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THE LIBBY REPORT OF 2005: EXPOSED THE MOTHER OF ALL MEDICAL FRAUDS, DOJ-DEA’S DECEPTION, TARGETING, FALSE IMPRISONMENTS, NOW THRU THEIR INCOMPETENCE TENS OF THOUSANDS ARE DEAD
Posted on March 2, 2024 by Norman Clement
DEA DIRECTOR ANNE MILGRAM: The concept of “pre-crime,” once relegated to science fiction, has taken on a chilling reality in contemporary law enforcement practices. In a thought-provoking article titled “Pre-Crime” and the Danger of “Risk Assessments” authored by Paul J. Hetznecker, the issue of “pre-crime” and the utilization of “risk assessments” by law enforcement is brought to the forefront.
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Russian-linked cybercriminals ALPHV/BlackCat hacked Unitedhealth and demanding ransomware
Posted on March 1, 2024 by Pharmaciststeve
UnitedHealth confirms ransomware gang behind Change Healthcare hack amid ongoing pharmacy outage
Ransomware gang ALPHV/BlackCat claims huge breach of US patient records
American health insurance giant UnitedHealth Group has confirmed a ransomware attack on its health tech subsidiary Change Healthcare, which continues to disrupt hospitals and pharmacies across the United States.
“Change Healthcare can confirm we are experiencing a cyber security issue perpetrated by a cybercrime threat actor who has represented itself to us as ALPHV/Blackcat,” said Tyler Mason, vice president at UnitedHealth, in a statement to TechCrunch on Thursday.
“Our experts are working to address the matter and we are working closely with law enforcement and leading third-party consultants, Mandiant and Palo Alto Network[s], on this attack against Change Healthcare’s systems. We are actively working to understand the impact to members, patients and customers,” the spokesperson said.
“Based on our ongoing investigation, there’s no indication that except for the Change Healthcare systems, Optum, UnitedHealthcare and UnitedHealth Group systems have been affected by this issue.”
In a post on its dark web leak site on Wednesday, ALPHV/BlackCat took credit for the cyberattack at Change Healthcare. The Russia-based ransomware and extortion gang claimed to have stolen millions of Americans’ sensitive health and patient information. Ransomware gangs typically publish the names of their victims to their dark web leak sites often as a way to extort the victims into paying a ransom demand.
ALPHV/BlackCat’s claims could not be immediately verified. ALPHV took down the post claiming responsibility, sometimes an indication that the victim is negotiating with the hackers. UHG spokesperson Mason did not respond to a comment asking if the company paid a ransom or is in negotiations with the hackers.
TechCrunch confirmed on Monday that the ongoing cyberattack was linked to ransomware. Reuters first reported the news.
UHG-owned subsidiary Change Healthcare is a health tech giant and one of the country’s largest processors of prescription medications, handling billing for more than 67,000 pharmacies across the U.S. healthcare system. The healthcare tech giant’s website says it handles 15 billion healthcare transactions annually — or about one-in-three U.S. patient records.
Change Healthcare merged with U.S. healthcare provider Optum in 2022 as part of a $7.8 billion deal under UnitedHealth Group, the largest health insurance provider in the United States. The merger allowed Optum broad access to patient records handled by Change Healthcare.
UnitedHealth Group collectively provides over 53 million U.S. customers with benefit plans and another five million outside of the United States, according to its latest full-year earnings report. Optum serves about 103 million U.S. customers.
Pharmacy outages stall prescriptions
The cyberattack began on February 21 early on the U.S. East Coast, causing widespread outages at pharmacies and healthcare facilities. Change Healthcare said it took much of its systems offline to expel the hackers from its systems.
Change Healthcare’s incident tracker page shows most of its customer-facing systems remain offline.
Hospitals, healthcare providers and pharmacies across the United States have reported that they are unable to fulfill or process prescriptions through patients’ insurance.
Nebraska television outlet KLKN-TV reports that the majority of Nebraska hospitals are unable to verify patient insurance for inpatient stays, provide precise cost estimates, or process patient billing as a result of the ongoing cyberattack at Change Healthcare.
U.S. military health insurance provider Tricare said in a statement this week that the cyberattack at Change Healthcare is “impacting all military pharmacies worldwide and some retail pharmacies nationally.”
UnitedHealth previously attributed the cyberattack to an unspecified nation-state actor. Researchers have yet to determine a link between the ALPHV/BlackCat group and a government.
“The ransomware problem has been getting worse for years. If governments don’t get it under control quickly, critical services will continue to be disrupted, with potentially catastrophic consequences,” said Brett Callow, a ransomware expert and threat analyst at Emsisoft, told TechCrunch.
It’s not yet clear how the hackers gained access to Change Healthcare’s systems. In an interview with TechCrunch on Thursday, ConnectWise chief information security officer Patrick Beggs ruled out a recent vulnerability in his company’s products as the cause of the cyberattack at Change Healthcare.
“With all the subsidiaries including United all the way down to Change Healthcare, we have no record or no indication of any [managed service provider supporting them, or them themselves having ScreenConnect installed on their infrastructure,” Beggs told TechCrunch.
UnitedHealth made $22 billion in profit during 2023, according to its full-year earnings filed in January. According to the company’s most recent report on executive pay, UnitedHealth’s chief executive Andrew Witty received close to $21 million in total compensation during the previous fiscal year.
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just because you have health insurance doesn’t mean you will GET HEALTHCARE
Posted on February 28, 2024 by Pharmaciststeve
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Cash crunch pushes independents to the brink, data shows PBMs the cause
Posted on February 28, 2024 by Pharmaciststeve
Last year almost ONE INDEPENDENT PHARMACY CLOSED EVERY DAY. If this article is correct, we could see ~15 independent pharmacies closing EVERY DAY in 2024. Both CVS & Walgreens are closing 200-300 stores each year for the next few years. Rite Aid is in bankruptcy and has closed some 600 stores, leaving with ~ 1500 stores whose future is unknown. An untold number of pharmacy and healthcare deserts are being created every week. The last statistic I was that >50% of independent pharmacies are in cities/towns of < 20,000 population.
Cash crunch pushes independents to the brink, data shows
https://ncpa.org/newsroom/qam/2024/02/27/cash-crunch-pushes-independents-brink-data-shows
Nearly one-third of independent pharmacy owners may close their stores this year under pressure from plunging prescription reimbursements by big insurance plans and their pharmacy benefit managers, NCPA has found based on survey responses from members around the country.
According to the survey, 32 percent of all respondents say they are considering closing their doors this year because of the cash crunch. More than 92 percent say they may drop out of Medicare Part D, which would decimate patient access across the country, especially for senior citizens. More than half of all respondents say Medicare Part D prescriptions account for at least 40 percent of their business. “This is an emergency,” says NCPA CEO Douglas Hoey. “And if Congress fails to act again, thousands of local pharmacies could be closed within months and millions of patients could be stranded without a pharmacy.”
NCPA sent a letter to CMS yesterday outlining the problem: “In 2023, there were over 300 independent pharmacy net closures — almost one less pharmacy open for patients a day — and there are approximately 2,200 fewer retail pharmacies than there were four years ago,” NCPA’s letter stated. “Increased vertical and horizontal consolidation of PBMs and health plans has caused severe inequities to pharmacies and Medicare Part D beneficiaries alike. These are startling developments. Action is needed to ensure independent pharmacies can continue to serve their patients.” Key congressional leaders received a copy of this letter as well.
Pharmacy owners are doing everything they can to avoid closing their doors. Forty-two percent got a line of credit to get them through the transition. Nearly 60 percent have had to use it. Many are cutting hours, reducing staff, and eliminating services. Nearly 70 percent, according to the survey, have had to dip into their personal savings.
To combat this and other disparities that plague independents, NCPA is calling on all members to join the fight to keep doors open — for the sake of patients and business, alike. Community pharmacists have answered our calls to action and sent over 10,000 messages to Congress since January. Yet PBM reform hangs by a thread. Call and email your legislators TODAY and tell them inaction is unacceptable. We need PBM reform NOW!
Congress continues to negotiate the funding package, and legislators need to understand the urgent need to address PBMs. They cannot delay acting! Several NCPA priorities have advanced through the committee process in at least one chamber, and one has even passed the full House of Representatives. Congress must not miss this opportunity to pass meaningful PBM reform provisions that can be signed into law.
Tell your legislators to support the following priorities:
- S. 2973, the Modernizing and Ensuring PBM Accountability (MEPA) Act (passed 26-1 out of the Senate Finance Committee)/H.R. 5378, the Lower Costs, More Transparency Act (passed the House of Representatives on an overwhelming bipartisan vote of 320-71)
- Bans spread pricing in Medicaid managed care by requiring a fair and transparent reimbursement to pharmacies and saves over $1 billion!
- S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act (unanimously passed the Senate Finance Committee)
- Includes the No PBMs Act which requires CMS to define reasonable and relevant contract terms in Medicare.
- S. 127, the Pharmacy Benefit Manager Transparency Act (passed 18-9 out of the Senate Commerce Committee)
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You can also engage your patients in the fight by displaying this flyer and QR code in your pharmacy so they can send their own messages to Congress to demand PBM reforms now, or you can share this link with them.
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Watching this 12 minute video – the truth of how our healthcare insurance industry works!
Posted on February 28, 2024 by Pharmaciststeve
https://twitter.com/BoesingLoretta/status/1762816596433576274
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US pharmacy outage triggered by ‘Blackcat’ ransomware at UnitedHealth unit, sources say
Posted on February 28, 2024 by Pharmaciststeve
Most/all pharmacies limit pts taking controlled meds to only being able to get a refill early anywhere from 1 to 3 days early. This article stated that pharmacies not having access to submitting bills to a PBM and got SIX DAYS BEHIND in filling prescriptions. It is just not pts taking controlled meds, there are a lot of high-acuity pts that being without their medication can dramatically compromise their QOL or even be life-threatening.
How many days is it going to take for these pharmacies to catch up from being SIX DAYS BEHIND? Even if they bring “all hands on deck” 24/7 until things are caught up. There are going to be a lot of overtime hours involved in doing this. Was United Healthcare, OptumRx, or the PBM at fault for not having state-of-the-art network protection processes in place?
Could some pharmacies end up buying DOUBLE the amounts of controls that they normally do in a 7-10 day period and the wholesaler’s computer could start throwing some red flags and delete some of the pharmacies’ orders for controlled meds. Further complicating the problems of high acuity pts and their inability to get their necessary meds?
If some of the high acuity pts end up with a hospital stay and many of these high acuity pts are on Medicare or Medicaid, so we taxpayers are going to end up picking up the tab for these healthcare costs.
US pharmacy outage triggered by ‘Blackcat’ ransomware at UnitedHealth unit, sources say
WASHINGTON, Feb 26 (Reuters) – Hackers working for the ‘Blackcat’ ransomware gang are behind the outage at UnitedHealth’s (UNH.N) technology unit that has snarled prescription deliveries for six days, two people familiar with the matter told Reuters on Monday.
The problems began last week after hackers gained access to Change Healthcare’s information technology systems and has led to disruptions at pharmacies across the United States.
Change Healthcare and UnitedHealth did not immediately respond to requests for comment. Blackcat, also known as “ALPHV,” did not immediately respond when asked whether it was responsible.
Alphabet’s (GOOGL.O) cybersecurity unit Mandiant is handling the investigation into the breach, the two people said. In a statement, Mandiant confirmed it “has been engaged in support of the incident response” but declined to comment further.
Blackcat is one of the most notorious of the internet’s many ransomware gangs – groups of cybercriminals who encrypt data to hold it hostage with the aim of securing massive payouts. It has previously struck major businesses including MGM Resorts International (MGM.N) and Caesars Entertainment (CZR.O)
In December, Blackcat was the subject of a takedown by U.S.-led international law enforcement, which seized several websites used by the group as well as hundreds of digital keys used to decrypt victims’ data.
The hackers had threatened to retaliate by extorting critical infrastructure providers and hospitals.
CISA, the U.S. cyber watchdog agency, and the FBI also did not immediately respond to emails seeking comment.
One expert said the news suggested that digital disruptions, while important, could not be counted on to knock ransomware groups out for good.
“It’s inevitable that if you have a group that’s making millions of bucks, they are going to attempt to make a comeback,” said Brett Callow, a threat analyst at the cybersecurity firm Emsisoft.
The allegation that Blackcat was behind the hack at Change Healthcare also raised questions about parent company UnitedHealth’s previous claim that it had been targeted by a “suspected nation-state associated cybersecurity threat actor.”
“I am not aware of any links between ALPHV and a nation state,” Callow said. “As far as I am aware they are financially motivated cybercriminals and nothing more.”
Reuters has not been able to gauge the full extent of the disruption.
A number of pharmacy chains, including CVS Health (CVS.N) and Walgreens (WBA.O) , have said the outage had knock-on effects on their businesses.
The American Pharmacists Association (APhA) said on Friday many pharmacies across the nation could not transmit insurance claims for their patients following the hack.
It said pharmacies were reporting “significant backlogs of prescriptions,” which they were unable to process.
Reporting by Raphael Satter and Christopher Bing in Washington; Additional reporting by Pratik Jain in Bengaluru; Editing by Sriraj Kalluvila, Shilpi Majumdar and Bill Berkrot
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Debunking the Hype: Opioid Overdose in Chronic Pain – The Truth
Posted on February 27, 2024 by Pharmaciststeve
A recent study aiming to find factors that increase risk of opioid overdose in chronic pain patients instead found that overdose is vanishingly rare, despite the researcher’s best efforts to obscure the truth. This recent Systemic Review and meta-analysis of almost 24 million patients set out to find what risk factors lead to opioid overdose in chronic pain patients. The results were not what the authors expected, with the data showing that while there were factors that increased the risk of overdose, the ABSOLUTE risk of overdose in chronic pain patients was less than 1%. That’s right. Less than 1% We covered another recent study which showed that addiction is also vanishingly rare. So the question begs to be asked – WHY are chronic pain patients being force tapered off their safe and effective long-term opioid therapy? This is a ground-breaking study, but not for the reasons the researchers hoped. They cherry-picked the data and selectively reported to hide the facts – that overdose is incredibly rare in chronic pain patients. Here’s link to the study – Predictors of fatal and nonfatal overdose after prescription of opioids for chronic pain: a systematic review and meta-analysis of observational studies Take note of the authors, they include David N. Juurlink and Jason W. Busse. If you found this information valuable, please consider giving the video a thumbs up, subscribing for more content, and sharing it with your network. Your support helps us continue to bring you high-quality, evidence-based research and STOP the FORCED TAPERS and undertreatment of chronic pain. To learn more about our chronic pain advocacy work, please visit Pain Patient Advocacy Australia https://painpatientadvocacyaust.org/ Please sign our petition protesting against ongoing forced tapers https://painpatientadvocacyaust.org/o… Read more of my articles on the truth about opioids and chronic pain on my substack https://substack.com/@arthriticchick Follow me on facebook 
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/ neen-monty-arthriticchick Follow Kevin R James on LinkedIn / kevin-r-james-971278190
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Walgreens decides that its ~ 8000 pharmacies will no longer fill controlled Rxs from a specific prescriber
Posted on February 27, 2024 by Pharmaciststeve
I am disabled. 66yrs old and all alone. I live in FL.
I have been on two controlled pain medications for 23 years. I have cancer and several other debilitating injuries and illnesses. In chronic pain!
I just recvd a letter from Walgreens
(See below) and I have only 6 days of medicine left before I am totally out!
I will not only be in severe pain but I will end up in the hospital! You can’t just go off this medicine. I have been going to the same Dr for 15+ yrs and the same Walgreens’s and the same pharmacist for 15 yrs. as well!
BUT I JUST GOT THIS LETTER FROM WALGREENS.
What does this mean?
I have another one of these letters from Walgreen addressed to a pt in Washington State from July 2023. The only thing different is the name of the doctor that they are no longer filling control meds for.
I did a blog post a few months ago, where there are several hyperlinks, explaining how 41 State AGs got the three largest drug wholesalers and the three largest chain pharmacies agreed to sell and fill fewer controlled meds. https://www.pharmaciststeve.com/dea-proposed-reduction-in-pharma-controlled-med-production-quotas/
From the text in the letter, it would appear that Walgreens is using some statistical analysis to determine what prescribers in a specific area are the outliers in writing the number of controlled meds and/or the most MMEs.
I would find the phrases in the letter quite humorous if it wasn’t that Walgreens was tossing pts taking controlled meds and who are highly likely to be disabled pt. So they are sorry for the inconvenience of probably throwing these pts into cold turkey withdrawal and possibly throwing them into a torturous level of pain. Below is the text from CMS website on discrimination of pts on Medicare or Medicaid. Is Walgreens directly or indirectly discriminating against this – and other pts – because they know how difficult to impossible it is for pts to find a new prescriber and/or new pharmacy to fill those C-II Rxs? It is clear in the Walgreens letter that Walgreens only questions this particular prescriber’s competency to appropriately prescribe controlled meds.
Nondiscrimination Notice
The Centers for Medicare & Medicaid Services (CMS) doesn’t exclude, deny benefits to, or otherwise
discriminate against any person on the basis of race, color, national origin, disability, sex (including
sexual orientation and gender identity), or age in admission to, participation in, or receipt of the services
and benefits under any of its programs and activities, whether carried out by CMS directly or through a
contractor or any other entity with which CMS arranges to carry out its programs and activities.
You can contact CMS in any of the ways included in this notice if you have any concerns about
getting information in a format that you can use.
You may also file a complaint if you think you’ve been subjected to discrimination in a CMS program
or activity, including experiencing issues with getting information in an accessible format from
any Medicare Advantage Plan, Medicare drug plan, state or local Medicaid office, or Marketplace
Qualified Health Plans. There are three ways to file a complaint with the U.S. Department of Health
and Human Services, Office for Civil Rights:
1. Online: hhs.gov/civil-rights/filing-a-complaint/complaint-process/index.html
2. By phone: Call 1-800-368-1019. TTY users can call 1-800-537-7697.
3. In writing: Send information about your complaint to:
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COPS, PAIN, COURTS TO PRISON THE RESHAPING OF PAIN HEALTHCARE AND ADDICTION: FASTRACK PATHWAY IN BECOMING A FEDERAL JUDGE
Posted on February 27, 2024 by Norman Clement
Among the higher-profile cases that McMillion worked on was the prosecution of Dr. Rajendra Bothra of Bloomfield Hills, who faced charges in an alleged $500 million health care fraud scheme. Bothra was acquitted last year after spending three years in jail prior to his trial. Bothra was found not guilty of more than 40 federal counts along with his former employees, Ganiu Edu, David Lewis, Christopher Russo in what was considered one of the biggest losses for the U.S. Attorney’s Office in more than 10 years. The one-year anniversary of the acquittal is Thursday.President Joe Biden plans to nominate another Michigan prosecutor to the U.S. District Court for the Eastern District of Michigan, Brandy R. McMillion,
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