand name is dispensed when a generic is available.
If there was few/no brand name opiates without a generic available. Historically, there is little/no promotion of a brand name opiates being promoted directly to prescribers.. the number of Rxs being prescribed will generally “fall off”. Pharmas making generics typically do not support a marketing staff to call on prescribers. The marketing to physicians is a very expensive endeavor and generic pharmas not have the profit margins to support a marketing staff.
This newspaper article did not elaborate on what was entailed in Kolodny’s “broke down how he believes the companies collaborated “
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When a pharmacist holds a pt’s meds at hostage
Posted on April 14, 2022 by Pharmaciststeve
Hello,
I have been disabled for over 10ys. I have lived in the same place and gone to the same pharmacy and received the same prescription for the duration. Recently I went to pick up my monthly prescription and was told because I had picked it up early a few months prior that the pharmacist would be adding those days to my new prescription and it would not be available for pickup for an additional 6 and 10 days. These are legal perscriptions given to me by my health care provider and approved by my insurance to be paid for yet because a “floater” came into the pharmacy, looked into my history, and decided I now needed to wait 36 and 40 days for my 30 day supply of medications. Is this legal? Do I have ANY recourse? I am religious in the way I take my medication and I have NEVER abused it. This is evident by what happened 4 months ago and because my medication was “not in stock” again (which it hasn’t been in stock for over 2 years and I always have to wait a few days), and I had to wait FOURTEEN DAYS to get my medication. Had I not gone in early on those times I did I would have ended up dead without my medication. Lucky for me I did have extra on hand because I don’t abuse my medication but if it was exactly 30 days every single time, which is what I’m apparently being punished for this time, I honestly would not be here to write this email.
I sure could use some help. I’ve got enough meds to last through this whole thing but I’m fearful for what my future may look like if this persists. I tried to call and all I was told was to call and have my doctor transfer my prescription to a different pharmacy. I have a feeling that would have put me on some kind of list for shopping around my prescription so I’m just going to wait for this date they magically came up with. My question is why only go back a few months and hold my prescription hostage? Why not go back 10 year and really stick it to me? I mean they clearly aren’t following any guidelines. It seems petty and a power play but its MY life and they just don’t seem to care. I need to know where to go from here. Please help me. Thank you for your time
When a pharmacist thinks that holding a pt’s medication as hostage because – according to their calculation – they pt should have a few doses still on hand. So the pt is suppose to just believe that the Pharmacist did not make some math errors in their calculation ? I wonder if these are the same pharmacist’s “mindset” that when they require the pt to wait until they are ready to take their last dose from the previous fill and they are out of stock of their meds… and they have no concerns that they won’t be able to get the pt’s med back in stock for several days… I am sure that the pharmacist has no idea of what is in like for a chronic pain pt to be thrown into cold turkey withdrawal and maybe into a torturous level of pain… maybe miss a couple of days of work… Filed under: General Problems | 8 Comments »
typed letter taped to counter that staffing issues are prohibitive to counting meds again when a patient picks them up
Posted on April 13, 2022 by Pharmaciststeve
Steve do you know . . .Has anyone ever had issues with receiving less meds than MD ordered? How did you handle it? My insurance only pays at Walgreens. Must wait until next year to change it. It’s not like I can confront the pharmacy without being called suspicious and med seeking. It would probably raise my narxcare score. They are rude enough to my family when they pick up meds as it is. My family used to ask for a count before leaving the counter, but with lay offs, short staffing, shorter hours, no weekend hours they won’t take the time to do it, unless my friend has floated over from another store. A days worth is bad enuf, but a week??&%$#@. I asked the group at American pain and disability. Got some suggestions.
Is there some kind of statement for pharmacist that says they need to count meds when we in drug store if it is requested?
They have a typed letter taped to counter that staffing issues are prohibitive to counting meds again when a patient picks them up.
Plus I don’t want to raise red flags. They might change narxcare score
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The future of better medical care for pts is HERE
Posted on April 12, 2022 by Pharmaciststeve
Matching drugs to DNA is ‘new era of medicine’
https://www.bbc.com/news/health-60903839
We have the technology to start a new era in medicine by precisely matching drugs to people’s genetic code, a major report says.
Some drugs are completely ineffective or become deadly because of subtle differences in how our bodies function.
The British Pharmacological Society and the Royal College of Physicians say a genetic test can predict how well drugs work in your body.
The tests could be available on the NHS next year.
Your genetic code or DNA is an instruction manual for how your body operates. The field of matching drugs to your DNA is known as pharmacogenomics.
It would have helped Jane Burns, from Liverpool, who lost two-thirds of her skin when she reacted badly to a new epilepsy drug.
She was put on to carbamazepine when she was 19. Two weeks later, she developed a rash and her parents took her to A&E when she had a raging fever and began hallucinating.
The skin damage started the next morning. Jane told the BBC: “I remember waking up and I was just covered in blisters, it was like something out of a horror film, it was like I’d been on fire.”
Image source, Jane BurnsJane Burns, now 50, has to be careful in the sun and is “terrified” of taking new medicines.
Her epilepsy medicine caused Stevens-Johnson syndrome, which affects the skin and is far more likely to happen in people who are born with specific mutations in their genetic code.
Mrs Burns says she was “extremely, extremely lucky” and said she supports pharmacogenomic tests.
“If it saves your life, then it’s a fantastic thing.”
Nearly everyone is affected
Jane’s experience may sound rare, but Prof Mark Caulfield, the president-elect of the British Pharmacological Society, said “99.5% of us have at least one change in our genome that, if we come across the wrong medicine, it will either not work or it will actually cause harm.”
- More than five million people in the UK get no pain relief from codeine. Their genetic code does not contain the instructions for making the enzyme that breaks codeine down into morphine and without it, the drug’s a dud.
- The genetic code of one in 500 people puts them at higher risk of losing their hearing if they take antibiotic gentamicin
Pharmacogenomics is already used for some medicines. In the past, 5-7% of people would have a bad reaction to the HIV drug abacavir and some died. Testing people’s DNA before prescribing the drug means the risk is now zero.
Scientists have looked at the 100 most prescribed drugs in the UK. Their report says we already have the technology to roll out genetic testing to guide the use of 40 of them.
The genetic analysis would cost about £100 and could be done using either a sample of blood or saliva.
Initially, the vision is to perform the test when one of the 40 drugs is prescribed. In the long term, the ambition is to test well ahead of time – possibly at birth if genetic testing of newborns goes ahead, or as part of a routine check-up in your 50s.
Precision
“We need to move away from ‘one drug and one dose fits all’ to a more personalised approach, where patients are given the right drug at the right dose to improve the effectiveness and safety of medicines,” said Prof Sir Munir Pirmohamed, from the University of Liverpool.
“What we’re doing is really going to a new era of medicine, because we’re all individuals and we all vary in the way we respond to drugs.”
He said that as we age and are prescribed more and more drugs, there’s a 70% chance that by the age of 70 you will be on at least one drug that is influenced by your genetic make-up.
Lord David Prior, the chairman of NHS England, said: “This will revolutionise medicine.”
He said pharmacogenomics “is the future” and “it can now help us to deliver a new, modern personalised healthcare system fit for 2022”.
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Duke U surgeon: will only speak with 16 y/o pt post surgery
Posted on April 12, 2022 by Pharmaciststeve
This video appears to be a video made by a parent of a 16 y/o that had back surgery and the surgery was done in the Duke University healthcare system. I had a heard a couple of years ago that Duke U had implemented a little/no opiate policy.
I can’t imagine a surgeon only willing to talk to a 16 y/o pt and won’t speak with the Mother. And according to this Mother the surgeon – or someone from the staff – would return a call after a couple of days from leaving a VM.
I suspect that if a parent – or anyone – intentionally inflicted pain or harm a child, I would expect that child protective services or cops would be looking for them… but… medical professionals seems to be exempt from being held responsible for a child being intentionally abused.
When is our society going to stop accepting/tolerating that pts being intentionally put in or left in pain without any consequences.. At least back in the 19th century, pts got a tree branch to chew on and bottle of WHISKEY.
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where will the 2022 CDC opiate dosing guidelines take the community ?
Posted on April 12, 2022 by Pharmaciststeve
We opened our independent pharmacy in 1976, back then the PBM industry was a minor part of paying for prescriptions, the vast majority of prescriptions were paid by cash/check/credit card.
In the early 80’s as the DRG reimbursement was implemented in the hospital system. Basically, when a person was admitted to a hospital, the hospital was given a fixed $$$ based on the pt’s diagnose and if the hospital spent less than the budgeted $$$ they made money… if they spend more than the budgeted $$$ the hospital LOSS MONEY.
The phrase quickly coined discharged “quicker and sicker”… The need/demand for various hospital equipment for the pt recuperating at home grew dramatically. So we began being a supplier for home medical equipment. Providing hospital beds, wheelchairs, walkers, crutches/canes, bedside commodes and the like.
As we got requests for items we did not normally stock, we expanded into new areas including home oxygen and related respiratory equipment & supplies, Home IV’s, Enteral feedings, T.E.N.S unit and both Barb and I got certified as prosthetic and orthotic fitters. Which allowed us to provide custom fitted back braces and Jobst custom compression stockings. Eventually we expanded adding a Mastectomy Center and Barb became our master fitter/trainer for women who had breast cancer and mastectomy surgery.
We had moved from our little 1200 -1400 sq ft pharmacy to a 5000 sq ft pharmacy, home medical equipment and Mastectomy center and a off site 2800 sq ft warehouse. We went from a one pharmacist and one full time and one part time pharmacy tech to a total staff of 18 employees.
We also moved from being primarily a cash/check/credit card business to one doing a great deal of billing to Medicare part B, Medicaid and numerous other insurance companies. To survive, we had to become experts in billing and dealing with all the different rules and regulations of all those various insurance entities.
During those years, we went to DC with two of national associations that we belonged to… when they had multi day legislative meetings and we would meet with our elected members of the House and the Senate to lobby them on some legislative changes that was up for discussion and changes to regulation that affected our business and the pts that we cared for.
What was pretty common is that – especially large – proposed changes would not be addressed or final posting would not happen until after Labor Day on years when there was a Federal Election. They would finalize the proposed rules then because all 435 members of the House and 33-34 members of the Senate would be out on the CAMPAIGN TRAIL… When the election was over the first week of Nov… Congress would come back to DC… those that did not get re-elected would start packing their office up… those who gained seniority because of the election would start jockeying for new/better office based on their new seniority.
Before you know it… it is time for Congress’ Christmas break… before the new Congressional session starts the first of Jan.. Then there is orientation for the new ‘freshman” members of Congress. So the bureaucrats have several months to implement their proposed regulation changes to implement… because no one in Congress is around to try to get them to intervene.
If history repeats itself, the CDC will finalize the 2022 proposed opiate dosing guidelines around Labor Day and the DEA will latch on to them and start their indoctrination of various entities that have DEA licenses to prescriber or dispense controlled meds and most likely, they will have been working on their “new standard of care and best practices” to start their intimidation of many as possible within the healthcare system… that 50 MME/day is – IN THEIR OPINION – is where a prescriber prescribing greater than 50 MME/day will constitute providing opiates outside of “valid medical need” – per the DEA’s medical expertise
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