This is like what happened to pharmacy around 1990. When the PBM’s passed the 50% of the mark of controlling/paying for all prescriptions. First, they started by reducing the “dispensing fee” that they paid pharmacies. Then they started making contracts with some pharmacy chains, and the pharmacy became the exclusive pharmacy for being able to fill/bill prescriptions to a particular PBM.

I had noticed during the recent open enrollment period, that much of the advertisement for MA programs were focused on Medicare/Medicaid pts.  Offering all sorts of “extras”, that traditional Medicare did not pay for. I am unsure if pts paid attention to their advertisements, that MA plans MAY CHANGED EVERY YEAR.  From the reasons why these healthcare providers are dropping from MA programs have turned into a  game of delay, deny, and not pay. Is this where they are going to get the money to pay for all these “extras”?

I expect to see those healthcare systems that stay in these programs, that pts will start seeing a lot of care being provided by mid-levels and an increase in the number of mid-levels being supervised by a single physician.  The pt’s choice of practitioners, hospitals, and other ancillary services will be fewer and fewer.  All healthcare practitioners are equally educated, but not all are equally competent. Our healthcare system is being forced by the insurance companies which could end up being a dramatic shift. Will that be good for the pt and provide equal or better health outcomes and improved QOL?

Hospitals are dropping Medicare Advantage plans left and right

https://www.beckershospitalreview.com/finance/hospitals-are-dropping-medicare-advantage-left-and-right.html

Medicare Advantage provides health coverage to more than half of the nation’s seniors, but a growing number of hospitals and health systems nationwide are pushing back and dropping some or all contracts with the private plans altogether.

Editor’s note: This article was originally published Sept. 27. It was updated Nov. 14 to reflect new contract developments between hospitals and Medicare Advantage plans, which are listed below.

Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. Some systems have noted that most MA carriers have faced allegations of billing fraud from the federal government and are being probed by lawmakers over their high denial rates.

“It’s become a game of delay, deny and not pay,” Chris Van Gorder, president and CEO of San Diego-based Scripps Health, told Becker’s. “Providers are going to have to get out of full-risk capitation because it just doesn’t work — we’re the bottom of the food chain, and the food chain is not being fed.” 

In late September, Scripps began notifying patients that it is terminating Medicare Advantage contracts for its integrated medical groups, a move that will affect more than 30,000 seniors in the region. The medical groups, Scripps Clinic and Scripps Coastal, employ more than 1,000 physicians, including advanced practitioners. 

Mr. Van Gorder said the health system is facing a loss of $75 million this year on the MA contracts, which will end Dec. 31 for patients covered by UnitedHealthcare, Anthem Blue Cross, Blue Shield of California, Centene’s Health Net, and a few more smaller carriers. The system will remain in the network for about 13,000 MA enrollees who receive care through Scripps’ individual physician associations.

“If other organizations are experiencing what we are, it’s going to be a short period of time before they start floundering or they get out of Medicare Advantage,” he said. “I think we will see this trend continue and accelerate unless something changes.”

Bend, Ore.-based St. Charles Health System took it a step further and was not only considering dropping all Medicare Advantage plans, but also encouraged its older patients not to enroll in the private plans during the upcoming enrollment period in October. The health system’s president and CEO, CFO and chief clinical officer cited high rates of denials, longer hospital stays and overall administrative burden for clinicians. Ultimately, the health system has decided to remain in network with four MA carriers and will not renew contracts with three.

“We recognize changing insurance options may create a temporary burden for Central Oregonians who are currently on a Medicare Advantage plan, but we ultimately believe it is the right move for patients and for our health system to be sustainable into the future to encourage patients to move away from Medicare Advantage plans as they currently exist,” St. Charles Health CFO Matt Swafford said.

“I feel terrible for the patients in this situation; it’s the last thing we wanted to do, but it’s just not sustainable with these kinds of losses,” Mr. Van Gorder added. “Patients need to be aware of how this system works. Traditional Medicare is not an issue. With these other models, seniors need to be wary and savvy buyers.”

Here are 13 more recent instances of hospitals dropping Medicare Advantage contracts:

1. In October, the Nebraska Hospital Association issued a report detailing how Medicare Advantage is “failing patients and jeopardizing Nebraska hospitals,” 33% of which do not accept MA patients. The report cited negative patient experiences, post-acute placement delays, and administrative and financial burdens on hospitals that accept MA patients.

2. York, Pa.-based WellSpan Health will no longer accept Humana Medicare Advantage and UnitedHealthcare-AARP Medicare Advantage plans starting Jan. 1. UnitedHealthcare group MA PPO and Humana employer PPO MA plans will still be accepted.
3. Greenville, N.C.-based ECU Health said it anticipates it will no longer be in network with Humana’s Medicare Advantage plans starting Jan. 1.
4. Raleigh, N.C.-based WakeMed went out of network with Humana Medicare Advantage plans in October. According to CBS affiliate WNCN, the plan provides coverage to about 175,000 retired state employees. WakeMed cited a claims denial rate that is “3 to 4 times higher” with Humana compared to its other contracted MA plans.
5. Zanesville, Ohio-based Genesis Healthcare System is dropping Anthem BCBS and Humana Medicare Advantage plans in 2024.
6. Brunswick-based Southeast Georgia Health System will terminate its contract with Centene’s WellCare Medicare Advantage plan on Dec. 8. The system said it started negotiations with the carrier after years of “inappropriate payment claims and unreasonable denials.”
7. Nashville, Tenn.-based Vanderbilt Health went out of network with Humana’s HMO Medicare Advantage plan in April.
8. Fayetteville, N.C.-based Cape Fear Valley Health dropped UnitedHealthcare Medicare Advantage plans in July.
9. Corvallis, Ore.-based Samaritan Health Services ended its commercial and Medicare Advantage contracts with UnitedHealthcare. The five-hospital, nonprofit health system cited slow “processing of requests and claims” that have made it difficult to provide appropriate care to UnitedHealth’s members, which will be out of network with Samaritan’s hospitals on Jan. 9. Samaritan’s physicians and provider services will be out of network on Nov. 1, 2024.
10. Cameron (Mo.) Regional Medical Center stopped accepting Cigna’s MA plans in 2023 and plans to drop Aetna and Humana in 2024. It plans to continue Medicare Advantage contracts with UnitedHealthcare and BCBS, the St. Joseph News-Press reported. Cameron Regional CEO Joe Abrutz previously told the newspaper the decision stemmed from delayed reimbursements.
11. Stillwater (Okla.) Medical Center has ended all in-network contracts with Medicare Advantage plans amid financial challenges at the 117-bed hospital. The hospital said it made the decision after facing rising operating costs and a 22% prior authorization denial rate for Medicare Advantage plans, compared to a 1% denial rate for traditional Medicare.
12. Brookings (S.D.) Health System will no longer be in network with nearly all Medicare Advantage plans in 2024, with the exception of Medica. The 49-bed, municipally owned hospital said the decision was made to protect the financial sustainability of the organization.
13. Louisville, Ky.-based Baptist Health Medical Group went out of network with Humana’s Medicare Advantage plans in September, Fox affiliate WDRB reported. The system will also go out of network with UnitedHealthcare and Centene’s WellCare on Jan. 1 without a new agreement in place.

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“THE UNINTENDED CONSEQUENCES OF MILITANT PROSECUTORIAL IGNORANCE OF PAIN HEALTHCARE”…SHAKEDOWN OF MEDICAL PROVIDERS LED BY DEA CHIEF ANN MILGRAM’S UNSPEAKABLE HISTORY OF CORRUPTION, FRAUD, AND DECEIT. SHE MUST RESIGN, STEP DOWN

 

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While this article starts talking about abortion.  All of us have seen the impact of politicians/bureaucrats exercising their opinions or the opinions of others who have lobbied these bureaucrats/politicians who convinced them what they were being told were the correct FACTS, which should be used to create some legislation. It also demonstrates how attorneys are imposing their opinions/beliefs on a large portion of our population in relation to how/if certain medical procedures/treatments should be provided and if provided on a limited basis. At what point can we expect attorneys & or the judicial system to stop trying to protect us from ourselves?

Recent abortion cases are a harbinger of things to come…

https://www.daily-remedy.com/abortion-harbinger-of-healthcare/

Two recent court cases that transpired just this week are harbingers of future judicial activism that is likely to ramp up next year during the election cycle.

First, the Texas Supreme Court recently made a controversial decision regarding the medical exemption for abortion in the case of Kate Cox, a woman carrying a fetus with a fetal chromosomal abnormality. The ruling prompted her to seek an abortion out of state.
Second, the Supreme Court agreed to review the issue of whether mifepristone, a commonly prescribed abortion medication, can be prescribed through telemedicine visits and shipped to a patient’s home by mail.
At first blush, it may feel like the two cases have little to do with one another aside from being about abortions. But the similarities run perniciously deep and reflect a common theme when it comes to abortion and its policy: non-clinically trained judges use legal rhetoric to justify an inherently moralized position on abortion.

Several factors determine which avenues of drug discovery that people in research and pharmaceutical companies focus on. Research funding amplifies the pace of scientific discovery needed to create new treatments.

How to strike a balance between providing incentives to develop miracle drug therapies for a few people at the expense of the many is a question researchers and policymakers are still grappling with.
In 2021, 51% of drug discovery spending in the U.S. was directed at only 2% of the population.
Of the more than 7,000 known rare diseases, defined as fewer than 200,000 people affected in the U.S., only 34 had a therapy approved by the Food and Drug Administration before 1983.

Clinical trials serve as the gold standard for evaluating the safety and effectiveness of new treatments. However, recent investigations have brought to light a disturbing truth: flawed data and fraudulent practices are more prevalent than we may realize.

One of the leading voices in exposing these issues is Dr. Carlisle, an Anesthesiologist working for England’s National Health Service, who meticulously examined a random sample size of over 500 studies and found that 44% contained flawed data, with 26% being completely untrustworthy.
The rise of paper mills, or journals that publish voluminous amounts of specious studies at an increasingly expeditious rate, has further exacerbated the problem, with tens of thousands of suspected fake papers flooding journals.
When flawed or fraudulent data is used to support the approval of a treatment, patients may be exposed to unnecessary risks or be denied access to alternative therapies that may be more effective and safer.

Coughs are notorious this time of the year, with the winter winds blowing and so many remaining indoors for prolonged periods.

It is ordinary enough to carry on with it, yet persistent enough to ruin anyone’s day. This delicate balance explains why ‘cough’ is among the most commonly searched terms on Google right now.
Interestingly enough, neither antibiotics nor antitussives or cough suppressants, make much of a difference. In a prospective study analyzing whether a cough resolved when treated with either medication, the majority found little to no symptomatic relief.
How much of this comes from actually being treated versus the placebo effect, or the perception of being treated, is still unknown, but we surmise most if not all the perceived improvement gleaned was more perceptual than true clinical benefit.

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Experts, Lawmakers Explore Downside of Drug-Price Negotiation

https://www.medpagetoday.com/publichealthpolicy/medicare/107855

Stifled innovation, reduced access suggested as future challenges

Potential unintended consequences of Medicare’s drug-price negotiation program were examined during a panel discussion hosted by The Hill and sponsored by the Alliance for Aging Research, an industry-funded nonprofit.

Wednesday’s panelists raised concerns that drug-price negotiation under the Inflation Reduction Act (IRA) could create access problems for vulnerable patients. Others worried that declining revenue for drug companies could lead to fewer breakthrough therapies.

Signed into law in 2022, the IRA capped insulin’s cost at $35 per month for Medicare Part D beneficiaries and limited their annual spending to $2,000; the bill for the first time gave Medicare the ability to negotiate the price of certain costly prescription medications.

In late August, the Centers for Medicare & Medicaid Services (CMS) unveiled the first 10 drugs targeted by the program, with negotiated prices expected to take effect on Jan. 1, 2026.

Ultimately, the IRA as currently structured, has the potential to hurt rather than help patients, said Sue Peschin, president & CEO of the Alliance for Aging Research, based in Washington D.C.

Hampering Access for Patients of Color

With regard to utilization management, Peschin explained that one element of the IRA involves restructuring Medicare Part D so that insurers become responsible for 60% of drug costs in 2025, which is “quite a jump” from their current 15%. Because of this increased responsibility, Peschin argued it’s “likely” insurers will leverage utilization management techniques such as prior authorization and step therapy to “ration” care.

Interventional cardiologist Sara Collins, MD, co-chair of the Health and Policy Committee for the Association of Black Cardiologists, voiced her concern that drug-price negotiation could inadvertently make it harder to access the selected drugs, particularly for African American and other minority patients.

Seven of the 10 drugs included on Medicare’s price negotiation list are cardiometabolic drugs that treat patients at high risk of stroke, pulmonary embolism, and deep vein thrombosis. For example, on the list are blood thinners rivaroxaban (Xarelto) and apixaban (Eliquis), both regularly prescribed at Collins’ office, she said. Similarly, sacubitril/valsartan (Entresto) is a key drug for heart failure that is to undergo price negotiation.

Notably, the selected cardiometabolic drugs were chosen not because of their list price but because of their high volume of use and their total cost to the Medicare program, Collins argued. That means the potential for harm if access is substantially restricted, and that any layering of utilization management techniques such as prior authorization  is going to “hit Black and Brown people harder,” she said.

Black adults have the highest rates of stroke, heart failure, and hypertensive renal disease, and the highest premature cardiovascular mortality in the country, Collins said.

In addition, Hispanic, Black, and Native Americans are 40% to 50% more likely to receive a diabetes diagnosis than white Americans. Diabetes medications are also included in the list of selected drugs.

“Utilization management complicates our ability to prescribe these medications and puts our patients in a precarious position as a result,” Collins said, adding that she hopes CMS will establish guardrails to prevent insurers from “rationing” healthcare for the most vulnerable patients by using tools like prior authorization.

Stifling Innovation?

Under the IRA, the Congressional Budget Office estimated that only one fewer innovative drug would reach the market over 10 to 15 years. “We’ll see if that’s actually true,” said Kurt Schrader, a former Democratic representative from Oregon, and now of the law and lobbying firm Williams & Jensen.

Schrader was one of the speakers who voiced concern on Wednesday over whether CMS’s drug-price negotiation was fair and whether it would hamper access to new drugs.

Craig Garthwaite, PhD, an economist and director of Healthcare for the Kellogg School of Management at Northwestern University in Evanston, Illinois, said CMS has been granted “an amazing amount of power” under the IRA.

It’s inaccurate to call this a negotiation, he said, as CMS can essentially tell drug companies to accept the price it chooses or leave the Medicare Part D program.

“I guess you negotiate with a mugger when they show up. It’s your money or your life,” said Garthwaite. “Technically you’ve got two options there, but most of us don’t think of it that way.”

Drugs like sacubitril/valsartan are very effective at treating heart failure, but people with certain types of heart failure may not respond as well as others, Garthwaite said. “We know there are companies trying to invest in [alternatives]. Are they going to get rewarded, if they provide more therapeutic value over what’s classified as a therapeutic substitute?”

Schrader was similarly skeptical about any actual “negotiation” happening under CMS’s plan. He described the penalties for drug companies not cooperating with the drug-price negotiation program — the excise tax or exclusion of any of a company’s drug from the Medicare program — as “outrageous.”

Asked whether he thought Congress might be able to create a technical fix, Schrader said, “This is an issue that resonates with everybody, so I think there’s an opportunity to do some bipartisan work.”

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I find it very interesting when one bureaucracy is going to sue another bureaucracy.  Especially when one bureaucracy’s action interferes with the ability to generate some revenue by another bureaucracy. Could this be a “backhanded”  process of the DEA’s wish to yank pharmacy’s DEA licenses so that there are few pharmacies in the state that could buy/dispense controls?

Georgia Medical Cannabis Officials Weigh Response To DEA Threat Against Pharmacies, Including Possible Lawsuit

https://www.marijuanamoment.net/georgia-medical-cannabis-officials-weigh-response-to-dea-threat-against-pharmacies-including-possible-lawsuit/

The commission that oversees Georgia’s medical marijuana program held a special meeting on Wednesday to discuss recent letters from the Drug Enforcement Administration (DEA) warning pharmacies that dispensing THC under a state-authorized program could put their businesses at risk.

Officials at the meeting generally said the letters stand in the way of expanding medical marijuana access to patients, with one calling on supporters to contact Congress about the issue and another alluding to potential litigation the state may file against DEA over the dispute.

Georgia is the first state in the nation to pursue a plan to distribute medical marijuana through existing pharmacies that already dispense other drugs. Already about 120 independent pharmacies have applied to offer low-THC cannabis products.

But in its November 27 letter to pharmacies across the state, DEA said that federally registered pharmacies “may only dispense controlled substances in Schedules II-V of the Controlled Substances Act. Neither marijuana nor THC can lawfully be possessed, handled, or dispensed by any DEA-registered pharmacy.”

At Wednesday’s special meeting of the Georgia Access to Medical Cannabis Commission (GMCC), members said they’re still committed to prioritizing safe access for patients despite the federal threats.

Currently the state has only nine licensed dispensaries in operation, said GMCC Chair Sid Johnson. There are also 23 pharmacists approved to provide medical marijuana, whom Johnson described as “a critical part of ensuring access to patients, particularly in rural areas.”

“I want patients to know that we are well on our way to fully implementing the Hope Act,” Johnson said, referring to a 2019 law that expanded the state’s limited medical marijuana program, “and we will continue to pursue our mission of ensuring access to medical cannabis for all patients across Georgia.”

He added that “we support the work of the Board of Pharmacy, which licenses pharmacists to dispense medical cannabis.”

The commission’s general counsel, Jansen Head, said she believed the Board of Pharmacy has since paused its licensing of pharmacies to dispense medical cannabis. But behind the scenes, Head added, officials are discussing how to respond.

“I don’t think the state is quiet. I think right now we’re gathering information and seeing what’s the best way to move forward while also keeping in mind the interests of our patients and the industry,” she said. “I know that’s not super specific, but there are things kind of developing in response to the letter.”

Any legal action, she suggested, would need to come from the state attorney general’s office.

“We’re not the only key players in the program, and so it does require collaboration with our sister agencies,” she said. “And then obviously, any kind of action that we would take are things that we would do through the arms of the AG’s office, through the executive branch.”

One issue Head highlighted is a congressionally approved budget rider that bars the federal government from interfering with state-legal medical marijuana programs.

Specifically, it prohibits the Department of Justice (DOJ) from using its resources to prevent states “from—and I’ll quote—’implementing their own laws that authorize the distribution, possession or cultivation of medical marijuana,’” Head said at the meeting. “And that’s the program we have in Georgia.”

The budget rider, she added, limits federal law enforcement “from taking legal action against the states directly in order to prevent us from promulgating or enforcing our medical marijuana laws.”

Whatever the intent was with the DEA letters,” the lawyer continued, “more than half of our access points for medical relief—which is the pharmacies—they’re impacted and at risk of no longer making this medicine available to patients, as recommended by their physicians.”

While Head didn’t explicitly say the state was weighing a lawsuit to fend off the DEA warnings, she described a path the state could take to push back against the threats.

Commission member Bill Prather, a pharmacist himself, said he interpreted DEA’s correspondence as a shot across the bow.

“I no longer own a pharmacy or any part of a pharmacy,” Prather said. “If I did, I would take the letter from the DEA as, in my opinion, exactly what it is, which is a direct threat to pharmacies, saying, ‘If you dispense this product, we’ll pull your DEA permit.’”

Andrew Turnage, executive director of GMCC, said the conflict demonstrates “the need for federal government to update the laws and policies regarding the use of cannabis.”

“It’s a federal issue, so we don’t have the authority to intervene,” he said, “but we certainly want to encourage everyone to reach out to their members of Congress and make their wishes and concerns known about this issue.”

Marijuana Moment reached out to multiple members of Georgia’s U.S. House delegation for comment last week and this week, with little response.

“Cannabis could have some medicinal benefits, and we owe it to patients to research and test the drug for that purpose,” Rep. Buddy Carter (R-GA) told Marijuana Moment. “The DEA has made it clear that pharmacies dispensing certain THC products are in violation of federal law and that guidance should be taken seriously.”

On the Senate side, meanwhile, staff for Sen. Raphael Warnock (D), who recently confronted bankers in a committee hearing about the need for social equity in marijuana reform, did not respond to emails. Sen. Jon Ossoff’s (D) office declined to comment.

Georgia’s Board of Pharmacy has also not responded to Marijuana Moment’s requests for comment.

State officials recently presented the pharmacy plan at a meeting of the Cannabis Regulators Association, or CANNRA, and Turnage said it was “definitely an item of discussion.”

“The feedback that we received in that environment was simply this: ‘This is exactly the way that it should have been from the beginning. This model makes perfect sense,’” he recalled. “But they also expressed concern as it relates to finding out about the DEA’s letter.”

“A lot of states who are also medical states, they’re kind of eager to learn more about what Georgia will do,” added Head, the body’s general counsel. “They’re really looking at how Georgia is going to handle this tension.”

Head also said she was happy to hear support at the CANNRA meeting from regulators in other states who have “dealt with the DEA in different situations.”

“They really encouraged us to really try to see that through, to not be afraid of the challenges,” she said. “I think we had about seven or eight other states really putting themselves out there to support Georgia if if there’s some developments in response to the DEA letter. They’ve got attorneys, also attorneys general who just kind of offer themselves up as a resource.”

Brather, the physician, said that “It would really help us as far as distribution of the product if pharmacies could dispense it, because there is a pharmacy I believe in all but three or four counties in this state.”

“It will be a huge help to our patients, which are the main focus, if they could get their medication in a pharmacy,” he said.

Turnage, the commission’s executive director, agreed.

“There’s something really important about a licensed professional being between a regulated drug in a patient with a medical need,” he said. “And to the extent that we have been able to under the framework of our state’s law, the commission and the Board of Pharmacy have carried that vision into reality.”

“While our licensed dispensaries are certainly more than capable of providing access for patients in Georgia,” Turnage added, “they are limited in number by the statute, and therefore they’re not always within the immediate vicinity of where patients live.”

One member of the commission said he appreciated DEA as an agency, which he claimed “provides some value.”

“I believe that we really don’t know enough about THC to be using it safely,” said Bill Bornstein, a doctor and chief medical officer at Emory Healthcare. “That’s not to say I’m not supportive of what we’ve done in the state of Georgia, but there are a lot more questions that need to be answered.”

At the same time, Bornstein said similar DEA threats wouldn’t apply to physicians, who don’t technically prescribe marijuana to patients but instead merely certify that someone has a qualifying condition for the program.

Georgia’s Board of Pharmacy began accepting applications from independent pharmacies to dispense low-THC cannabis oil, which under state law can contain no more than 5 percent THC, in October. The goal was to improve access to medical marijuana among patients, who are otherwise restricted to just seven dispensaries that have opened in the state since April.

The Atlanta Journal-Constitution reported early that month that nearly 120 pharmacies had applied to the Board of Pharmacy to dispense marijuana products made by Botanical Sciences, one of the state’s two licensed producers. Pharmacies could also distribute medical cannabis from Trulieve, the state’s other licensed producer.

As of late October, at least three pharmacies had begun dispensing Botanical Sciences products, the company said in a press release. According to a map on the company’s website, more than 100 more are slated to open soon.

If sales of medical cannabis products went online in all locations, about 90 percent of Georgians would be within a 30-minute drive of a pharmacy selling marijuana, according to an Associated Press report. The state allowance applies only to independent pharmacies, not larger chains such as CVS and others.

DEA sent the warning letters to Georgia pharmacies amid the federal agency’s ongoing review of a recommendation by the Department of Health and Human Services (HHS) that marijuana be rescheduled under the Controlled Substances Act (CSA), reportedly to Schedule III. The recommendation was leaked in late August, and DEA has yet to publicly act on it.

While the Congressional Research Service (CRS) recently concluded that it was “likely” that DEA would follow the HHS recommendation based on past precedent, DEA reserves the right to disregard the health agency’s advice because it has final jurisdiction over the Controlled Substances Act (CSA).

In October, HHS first publicly revealed a one-page version of the rescheduling memo, though it was heavily redacted to remove key information. This past week, the government handed over another 252-page tranche of documents related to the review, again with the majority of information blocked out.

Broadly, the new documents outline new scientific information that’s come to light in recent years subsequent to an earlier denial of a rescheduling petition, which HHS suggests might now necessitate rescheduling marijuana.

“The current review is largely focused on modern scientific considerations on whether marijuana has a CAMU [currently accepted medical use] and on new epidemiological data related to the abuse of marijuana in the years since the 2015 HHS” evaluation of marijuana under the CSA’s eight-factor analysis.

HHS also notes that it “analyzed considerable data related to the abuse potential of marijuana,” but added that it’s a complicated consideration, “and no single test or assessment provides a complete characterization.”

Earlier this month, six Democratic governors wrote a letter to the Biden administration urging that rescheduling be completed by the end of the year. As DEA implied in its letter to the Georgia pharmacy, pharmacies would be permitted to dispense marijuana if it’s moved to Schedule III, although pharmaceutical products would first need to be approved by the Food and Drug Administration.

“Rescheduling cannabis aligns with a safe, regulated product that Americans can trust,” says the governors’ letter, which points to a poll that found 88 percent of Americans support legalization for medical or recreational use. “As governors, we might disagree about whether recreational cannabis legalization or even cannabis use is a net positive, but we agree that the cannabis industry is here to stay, the states have created strong regulations, and supporting the state-regulated marketplace is essential for the safety of the American people.”

Even if THC is moved to Schedule III, however, the Food and Drug Administration (FDA) would still need to approve marijuana-based drugs before they could be legally distributed at registered pharmacies like those in Georgia.

 

 

 

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Where is the logic/common sense is these statements?

Since 2017, there has been a 26% reduction in daily opioid prescriptions

541 drug overdose deaths in Utah in 2022, opioid-involved fatal drug overdoses have remained relatively stable in recent years. 74% involved an opioid.

I wonder what drugs were involved in the 26% of fatal drug overdoses. This appears that this healthcare organization has little concern of the roughly 190 people died from those other drugs. I could help but notice that they LUMPED ALL OPIOID DRUGS as if a single category.  How many pts prescribed opioids OD’d on their prescribed medication(s)?  How many OD’s on pharma opioids that were diverted? How many people OD’d on illegal drugs from China/Mexican cartels?  Maybe putting forth the DETAILS, would point out how warped their logic is?

It states in the article that  Rula Hunter had a back injury and was prescribed Oxycontin in 1996  and IMMEDIATELY BECAME ADDICTED and there is a mention of her going to rehab – no date or duration.  Here is her Obit  https://www.lindquistmortuary.com/obituaries/rula-hunter. She died in 2023 at the age of 72 y/o.

Did Intermountain Health start this program after the CDC published their 2016 opioid guidelines in 2016? We all know that those guidelines where misapplied and misguided.

Intermountain Health Partners with Utah Agencies to Achieve 26% Daily Opioid Prescription Reduction

https://www.prunderground.com/intermountain-health-partners-with-utah-agencies-to-achieve-26-daily-opioid-prescription-reduction/00323472/

Intermountain Health, Bonneville Communities That Care, and Utah prevention campaign Know Your Script unveiled 20-foot-high standing chandelier display.

Ogden, UT (PRUnderground) December 12th, 2023

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I have heard from a number of attorneys that when a federal prosecutor takes someone to federal court, 90%-95% of the time they will be found guilty. After you watch this 17 minute video of a Federal Prosecutor, you will easily understand how that high conviction rate can be attained. What I suspect, that each possible violation this attorney claims. He is only talking about a single pt and a single interaction with a practitioner.  Just imagine, the number of possible federal law violations can could be fabricated on just 1-2 handfuls of pts from a particular practitioner’s practice?

As I remember, several years ago, a particular rural doctor, was initially charged with 400 counts. Each count worth 20 yrs in prison. Makes sense why he agreed to plead guilty to a SINGLE COUNT.  As I remember this practitioner was in his 60’s, so a single count was worth 20 yrs in prison and as I understand it, there is no early parole in our federal system. They must serve at least 85% of their sentence.

It was indicated that this was in 2019,  I wonder if these Federal prosecutors are still going after prescribers, since the number of  poisoning/ODing from illegal Fentanyl from China & Mexican cartels have probably doubled since then. Maybe it is too difficult to confiscate assets of these criminals that are “off-shore”?

I think if you consider the video – as a whole – these Federal prosecutors’ end goal was criminal/civil asset of a prescriber’s assets. that is “free money” that these Feds can put in their dept’s coffers to use/spend as they wish.

 

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Bombshell Revelation from Government

https://doctorsofcourage.org/bombshell-revelation-from-government/

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I saw someone make this statement on the web. Don’t they know who they work for? The “they” ,that they are talking  about is POLITICIANS. Particularly those in Congress.  https://www.bbc.com/news/av/election-us-2020-54696386  According to this article in 2020 Federal Presidential and Congressional candidates spend 14 BILLION – TWICE AS MUCH as was spent on the 2016 election.

That doesn’t include the 4.1 billion that was spent on lobbyist in 2022. That is 11+ million/day, to help influence the 535 members of Congress. That averages out to abt $11,000/day – 7 days a week on each member of Congress.  https://www.opensecrets.org/news/2023/01/federal-lobbying-spending-reaches-4-1-billion-in-2022-the-highest-since-2010/

With all those $$ flowing into election campaigns, and $$ to influence members of Congress by Lobbyists, who believes that any letters, emails, phone calls to member of Congress will influence their decisions in any way?

Congress basically functions on a seniority system.  Both the House & Senate have numerous committees. Each committee has a chairman, who will belong to the political party of the majority of the particular party and a co-chair that belongs to the political party that is the majority. The balance of each committee will reflect the percentage of the political party in the majority.

For anything to potentially become a law, it starts with a bill being introduced by one of the members of a the appropriate  committee. The chairman may nor may not bring up a bill for a vote. If the chairman does not bring a bill up for a vote. It becomes DOA.  I saw it reported that Alexandria Ocasio-Cortez  (AOC) introduced 20 bills during her first 2-yr term in the House, and none was brought up by chairman of the committee for a vote.

If a bill get voted out of committee, the bill goes to the Speaker of the House or Head of  the Senate. Each can chose to bring the bill to the floor for a vote or not. If one or both of those refuses to bring the bill to the floor for a vote, the bill DIES!

If the bill is passed by the House and the Senate, it is then sent to the President to sign it into law.

The President can sign the bill into law or veto it. If the President VETOES the bill, then the Senate and House has the option to override the President’s veto with a 2/3 vote by each. If the Senate or the House fails to vote to override the bill, the bill becomes law.

 

 

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This post originally appeared on my blog Nov 16,2014 and last updated Feb 4,2016. https://www.pharmaciststeve.com/genocide-in-america/ This is before the CDC 2016 opioid dosing guidelines were published and about 2-3 yrs after the opioid Rxs dispensed had peaked.  Some states have passed law in recent years, that is suppose to protect practitioners and pts when prescribing opioids to pts. But few seem to admit that they have done little/nothing to help all involved. Is all the deaths from under/untreated pain or is all the suicides just “swept under the rug” and all the relatives leave the funeral home, saying ” .. at least he/she is “at peace…”

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This page is going to contain posts made on other places on the web by those in chronic pain and how the war on drugs has turned into a war on pts. The number of people who are abusing some substance is not going down, but the number of chronic pain pts not being able to get their chronic pain adequately treated is rapidly increasing… as is the use/abuse of Heroin.

History shows us other countries that have had a OVERT genocide… It would appear that our society has chosen to have a COVERT genocide. The rules/guidelines in place is like playing cards with a stacked deck  Just label it as a accident ?

And the whole process’ genesis was based on racism and bigotry War on Drugs GENESIS… BIGOTRY ?

As more and more chronic painers lose or have their therapy cut or they are more and more home bound and more and more INVISIBLE to our society.. They are emotionally, physically, mentally exhausted… many are losing or have lost the will and ability to “FIGHT” and having to deal with increased depression.

I am not encouraging or endorsing suicide.. I am trying to make those with chronic pain MORE VISIBLE to those in our society that are CLUELESS !

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For 16 yrs I used pain meds with very little problems. I took higher doses then most. Some people think if u weight 100 lbs u shouldn’t need the same dose as a 200 lb man. I sometimes vacation from one med to another for a month or two then go back . This helped to keep doses from getting higher and higher. Worked for me. I took my meds every 4 hours. i lived a pretty good life. Could work clean house and care for the kids. Do my community service. Felt pretty good about myself. Then last yr around this time it all went down hill. Only allowed to use meds every 6 hrs and at half the dose. Then no one would fill my scripts because my drs office was 40 miles from my home. For one yr I got my meds by mail or fed ex. That really sucked waiting and waiting for my meds to come. Then Aug 21 2014 I got that letter from my dr. Dropping me as a patient after 16 yrs. now I have nothing. I suffer everyday every hour every min. I can’t sleep I can’t function. I wake up everyday wishing I hadnt. Why didn’t I just die? I never thought this would happen to me never never but it did. I almost did kill myself two weeks ago but I don’t want to do that to my son. The pain it would cause him. What is my future don’t know? I did get lucky a couple days ago and found an old pain patch from 2008. Worked great. Don’t want to hear anything about it being expired nor do I suggest this to anyone else. What did I have to lose? I got to be a person again for a few days.got some stuff done. Made me feel better about myself. I smiled and got some sleep. I know that my life has to have some kind of pain management or I will kill myself. I would like to have my old meds back but those days r gone now. Medical marijuana is now my only hope because the pill problem keeps getting worse. I need that hope. I don’t want to die but I can’t live with this nerve pain. At the city hall meeting for mmj those people against talked about pain meds and pot as one and the people that used them r just the scum of the earth.the looks I got. I am sick not an addict or a bad person. I am a good caring person and didnt deserve the looks I got. I hope this doesn’t happen to anyone else in this group. But I don’t see things getting better only worse in this state of FL. This group keeps growing more groups r popping up. Sorry to say but we r at war. I know how the Jews felt when Hitler came to town. People,here in FL Pam Bondi is way ahead in polls. Why she is a monster. I have new found hope from younger people voting and or getting involved in their government. But this too might take some time. Got to vote. Talked to over 50 kids yesterday at the mall about voting this coming election.they can make things better for us so u better treat these kids with respect. They r our future

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WELL SHIT!!!! I JUST GOT OUT OF ICU FOR TRYING TO KILL MYSELF BECAUSE IM SO TIRED OF HAVING UNMANAGED PAIN TO BEGIN WITH HERE IN LOVELY FLORIDA……GOOD THING I HAVE A BACK UP PLAN CAUSE IM NOT DRINKING CHARCOAL AGAIN!

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http://www.news-press.com/story/news/crime/2014/09/08/death-investigation-at-groves-rv-park-in-fort-myers/15280035/

A husband and wife were found dead at their trailer Monday at the Groves RV Resort on John Morris Road, apparently the victims of a murder-suicide.

The Lee County Sheriff’s Office responded to unit #100 in the resort at 16175 John Morris Road at 8:30 a.m. Monday.

The sheriff’s office report said the response was in reference to a male caller advising the LCSO that he and his wife “could no longer stand the pain and that they were leaving.”

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 We SHOULD BE spending our time trying to take care of our pain !!!  I don’t think heroin addict’s spend that much time running around looking for it on the streets !!!
I ALMOST HAD TO go that route … Because of WAY Too much pain …  With absolutely no pain relieving medication  Better off …going to the streets eh ???
No judgements or rationing on the streets !!!  No wonder we turn to the streets for our necessary/life saving medication !!! Is that their agenda ???
Or just wait till we kill our selves because the pain is too bad ???  Kinda like genocide by suicide ?!?! It’s just unacceptable !!!

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Just can’t do this anymore

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I am done. Fed up of pain. Fed up of drs and people screwing my life up. Making me live in agony for no reason when they have the power to help. I only ever go to hospital when there is no other choice, when I am in a full blown life threatening crisis. I only ever cry out for support when I am at the end of my rope. But now that rope has snapped. Can’t keep asking for help and support and being rejected by everyone again and again. It is in humane to be in this much pain, it is cruel. I don’t know how much everyone expects me to deal with all the time but I am DONE. I am not living like this anymore.

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I’m about done with living. This isn’t living and I hate the quality of so called life I have. This whole thing has thrown me into a fibro flare on top of my back pain. I hurt so bad now I want to die.

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 This is a debate question. Not a plan of action !!!!   When is it okay to give up?  When is it okay to want to stop this constant pain?  My wife says it’s selfish for anyone to contemplate taking their life but I think it’s selfish to make someone live like this Every day …..day after day after day.  Today is not a horrible day. Today is an okay day. This is a debate question. Not a plan of action !!!!

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 Maybe I shouldn’t ask this, but I’m absolutely at my end. Feel free to message me if you don’t feel comfortable here. I need pain meds, BADLY. I can’t go on much longer this way. I contemplate suicide daily. I’m not a good mother. Or wife. Or friend (which I’ve lost most because the pain makes it unbearable to go out and be social). I can’t work much anymore, which is putting a huge financial and mental/emotional strain on my poor husband. I can barely keep up with my housework either. I feel like a 30 year old failure. My doctor took me off of the one thing that helped me, tramadol. Since then I’ve rapidly gone down hill.

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 I bet no one would care if I died, so why not get it over and done with, I mean no one wants to help me. So why bother with life. I’m in agonizing pain daily. Im a looser now and always will be and I drive people away so dont bother being my friend because ill probably make u hate me like I do with everyone else.

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 My wife has really been struggling in the last few months. This month has especially been difficult. She has stated many times that her fibro is getting worse. She has ran out of her pain meds and became very depressed. Yesterday she tried to kill herself. I found her face down on her bedroom floor. She had overdosed on other medications and was barely conscience. Ambulance took her to er, after 5 hours a private room. She finally became alert at 11pm enough to answer questions. She was transferred to an ICU last night and today at 5pm transferred to another hospital to deal with the depression.

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 I know it is heartbreaking to miss these things and see the disappointment on their faces and people and family want to judge me because I have decided to end my pain on my dad’s bday and are making preparations to do so then I do not have to face begging doctors for enough ends that don’t even touch my pain and be treated like a criminal because I have multiple health issues. I give up

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 http://www.infowars.com/i-am-sorry-that-it-has-come-to-this-a-soldiers-last-words/

This is what brought me to my actual final mission. Not suicide, but a mercy killing. I know how to kill, and I know how to do it so that there is no pain whatsoever. It was quick, and I did not suffer. And above all, now I am free. I feel no more pain. I have no more nightmares or flashbacks or hallucinations. I am no longer constantly depressed or afraid or worried

I am free. I ask that you be happy for me for that. It is perhaps the best break I could have hoped for. Please accept this and be glad for me.

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 I have a family member who has been in excruciating pain for years, surgeries and injections made it worse. The only thing that gave him the slightest relief was methadone. Well, insurance changed their rules and would not pay anymore, so they have been paying out of pocket. Sunday night he snapped, couldn’t take it anymore and took his life. Why am I telling you? His family is falling apart.

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 Hey everyone, I am xxxxxx, 33 years old RSD both legs from thigh to toes, spreading to my hands and calves. I am the most depressed I have ever been, I lost my job, Im a nurse, nothing bad, they were just ridding themselves of Per Diem nurses so I took that hit. I am a single mother of two beautiful girls, 4 years old and 19 months old. My car is about to die, my pain is incredible and nothing seems to work,my hair is falling out root to tip in clumps, I cant stop crying, all I need is a hug. It is so hard to wake up every day and be in this horrific pain. Im out of options, I don’t have any fight left in me,im done with this.

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 i am seriously considering participating in Doctor assisted end of life ..reason i can’t take this pain anymore.. It’s not fair for my wife to see suffer on a daily basis.. we don’t have children.. I understand such bill is directed to terminally ill..I will find a mental health provider who will support my decision.. No body cares!.. I reach out to the medical community they use me for $$$ i am referring to surgeons and the legal community could care less.. I guess my ethnicity as a latino in spite of my american heritage is not worth the effort.. It’s not just the arch problem i have a torn theal sac and my orthopaedic surgeon has abandoned me completey.. Sure my wife’s insurance has made him rich along with my medicare due to Permanent disablity.. let’s face it.. the medical and legal community would see me as a total loser..If i hit the lottery or had resources life would be totally different in spite of my pain..I am sick and tired of the bullshit and pain that i endure each and every day…

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 Last night a 19 year old friend from Key West died. Pain medication overdose how sad.

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 http://www.rawstory.com/rs/2014/11/mich-medical-marijuana-card-holder-commits-suicide-after-police-witch-hunt-over-pot-butter/

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 This weekend has been awful. I lost 2 good friends. One died of a heart attack and the other committed suicide pain level is out of the roof

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 I just want to die, then I will be in peace no more pain!

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Have anyone of you got to the end of the rope and want to let go. No more pain, i wouldn’t in my wildest dreams wish the amount of pain im in on my worse enemy. There is days i pray for god to end it. in sick and tired of being sick and tired. all the meds im on even meds for depression are not helping.i cant sleep, sit, stand, walk w/o being in major pain. i need help i cry myself to sleep the nights i do sleep. im at my max by the DEA law idk what else to do

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 Sxxxxx  hung herself Christmas morning. She could no longer take the pain. She tried for a year and a half. She lost her job and had to move in with her son. She spent her last months home bound. She was very scared and alone. The pain was bad enough where she needed help getting into the bath…
Everyone please think of her today. This could be any one of us….
How much can you take? It’s not like she could put the pain away in a drawer for a while. She couldn’t just take a vacation from it. It caused her daily severe panic and fear of leaving the house…Or thinking of the future. She left no note …  12/28/2014

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My late wife Karen lost her battle to Chronic Pain via suicide. I’d like to find out more about the (Cake) movie?

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At around 330 am my cell phone rang and when your phone rings at that time it’s not going to be good, a very good and close personal friend of mine had been found unresponsive in her bathroom by her hubby, one of my best friends and how I met her actually, he thought maybe she had a heart attack and called 911. They get there and get her to the hospital had to shock her 5 times before they called it. Not knowing the reason they had to run to screens and do an autopsy. She was a chronic pain patient who her new PCP told her she was to young to be experiencing that kind of pain and sent her to a Psychiatrist early this week who was very nice and respectful to her and gave her phych meds and a sleeping pill. Her new Dr being a yutz that she is cut her off of her pain meds accept topomax and a muscle relaxer, this down from oxycodone and other meds. She committed suicide early this morning. Her daughter found the note along with all her personal papers including a living will that was DNR, hospital ER staff is not to blame nor the EMT’S because it has not been notorized as of yet. But this Doctor, boy this Doctor she is going to be meeting my lawyer friend I went to High School and some College with and if he can win a case before the supreme court he can kick this Doctors ass. I will also be calling the Bishop Cupich and a very old friend Cardinal Timothy Dolan who started out as a Priest and the Bishop in Milwaukee to get her a dispensation to be buried in consecrated ground and to be able to have her mass and funeral at her Church. So after typing all of this it was to say we have lost another one unable to bear the pain anymore. No she wasn’t in this group she is from Chicago area.

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