International GUIDELINESon HUMAN RIGHTSand DRUG POLICY
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International GUIDELINESon HUMAN RIGHTSand DRUG POLICY
29 pages click link to upload *.PDF
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They once were the obscure middlemen reaping billions off prescription-drug transactions as they worked behind a veil of secrecy. But a wave of reforms to the $400 billion-a-year industry of pharmacy benefit management is cresting across the United States.
According to the National Academy for State Health Policy, 101 PBM reform bills are being considered in 41 states this year.
PBMs, such as CVS Caremark, OptumRx and Express Scripts, act as the middlemen between health insurers, drug manufacturers and pharmacies. Their contracts typically keep pricing and rebate data secret, leading many people to conclude that they’re partly to blame for the rising price of drugs, which itself is the fastest-rising part of the health-care sector.
Following a Dispatch analysis last year of confidential pharmacy-reimbursement data, the Ohio Department of Medicaid released its own analysis showing that in 2017, CVS Caremark and OptumRx charged taxpayers $224 million more for drugs than they reimbursed pharmacists. That was three to six times the going rate, according to the analyst who did the report, which didn’t look at whether the PBMs were pocketing portions of rebates and other fees they were collecting.
“Unfortunately, things were really, really bad in Ohio,” said Anne Cassity, vice president of federal and state affairs for the National Community Pharmacists Association, an industry group representing independent pharmacies.
But things also were bad elsewhere, such as in Kentucky, where a state report determined that the “spread” between what PBMs billed taxpayers for Medicaid drugs and what they paid pharmacies was $123.5 million in 2018, prompting Kentucky Attorney General Andy Beshear to launch an investigation.
Louisiana, New York, and Arkansas each has either passed or is considering measures that would ban such spread pricing. Other states are considering various types of bills, such as ones in California and Oregon intended to increase transparency, while still other states are considering bills that would require PBMs to provide pharmacists with minimum reimbursements.
In West Virginia, rising drug costs in the Medicaid program prompted officials there to carve Medicaid drugs out of its managed-care system. State Medicaid officials have broken up PBM functions, leading to an increased transparency that they say saved $54.4 million a year.
Cassity, of the national association of pharmacists, praised that approach and said that states are leading the way in approaches to reform.
Pharmacy benefit managers defend their role, saying that they save money for consumers and arguing that many of the recent legislative initiatives would increase costs.
“Pharmacy benefit managers (PBMs) serve as the only check in the prescription-drug supply chain against drug-makers’ sole power to set and raise prices,” said Greg Lopes, spokesman for the Pharmaceutical Care Management Association, a national organization representing PBMs. “Any new state legislative mandates that undermine PBMs’ cost-savings tools would not reduce prescription-drug prices for consumers; rather they would reduce access and increase prescription-drug costs.”
Lopes cited a 2017 study by the University of Southern California that found that for every $100 spent on branded drugs, PBMs retain about $2, compared with $58 for manufacturers. For generic drugs, PBMs retain $7, compared with $18 for manufacturers.
However, Neeraj Sood, who conducted the study, told The Dispatch in January that it’s incorrect to use his work to evaluate whether that’s a fair split between manufacturers, which develop and produce medicines, and PBMs, which facilitate sales.
“You and I ask, ‘Is (the amount PBMs are getting) a reasonable number, or should PBMs be making less than that?’ My research didn’t address that question,” Sood said. He added that he is working on a study to try to find an answer.
The Montana legislature recently passed a bill meant to attack the PBM problem. Senate Bill 71 would require the Montana Securities & Insurance Commissioner to regulate PBMs that serve private health plans on the individual market. Similar reforms already have been made for state employees through the companies that administer the state’s self-funded insurance plan. The change is intended to require insurers to look out for taxpayer interests and to give state regulators the power to effectively check insurers’ math.
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The bill would allow the insurance commissioner access to PBM contracts and require insurers to use a list of drug prices that would be disclosed to regulators, secret, PBM-generated cost lists that prevail in the industry. It would outlaw spread pricing by requiring PBMs to pay pharmacists their costs plus a dispensing fee. It would eliminate after-the-fact fees that PBMs charge to take back part of the reimbursements they’ve already paid pharmacists.
SB71 also would take away health plans’ incentive to steer patients to expensive drugs with big rebates by mandating that all money collected by PBMs from manufacturers be returned to the state, and by forcing open contracts and other records to ensure that happens.
That provision would prevent insurers from boosting profits by classifying some portion of rebates as a medical expense, said Derek Oestreicher, an attorney for the Montana insurance commissioner who was involved in developing the measure.
“It’s ultimately important that insurers take back the reins from pharmacy benefit managers,” he said, explaining that he’d seen crazy things as he worked on the bill. One PBM contract he saw defined “rebate” as a number of things — “rebates” not among them.
Marilyn Bartlett was recently named 13th on Fortune magazine’s list of the World’s Greatest Leaders for her work reforming how Montana does business with hospitals, managed-care companies and PBMs. She said it took a hard political fight to pass SB71 over the objections of insurers and PBMs. It remains to be seen whether Democratic Gov. Steve Bullock will sign the bill. His office didn’t respond to a call last week for comment.
Maine lawmakers began hearings this month on a sweeping package of five bills broadly modeled on the Montana legislation.
The role of PBMs “is supposed to be about working on behalf of patients to drive down the cost of prescription drugs and serve as a check against the power of pharmaceutical companies,” said state Sen. Heather Sanborn, D-Portland. “However, more and more evidence has emerged that PBMs have taken advantage of their secrecy and used their position to pad their own investors’ pockets rather than drive down costs for consumers.”
In Ohio, Medicaid managed-care company CareSource earlier this month touted a new contract with Express Scripts that it says will bring new transparency to the system. The contract will be available to state officials, but not the public, however.
Company officials say making the contract public would give an unfair advantage to its competitors.
Montana’s Oestreicher isn’t buying that.
“Let’s be clear, we’re not dealing with the Coca-Cola recipe here,” he said. PBMs “are always coming up with more algorithms to become more profitable and more secretive.”
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(CNSNews.com) – The Department of Justice has declined to prosecute a Drug Enforcement Agency special agent who “provided false statements under oath” to the Office of the Inspector General of the Department of Justice about a subordinate who “apparently engaged in sexual activity in a public park,” according to a summary of the case released by the IG.
“The Department of Justice Office (DOJ) of Inspector General (OIG) initiated this investigation upon the receipt of information alleging that a Drug Enforcement Administration (DEA) Assistant Special Agent in Charge (ASAC), since retired, had contact with a local police officer after the officer observed the ASAC apparently engaged in sexual activity in a public park,” said the IG’s summary.
“The ASAC was on annual leave on that date,” said the summary.
“During the course of the investigation, the OIG found indications that the ASA’s immediate supervisor, the Special Agent in Charge (SAC), failed to properly report the ASAC’s contact with the local police to the DEA Office of Professional Responsibility (OPR), and provided false statements during his OIG interview concerning the ASAC’s conduct.
“The OIG investigation found that by apparently engaging in sexual activity in a public park, the ASAC failed to act in a professional manner as a DEA employee, in violation of federal regulation and DEA policy,” said the summary.
“The OIG investigation further found that the SAC failed to properly report to DEA OPR the ASAC’s contact with local police; showed favoritism to the ASAC by not reporting the incident to DEA OPR, which would have allowed for an impartial review of the incident; and provided false statement under oath to the OIG concerning his knowledge of the allegations involving the ASAC, all in violation of federal regulations and policies,” said the IG’s summary.
“Prosecution of the SAC was declined,” said the IG’s summary.
“The OIG has completed its investigation and provided its report to the DEA for appropriate action,” said the summary.
So when you work for law enforcement and you commit a crime and then another person in law enforcement LIES ABOUT WHAT WENT ON… and everyone goes on with their life without any consequences. Laws apparently are only meant to apply to those outside of law enforcement ?
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https://www.addictionpro.com/article/kolodny-opioid-makers-deception-merits-dramatic-responses
In a workshop talk on preventing future public health catastrophes at the Rx Drug Abuse & Heroin Summit, Andrew Kolodny, MD, opened with the comment, “I’m not playing the blame game.” Still, the co-director of the Opioid Policy Research Collaborative at Brandeis University delivered blistering criticisms for many contributors to the opioid epidemic.
Makers of powerful opioids clearly headed the list, but government regulators, state medical boards and accrediting agencies all were targeted during Kolodny’s talk. At the heart of his concern is the role that pharmaceutical industry money has historically played in compromising the mission of these other entities.
“A big problem, I believe, is the revolving door,” said Kolodny, referring to the common practice of drug regulators leaving government to take jobs in the industry they had been overseeing. Kolodny, who disclosed he is assisting states in lawsuits against opioid manufacturers, placed atop his list of solutions the imposition of limits on the revolving-door practices.
He also advocates campaign finance law reform. “Congress failed in its oversight,” he said, as the Food and Drug Administration recklessly allowed opioid manufacturers, absent research evidence, to promote the idea that opioid painkillers were safe for long-term use.
Questioning accepted wisdom
Kolodny questions the general explanation for how the opioid crisis has evolved in the U.S. The account goes that a first wave of overprescribing of prescription painkillers led to a crackdown that forced addicted individuals to heroin, which then became a more deadly trend when fentanyl infiltrated the supply. Kolodny believes this explanation oversimplifies the issue somewhat. First, “We really haven’t had a crackdown—we’re still massively overprescribing opioids,” he said.
Also, the three-wave construct ignores that heroin use was steadily increasing in many places at early stages of the prescription opioid crisis, Kolodny said. Young, mainly white, adults started with prescription opioid use and moved to heroin because doctors grew more uncomfortable writing multiple prescriptions for younger patients, a concern they didn’t apply to older patients who were able to stay on prescription opioids, he said. Another cohort that is ignored in the conventional wisdom, he said, are older inner-city adults, mostly non-white, who had a longtime heroin addiction but now faced deadly consequences of their use. In Washington, DC in particular, “Fentanyl was killing men who had survived 40 to 50 years with a heroin addiction,” Kolodny said.
He outlined the well-financed marketing efforts of Purdue Pharma and other drugmakers in assisting prescribers to grow more comfortable with opioids as a class, as they characterized any resistance to prescribe as “opiphobia” that would result in patients suffering needlessly. Helping the effort, however, were also entities such as the Federation of State Medical Boards, which sent the message that physicians would be sanctioned for undertreating pain, and the Accreditation Council for Continuing Medical Education, which failed to enforce its standard that continuing medical education be free from commercial bias, Kolodny said.
Outcome-focused sessions
Another workshop on the second day of the conference discussed a University of Kentucky team-based initiative to link emergency medical patients with opioid use disorders to ongoing care. The First Bridge Clinic was launched in early 2018 and involves the cooperation of a multidisciplinary team that includes waivered doctors and nurse practitioners, a nurse navigator, a licensed therapist and a certified peer support panelist.
Among the panelists, and Bridge Clinic leaders, was cardiac anesthesiologist J. Thomas Murphy, MD, who said he became board certified in addiction medicine and waivered to prescribe buprenorphine after seeing an increase in patients needing surgery for complications of endocarditis.
Another outcome-focused session at the conference featured two physicians who discussed improving services for pregnant women with opioid use disorder and their families. Mishka Terplan, MD, MPH, professor of obstetrics and gynecology and medical director of the MOTIVATE Clinic at Virginia Commonwealth University, lamented the lack of evidence-based care for pregnant women, even though it has been known since the 1970s that methadone is compatible with an uneventful pregnancy and the birth of a child with manageable symptoms. From 2002 to 2009, the percentage of addiction treatment centers offering services for pregnant and postpartum women actually declined from 19% to 13%, Terplan said.
Stephen Patrick, MD, MPH, director of the Vanderbilt Center for Child Health Policy, discussed the successes of an interdisciplinary Team Hope project at Vanderbilt that has been able to reduce lengths of stay for newborns who have been exposed in utero to opioids. The effort has emphasized standardizing protocols and taking a more compassionate approach that seeks not to routinely separate the baby from the mother.
I remember AK stating that he has never said that opiates SHOULD NOT BE USED FOR TREATING LONG TERM CHRONIC PAIN LONG TERM
but in this article AK is quoted: He also advocates campaign finance law reform. “Congress failed in its oversight,” he said, as the Food and Drug Administration recklessly allowed opioid manufacturers, absent research evidence, to promote the idea that opioid painkillers were safe for long-term use.
AK seems to vision himself as a “knight on a white horse” that save our country from continued opiate crisis… but is he more like Don Quixote
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HAMMOND — A doctor has been sentenced to serve 15 months in prison for over-prescribing pain medication at a Munster clinic.
Dr. Jay K. Joshi, 34, a general practice physician at Prestige Clinic in Munster, was sentenced Monday by U.S. District Court Judge Philip Simon to serve 15 months followed by three years of supervised release, a $7,500 fine and a $100 special assessment after pleading guilty to dispensing hydrocodone, an opioid, for non-medical purposes, according to the U.S. attorney’s office for nothern Indiana.
“Prescribing controlled substances that are not medically necessary intensify the opioid problem our nation faces,” U.S. Attorney Thomas Kirsch said. “We, working with our law enforcement partners, are focused on reducing opioid abuse in the Northern District of Indiana. Doctors who abuse their authority are just one of the areas on which our partners are focusing.”
Between September 2017 and December 2017, the Drug Enforcement Administration and Munster Police Department obtained information about Joshi’s history of prescribing controlled substances through Indiana’s prescription monitoring system, INSPECT, according to Kirsch.
INSPECT data obtained by investigators showed that from April 2017 to November 21, 2017, Joshi issued more than 6,000 prescriptions for controlled substances.
Joshi was ranked first in Lake County and ninth in the state among registered drug providers in 2017 for the number of prescriptions written for controlled substances, court records state.
Joshi’s medical license has been suspended since February 2018.
If one does the “reverse calculation” of the Rxs and time frame and this doctor could have some 300-600 pts on controlled meds
But did the DEA really screw up?… sure they went after the largest controlled substance presciber in his county and 9th largest prescriber in Indiana… But they went after a YOUNG PHYSICIAN… who probably don’t have much assets – still has a VERY LARGE student loan debt.
NO JURY TRIAL… just got him to plead guilty to Hydrocodone for non medical purposes. – 15 months in jail and some fines. His license was suspended but no mention that he can’t petition to have his medical license reinstated after jail time. Not typical of we normally see when the DEA raids a practice and what they do to the prescriber.
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www.disabledveterans.org/2019/04/30/tragic-veteran-suicide-at-cleveland-va-medical-center/
A veteran tragically took his own life yesterday at the Cleveland VA Medical Center just outside the facility’s emergency department.
“Our deepest condolences go out to the loved ones affected by this death,” the VA Northeast Ohio Healthcare System said in a statement. “Suicide prevention is VA’s highest clinical priority. One life lost to suicide is one too many.”
The facility cited privacy concerns when asked to provide additional details about the suicide. The immediate response is not unlike that of other facilities where veterans committed suicide on agency property including two suicides in Atlanta and the third in Texas.
Gary Pressley, 29, shot himself in a parking lot with a self-inflicted gunshot wound. Olen Hancock, 68, shot himself and died the following day. A third veteran shot himself in a VA waiting room located in Austin, TX.
“Every one of these is a gut-wrenching experience for our 24,000 mental health providers and all of us that work for VA,” Richard Stone, MD, of the Veterans Health Administration (VHA) said at the time. Dr. Stone is the Executive in Charge for VHA.
“I am heartbroken following the suicide of a veteran outside the Cleveland VA this morning,” said Rep. Marcy Kaptur (OH). “The level of pain that brings someone to suicide is fortunately unimaginable to many of us. My sincere condolences and prayers are with the veteran’s family and friends during this immensely difficult time.”
“The fact that 20 veterans a day take their own life – over 7,000 a year – is a tragedy. With seven incidents of veteran suicide on VA property in 2019 alone, 25 in the last 18 months, it’s critical we do more to stop this sustained national crisis. That is why I am working closely with my colleagues in the House and Senate to take decisive action to investigate and bring to an end the epidemic of veteran suicide.”
Over 6,000 veterans have committed suicide since 2016. After the recent suicides, VA reiterated that suicide prevention is VA’s top clinical priority.
“The sad thing that we confront every day is that of the 20 veteran suicides that occur across the country 14 of those veterans are outside of our department,” Wilkie said.
“What I’ve envisioned is the opening of the aperture to the states and localities to get them resources to find those veterans. One of the tragedies is that many of those veterans who take their lives come from my father’s era – Vietnam. So we have Americans whose problems in many cases began building when Lyndon Johnson was president. We have to tackle this issue in a way that we haven’t tackled it before.”
One theme that keeps coming up is the VA’s argument that 2/3 of veteran suicides are by veterans not receiving health care from VA. Somehow, the argument goes, VA will reduce veteran suicides by pushing all veterans into the VA system.
Here’s the thing.
Most veterans do not receive health care from VA, around 2/3. So, it makes sense that around 2/3 of the veterans committing suicide are outside the VA system.
Is that fact alone a bad thing?
On its face, the numbers seem to suggest a veteran is at least as likely to commit suicide who uses VA health care services as a veteran who does not use those same services.
So, is pushing all veterans into the VA for health care the answer to veteran suicide?
It seems unlikely.
The Cleveland VA Medical Center serves over 110,000 veterans. It is part of the VA Northeast Ohio Healthcare System, which is part of VISN 10 that serves 685,000 veterans throughout Michigan, Ohio, Northern Kentucky, and Indiana.
If you are reading this and experiencing mental health struggles, you are invited to call the Veterans Crisis Line at 1-800-273-8255 and press 1.
However, please note that some veterans who call the hotline report that they receive visits from police shortly after calls.
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www.statnews.com/2019/04/30/loosen-restrictions-on-prescribing-buprenorphine-addiction-treatment/
WASHINGTON — Eighteen state public health directors, a growing group of physicians, and a prominent member of Congress are pushing a dramatic expansion of substance use treatment by posing a simple question: Why can’t doctors who prescribe opioids also prescribe drugs to treat opioid addiction?
Their push to deregulate use of buprenorphine, which is used to lessen opioid cravings and withdrawal symptoms, would represent a fundamental shift in U.S. substance abuse treatment. The medication — and addiction medicine in general — are highly regulated, largely due to fears that opioid-based treatment drugs like buprenorphine and methadone could be misused.
This week, the effort will gain support from Washington: Rep. Paul Tonko (D-N.Y.) will soon introduce legislation to allow any medical practitioner licensed to prescribe controlled substances to prescribe buprenorphine, he told STAT. Currently, physicians must undergo an eight-hour training to prescribe the drug — 24 hours for nurse practitioners and physician assistants.
“These professionals can use their training and skill and ability to provide medication for treatment of pain,” Tonko said in an interview. “But when it comes to addressing the illness of addiction, they have to jump through additional hoops.”
The bill, Tonko said, “removes unnecessary obstacles and really expands the access we’ve created to provide for treatment on demand.”
Tonko’s push — though in its early stages — gives formal backing to an effort by treatment advocates who have long argued the federal government’s response to a crisis claiming 50,000 lives each year has been irresponsibly slow and at times counterproductive.
This month, top health officials in 18 states, three U.S. territories, and the District of Columbia wrote health secretary Alex Azar urging him to relax restrictions on the addiction medication.
Deregulating buprenorphine would make it far easier for Americans to get addiction care from their own doctors instead of being pushed through bureaucratic hoops and into treatment programs of varying quality, said Dr. Andrew Kolodny, the co-director of the Brandeis University Opioid Policy Research Collaborative. Currently, just 1 in 20 doctors have obtained the license necessary to prescribe it.
“For your average person who is opioid-addicted, who may have a relationship with their primary care doctor who they know and trust,” Kolodny said, “there’s a 95% chance that doctor is going to have to say: Well, let’s find a place to send you.”
The movement, however, appears to lack institutional support from major addiction medicine groups, including the American Society of Addiction Medicine. The National Council for Behavioral Health, which represents mental health and addiction providers, has no position on the proposal.
Opponents of deregulating addiction medicine say it could encourage more people to use buprenorphine illegally. In recent years, the Drug Enforcement Administration has raided the offices of numerous physicians who prescribe buprenorphine, including a leading addiction doctor in Tennessee and the past president of the American Society of Addiction Medicine, to investigate whether the high-volume treatment facilities had effectively become “pill mills.”
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Privacy was used as an excuse by lawmakers in the 2000s in establishing a database that could be used to alleviate a burgeoning opioid crisis. Now, lawmakers are using the same excuse to prevent Florida from using the data to help its case against Big Pharma.
TALLAHASSEE — Throughout the 2000s, Florida lawmakers tried repeatedly to create a database of drug prescriptions to fight the pill mill crisis as it bloomed into a full-blown epidemic.
But every year for nine years, it was shot down over concerns about patient privacy. It was only when the issue escalated into a national crisis did lawmakers finally establish a database that could be used to track problem doctors and keep addicts from getting pills.
Now, Florida senators are using the same excuse they used then — patient privacy — to reject a request by Florida’s top law enforcement official. Attorney General Ashley Moody wants access to the database to bolster the state’s lawsuit against the nation’s largest drug makers, distributors and pharmacies, which could be worth billions in damages for Florida and its opioid victims.
On Monday, the Florida House passed their bill 111-0 granting her access to the Florida Department of Health’s data.
But in the Senate, Moody’s request remains in deep trouble, stranded in a committee with four days left before legislative session ends.
The extraordinary standoff, pitting Senate Republicans against their new attorney general, threatens to delay the state’s lawsuit against companies like Purdue Pharma, the maker of Oxycontin, and pharmacy giants CVS and Walgreens.
Florida is one of many states suing the companies over their roles in the opioid epidemic. If the bill succeeds, some say it could serve as a model for other states.
“This is a very significant piece of legislation,” said William Large, president of the tort reform advocacy group Florida Justice Reform Institute, and a critic of Moody’s effort. “If this passes, it will be the template for the other states to try to get the data in a civil context.”
Florida was slow to react to the pill mill epidemic of the 2000s. From 2001 to 2008, lawmakers proposed creating a key tool to help in the fight: a prescription drug monitoring program that would track doctors and pharmacies’ prescribing habits.
Many other states had such a system, and as their numbers grew, more and more people from other states came to Florida for their pills.
Other states had a drug monitoring program that helped crack down on abuse. But Florida lawmakers continued to reject adopting a similar program. As the Sunshine State became a destination for addicts, governors in other states to begged Florida to create a database.
It wasn’t until 2009 that Florida did so, and it proved instrumental in shutting down pill mills. So instrumental, in fact, that the nation’s opioid addicts that year turned to heroin, a chemically similar drug.
Today, current and former lawmakers see the same privacy argument, and some suspect it’s just an excuse to give cover for big corporations.
“They used the word ‘privacy,’ which gets people’s attention,” said former Sen. Mike Fasano, who was instrumental in getting the drug database created in 2009 and is now the Pasco County tax collector. “What this comes down to is protecting the corporations that need to be held accountable for helping to create this epidemic we have.”
Sen. Gayle Harrell, R-Stuart, tried and failed six times to get the bill passed in the House in the 2000s. She supports Moody’s effort.
“It’s the same privacy argument,” she said. “But we have learned a lot along the way. And it’s even, I think, less germane at this point.”
The database tracks all monitored drugs, from oxycodone to sleeping pills. But Moody can’t use it for her civil lawsuit. By law, it’s restricted to criminal cases and administrative actions against doctors.
It’s not Moody’s only way to get the data. She could get it from the companies themselves, through the discovery process. But the companies could drag the process out for years.
She’s asking lawmakers to use parts of the state’s own data in her civil case. She would not get patients’ names, dates of birth, sex or addresses. Each patient would be assigned a random ID number.
And she would only be allowed to get the database under a court order, and under very specific circumstances.
Behind the scenes, some of the companies being sued have lobbied lawmakers against the bill.
Publicly, however, the most vocal opponent of Moody’s bill has been Large, the president of the tort reform organization.
A Walgreens vice president is on the organization’s board, but Large said he’s is mostly opposed to the bill for philosophical reasons.
“I’m advocating against this bill because it’s an expansion of civil liability and uses a state database to prove the civil liability parts of the AG’s case,” Large said.
He also has practical concerns about the bill. He fears that each person’s “unique identifier number” will not really be unique, and that whoever gets the data will be able to decode it.
He also fears a potential data breach. While Virginia’s drug database was hacked in 2009, however, Florida’s has not been. And privacy concerns have largely centered around the fact that police were getting access to the database at an alarming rate. Lawmakers tightened the system a few years ago.
A spokeswoman for Moody dismissed Large’s concerns.
“These issues are nothing more than conspiracy theories of a high paid lobbyist of a defendant in the State’s lawsuit with no basis in reality,” Lauren Schenone said in a statement. “Experts have concluded that you are more likely to be struck by a meteor than have your privacy compromised by this bill.”
Whether the Senate will take it up this week, in the final days of session, remains to be seen. Moody has been lobbying senators herself, and met with Senate President Bill Galvano, R-Bradenton, on Monday.
But on Friday, Galvano was skeptical his chamber would take it up. The bill has to pass the Rules Committee, but chair Lizbeth Benacquisto, R-Fort Myers, has refused to hear it, citing privacy concerns. Her brother-in-law is also a lobbyist for Walgreens.
“The concerns that were raised to me were regarding the privacy of certain information, and protecting certain information from an open analysis,” Galvano said.
The bill sponsor, Sen. Tom Lee, R-Thonotosassa, thinks he has the numbers to get it passed — if it could get a hearing.
“I think there’s clearly a privacy issue,” Lee said. “And it is that there are certain pharmacies that want their information to remain private.”
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https://www.drugstorenews.com/insights/part-of-the-solution-nacds-opioid-abuse-prevention-work/
NACDS members are meeting at the 2019 NACDS Annual Meeting amid rapid change. Throughout the event, NACDS will update the industry on public policy priorities. These issues have a profound impact on the operating environment in which members are conducting business and serving consumers.
Many of our policy discussions will focus on direct and indirect remuneration, or DIR, fee relief; addressing immediate and long-term pharmacy reimbursement issues; enhancing pharmacy’s scope of business; and serving as part of the opioid-abuse solution. Because NACDS hears from senior leaders of chains and suppliers that they are interested in the association’s opioid abuse-prevention work — as part of a larger community engagement platform — I am dedicating this space to an update on this issue.
NACDS’ opioid abuse-prevention work reflects chains’ ongoing commitments in the areas of compliance programs; drug disposal; patient education; security initiatives; fostering naloxone access; helping to stop illegal online drug sellers and rogue clinics; philanthropic programs; and more. It also reflects extensive work on the part of NACDS associate members.
NACDS’ ongoing engagement in federal and state policymaking reveals the complexities associated with the opioid abuse epidemic. NACDS and our state partners continue to advance sound policies that approach a comprehensive solution, and we also are working to prevent misguided policies. All of this is occurring amid a national discussion of opioid-related issues that continues to evolve, along with the understanding and perspective of policymakers, thought leaders and citizens.
One thing remains clear: NACDS remains focused on advancing the public policy recommendations that we established, based on pharmacists’ firsthand experiences on the front lines of health care and on collaboration with health and enforcement agencies. As I write this, 18 states have enacted NACDS-supported electronic prescribing legislation to help prevent fraud and abuse. Legislation continues to advance in other states as well. These results build on the momentum of federal electronic prescribing legislation enacted in 2018. At the federal level, legislation (S. 724/H.R. 1614) now has been reintroduced to limit to seven days a patient’s first opioid prescription prescribed for temporary pain. NACDS also remains focused on advancing our recommendations regarding prescription drug monitoring plans.
Also of vital importance, NACDS works to prevent harmful policies that, in the name of opioid abuse prevention, would do harm to patients, to pharmacies and to communities. NACDS is collaborating with our state association partners to confront proposed “opioid taxes,” which are taxes on patients, pharmacies, hospitals and others. In addition, we are battling mandatory drug take-back proposals as well, even while noting the importance — and pharmacy’s commitment to — effective and flexible drug-disposal solutions.
Throughout NACDS’ work on all of these issues, a trend is becoming apparent: More and more government leaders, reporters and citizens are starting to key into the notion that illegally manufactured and trafficked fentanyl and heroin comprise a significant part of the drug-abuse epidemic. NACDS is contributing to this discussion and helping to advance such solutions as the enhanced availability of overdose antidotes. The results of the national Morning Consult survey that NACDS commissioned in January suggested that the public understands the different forms of drug addiction that exist. When asked if legal prescriptions or illegally trafficked fentanyl is a bigger contributor to the opioid epidemic, one-third identified illegally tracked fentanyl; 40% said both; 10% said legal prescriptions; and 16% did not express an opinion. The media are dedicating increasing coverage to the notion that illegal fentanyl presents a significant portion of the challenges.
NACDS’ work is entirely consistent with pharmacies’ commitment to serve as the face of neighborhood health care, and to the context of members’ discussions at the 2019 NACDS Annual Meeting.
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https://www.cnn.com/2019/04/26/health/aetna-settlement-california-investigation/index.html
Aetna has settled a lawsuit in which a company medical director said under oath that he never looked at patients’ records when deciding whether to approve or deny coverage — testimony that prompted an investigation by the California insurance commissioner.
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