Ads That Can Kill: Lawyers Scare Patients Out Of Taking Medication, Legal Reform Group Says

Ads That Can Kill: Lawyers Scare Patients Out Of Taking Medication, Legal Reform Group Says

https://www.forbes.com/sites/legalnewsline/2017/10/25/ads-that-can-kill-lawyers-scare-patients-out-of-taking-medication-legal-reform-group-says/#1ed130162ae4

A new paper says lawyer advertising is scaring patients into not taking their medications, leading to dozens of serious incidents – including six deaths from individuals who stopped using their blood-thinner.

The paper, released by the U.S. Chamber Institute for Legal Reform as part of its annual Legal Reform Summit, says television viewers were blitzed with 1.2 million such ads in 2016 by mass tort lawyers who should approach $1 billion in spending this year. The ILR owns Legal Newsline.

“There is mounting evidence that misleading information and exaggerated claims made in lawsuit ads prevent people from seeking treatment or lead them to stop taking a prescribed medication without consulting a doctor,” says the paper, prepared by Cary Silverman of Shook, Hardy & Bacon.

 

Projections for 2017 have lawyer advertising surpassing previous years. Nearly a half-million ads over prescription drugs and medical devices are expected, and asbestos ads should approach 200,000, the paper says.

A small group of law firms and marketing companies were responsible for half of the spending in 2016, according to statistics provided by X-Ante. They are the Pulaski Law Firm, Relion Group, Knightline Legal, Davis & Crump and Gold Shield Group.

 

“Even when scientific evidence suggests that some patients may experience side effects of complications from a drug or medical device, lawsuit ads do not discuss the actual level of risk,” the paper says.

“Without such information, viewers cannot compare the potentially life-saving or significantly life-improving benefits that the medication or device offers to what may be relatively infinitesimal risks.”

In 2016, the American Medical Association took a similar stance against lawyer advertising, deciding to advocate for a requirement that commercials include “appropriate” and “conspicuous” warnings.

The AMA said commercials can frighten patients and cause distrust between them and their doctors by emphasizing side effects while ignoring benefits.

“For many patients, stopping a prescribed medication is far more dangerous, and we need to be looking for them,” AMA board member Dr. Russell Kridel said last year.

For example, the Food and Drug Administration received reports that 31 patients who stopped taking the blood-thinner Xarelto after seeing a commercial experienced a medical event during a 15-month period after spending spiked on commercials targeting the drug. There are lawyers that help businesses avoid lawsuits and charges in case there is some issue.

Most of those patients experienced strokes, with two patients being paralyzed and two others dying.

The FDA’s most recent report, submitted Dec. 31 in response to a Congressional inquiry, showed 61 patients stopped using their Xarelto or Pradaxa after seeing commercials. Of that group, six died – three from strokes, one from cardiac arrest, one from a pulmonary embolism and one from an unreported cause.

 

“While harming patients, these lawsuit ads have achieved the results sought by plaintiffs’ lawyers,” the paper says.

“Over roughly three years, the ads have generated over 19,000 claims in federal court targeting Xarelto.”

So far, though, the cases that have gone to trial have resulted in defense verdicts. In Philadelphia, a large state court docket also features more than 1,500 Xarelto claims.

Philadelphia personal injury lawyer Max Kennerly told Legal Newsline last year, in response to the AMA’s concerns, that the organization is driven by its desire to have doctors be the sole source of information to patients about medications.

“Numerous studies have shown that: doctors spend only a few minutes with their patients discussing medication options, doctors routinely prescribe medications ‘off-label’ for purposes that weren’t approved by the FDA, doctors’ decisions about prescribing are heavily influenced by drug-company spending on the doctors, like free lunches and speaking opportunities.”

While he doesn’t purchase advertising online or on television, but instead maintains a website that discusses the cases he handles, Kennerly admitted that many of his clients were referred to him by attorneys who do, in fact, advertise.

 

“Advertisements play a central role in connecting people injured by drugs and medical devices to the lawyers who can help them,” he explained.

That being said, he doesn’t think the AMA’s push for warnings are necessary.

“Patients should know the potential risks of their drugs and should be able to have an informed conversation with their doctor about the drug they’re taking. Attorney advertisements are one of the primary ways that the public learns about new dangers of drugs and medical devices,” he said.

 Plaintiffs’ lawyers don’t make up drug and medical device lawsuits “out of thin air,” he contends.

“If we can make it a few months without another drug or medical device being revealed as a threat to public safety, then we’ll see fewer attorney advertisements,” he said.

The paper also includes testimonials from doctors who had a patient stop using his or her medication. Dr. Ilana Kutinsky says she treated a woman for several years, finally convincing her to take anti-coagulates.

When she had a massive stroke three years later, she was surprised to find that, two weeks earlier, the woman had received a flyer in the mail that warned her against using the medicine.

“She didn’t want to die and so she stopped her medication. She didn’t want to ‘bother’ me and decided to wait until her next appointment to discuss her decision,” Kutinsky said.

“Patients are dying because they are afraid to take the medications prescribed for them due to the fear brought on by these negative and one-sided campaigns.”

In March, House Judiciary Committee Chairman Bob Goodlatte, R-VA, wrote letters to each state bar urging them to require attorneys to include disclaimers that patients shouldn’t discontinue using their medications without consulting their doctors first.

 The ILR paper, though, doesn’t expect lawyers to impose restrictions on themselves in this field, for several reasons:

-Ethics rules concern misleading communications about legal services, not misleading medical information;

-Ethics rules are enforced based on complaints filed by clients and competitors, not the public;

-Bar associations can’t regulate advertising by non-lawyer lead generators; and

-Bar associations are moving away from oversight of attorney advertising.

Indeed, Goodlatte’s efforts indicate the ILR’s view is true. The ABA and state bars have not adopted Goodlatte’s suggestion.

The ILR urged the Federal Trade Commission to get involved by prohibiting lawsuit advertising practices that are “clearly deceptive” and believes Congress should allow FDA to regulate drug information given in lawsuit commercials.

DEA: seeking evidence from prescriber’s office to prove a preconceived conclusion/crime ?

Elizabeth Korcz, MD

by Linda Cheek, MD

www.doctorsofcourage.org/elizabeth-korcz-md/

Elizabeth Campbell Korcz, a Board Certified, Family Medicine Physician at Alt MD in Hoover, Al was raided in August, 2017. As a result, her office has closed.

DEA Agent Bret Hamilton, the FBI, Hoover Police, members of the Alabama Pharmacy Board and officials with the US Attorneys’ Office were present as boxes of office records were seized, but Hamilton would not say what the records entailed. He did, however, make inference of “pursuing doctors that are prescribing narcotics without a legitimate medical need”.  However, Dr. Korcz was not arrested, nor were charges filed. They will take the patient records and then construct a crime.  As one media headliner stated: “DEA raids Hoover doctor’s office seeking evidence on unneeded narcotics prescriptions.” You see, they don’t have any evidence of wrongdoing—they construct it after the fact. That shows that they are violating a doctor’s 4th amendment rights with and illegal search and seizure.

Dr. Korcz graduated first in her class at Morehouse School of Medicine in Atlanta, GA, in 2005, while raising three beautiful children.  She studied acupuncture and TCM (Traditional Chinese Medicine) developing skills in complementary practices like natural/herbal medicine and hypnosis.  Her practice also provides counseling, prayer, relaxation therapy, natural and medicated weight loss treatments, fitness advice, pain management, suboxone addiction recovery services, botox, facials, chemical peels and blemish removal. Her desire is for a more Holistic approach to treating and caring for patients.

This is the second such search warrant executed in the state in recent weeks. Over the past three years, the DEA has investigated and convicted 10 Alabama doctors for prescribing narcotics without a legitimate medical need. That includes Drs. Couch and Ruan of Mobile. The newly appointed U.S. Attorney for the Northern District of Alabama, Jay Town, has chosen to jump on the gravy train to prosecute doctors for easy money, jobs, and promotions. He is quoted as saying

“As long as there are doctors in the state of Alabama prescribing narcotics without a legitimate medical need, the DEA will continue to investigate.”

But according to the Controlled Substance Act, it is the doctor who decides that there is a medical need. The DOJ, however, because of people’s past belief that our government agents were ethical and moral, has taken it upon themselves to misinterpret the code, and people have swallowed the bait. That is putting hundreds of innocent doctors in prison across the country.

Besides being an independent family practice physician doing alternative, healing medicine, Dr. Korcz’s husband, Matthew Korcz, is listed as the office manager. That means that by attacking her office, the government can confiscate everything they own, by charging both with a crime. This appears to be a new “criteria” for targeting, as was done with Oscar Stokes, MD and Milind Tilak, MD.

Patients have made the following comments:

Dr Korcz is an amazing doctor who helps many. If a patient lies to her about the amount of pain they are in how can she know they are being deceitful? The DEA needs to move on and leave a small family practice with a lovely caring doctor alone and actually look for some real criminal activity. Dr Korcz drug tests all of her patients that require that and she gets rid of patients that fail the test. She is fair and knowledgeable. I hope her practice recovers and she is vindicated in these false allegations. I’m a patient here and I have been on the same dosage ( very low) for 5 years. She is conservative and doesn’t hand out medicine that isn’t needed.

I am a patient there and all these accusations are totally false. Hoover police need to go after the real dope dealers and stop pretending that they are doing something by busting up a doctor’s office. This Dr.s is needed by many. There is no illegal activity there.

People of America: Wake up and stop convicting innocent doctors. Recognize the illegal activity of your government officials.

Doctor Korcz, DO NOT waive your right to a speedy trial. DO NOT take a plea. They have no case. They take 2 years to construct one. Consult us at Doctors of Courage. We can help you get your practice back.

Linda Cheek, MD | October 25, 2017 at 10:49 am | Tags: alternative medicine, Elizabeth Korcz MD | Categories: Doctor Raided | URL: http://wp.me/p7lNfE-Ca

Thanks for seeking justice

Thanks for seeking justice

 

Today the U.S. appeals court in Washington, D.C. ruled the Trump administration must allow “Jane Doe” – a 17-year-old immigrant woman – to obtain a legal abortion.

The court’s ruling respects Jane Doe’s decision and her dignity. Now it’s time for Trump administration officials to stop forcing this young woman – and others like her – to stay pregnant when they don’t want to be.

We’ll deliver your petition signatures to the Office of Refugee Resettlement to demand they stop breaking the law by denying immigrant women safe access to abortion care. Can you add your name to join us right now?

Sign our petition right now to tell the Trump administration that it’s unconstitutional and unconscionable to force immigrant women to carry their pregnancies to term.

The fight isn’t over. The Trump administration has shown it will do everything it can to block Jane from making this decision on her own. And, unfortunately, this no-abortion policy applies to all young women in immigration custody. But the ACLU will continue to fight for justice for all Janes. You can go on this page here to get advice on abortion and get more info.

Read more details on the case and the ACLU’s involvement in defending “Jane Doe” and suing Scott Lloyd – Trump’s Director of the Office of Refugee Resettlement – below.

Any threat to reproductive rights in this country is a threat to all of our rights.

Thanks for all you do,

Louise Melling
Deputy Legal Director


The Trump administration’s Office of Refugee Resettlement – and its anti-choice director, Scott Lloyd – is illegally and outrageously blocking a 17-year-old woman, “Jane Doe,” from obtaining an abortion she desires and has the right to acquire.

Make your voice heard – tell the federal government we want justice for Jane and all immigrant youth in government custody.

We took the government to court this week, and the judge agreed with us – quickly and decisively – and ordered the government to allow Jane to have her abortion. But then the Trump administration appealed. And now, a court has delayed Jane’s access to care even longer, pushing her even further into a pregnancy she decided to end weeks ago.

This fight is far from over. The only way we’re going to get Lloyd and the Trump administration to stop denying these young people their basic human rights is to expose their illegal actions.

Tell Scott Lloyd and the Office of Refugee Resettlement to stop breaking the law and stop denying immigrant women their constitutional right to safe abortion care.

It’s illegal to force a young woman to carry her pregnancy to term against her will. Period.

Not only did government officials block Jane from her healthcare appointments for a safe abortion, they forced her to go to a religiously-affiliated “crisis pregnancy center” where she received coercive counseling and an invasive, unnecessary ultrasound performed on her by non-medical staff against her will.

Jane Doe’s story is far from an isolated incident.

In another case, a young woman was forcibly sent to an emergency room after she’d taken an abortion pill to try to prevent her from completing her abortion. In yet another case, a senior U.S. government official was personally sent to visit a young woman who was seeking an abortion to attempt to talk her out of her decision.

And those are just some of the cases we know.

Government officials don’t have free reign to force their ideology and religious views onto undocumented youth. But this will only stop if we shine light on and stand up to illegal actions, in the courtroom and on the streets.

Tell Director Lloyd and the Office of Refugee Resettlement to stop illegally blocking safe abortion care for young immigrant women.

Thanks for seeking justice,

Louise Melling
Deputy Legal Director


MISSION STATEMENT OF ACLU:

The ACLU TODAY

For nearly 100 years, the ACLU has been our nation’s guardian of liberty, working in courts, legislatures, and communities to defend and preserve the individual rights and liberties that the Constitution and the laws of the United States guarantee everyone in this country.

Whether it’s achieving full equality for LGBT people, establishing new privacy protections for our digital age of widespread government surveillance, ending mass incarceration, or preserving the right to vote or the right to have an abortion, the ACLU takes up the toughest civil liberties cases and issues to defend all people from government abuse and overreach.

With more than 2 million members, activists, and supporters, the ACLU is a nationwide organization that fights tirelessly in all 50 states, Puerto Rico, and Washington, D.C., to safeguard everyone’s rights.

IN THE BEGINNING

“So long as we have enough people in this country willing to fight for their rights, we’ll be called a democracy.” — ACLU founder Roger Baldwin

When a roomful of civil liberties activists — led by Roger Baldwin, Crystal Eastman, and Albert DeSilver — formed the ACLU in 1920, the Supreme Court had yet to uphold a single free speech claim. Activists languished in jail for distributing anti-war literature. State-sanctioned violence against African-Americans was routine. Women won the right to vote only in August of that year. And constitutional rights for LGBT people were unthinkable.

The ACLU was founded to ensure the promise of the Bill of Rights and to expand its reach to people historically denied its protections. In our first year, we fought the harassment and deportation of immigrants whose activism put them at odds with the authorities. In 1939, we won in the Supreme Court the right for unions to organize. We stood almost alone in 1942 in denouncing our government’s round-up and internment in concentration camps of more than 110,000 Japanese-Americans. And at times in our history when frightened civilians have been willing to give up some of their freedoms and rights in the name of national security, the ACLU has been the bulwark for liberty.

WHY WE DO WHAT WE DO

The ACLU is frequently asked to explain its defense of certain people or groups — particularly controversial and unpopular entities such as  the Ku Klux Klan, the Nation of Islam, and the National Socialist Party of America. We do not defend them because we agree with them. Rather we defend their right to free expression and free assembly.

Historically, the people whose opinions are the most controversial or extreme are the people whose rights are most often threatened. Once the government has the power to violate one person’s rights, it can use that power against everyone. We work to stop the erosion of civil liberties before it’s too late.

HOW WE DO IT

We have grown from a roomful of civil libertarians to more than 1 million members, activists, and supporters across the country. The ACLU is now a nationwide organization with a 50-state network of staffed affiliate offices filing cases in both state and federal courts. We appear before the Supreme Court more than any other organization except the Department of Justice.

In addition, we work to change policy as well as hearts and minds. Our Washington Legislative Office lobbies Congress to pass bills that advance or defend civil liberties and defeat those that do not, our affiliates work in state houses across the country to do the same, and we use strategic communications to engage supporters on the most pressing civil liberties issues of our time. The defense of America’s core liberties cannot rely on the courts alone. Politics and public opinion matter too.

The ACLU is nonprofit and nonpartisan. We do not receive any government funding. Member dues as well as contributions and grants from private foundations and individuals pay for the work we do.

If you wish to join the ACLU, or you believe your civil liberties have been violated, contact ACLU headquarters (https://www.aclu.org/contact-us) or your local ACLU (https://www.aclu.org/affiliates).

most illicit fentanyl is coming from China, where weak regulations allow underground labs to thrive

This is fentanyl: A visual guide

For example, the chemical difference between fentanyl and carfentanil is just a few molecules. But the difference in potency is significant: Fentanyl is up to 100 times more powerful than morphine, but carfentanil is up to 10,000 times more powerful than morphine. Carfentanil is used as a tranquilizer for large animals like elephants and has been blamed in fatal drug overdose outbreaks in Ohio and West Virginia.

Illicit drug makers change compositions so that if they are caught with the drug, they technically have a different chemical compound from fentanyl or some other already regulated compound. The idea is to get around the law. So the Drug Enforcement Administration is constantly adding new variations to its list of controlled substances. It’s a cat and mouse game.

Deadly dose

Why add these fentanyl variations into the mix? Because they are so potent that it just a little bit can be cut and mixed into other drugs such as heroin or pills, stretching out the supply.

 

Consider that you can buy about a kilogram of black-market fentanyl or a derivative online for about $8,000. That can be used to cut 1 million pills, and on the street, those pills can bring in a total of $20 million to $30 million.

But that potency can also be very deadly. An amount you can’t even see can kill you. There’s also no real quality control over the final drug. One batch may have the fentanyl evenly distributed throughout, while another may have some pills with much higher concentrations of fentanyl than others.

Made in China

According to US law enforcement, most illicit fentanyl is coming from China, where weak regulations and poor monitoring have created an environment ripe for underground labs to thrive. Illegal fentanyl and the chemicals to make it can be easily bought on the internet. Most are shipped into Mexico, where they are further processed before they are smuggled over the border. Sometimes, these drugs are shipped directly into the US.

It’s a major challenge for US Customs and Border Protection agents. In fact, according to the agency, it has had to change its drug testing protocols to prevent accidental overdose from inhalation or absorption through the skin. Of the 328 air, land and sea entry points into the US that the

agency oversees, at least 15 locations, including some along the US-Mexico border, now have naloxone, the opioid overdose antidote, in case of accidental overdose. However, not all offices are equipped with the field testing equipment needed to determine whether agents are actually handling fentanyl.

Special delivery

But there’s another route that drug smugglers have also found to be effective: the US Postal Service. Some drug dealers are even buying from China directly into the United States. Considering that the Postal Service handles about 154 billion pieces of mail every year, it’s the proverbial needle in the haystack. Working with Customs and Border Protection, the Postal Service uses a range of tools, such as dogs, X-rays and an their intrinsic ability to spot something that just seems out of the ordinary.

Law enforcement officials say that at the moment, the government can’t effectively identify which packages to inspect because so little tracking information accompanies international mail bound for the United States.

Packages sent via private couriers such UPS and FedEx come with information such as who sent them, transit stops the package made and who it is b

ound for, but only about half of all packages that come into the US carry that information. Bills currently in Congress aim to increase oversight of international packaging to help track their origins.

For example, the chemical difference between fentanyl and carfentanil is just a few molecules. But the difference in potency is significant: Fentanyl is up to 100 times more powerful than morphine, but carfentanil is up to 10,000 times more powerful than morphine. Carfentanil is used as a tranquilizer for large animals like elephants and has been blamed in fatal drug overdose outbreaks in Ohio and West Virginia.

Illicit drug makers change compositions so that if they are caught with the drug, they technically have a different chemical compound from fentanyl or some other already regulated compound. The idea is to get around the law. So the Drug Enforcement Administration is constantly adding new variations to its list of controlled substances. It’s a cat and mouse game.

Deadly dose

Why add these fentanyl variations into the mix? Because they are so potent that it just a little bit can be cut and mixed into other drugs such as heroin or pills, stretching out the supply.

 

Consider that you can buy about a kilogram of black-market fentanyl or a derivative online for about $8,000. That can be used to cut 1 million pills, and on the street, those pills can bring in a total of $20 million to $30 million.

But that potency can also be very deadly. An amount you can’t even see can kill you. There’s also no real quality control over the final drug. One batch may have the fentanyl evenly distributed throughout, while another may have some pills with much higher concentrations of fentanyl than others.

Made in China

According to US law enforcement, most illicit fentanyl is coming from China, where weak regulations and poor monitoring have created an environment ripe for underground labs to thrive. Illegal fentanyl and the chemicals to make it can be easily bought on the internet. Most are shipped into Mexico, where they are further processed before they are smuggled over the border. Sometimes, these drugs are shipped directly into the US.

It’s a major challenge for US Customs and Border Protection agents. In fact, according to the agency, it has had to change its drug testing protocols to prevent accidental overdose from inhalation or absorption through the skin. Of the 328 air, land and sea entry points into the US that the agency oversees, at least 15 locations, including some along the US-Mexico border, now have naloxone, the opioid overdose antidote, in case of accidental overdose. However, not all offices are equipped with the field testing equipment needed to determine whether agents are actually handling fentanyl.

Special delivery

But there’s another route that drug smugglers have also found to be effective: the US Postal Service. Some drug dealers are even buying from China directly into the United States. Considering that the Postal Service handles about 154 billion pieces of mail every year, it’s the proverbial needle in the haystack. Working with Customs and Border Protection, the Postal Service uses a range of tools, such as dogs, X-rays and an their intrinsic ability to spot something that just seems out of the ordinary.

Law enforcement officials say that at the moment, the government can’t effectively identify which packages to inspect because so little tracking information accompanies international mail bound for the United States.

Packages sent via private couriers such UPS and FedEx come with information such as who sent them, transit stops the package made and who it is bound for, but only about half of all packages that come into the US carry that information. Bills currently in Congress aim to increase oversight of international packaging to help track their origins.

After keeping a video secret for five years, the world is now finally seeing how the DEA can kill innocent people and get away with it.

Secret Video Released Showing DEA Agents Execute 2 Women, a Child, and a Man

After keeping a video secret for five years, the world is now finally seeing how the DEA can kill innocent people and get away with it.

www.thefreethoughtproject.com/dea-agents-execute-2-women-child-man/

DEA

In the federal government’s relentless and futile pursuit to control what Americans can and cannot put into their own bodies, all too often, innocent people become the victims of state-sponsored violence. Since its inception during the Nixon years, the drug war has not only failed at its task but it’s served to create a massive opioid epidemic and eviscerated rights—all while fostering corruption and violence within the government. At the head of this violent and corrupt beast is the government office known as the Drug Enforcement Administration, DEA.

A scathing new report out of ProPublica has just shined some light on the DEA’s dark and violent history. This new evidence, accompanied with a video, shows that for the past five years, the DEA has been lying about an incident that resulted in them killing four innocent civilians, including two women and a child.

The incident happened in Honduras during an operation carried out under the cover of darkness in one of many futile attempts to stop people from selling arbitrary substances.

According to the report from ProPublica:

Advertisment
 

In the DEA’s view, the dead — one man, two women and a 14-year-old boy — were among those on a boat that shot at a canoe carrying a joint DEA-Honduran anti-drug team. The DEA said it had evidence in the form of night-vision video taken from a surveillance plane showing an “exchange of gunfire” between the two vessels after the larger boat collided with the canoe carrying the agents.

 

Now, for the first time, the three-hour video has been released to the public. It strongly suggests that the DEA’s account of crossfire in the May 2012 mission was not accurate. The release of the video, under a Freedom of Information Act request, follows a scathing report published by the inspectors general of the Departments of Justice and State earlier this year that challenged the DEA’s version of events.

ProPublica, along with the NY Times hired a forensic expert to analyze said video. According to the expert, Bruce Koenig, the video shows numerous flashes originating from the DEA and not the family who was murdered.

READ MORE:  No Charges for DEA Agent Who Shot Innocent Grandmother During Botched Raid

Mr. Koenig, who formerly was the supervisor of the F.B.I.’s forensic audio/video group, examined the video frame by frame and concluded that only one flash originates from the passenger boat, according to the report. However, it was determined that this single flash could’ve been caused by a gunshot to the motor of the victim’s boat. Indeed, experts later found a bullet hole in the motor.

Just prior to the release of this video—in a likely attempt to quell backlash beforehand—the DEA disbanded the agency’s program that carried out this attack in Honduras. The operation was named the Foreign-Deployed Advisory Support Teams, or FAST, and it provided military-style training to law enforcement officers in other countries to counter drug traffickers.

 

According to ProPublica, the inspectors general report, which found no evidence to support the DEA’s account that its agents were fired upon, has also drawn attention from lawmakers. A bipartisan group of four senators asserted that the DEA and State Department “repeatedly and knowingly misled members of Congress and congressional staff.”

“The DEA convinced themselves of a false version of events due to arrogance, false assumptions, and ignorance,” said Tim Rieser, an aide to Sen. Patrick Leahy and one of the staff members who has spent years delving into the shooting. “They rushed to judgment and then stuck to their story.”

 

For over five years, the DEA kept this video secret despite claiming that it exonerated the officers in the killing of the man, two women, and one child. Peter Quilter, a former staff member of the House Foreign Affairs Committee who attended some of the initial briefings explained the DEA’s deception from the beginning. “It was very difficult to second-guess them,” he said, adding, “They very simply misled the Congress. The video did not back up their story of what happened.”

READ MORE:  Excessive Force? Three Cops, One with a Boot on his Head, Hold Down and Taser a 60 Year Old Man

ProPublica detailed the events of the video which sounds like a scene straight out of Hollywood.

In the video, the cocaine-filled pickup truck can be seen driving through the village to a landing on the twisting Patuca River. There the traffickers offload the drugs into a motorized canoe.

 

Four government helicopters appear and chaos erupts. The traffickers quickly abandon their task. One of them pushes the drug-laden canoe into the middle of the river and flees into the jungle with the others. Three members of the anti-drug team — two Honduran police and one DEA agent — ignore the men and pursue the canoe downstream.

 

The three men manage to climb on board. The DEA agent, sitting in the back, begins to pilot it back toward the landing. But the motor stalls and the canoe starts to drift downstream. The DEA agent can be seen vainly jerking the starter rope to try to restart the engine.

 

As he does this a second boat appears in the frame. It seems to be maneuvering directly toward the drifting canoe carrying the drugs. This second boat would turn out to be a water taxi, carrying a dozen passengers and cargo upriver to Ahuas.

 

The passengers and pilot on the civilian boat would later say they were terrified by the helicopters and did not intend to steer toward the canoe containing the law enforcement agents. For their part, the drug agents assumed the second boat was trying to recover the drugs.

 

It remains unclear why the civilian craft steered directly into the boat with the agents, but the boats collided.

 

The video clearly shows gunfire from the anti-drug agents. As passengers leap into the water, the anti-drug team continues to fire at them. An eight-second burst of machine gun fire comes from one of the helicopters. (The inspectors general report said a DEA agent ordered a Honduran door gunner to fire.)

 

The footage cuts away for a moment, and the edges of the video are blocked by DEA redactions, obscuring the surveillance plane’s altitude and other technical intelligence-gathering data the agency deemed sensitive.

The DEA was unable to show that anyone in the boat had been armed as no bullets struck the agents, the helicopters, or their canoe. In total, three people were injured and four were killed.

READ MORE:  ASU Professor Thrown to Ground, Charged with Assault for Walking Across the Street

Below is a video illustrating how the government can quite literally get away with murder and justify it by claiming to keep you safe from substances they deem illegal.

ProPublica reached out to one of the victims of the shooting who still has no idea why the DEA shot at them. Hilda Lezama, who operated the boat with her husband says she is no longer able to work as both of her legs suffered debilitating bullet wounds. “I can’t afford to support my daughters,” she said. “We still don’t know why this happened.”

REPEAL: Ensuring Patient Access and Effective Drug Enforcement Act of 2016

Ensuring Patient Access and Effective Drug Enforcement Act of 2016

H.R.4095 – DEA Opioid Enforcement Restoration Act of 2017

share your denial of care story

 

 

 

 

 

 

 

 

 

 

 

Hello Everyone, I have been really busy spreading our plight on social media. I am now working with Jonelle Elgaway at CAW360 Conspiracies Against Wellness and we are interested n your stories. Please email them to stacy.f@conspiraciesagainstwellness.com and please include if we can contact you about interviewing on air with us! #WeR1 Gotcaw.com CONSPIRACIESAGAINSTWELLNESS.com

Thank You All,.. We MUST Keep Fighting!!

Is this how employers lay the ground work to discharge employees treating chronic pain with opiates ?

This is a recent memo from the TSA dept… it would appear by some who work for the TSA that they are laying the ground work for forcing employees off prescribed opiates and/or find reason to discharge employees who require opiates to treat their chronic pain.

Those chronic pain pts know that the taking of opiates typically do not affect their ability to perform most/all functions without compromise.

Of course, those who don’t have experience with taking opiates for chronic pain seem to refuse to listen/believe such

 

 

Medicare/Medicaid: level of acceptable care for pts… depends on where treatment is provided ?

Immediate jeopardy: True or false?

https://www.iadvanceseniorcare.com/blogs/alan-horowitz/regulatory-compliancecms/immediate-jeopardy-true-or-false

Probably no two words strike more fear in the hearts and minds of nursing home owners and operators than “immediate jeopardy.” And, for good reason. When immediate jeopardy is alleged by a survey team, a cascade of painful consequences is about to unfold. 

When a survey team cites immediate jeopardy, it must notify the Centers for Medicare and Medicaid Services (CMS). The clock begins to tick: CMS will terminate a nursing home’s Medicare provider agreement within 23 calendar days if the immediate jeopardy is not removed.

Termination as a Medicare provider will lead to removal from the Medicaid program as well, and few nursing facilities can survive once that happens. In addition to possibly losing their business, nursing facilities cited with immediate jeopardy face huge civil money penalties (CMP), frequently exceeding $1 million.

Immediate Jeopardy

Federal regulations define immediate jeopardy as “a situation in which the provider’s noncompliance with one or more requirements of participation has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident.” (42 CFR 488.301). Thus, in order for immediate jeopardy to exist, there must have been noncompliance with a requirement of participation that either: 1) caused serious injury, harm or death to a resident, or 2) “is likely” to cause such harm.

The first part of the definition is usually simple to determine: Either a facility’s noncompliance, also called a “deficiency,” caused serious harm or death, or it did not. But the second prong of the definition, whether an alleged deficiency was “likely” to cause harm, often becomes a legal battle that is fought and resolved in the various stages of an appeal.

CMS publishes the State Operations Manual (SOM) as “guidance” to surveyors. The SOM helps surveyors interpret and understand the regulations, but it does not have the force of law. CMS has published Appendix Q of the SOM, Guidelines for Determining Immediate Jeopardy in order to help surveyors understand what constitutes immediate jeopardy.

Appendix Q notes that there are three components to immediate jeopardy: 1) harm – either actual or that which “is likely” to occur, 2) culpability, and 3) “immediacy.” Notably, Appendix Q informs surveyors that if serious harm or death has not already occurred, it is considered “likely” if it is likely to occur “in the very near future.” Appendix Q repeats the phrase “in the very near future” multiple times.

If something has not occurred for a year or say, seven months, is it really “likely to occur in the very near future”? CMS thinks so. In spite of its explicit guidance in Appendix Q, CMS has been known to argue that immediate jeopardy existed for many months even if there is no harm at any level during that period.

The problem for providers is that in such cases, CMS has often already imposed a CMP in excess of $1 million, which must be collected and placed in escrow. Unfortunately, an appeal can take years before a final decision is rendered.

Getting Justice

There is a silver lining for providers who wish to challenge immediate jeopardy determinations where CMS claims that immediate jeopardy existed for many months even in the complete absence of any harm or even a minor bruise to any resident.

In a recent case litigated by the author, CMS alleged that immediate jeopardy existed from September of 2012 to April of 2013. There was no harm to any resident during those seven months, and CMS did not allege that any resident was harmed from September to April.

Yet, CMS chose to demand a CMP of more than $700,000, to be paid by the provider years before the resolution of the case, which was then appealed. In 2017, when a final decision was rendered, the judge agreed that immediate jeopardy had existed, but only for several days—not seven months. The judge ordered CMS to repay the provider most of the CMP it had collected.

But, the story gets better. The Affordable Care Act contains a provision that requires CMS to repay any CMP it collected following a successful appeal by a provider—and pay interest on the amount held in escrow. In the case above, CMS had to repay the provider more than $600,000—with interest payments at the federal rate, totalling an additional $53,250!

In another current appeal filed by the author, the amount of the CMP is more than $4 million, compiled from three separate per-day CMPs. As noted above, where CMS escrows a CMP and a provider prevails at appeal, CMS would be required to return the escrowed money plus interest.

It depends on what the meaning of “is” is

Words matter. Since the federal regulation governing immediate jeopardy states that a provider’s noncompliance must have caused death or serious harm to a resident or that serious harm or death “is likely” to result from noncompliance, a closer examination of “is likely” may be helpful. Note that the regulation does not state that serious harm or death may be likely; it must be likely if immediate jeopardy exists. And, as noted above, the guidance CMS provides to surveyors defines the “immediacy” component as having to occur “in the very near future.” Immediate jeopardy should not be based on a theoretical or abstract level of harm that is not likely to occur in the very near future.

So, if no harm—let alone serious harm or death—has not occurred in many months or a year, is it really “likely” to occur? Common sense may suggest otherwise.

How likely is “likely”?

The Health and Human Services’ Departmental Appeals Board (DAB or Board) decides appeals of CMS enforcement actions. The DAB has defined “likely” in the context of immediate jeopardy as a word that is “ordinarily or commonly used to describe an outcome or result that is ‘probable’ or reasonably to be expected though ‘less than certain.’”

The DAB noted that Black’s Law Dictionary defines “likely” to mean “probable” which implies a greater degree of probability that a particular event will occur than do the terms “possible” or “potential.”  According to the DAB, “probable” means that there is more evidence than not that an event will occur. On the other hand, “possible” is defined as “capable of existing” and “free to happen or not,” according to the DAB.

In explaining what “likely” means in the context of immediate jeopardy, and distinguishing between “probable” and “possible” the DAB stated that “In this regard, we have emphasized that a ‘mere risk’ of serious harm is not equivalent to a ‘likelihood’ of such harm.”

It is a well-established axiom of law that when the meaning of words is explicit and unambiguous, effect should be given to the plain meaning of words as expressed in a statute or regulation.

Providers face a significant legal obstacle according to the Administrative Law Judges who decide appeals of CMS enforcement actions. CMS’ determination of immediate jeopardy is “presumed correct.” The legal standard for a provider to successfully challenge allegations of immediate jeopardy is to demonstrate to the satisfaction of the judge that CMS’ determination was “clearly erroneous.” That places a high, but not insurmountable burden on providers.

In the past few years, CMS has increasingly taken the position that immediate jeopardy exists as of the date there was an alleged deficient practice and continuing through to the survey and beyond—even if the period is for many months—and there is an absence of harm or even the likelihood of harm. Recall that “likely” is synonymous with “probable” or “more likely than not” to occur.  Gentle reader, if something has not happened day after day, for months on end, can it truly be said to be likely to happen? The answer lies in understanding the distinction between probable and possible.

Apart from the frequently enormous financial burden the penalties for immediate jeopardy place on a nursing facility, there are other adverse and negative consequences, not the least of which, is demoralizing the staff and upsetting residents. Providers would be encouraged if CMS considered the literal meaning of the word “likely” as used in the federal regulations.   As noted above, the DAB has emphasized that, “a mere risk of serious harm is not equivalent to a ‘likelihood’ of such harm.” Thus, it logically follows that a “mere risk of serious harm” is not tantamount to immediate jeopardy.

The question often isn’t whether immediate jeopardy existed at all. That analysis is usually straightforward. The issue is whether, in the absence of serious harm for many months or even a year, can immediate jeopardy truly exist? If one strikes a match, a flame will immediately appear. However, if one rubs two sticks together, a flame may eventually appear or may never appear. Therein lies the difference between likely and possibly.

After the inception of this article and numerous complaints about the exorbitant amounts of per-day CMPs based on months of alleged immediate jeopardy, CMS modified its CMP policy. In a Survey and Certification Memo addressed to all State survey agency directors dated July 7, 2017, CMS stated that “per instance CMPs [are] the default for noncompliance that existed before the survey.”1 (The difference between a per-instance and a per-day CMP can be in the millions of dollars.) However, the same CMS Survey and Certification Memo also indicated that per day CMPs should be issued where immediate jeopardy “was cited with actual harm to a resident.”

  1. Revision of Civil Money Penalty (CMP) Policies and CMP Analytic Tool, Ref: S &C: 17-37-NH (July 7, 2017), available at: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Survey-and-Cert-Letter-17-37.pdf

Some of the things that a nursing home provider can be found guilty of some level of  “pt mistreatment” or ” lack of pt treatment”  It would appear that the standard of care that these same pts receive in a out patient/home setting has a much higher bar to constitution pt abuse/mistreatment.

Why do we have a double-triple standard of care for ambulatory/home bound Medicare & Medicaid pts ?

Labor Secretary Alexander Acosta said reducing opioid prescriptions was important to get unemployed Americans back into the workforce

Insurers Promise More Cuts in Rx Opioids

By Pat Anson, Editor

Less than two weeks before its final report is due, President Trump’s opioid commission held its fourth and final public meeting Friday – hearing testimony from top government officials and insurance industry executives about the nation’s worsening overdose crisis.

“Insurance companies are going to be a very, very important part of whether we will be able to stem the tide here or whether we’re not,” said commission chairman Gov. Chris Christie of New Jersey.

It was clear from their testimony that many insurers are planning to tighten access to prescription opioids even more than they already have.

Aetna’s chief medical officer told the commission the insurance giant was planning to reduce “inappropriate opioid prescribing” to its members by 50 percent within the next five years.  He did not explain what would be considered inappropriate.

insurers at comm.png

Aetna has already sent warning letters to hundreds of physicians and dentists identified as “super-prescribers,” urging them to reduce the number of opioid prescriptions they write.

“We’re now re-running our analysis and planning more aggressive interventions for those providers who haven’t improved their opioid prescribing habits over the past several months,” said Harold Paz, MD.  

The chief medical officer of Cigna said his company was close to achieving a 25 percent reduction in coverage of opioid prescriptions, a priority it set last year.

“That’s only the first of our goals,” said Alan Muney, MD.

Insurer Harvard Pilgrim said its coverage of opioid prescriptions has declined by over 20 percent since 2014.

“That’s not enough.  This feels like a balloon where you tap on one end and it comes out somewhere else. So it doesn’t mean we’re even close to solving this,” said Michael Sherman, MD, chief medical officer of Harvard Pilgrim.

Insurers clearly have the ear of the federal government when it comes to opioids. As PNN has reported, an obscure federal advisory group composed of insurers, law enforcement, and federal and state regulators has discussed eliminating opioid prescriptions for acute pain, as well as paying doctors not to prescribe opioids.

The Healthcare Fraud Prevention Partnership also wants access to the “personally identifiable and protected health information” of 57 million Medicare beneficiaries to see if they are abusing opioids.

Reducing Opioids a ‘Win-Win’

Labor Secretary Alexander Acosta said reducing opioid prescriptions was important to get unemployed Americans back into the workforce. He cited a recent study that found that about a third of unemployed men aged 25 to 54 were using prescription painkillers.   

“Reducing the amount of opioids is a win-win across the board. It’s a win for the individual who doesn’t want to get hooked,” Acosta said. “It’s a win for the insurance companies who don’t want to be paying for medicines that people don’t need. And it’s a win for the American workforce, because if we can get people back to work and paying taxes and participating fully, that’s a win for them and it’s a win for the country.”

Acosta cited no studies that might indicate how many Americans currently taking opioids would become unemployed or disabled if their pain medication was reduced or taken away. 

No pain patients, patient advocates or experts in pain management were asked to appear before the commission. No one from the pain community has testified during any of the commission’s public meetings, although thousands have submitted written comments.

An interim report released by the opioid commission in July focused on expanding access to addiction treatment and developing new ways of treating pain without opioids. Since then, the commission has increasingly focused on limiting opioid prescriptions. The final report from the commission is expected November 1.

The interim report also strongly urged President Trump to declare a national emergency to speed up efforts to combat the overdose crisis, something he has yet to do.  “We’re going to be doing it in the next week,” Trump told reporters on Monday.  However, there appears to be little consensus in the administration about what actions to take after an emergency is declared or how to pay for them.

“Everyone wants opioids to be a priority, but there’s a lot of resistance to calling it an emergency,” a senior administration official told Politico.

We have what is INTENTIONALLY UNDER/UNTREATED chronic disease and the insurance companies are looking to reduce the amount of opiates that they pay for by up to 50%, and according to this article … the insurance companies are considering PAYING PRESCRIBERS to NOT PRESCRIBE OPIATES… basically – paying prescriber to DENY CARE to the very patients that are paying those same insurance companies premiums to pay for needed care.

about a third of unemployed men aged 25 to 54 were using prescription painkillers.”  

That above statement suggests that they are targeting men who are receiving monthly workman comp monies.  There are no WOMEN in that age group that are taking opiates and unemployed. Has anyone seen this study they are referencing ?

They also want access to the HIPAA protected PERSONAL HEALTH INFORMATION… so if this happens..  would this suggest that there could be a MAJOR HIPAA VIOLATION by our government and the insurance companies.. Could the very fact that are given access would be UNCONSTITUTIONAL…  ACLU where are you ?