There is many things starting to STACK UP against the DEA/DOJ and their 5 decade war on drugs/pts. There is more and more practitioners – especially pharmacists – that are work with pharmacogenomics  https://www.pharmaciststeve.com/21st-century-testing-to-help-chronic-pain-pts-justify-needing-higher-doses/ to help determine if a pt metabolizes different categories of medications differently.  Pointing out that some pts are fast/ultrafast metabolizers of many meds are dealing with pts suffering from subjective diseases (pain, anxiety, depression, ADD/ADHD, various mental health issues) where historically there have been lab/test issues that have been ignored or dismissed they were involved in adversely affecting a pt’s QOL… 

That the MME system has no science nor double blind clinical studies supporting their conclusions are nothing more than JUNK SCIENCE, but “they” have continued to use them as a ONE SIZE FITS ALL in the treatment of subjective diseases.  https://www.acsh.org/news/2022/03/01/true-story-morphine-milligram-equivalents-mme-16154

“They” continue to blame Purdue Pharma was the genesis of the fabricate opioid crisis  – yet it has been claimed that Purdue Pharma’s opioids were only 4% of all opioid Rxs.

“They” ignore that over the last decade, legal opioid Rxs have been reduced abt 50%, while concurrently the number of Opioid OD/poisoning have increased 7-8 fold, but only mention that those deaths were from Fentanyl – mostly failing to mention that the Fentanyl analog involved – that is mostly coming from China and Mexican cartels – is not the same FDA approved Fentanyl analog.

Now the 50 state AG’s sued the top 3 drug wholesalers and three largest chain pharmacies and besides getting these corporations to “cough up” tens of billions of dollars in fines for “contributing’ to the fabricated opioid crisis and at the same times getting these corporations agree to sell fewer control meds to pharmacies and chain pharmacies agreeing to dispense fewer controlled meds.  Apparently doing so, in little regards for the pts valid medical needs for these medications.  https://www.pharmaciststeve.com/dea-surrogates-are-trying-to-throttle-the-availability-of-controlled-meds-to-pts/

       Practitioners have been reducing or eliminating a pt’s pain medication and ignoring some predictable comorbidity complications, especially  hypertensive blood pressure,  heart attacks,  strokes,  increase pain,  anxiety & depression & suicidal idealization. 

Chronic Pain Detected in the Brain for the First Time

Real-world signals were seen mostly in the orbitofrontal cortex

https://www.medpagetoday.com/neurology/painmanagement/104635

Chronic pain was detected in the human brain for the first time, researchers reported.

Data were collected over months from four participants with refractory neuropathic pain who had intracranial electrodes implanted, according to Prasad Shirvalkar, MD, PhD, of the University of California San Francisco, and co-authors. Over 3 to 6 months, participants reported their pain levels several times a day at home while the electrodes recorded their brain activity.

The recordings showed that chronic pain states were mostly associated with activity changes in the orbitofrontal cortex, Shirvalkar and colleagues wrote in Nature Neuroscienceopens in a new tab or window. This differed from transient or acute pain, which was associated with anterior cingulate cortex signals in two participants.

Functional MRIs have shown that the anterior cingulate cortex and orbitofrontal cortex regions are activated during acute pain experiments, Shirvalkar noted.

“We were interested to see whether these regions also played a role in how the brain processes chronic pain,” he said in a press briefing. “We were most interested in questions like how pain changes over time, and what brain signals might correspond to or predict high levels of chronic pain.”

Pain is one of the most fundamental experiences an organism can have, Shirvalkar observed. “Despite this, there is still so much we don’t understand about how pain works,” he pointed out. “By developing better tools to study and potentially affect pain responses in the brain, we hope to provide options to people living with chronic pain conditions.”

Chronic pain has no objective biomarkers to help guide diagnosis and treatment, Shirvalkar added.

In the U.S., the prevalence of chronic painis about 21%, affecting an estimated 51.6 million adults. New cases of chronic pain occur more frequently than new cases of diabetes, depression, or hypertension.

This study, which was supported by the NIH’s BRAINand HEAL initiatives, may be a first step toward developing novel methods for tracking and treating chronic pain, noted Walter Koroshetz, MD, director of the National Institute of Neurological Disorders and Stroke. “We are hopeful that building from these preliminary findings could lead to effective, non-addictive pain treatments,” Koroshetz said.

Shirvalkar and colleagues surgically implanted electrodes that targeted the anterior cingulate cortex and orbitofrontal cortex of four participants. Three participants had post-stroke pain and one had phantom limb pain.

Participants were asked to evaluate the pain they were experiencing — strength, type of pain, and how the pain made them feel — several times a day. They then clicked a remote-control device to create a 30-second brain recording of that moment.

Using machine learning methods, the researchers successfully predicted the pain severity scores of each individual from their orbitofrontal cortex activity with high sensitivity. Each person showed unique brain activity.

“Each patient’s biomarker was actually like a unique fingerprint,” Shirvalkar said. “I think that tells us something very important.”

In a separate analysis, Shirvalkar and colleagues examined how the anterior cingulate cortex and orbitofrontal cortex responded to acute thermal pain. In two participants, activity in the anterior cingulate cortex predicted acute pain responses.

The findings suggest that signals in the orbitofrontal cortex can track current chronic pain severity for neuropathic pain syndromes such as central post-stroke pain or phantom limb pain, the researchers said. The data also suggest that the brain may process chronic and acute pain differently in chronic pain patients.

“Global cerebral pain networks in all participants likely underwent rewiring over many years living with chronic pain,” Shirvalkar and co-authors wrote. “Still, ongoing ‘background’ chronic pain may have influenced acute pain perception even in the unaffected body side,” they noted.

Future work involving more participants may help determine whether different pain conditions share the orbitofrontal cortex activity found in these participants or how signatures may vary among persons with different pain conditions, the researchers added. Whether similar signals could be recorded non-invasively with electroencephalography (EEG) is not known.

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I got the text below today as a email. How many of those in the chronic pain community have reached out to the ACLU for assistance in because of their disabilities being discriminated against and all have been told that ” we don’t have the resources” … According to this text, … Here’s your rundown,  and we’ll be back with more news tomorrow on the slew of lawsuits we’ve hustled to file once our attorneys have had a moment to breathe.  One would think that the estimated 50 million of adults and USA citizens dealing with chronic pain would fall into ACLU’s Over the past two weeks, our attorneys have been filing lawsuit after lawsuit to fight against the surge of attacks on people’s most fundamental rights & BEYOND.  As Cardinal drug wholesaler is notifying independent pharmacists that – effective immediately, they are no longer going to sell them controlled meds and Walgreens are sending pts a 23 point questionnaire for their prescriber to fill out – mostly with a narrative answer – if Walgreens will continue to fill the prescriptions of a particular prescriber going forward. Here is a recent blog post laying out what may be coming down the pike for those in the chronic pain community

DEA & surrogates are trying to throttle the availability of controlled meds to pts

Over the past two weeks, our attorneys have been filing lawsuit after lawsuit to fight against the surge of attacks on people’s most fundamental rights: From the rights and safety of trans people to voting rights to abortion access and beyond.

We will be back with further updates on these urgent fights in the courts soon, but we wanted to uplift one particular breaking lawsuit that our legal teams just filed this week in the state of Florida against yet another harmful ban from Governor DeSantis.

Here’s your rundown,  and we’ll be back with more news tomorrow on the slew of lawsuits we’ve hustled to file once our attorneys have had a moment to breathe.

The Ban: Florida Governor Ron DeSantis very recently signed into law SB 264. This racist law forbids many immigrants from China, Cuba, Venezuela, Syria, Iran, Russia, and North Korea from buying a home in the state – with very limited exceptions. The law singles out people from China for especially draconian restrictions and harsher criminal penalties. Gov. DeSantis has said that this bill is “necessary to combat the influence of the Chinese Communist Policy in Florida,” but he is wrongly equating Chinese people with the Chinese government. This law will not keep Floridians safe. It will upend people’s lives and make it far more challenging for immigrants to prosper economically in the state.

Our fight back in court: The ACLU, ACLU of Florida, Asian American Legal Defense and Education Fund, and DeHeng Law Offices PC are working together to challenge the Florida law before it goes into effect on Saturday, July 1. The plaintiffs in our case include Chinese citizens who live, work, study, and raise families in Florida, and who will soon be prohibited from purchasing real estate.

Why this is so important nationally: Worryingly, Florida isn’t alone. Lawmakers across the country are trying to pass laws to ban Chinese citizens and other immigrants from owning property. Just as states have continued to bring out anti-trans, anti-abortion, and anti-voter legislation in droves this year – despite citizens and public opinion clearly stating the opposite – so too are we seeing similar anti-immigrant and xenophobic bills like this one take shape.

The bottom line,  is this: At a time when one in two Asian Americans report feeling unsafe in the U.S. due to their ethnicity – and nearly 80% don’t feel they fully belong or are accepted – Florida’s leaders have a responsibility to the people who live there to do better.

Until they do, we’ll see them in court.

More from our attorneys soon,

The ACLU Team

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Maybe this is why they are starting to refer to this as Medicare-C – because there is no advantages

Congress Hearing Explores Medicare Advantage Routines That Deny, Delay Needed Care

https://www.medpagetoday.com/publichealthpolicy/medicare/104569

WASHINGTON — A 79-year-old man with prostate cancer needed a PET scan, but his Medicare Advantage (MA) plan refused to pay for it. Another MA plan denied approval for a wheelchair for a patient with multiple sclerosis and a tibia fracture. Still another enrollee recovering from a stroke found he was ineligible for coverage for physical therapy.

The neurosurgeon treating a fourth patient, the late University of Connecticut physics professor and melanoma patient Gary Bent, PhD, referred him for acute rehab after removing a lesion from his brain. But Bent’s MA plan intermediary refused, putting him and his wife, Gloria, through a lengthy ordeal They were told he “couldn’t withstand intense therapy,” she said.

He was eventually admitted to a skilled nursing facility, but was discharged from there after about 5 weeks because his MA plan discontinued payment, even though it turned out he had bacterial meningitis, she said.

Those were among many examples of how MA plans have routinely denied coverage for medical services — despite their doctors’ orders and despite Medicare policy that they should be covered — presented Wednesday during a hearing of the Senate Homeland Security and Governmental Affairs Permanent Subcommittee on Investigations.

Lawmakers have collected many examples in which MA plans are failing beneficiaries, “denying or delaying care,” said committee chair Sen. Richard Blumenthal (D-Conn.) at the start of the hearing. They “face denials in the middle of major medical crises, forcing them and their loved ones to fight even as they are fighting for their lives.”

Algorithms Decide

“Perhaps most troubling of all,” Blumenthal continued, “there is growing evidence that insurance companies are relying on algorithms rather than doctors or other clinicians to make decisions to deny patient care.”

Sen. Roger Marshall, MD (R-Kan.), an ob/gyn, listed many examples of denials, including the examples above.

He said a huge culprit is prior authorization, in which MA companies — to avoid waste and reduce costs — require doctors to get many kinds of medical care pre-approved. A few years ago, an MA plan canceled Marshall’s patient’s next-day surgery because Marshall was required to talk with a plan representative first. Prior authorization has “become a tool to delay care — hoping the patient dies so they don’t have to give any more care, I guess.”

One focus during the hearing was on the MA plans’ frequency of incorrectly denying care. Of 35 million prior authorization requests submitted to MA plans in 2021, 6% or two million were denied, said Jean Fuglesten Biniek, PhD, associate director of Medicare policy for the Kaiser Family Foundation here. Of those, only 11% were appealed and when they were, 80% of the denials were overturned, suggesting that many denials should have been initially approved.

These denials burden providers’ staff resources and impose delays for enrollees “during a point in their lives when they’re potentially in very poor health,” she said.

Why such a low rate of appeals? Biniek was asked. “People may not know how to appeal; they may not believe they have a case to appeal. And people are often very ill … and if they don’t have a caregiver or somebody to assist them or access to legal services, going through that process can be difficult,” she replied.

A key problem with MA plans is their refusal to pay for skilled nursing facility stays or approve coverage for lengths of stays that doctors say their patients need, said Christine Huberty, an attorney with the Greater Wisconsin Agency on Aging Resources, which provides free legal services for seniors.

For a patient who has undergone hip replacement surgery in a hospital, for example, she said, “their doctor generally recommends several weeks in a skilled nursing facility until they’re ready to safely go home.”

In regular Medicare, that patient would be covered for up to 100 days of skilled nursing facility care after a 3-day hospitalization. But although MA plans are supposed to provide the same coverage, Huberty said, too often they don’t.

Dizzying Red Tape

Instead, a senior “can expect to receive a denial well before their doctor even says they’re ready to go home … they’re thrown into a maze of red tape that is dizzying, even to our experienced legal team,” fighting a denial that is made by “a third-party contractor using an algorithm,” Huberty said.

The length of that patient’s stay is determined by a computer based on millions of “past beneficiary data points, not the patient’s plan of care or the advice of their doctors,” she continued. If the patient chooses to fight, denials at each level are upheld by a quality improvement organization, often with little to no explanation, she said.

Megan Tinker, chief of staff of the Office of Inspector General (OIG) for the Department of Health and Human Services (HHS), noted that Medicare pays MA plans a capitated rate per beneficiary, and thus have “a potential incentive” to deny access to services they should cover.

For example, she said, a plan denied payment for a computed tomography scan, medically necessary to rule out a life-threatening aneurysm, referencing a rule that beneficiaries are supposed to first get a less-expensive x-ray. “But Medicare has no such requirement,” Tinker said.

Prior authorization is being used to deny care that, in 13% of the cases investigated, traditional Medicare would have paid, Tinker told lawmakers. “Plans make more money by providing fewer services.”

Although OIG has reported on this problem, its oversight abilities are limited by resources. The agency receives 2¢ to oversee every $100 HHS spends, and each year turns down between 300 and 400 “viable criminal and civil healthcare fraud cases,” leading to the “potential for patients to be put in harm’s way, including individuals enrolled in Medicare Advantage,” Tinker said.

They Didn’t Choose

It’s not as if the cost savings that MA plans were designed to achieve are happening, Biniek said. In its report, the Medicare Payment Advisory Commission projectedopens in a new tab or window that in 2023, the trust fund will pay $27 billion more for MA enrollees, or 6% more, than similar patients with traditional Medicare.

One witness at the hearing, Lisa Grabert, MPH, a visiting research professor at Marquette University’s College of Nursing in Milwaukee and a former staff member of the House Ways & Means Committee, praised MA plans, saying that both of her parents are enrolled in them.

She said beneficiaries are choosing MA plans for their comprehensive benefit packages and “improved financial protections” and “choice simplicity,” and that beneficiaries are willing to accept the trade-offopens in a new tab or window of using a provider network with some utilization review requirements such as prior authorization.

“It is our expectation that a Medicare beneficiary has a basic understanding of this when they elect their choice of coverage,” she said. “However, it may not be clear to beneficiaries what they are agreeing to when it comes to prior authorization.”

Later in the hearing, Blumenthal referenced Bent’s case, and whether he had an informed choice to buy an MA plan.

“Actually,” his widow replied, “Gary was a retired state employee whose benefits were determined by the Office of the State Comptroller … Someone else made the decision for us that we would be on Medicare Advantage.” Her husband died in March after developing an infection.

Blumenthal summarized as he adjourned the hearing: MA plans’ denials and delays of care “deeply impact people, impoverishes them financially but also spiritually when they have to be on the battlefield at the same time their loved ones are fighting for their lives,” he said.

“The fact of the matter is [an MA plan] works until you need it,” he said. “It’s fine, so long as you don’t need it for the big stuff, like melanoma, like long term care, like certain kinds of injections, and other needs that everyday Americans have.”

How Congress should fix the problem remains unclear. But, Blumenthal said, “This investigation will continue. There’s a lot here that needs to be known.”

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If you are reading this, YOU NEED TO SHARE THIS – not just LIKE IT… unless you feel that there is no one in your circle of family & friends who are dealing with chronic health issues, that could possibly benefit & enjoy improving their QOL. If you are a intractable chronic pain pt, this could give your prescriber HARD JUSTIFICATION why you need a higher dose.

For years, those who follow and read my blog… Have heard me routinely talk about pharmacogenomics (PGx). “back in the day”, I was a hard-charging, card carrying, type-A workaholic.  Now in my 8th decade on this earth, those words no longer really applies to me. I could not, in good conscience , pull back from supporting those in  the chronic pain community, to try and get up to speed with PGx. So I started looking around to find a Pharmacist that has this PGx stuff down pat. Must have been my GOOD KARMA day. I found Cari A. Lalande, PharmD, RPh
Owner | Clinical Genetic Pharmacist.

FULL DISCLOSURE: I won’t get the first penny for being a conduit in connecting Cari, with someone in the community who wants to see if PGx/NGx could help improve their overall health/QOL.  This is Cari’s professional business/practice, and she does charge for her services and will bill insurance, if it is covered. I think that it would be best, if any/all pts asked their practitioner if they will use/believe in PGx testing. There are some practitioners that are still working with 20th century knowledge and skill sets.

Last, but not least, Cari has agreed to become a contributor to my blog. Sharing stories about pts she has helped using PGx & NGx and the positive QOL outcomes she has been able to accomplished for these pts.

Health By Genetics™ is a unique pharmacist owned genetic lab designed to conduct comprehensive pharmacogenomic (PGx), nutrigenomic (NGx) molecular testing. Our wholistic approach to patient-centered care empowers individuals to live life abundantly, on their terms.

Utilizing genetics as the basis, we work with both the patient and their providers to determine the best medication choice for each thereby reducing the occurrence of side effects, polypharmacy, and increase awareness of better lifestyle choices. 

Our goal is to solve for challenges most patients face when multiple providers are involved in prescribing various

medications without communicating with each other thereby increasing the risk of adverse side effects and related events.

To continue to support our patients, because genetic testing is not a one and done type of test, we created our PharmaAssist^TM Concierge clinical services program that provides patients a personal genetically trained pharmacist to act as their patient advocate with their healthcare providers.

Click here to schedule a meeting: https://calendly.com/health-by-genetics

Click here to schedule a meeting: https://calendly.com/health-by-genetics

Nutrigenomics is a field of study that investigates the relationship between nutrition and an individual’s genes. It explores how genetic variations influence the body’s response to different nutrients and how diet can affect gene expression and function.

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Chronic Pain Incidence Is High in the U.S.

https://www.medpagetoday.com/neurology/painmanagement/104558

New cases of chronic pain — defined as pain experienced on most days or every day over 3 months — occurred more frequently than new cases of other common chronic conditions, U.S. survey data showed.

Chronic pain incidence was 52.4 cases per 1,000 person-years, reported Richard Nahin, MPH, PhD, of the NIH in Bethesda, Maryland, and co-authors.

This was higher than the incidence of diabetes (7.1 cases/1,000 person-years), depression (15.9 cases), and hypertension (45.3 cases), the researchers said in JAMA Network Openopens in a new tab or window.

Moreover, chronic pain was persistent: nearly two-thirds (61.4%) of adults with chronic pain in 2019 continued to have it in 2020.

The findings come from National Health Interview Survey (NHISopens in a new tab or window) data and are the first nationwide estimates of chronic pain incidence.

Recent NHIS data showed the prevalence of chronic painopens in a new tab or window in the U.S. was about 21%, affecting an estimated 51.6 million adults. High-impact chronic pain — pain severe enough to restrict daily activities — affected 17.1 million people.

“Understanding incidence, beyond overall prevalence, is critical to understanding how chronic pain manifests and evolves over time,” Nahin said in a statement. “These data on pain progression stress the need for increased use of multimodal, multidisciplinary interventions able to change the course of pain and improve outcomes for people.”

The NHIS is a cross-sectional poll conducted annually by the National Center for Health Statistics. Nahin and co-authors evaluated 10,415 adults who participated in both the 2019 and 2020 surveys. Participants with chronic pain during both periods were considered to have persistent chronic pain.

The sample included 51.7% women. More than half of the study population — 54% — were ages 18 to 49. Most participants (72.6%) were white; 16.5% were Hispanic and 12.2% were Black. Most (70.5%) were not college graduates.

At baseline (2019), 40.3% of participants reported no pain, 38.9% reported non-chronic pain, and 20.8% reported chronic pain.

Of those without pain in 2019, the rate of incident chronic pain was 52.4/1,000 cases (95% CI 44.9-59.9). The rate of incident high-impact chronic pain was 12.0 (95% CI 8.2-15.8). Lower educational attainment and older age were associated with higher rates of chronic pain in 2020, regardless of pain status in 2019.

In 2020, rates of persistent chronic pain and persistent high-impact chronic pain were 462.0 and 361.2 cases per 1,000 person-years, respectively.

Of those reporting non-chronic pain in 2019, 14.9% had progressed to chronic pain at follow-up. Of those reporting chronic pain in 2019, 10.4% had fully recovered (were pain-free) in 2020.

“Although chronic pain is sometimes assumed to persist indefinitely, our finding that 10.4% of adults with chronic pain experienced improvement over time is consistent with previous evidence from studies in Denmark, Norway, Sweden, and the U.K., which revealed rates ranging from 5.4% to 8.7%,” the researchers noted.

The study did not include information about the underlying causes of pain and survey data were collected only twice across 2 years of follow-up, Nahin and co-authors acknowledged. It’s possible that people experiencing new or persistent chronic pain or high-impact chronic pain were less likely to participate in the 2020 follow-up survey, which may have led to rates being underestimated.

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Open Letter to DEA Administrator Milgram

Directly oversee the investigation of your DEA agents

https://www.daily-remedy.com/open-letter-to-dea-administrator-milgram/

Dear Administrator Anne Milgram,

I hope this letter finds you well.

I request you to oversee the investigation into the misconduct of DEA agents in my case. I initially filed a complaint with the Office of Inspector General which has been transferred to the Drug Enforcement Agency Office of Professional Responsibility.

The DEA has shown a lack of willingness and an inability to uphold it standards of conduct. Oversight agencies have consistently shown repeated incidents of misconduct by DEA agents, with only a few receiving much, if any, accountability.

I understand you are trying to reform the DEA and to enact much-needed reform. I thank you for listening to the public and for delaying the implementation of restrictive telehealth policies. Now I ask you to review the misconduct by DEA agents who targeted me in 2017 and manipulated evidence in my case that led to an indictment in 2018.

These agents solicited perjured statements from former employees who were forging prescriptions using my DEA license. They materially altered evidence in my case, including falsifying a police report and submitting an affidavit with false claims that were known to be untrue at the time of submission.

How they did this was quite clever. They would tamper with evidence and then obtain perjured statements to corroborate the tampering. Let me provide an example. Look at the police report I filed against the employee who was forging scripts under my name. You will see the report claims I reported her brother for threatening me, but somehow did not report her forgeries. How could I report one but not the other? Her brother threatened me because I planned to report her to the police.

This fraud was then complemented by perjured statements taken during the grand jury testimony. The same employee was asked by federal prosecutors whether she had forged scripts under my name – to which that employee answered no with no pushback from either DEA agents or federal prosecutors. This is all the more curious, since both DEA agents and federal prosecutors had many forged prescriptions in their hand.

The misconduct is easy to discern when you parse through the evidence in this way. But it makes the efforts to distort evidence in this case all the more concerning. And it’s precisely why you must directly intervene in this investigation.

I have written a book that details the misconduct by the DEA in this case. I also compiled all legal documents in this case and plan to share them with investigative journalists and criminal justice reform organizations. These efforts are intended to raise awareness of the misconduct in my case. I plan to involve all interested parties in the review of DEA misconduct. Thank you in advance for your time and effort.

Respectfully,

Dr. Jay K Joshi

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FDA OKs Spinal Cord Stimulation Devices for Chronic Back Pain

https://www.medscape.com/viewarticle/992053

The US Food and Drug Administration (FDA) has expanded the indication for Abbott Laboratories’ spinal cord stimulation (SCS) devices to include treatment of chronic back pain in patients who have not had, or are not eligible for, back surgery, the company has announced.

The new indication spans all of Abbott’s SCS devices in the US, which include the recharge-free Proclaim SCS family and the rechargeable Eterna SCS platform.

The devices feature the company’s proprietary, low-energy BurstDR stimulation waveform, a form of stimulation therapy that uses bursts of mild electrical energy without causing an abnormal tingling sensation to help disrupt pain signals before they can reach the brain, the company explains.

The expanded indication was supported by results from the DISTINCT study, which enrolled 270 adults suffering from severe, disabling chronic back pain for an average of more than 12 years and who were not eligible for surgery.

“This new indication for Abbott’s SCS devices, together with BurstDR stimulation, allows physicians the ability to identify and treat a new group of people, providing them with relief from chronic back pain,” Deer adds.

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CVS Health is expanding its vertical integration into providing healthcare. Besides the nearly 10,000 community pharmacies, they have specialty pharmacies, mail order pharmacies, Aetna insurance, the PBM Caremark, Silver Scripts Medicare Part D now part of Aetna and a Medicare -C (Advantage) prgms, and in many of their community pharmacies they have MINUTE CLINICS and this acquisition  of was < 60 days since acquiring  CVS closed $8B deal for health services company Signify Health

Those pts who have their medical care provided by CVS Health are pretty familiar with the restricted networks that entities like CVS force pts to use. It is much like when a fish bites down on a “baited hook” …  there is no getting off the hook.

CVS closes $10.6B acquisition of Oak Street Health to expand primary care footprint

https://www.fiercehealthcare.com/providers/cvs-closes-106b-acquisition-oak-street-health-expand-primary-care-footprint

CVS Health has sealed the deal on its acquisition of Oak Street Health, picking up about 169 medical centers in 21 states.

The acquisition cleared a major regulatory hurdle back in late March when the Department of Justice and the Federal Trade Commission allowed the antitrust waiting period to run out on without taking action to halt the deal. Sen. Elizabeth Warren, D-Massachusetts, had urged the FTC to take a closer look at the deal and challenge any M&A activity in healthcare that could lead to higher prices, less competition and lower care quality.

The retail pharmacy giant announced the deal on February 8 as an all-cash transaction for $39 per share, representing an enterprise value of approximately $10.6 billion. The company financed the transaction with borrowings of $5.0 billion from a term loan agreement entered into on May 1, 2023 and existing cash and available resources.

Oak Street Health will continue to operate as a multipayer primary care provider as part of CVS Health.

Oak Street CEO Mike Pykosz will continue to lead the Medicare-focused primary care company when the deal closes, CVS said, and the provider would be folded into its newly created healthcare delivery arm.

Closing the Oak Street deal follows closely on the heels of CVS finalizing its $8 billion acquisition of home health and technology company Signify Health.

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