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Both Pres Trump & candidate Biden seemed to state that PRE-EXISTING HEALTH ISSUES WOULD BE COVERED… by whatever health insurance system that either one will bring to the market place.

For the chronic pain community.. this pay provide a path for some law firms to find a way to take various parts of our healthcare system to task for failing to provide treatment for the various subjective diseases that impact those within the community.

Take for example,  According to https://www.medicare.gov/plan-compare/#/?lang=en&year=2021 Humana Part D policy in 2021 will NO LONGER COVER Benzodiazepines.  I did not investigate what other meds are not going to be covered during 2021.

If it is going to be stated that all insurance programs are to cover pre-existing health issues… should that give the insurance company to NOT COVER a particular med or category/class of meds ?  Could this dove-tail into civil rights/discrimination issue under the Americans with Disability and Civil Rights Act ?

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Walmart sues government in pre-emptive move ahead of expected opioid lawsuit

https://www.marketwatch.com/story/walmart-sues-government-in-pre-emptive-move-ahead-of-expected-opioid-lawsuit-11603402626

Retail giant says U.S. government is trying to use it as a scapegoat

Walmart Inc.  sued the federal government in an attempt to strike a pre-emptive blow against what it said is an impending opioid-related civil lawsuit from the Justice Department.

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Prescription Drugs From Canada? Not So Fast

https://www.medicaldaily.com/prescription-drugs-canada-not-so-fast-456815

Almost a month after President Donald Trump announced that states could begin importing drugs from Canada, pharmacists on both sides of the border don’t like what he’s prescribing.

Importing medications from Canada is part of the president’s America First Healthcare Plan to lower drug costs for Americans, especially older adults. The order, however, excludes some expensive biological drugs, including insulin.

“This will be a game-changer for American seniors,” the president said, according to Kaiser Family News. “We’re doing it very, very quickly.”

The new U.S. Department Health and Human Services’ (HHS) rule takes effect in 60 days.

Medications are cheaper in Canada

Prescription medicines are cheaper in Canada because the government limits what drug manufacturers can charge.  And for years, Americans have crossed the border to buy medications from Canadian-regulated pharmacies.

In fact, roughly 4 million Americans already buy their medications from abroad, even though it is illegal. Kaiser Family News also reported that another 20 million say they or someone they know has imported medications from foreign countries because the cost is substantially less. The government generally looks the other way for personal use purchases.

The President’s plan

Under the president’s plan, a Canadian-licensed wholesaler would buy medications approved for sale in Canada from a pharmaceutical company, then export the drugs to a U.S. importer. The importer would contract with a state, which would then dispense the drugs to pharmacies.

The fly in the ointment, however, is that the Canadian government has said it doesn’t have the drugs to spare. And many Canadian pharmacists and distributors have pledged not to participate. Daniel Chiasson, president and CEO of the Canadian Association for Pharmacy Distribution Management, told Reuters that job one for his members is to ensure a safe and stable supply of medications for Canadians.

Loblaw Companies, Ltd, which owns Shoppers Drug Mart, one of Canada’s largest pharmacy chains, told Reuters it had not been contacted about participating and had no plans to.

Safety Not Guaranteed

South of the border, the American Pharmacist Association (APhA) has said that it opposes the president’s order for several reasons, safety being first and foremost.

“Nothing in the final regulation and other supporting documents that the FDA [Food and Drug Administration] published demonstrates that this can be done safely and will result in savings for patients,” Ilisa Bernstein, APhA’s senior vice president for pharmacy practice and government affairs, told Medical Daily.

The supply chain from Canadian wholesaler to the American pharmacy counter, Ms. Bernstein said, is fraught with opportunities for mischief. Drugs will change hands several times and may be relabeled and added to the importer’s supply chain, which includes drugs from other countries. It is possible, she said, that when you pick up your prescription, you won’t get the FDA-approved version, but a counterfeit drug.

The final HHS rule also mentions a second plan “in the future” that would allow pharmacists to import drugs directly from Canada.

“There is very little information HHS has given about that, and that poses even more significant risks,” Ms. Bernstein said. “You don’t know what you’re getting from the global supply chain. Most online drug sellers that present themselves as pharmacies are really rogue and buying drugs from the unregulated global market.”

It’s a complex issue

Ms. Bernstein said that lowering the cost of medication in the U.S. is a complex issue that will take a multipronged approach to resolve. In the meantime, the APhA will focus on working with states to mitigate risks as each state develops its proposals for buying drugs from Canada.

“Pharmacists want to protect our patients,” she said. “Whether the patient is in the U.S. or Canada, as pharmacists we are the last step before the patient can get that drug. It is really important that we are giving a high-quality product.”

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OxyContin maker to plead guilty to federal criminal charges, pay $8 billion, and will close the company

https://www.cnn.com/2020/10/21/business/purdue-pharma-guilty-plea/index.html

The company will be dissolved as part of the criminal charges, and its assets will be used to create a new government-controlled company.

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https://www.medicare.gov/plan-compare/#/?lang=en&year=2021

Everyone needs to look at the Part D plan… many will not have to change their plan but others may be forced to change.

What I found was that some of the Part D policies is that they are currently not listing prices of individual medications.

When comparing prgms for us… I was offered one policy from Anthem and when comparing Barb’s … she was not offered that same Anthem Part D policy, but a different Anthem policy with a higher monthly premium, but lower copay… in reality looking at premium and deductible… she would be paying $100 more per year than would I.  I talked to a licensed agent for Anthem and he stated that Barb should have been offered the same policy as was offered me.

Some policies are stating that they are NO LONGER PAYING FOR  some Medication – like Alprazolam (Xanax), Methocarbamol (Robaxin ) and others.

Everyone need to pay attention to the prices listed for each medication. I saw a few where the price in the deductible period is the same as after the deductible is met… since suggests to me that the particular medication is basically the pt will be paying the “full rack rate” for the entire year for the particular medication.

There could be some software issues with this program – like no prices listed – or not offering a particular policy for some odd reason.

If you are not happy with your current Part D Policy… it is important to look at your options, but … given the errors that I ran into … it might be advisable to not commit to a specific policy until towards the end of the open enrollment period — and hopefully any software issues have been corrected.

Of course, if you want to keep the policy that you have now… you NEED TO DO NOTHING… you will automatically be re-enrolled into that policy

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Court tosses $7M judgment awarded to patient paralyzed after spine injection at ASC

https://www.beckersasc.com/asc-news/court-tosses-7m-judgment-awarded-to-patient-paralyzed-after-spine-injection-at-asc.html

The Colorado Court of Appeals reversed a $7 million judgment against Surgery Center at Lone Tree (Colo.) on Oct. 15, saying the ASC should not have been held vicariously liable for a spine surgeon’s alleged malpractice.

Plaintiff Robbin Smith lost all feeling in her lower extremities after receiving “a bilateral S1 L1-L2 transforaminal steroid injection using the particulate corticosteroid Kenalog” at Surgery Center at Lone Tree, according to court documents. Ms. Smith was later diagnosed with bilateral lower extremity paraplegia secondary to spinal infarct/ischemia and is permanently paralyzed below the waist.

She and her husband, Doyle Edward Smith Jr., filed a lawsuit against three defendants: the spine surgeon who performed the epidural, SpineOne Spine & Sport Medical Clinic, and Surgery Center at Lone Tree, where the injection took place.

However, only the claims against the ASC proceeded to trial. Claims against the spine surgeon were settled before trial, and claims against Lone Tree-based SpineOne Spine & Sport Medical Clinic, which is the surgeon’s employer, were dismissed.

During trial, the plaintiffs alleged Surgery Center at Lone Tree had an obligation to either prevent its surgeon’s off-label use of Kenalog, which they believe contributed to Ms. Smith’s paralysis, or ensure Ms. Smith had given her informed consent to its off-label use.

After an eight-day trial, a jury ruled in favor of the Smiths and awarded them $14.9 million in damages. The trial court reduced the amount of the verdict to roughly $7 million. The ASC appealed the jury’s ruling, and the Smiths cross-appealed the reduction in damages.

Citing Colorado’s corporate practice of medicine doctrine, which “prohibits healthcare facilities from controlling a physician’s independent professional judgment regarding the practice of medicine, diagnosis or treatment,” the Colorado Court of Appeals reversed the trial court’s judgment and remanded the case for judgment in favor of Surgery Center at Lone Tree.

“We conclude that the trial court should have dismissed the corporate negligence and uninformed consent claims against [Surgery Center at Lone Tree] as a matter of law because, under the corporate practice of medicine doctrine, [Surgery Center at Lone Tree] was not vicariously liable for any malpractice” by the operating surgeon, nor was the ASC obligated to assume any medical responsibilities the surgeon failed to fulfill, the Colorado Court of Appeals said.

The court also dismissed the Smiths’ claim for negligence per se, on the grounds that state licensing and federal Medicare regulations weren’t enacted primarily for public safety reasons.

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Leaving the bench

Today I turned in my resignation as a certified pharmacy technician with CVS.

I’ve been working as a tech for the last 18 years and the changes that come down on us are getting worse and worse. I’ve lost hope that our patients will be taken care of. Last week was the worst shift of them all. A flood of people coming in for flu shots, phone lines lighting up, people piling up at the register, and stacks of prescriptions waiting to be filled. We were drowning with no relief in sight. As I looked at my overtaxed pharmacist all I could see was a mistake waiting to happen. She’s being pulled in no less than 5 different directions, while the flu shots are piling up and she’s suiting up for the task, the narcotic waiter she still has to count and verify is 40 minutes past the promised time. While the patient was extremely understanding after watching us for the last hour, it’s not fair to him or any of our patients to have our attention pulled away in different directions constantly. I went home after my shift, defeated, and really thought about why I was still working here. It most certainly wasn’t because of the money, I could make more working at a coffee shop or as a cashier at a grocery store, shoot a lot of them even got hazard pay during this time. No raises since my pharmacy was bought out 5 years prior and most likely none in the future even with minimum wage creeping up in my state. No hazard pay, no thank you for coming in, nothing but headaches and chest pains. Our patients are no longer patients but are treated as customers who should be up sold at every interaction. Do you need this or that, how about we call your doctors for refills you don’t need, what about auto filling, what about any of these 3-5 vaccines, do you have a rewards card…. Looking back over the years the best thing to happen to me was NOT going to pharmacy school where I would have been saddled with a mortgage in student loan debt and in a job market that’s over saturated. 12 hour shifts, no time for a bathroom break, let alone trying to have a lunch break and many working extra hours before and after their shifts uncompensated just to clear the work for their colleagues. It was bittersweet turning in my 2 week notice, I feel awful for the team I’m leaving behind but I’m glad the abuse will be over. I did not join the pharmacy team to become a used car salesman but that is what CVS has turned it into, minus the commission of course. It’s time to let go and focus on myself, my son has been counting down the days to my last pharmacy shift so he came have some more mommy time… life is too short.

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My state drivers license was suspended unknown to me, to make matters worse my great-grandson took nana’s d.l. for the picture of nana long story short he lost it. We were in the hectic throws of covid, dept of Licensing closed. I went and got veteran’s affairs outreach office to make me a copy of that Driver’s license also included my social security. Card. My pharmacist at took the copy for months (7) now they are refusing unless I have a original drivers license. Because of covid I don’t have a chance of getting a new one. I paid my fines but the drivers license dept is telling me because of covid they have to send it out of state using the picture off my old dl.picture.this will take 6 weeks. I am disabled on social security. My pain meds I have been on for 10 years. I cannot just stop. Pain is constant and I can function with my meds . I have implants that have gone wrong. I need to have surgery, I also have nerve damages, spinal stenosis, nerve damage in my back, Deep vein th. Thyroid disease. Have gone thru therapy, exercises, non-opiod meds. Nothing help. My dr. Had me classified as completely disabled, no Hope’s of going back to my job of 15 years. But also let me tell you when I became aware of my lost of license I did what I could to correct it. Can you advise me? My meds are due 10-19-20. I am afraid of what will happen if I cant find a way to get this copy to be accepted the GOVERNMENT gave me a copy of the original. My script has my photo on it I have my photo on my copy. What more can I do?? Please respond, thank you

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