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America United International AUI Interviews Dr. Jay Joshi
Posted on March 13, 2023 by Pharmaciststeve
The FTC Fires Its First Shot – at www.goodrx.com – Under the Health Breach Notification Rule
Posted on March 13, 2023 by Pharmaciststeve
The FTC Fires Its First Shot – at www.goodrx.com – Under the HBNR
https://www.lexology.com/library/detail.aspx
Last month, the Federal Trade Commission (“FTC”) announced its first-ever enforcement action under the Health Breach Notification Rule (“HBNR” or “the Rule”). In a complaint filed in February, the agency alleged that GoodRx Holdings Inc., a prescription drug discount and telehealth provider, violated the HBNR by sharing users’ personal health information with third-party digital advertising providers without users’ consent. The FTC also alleged that GoodRx violated Section 5 of the Federal Trade Commission Act (“FTC Act”) by engaging in unfair and deceptive business practices related to its data-sharing. The company did not admit to any wrongdoing, but agreed to pay a $1.5 million civil penalty and take corrective action as part of a settlement entered on February 17, 2023.
The HBNR applies to vendors of personal health records and related entities (think: fitness trackers, health apps, and other online businesses that collect personal health data) that are not subject to the Health Insurance Portability and Accountability Act (“HIPAA”). The Rule requires covered entities to notify consumers, the FTC, and, in some cases, the media, about breaches of security of identifiable health information. Companies that fail to comply with the HBNR may face civil monetary penalties and other sanctions.
In January 2022, the FTC released guidance explaining that a breach under the rule “is not limited to cybersecurity intrusions.” Rather, “[i]ncidents of unauthorized access, including a company’s disclosure of covered information without a person’s authorization” can also trigger notification obligations under the Rule.
The government’s complaint alleged that GoodRx violated the HBNR by tracking and disclosing users’ personal health information to third parties, such as advertisers and social media companies, without consent. According to the FTC, GoodRx’s unauthorized data-sharing practices amounted to a “breach” that triggered notification requirements under the HBNR. The FTC also alleged that GoodRx violated the FTC Act’s prohibition on unfair and deceptive trade practices by engaging in data-sharing practices that were contrary to company’s own privacy policy and other assurances that it had made to its users.
In addition to the $1.5 million civil penalty, the company also is permanently barred from disclosing user information to advertisers, with limited exceptions, and will be required to obtain users’ affirmative consent before disclosing their health information for any purpose. Additionally, GoodRx must notify users about prior disclosures and direct third parties to delete the user information that it shared with them. The company also will be required to establish a comprehensive privacy program, adopt a public data retention schedule, and undertake periodic third-party compliance assessments.
The action against GoodRx is notable for several reasons. First, the action marks the first time that the FTC has enforced the HBNR since promulgating the Rule in 2009. Moreover, the action demonstrates the FTC’s commitment to enforcing the HBNR to penalize companies that share health information without consumers’ consent, as previewed in the guidance the agency issued last year. Companies that manage personal health information should be aware of the FTC’s increased scrutiny in this area and consider whether they are covered by the Rule.
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PBM abuse: to adequate pt access to their meds- cost of their meds – all to put $$$ to their bottom line
Posted on March 11, 2023 by Pharmaciststeve
Loretta Boesing has a little child that has had a transplant and was forced to use a PBM mail order pharmacy to get anti-rejection medication from her PBM mail order pharmacy. These medication(s) have a very specific temperature storage requirement – in order to maintain their potency. After her child started rejecting his/her transplanted organ — because the PBM mail order did not properly package these meds to maintain the required storage temp and thus the med did not maintain its proper potency.
This one single incident with Loretta’s child apparently brought out Loretta’s “MAMA BEAR INSTINCTS” and she has been on a crusade about mail order pharmacies in particular and their blatant disregard to maintaining FDA required storage temp when mailing medications to pts.
There is FIVE MAJOR PBM’S – all owned by insurance companies – and each having their own mail order pharmacy andcollectively controlling some 80%-90% of the reimbursement for all Rxs. Most all use some sort of financial disincentives to get their beneficiaries to use their mail order pharmacy or a particular chain pharmacy. Anything from higher deductibles & co-pays, no coverage, if not filled in their preferred pharmacy.
One company in particular is expanding via what is called vertical integration – CVS Health, who owns Aetna Insurance, PBM Caremark, Medicare Part D (Silver Scripts), specialty pharmacies, mail order pharmacies, Omnicare Nursing home pharmacies, Minute Clinics – in store “doc in a box” and other such expansions that it is hard to keep up with the “medical tentacles” this “medical octopus” is adding to its array of medical services provided.
Loretta has created an extensive assortment of videos of those involved with or adversely affected by the PBM industry. I was starting to try and share some of Loretta’s video but she has so many and she is constantly adding to them. I decided that I would just put the link below to her library of TicTok videos.
Below is a graphic that outlines into whose pockets the $$$ that the pt pays at the Rx register really goes. The PBM industry started the year I graduated from pharmacy school and first licensed. I have had a front row seat for the past 50+ yrs, to their financial shenanigans.
This particular video https://www.tiktok.com/@lorettaboesing/video/7209117283954740522?q=lorettaboesing&t=1678548023753 shows the arrogance of the PBM industry as a whole. Pay attention to President Biden when he talks about lowering prescriptions prices, the insurance/PBM industry is never mentioned as a source of reducing Rx pricing. Maybe because as a former Senator, Biden understands the “army” of lobbyists and attorneys that the insurance/PBM industry could cause to descend on Congress when they were for/against something. Biden was first a Senator in 1973, I am sure that he is well aware of their abilities and why he doesn’t mention them as part of lowering Rx prices
https://www.tiktok.com/search?q=lorettaboesing&t=1678548023753
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PBM before Indiana Legislative meeting
Posted on March 10, 2023 by Pharmaciststeve
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Dr. David Suetholz, MD:was convicted by a jury in September, 2022 of prescribing controlled substances to three patients
Posted on March 10, 2023 by Pharmaciststeve
https://doctorsofcourage.org/david-suetholz-md/
Dr. David Suetholz, MD, 74, is a family medicine doctor who practiced in Ft Mitchell, KY. Suetholz also served in the Kenton County Coroner’s Office for over 40 years, 30 of which he served as coroner. He retired from that position in June 2021 but continued his private practice. He has worked as a family physician for over 45 years
He was convicted by a jury in September, 2022—in spite of the Ruan v. United States decision in June of that year—of 12 counts of prescribing controlled substances — oxycodone, OxyContin and fentanyl — to three patients from September 2018 to February 2020. Ten of those counts are shown:
The government’s case was based on their charge that Dr. Suetholtz
“unlawfully prescribed controlled substances to his patients outside the usual course of professional practice and not for a legitimate medical purpose. Some patients were prescribed high doses of medication and in dangerous combinations without justification. Suetholz also prescribed to patients without assessing their risks for addiction or their past history of substance abuse.”
Excuse me! The prescriptions shown are of low dose and minimum number for effective pain relief. And none of these were filled early, but in actuality many lasted longer than they needed to. So how could he have been found guilty? Simply by the propaganda that people now believe—that opioids cause addiction, so doctors are drug pushers.
Following his conviction, Dr. Suetholz’s lawyers filed a motion asking the federal court to reverse his conviction or grant him a new trial, saying that, given the evidence presented in court, “no reasonable jury could conclude beyond a reasonable doubt that he knowingly or intentionally violated the law.”
“Not a single witness testified Dr. Suetholz was doing anything other than treating his patients in the best way he knew how,” the lawyers said in court filings. “The evidence painted a picture of a trusting and selfless healer who treated patients like family and would do anything to help those who are struggling.”
In court filings, Suetholz’s lawyers also claimed the court erred during the trial. Those alleged errors include:
- Instructing the jury on deliberate ignorance.
- Allowing prosecutors to admit evidence of “unrelated” medical licensure board proceedings.
- Permitting the admission of “extremely prejudicial” evidence of uncharged patient deaths.
- And prohibiting defense lawyers from admitting the government’s recorded statement of one of Suetholz’s patients.
Now why would a government employee for 40 years become a target for the DOJ? Basically for 2 reasons. His age means that he has assets. And in Kentucky, a lot of law enforcement jobs depend on the systemic attacks on doctors for prescribing opioids. Since the Ruan SCOTUS decision is falling on deaf ears in the DOJ—which I warned people would happen—they know that the conviction will ride on the propaganda in the jurors’ heads that simply by prescribing opioids the doctor is guilty. Those reaping the benefits of this illegal attack are trial attorneys Dermot Lynch and Maryam Adeyola, Assistant Attorney General Kenneth A. Polite, Jr., U.S. Attorney Carlton S. Shier, IV, FBI, DEA, HHS, and the Kentucky Medicaid Fraud Control Unit, among others.
Just to show the REAL cause of these attacks, here is the forfeiture paperwork in the indictment: 2021 Indictment
Are you getting tired yet, of good, compassionate physicians lose their livelihood and more because of a rogue DOJ? We have the answer on DoC. I teach the REAL cause of addiction. People just won’t learn it and pass it on. So these attacks will continue and more pain patients will suffer. I predict that if people don’t join my effort to get the truth out, then there won’t be any opioids by 2030. But, if you aren’t willing to learn what will stop it, you are doomed to live it. It’s YOUR choice.
Dr. Suetholz is scheduled for sentencing later this month.
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Ankle Docs See Falling Medicare Payments
Posted on March 10, 2023 by Pharmaciststeve
Ankle Docs See Falling Medicare Payments
https://www.medpagetoday.com/meetingcoverage/aaos/103471
Inflation-adjusted reimbursements for fusion, joint replacement slip
LAS VEGAS — From 2000 to 2020, Medicare reimbursements for ankle arthroplasty have fallen more than 30% after adjusting for inflation, and payments for ankle arthrodesis declined nearly 7%, a researcher said here.
Meanwhile, the volume of these procedures has more than doubled over that time, according to Olufunmilola Adeleye, MBA, a medical student with the Mayo Clinic in Scottsdale, Arizona.
“These trends should be understood and considered by surgeons, healthcare administrators, and policy-makers in order to develop and implement agreeable models of reimbursement while ensuring access to quality surgical orthopedic foot and ankle care in the United States,” she told attendees at the American Academy of Orthopaedic Surgeons’ annual meetingopens in a new tab or window.
She noted that, as Medicare moves away from its traditional fee-for-service model, there may be opportunities for exactly such conversations.
Physicians in all specialties have long complained about inadequate and seemingly arbitrary payment schedules in Medicare. Now they may have more ammunition to back that argument.
Adeleye and colleagues pulled Medicare reimbursement data for diagnostic codes related to ankle replacement and joint fusion for 2000-2020, along with changes in the consumer price index that the group used to adjust for inflation.
The researchers counted just over 100,000 such procedures performed during these 2 decades. Rates soared from 0.88 per 10,000 beneficiaries in 2000 to 1.98 per 10,000 in 2020. Adeleye and colleagues also found that arthroplasties increasingly dominated the landscape.
Payments for arthrodesis averaged about $1,200 in 2000, while for total arthroplasty the mean reimbursement was roughly $950. Payments for both procedures declined substantially and steadily at about the same rates through 2010. At that point, the inflation-adjusted means for arthrodesis and arthroplasty were about $950 and $700, respectively.
In the second decade, average reimbursement for arthrodesis recovered somewhat, ending at $1,150. But payment for arthroplasty continued to fall, below $650 as of 2020. Overall, the declines were 6.91% and 30.15%, respectively.
“Your study made me very sad,” quipped session co-moderator Christopher Gross, MD, of the Medical University of South Carolina in Charleston, during the discussion after Adeleye’s presentation.
Gross told MedPage Today that he knew of no real reason for the decline in Medicare reimbursement. If anything, he said, these arthroplasties and arthrodesis procedures are more costly than ever. Implants have become dramatically more expensive and now clinicians may use patient-specific instrumentation. “That’s another $1,500,” he said. He acknowledged that average operative time may be shorter “by maybe 30 minutes,” but that is more than offset by increases in most other costs.
His feeling is that CMS is simply trying to save money with a special focus on procedures for elderly, whose numbers are rapidly growing as Baby Boomers age. Medicare payments don’t appear to reflect actual costs but are merely arbitrary, he said.
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does the body’s metabolism of acetaminophen produce toxic metabolites
Posted on March 9, 2023 by Pharmaciststeve
The article states that they had data from 1998 to 2019, but it is not mentioned any analysis of liver toxicity using the data after the 2016 CDC opioid dosing guidelines until the end of data that they had. Is a 3-4 yr period not statistically significant enough for a valid comparison or did the statistics do a “turn around” after the CDC published those dosing guidelines and all too many chronic pain pts’ opiate doses were reduced or completely cut off and the pts were told to take a NSAID and/or Tylenol/Acetaminophen and this group did not want to divulge the reality of liver toxicity associated with the use/abuse of Tylenol/Acetaminophen.
This quote seems to reference that a liver toxic dose can’t be figured out, because: Furthermore, Ghany and Watkins wrote, “doses as low as 200 mg daily have been associated with toxicity, and conversely doses of more than 12 g per day have not.” This appears to be a “back door” reference to pharmacogenomic testing as to how individualized Tylenol/Acetaminophen dosing and liver toxicity can be linked. It may also suggest that without pharmacogenomic testing be done on all pts in the study and that test did not start being available until sometime after our DNA was fully mapped and that was around year 2000.
From CHAT GPT: does the body’s metabolism of acetaminophen produce toxic metabolites
Yes, the metabolism of acetaminophen can produce toxic metabolites if taken in excessive amounts or if the liver’s detoxification pathways are overwhelmed. The primary pathway for the metabolism of acetaminophen is through conjugation with glucuronic acid and sulfate in the liver, which leads to the formation of non-toxic metabolites that are excreted in the urine.
However, when the liver’s capacity to metabolize acetaminophen is exceeded, a small percentage of the drug is metabolized via a different pathway, which leads to the formation of a highly reactive metabolite called N-acetyl-p-benzoquinone imine (NAPQI). NAPQI can cause oxidative damage to liver cells and lead to liver failure if not promptly detoxified by the liver’s antioxidant defense system.
Therefore, it is essential to follow the recommended dosage of acetaminophen to avoid toxicity and to seek medical attention if you experience symptoms such as abdominal pain, nausea, vomiting, or jaundice, which may indicate liver damage.
FDA Mandate on Acetaminophen-Opioid Combinations Appeared Effective
https://www.medpagetoday.com/gastroenterology/generalhepatology/103418
Hospitalizations for liver toxicity declined after FDA limited acetaminophen dose
An FDA mandate limiting the amount of acetaminophen in combination with opioids in prescription products was associated with significant declines in hospitalizations due to acute liver failure (ALF), according to an analysis of national medical databases.
The analysis by the U.S. Acute Liver Failure Study Group found that although the percentage of ALF cases involving acetaminophen and opioid toxicity had been increasing by 7% per year before the mandate, the percentage decreased 16% per year afterward (P<0.001), reported Jayme Locke, MD, of the University of Alabama at Birmingham, and colleagues. The mandate was announced in 2011, and manufacturers had until 2014 to comply.
The odds of hospitalization with acetaminophen and opioid toxicity had been increasing by 11% per year prior to the mandate (OR 1.11, 95% CI 1.06-1.15) but decreased by 11% per year afterward (OR 0.89, 95% CI 0.88-0.90, P<0.001 for trend), the study found.
“In contrast, the yearly rate of hospitalizations and proportion per year of ALF cases involving acetaminophen alone increased after the mandate,” the researchers wrote in JAMA, adding that the finding is further evidence that the FDA action targeting acetaminophen-opioid combinations worked.
The mandate limited the amount of acetaminophen in combination products to 325 mg and required manufacturers to label the products with a boxed warning about the risk of severe liver injury. Prior to the FDA action, the combination products could contain as much as 750 mg of acetaminophen.
Locke and co-authors noted that more than 60,000 people in the U.S. are hospitalized each year with acetaminophen toxicity, often due to intentional overdose. However, 40-58% of ALF cases due to acetaminophen hepatotoxicity are unintentional, and many of those involve combination acetaminophen-opioid products.
Furthermore, patients are often unaware that the products they take contain acetaminophen, the researchers said. For example, one survey of opioid users in the general population found that less than half correctly identified acetaminophen-containing products; and in another survey of patients in a general medicine clinic, only 15% correctly identified commonly prescribed combination products as containing acetaminophen.
The FDA should be “heartened” by the results, said Marc Ghany, MD, of the National Institute of Diabetes and Digestive and Kidney Diseases in Bethesda, Maryland, and Paul Watkins, MD, of the Eshelman School of Pharmacy at the University of North Carolina at Chapel Hill, writing in an accompanying editorial.
They added that the agency should continue efforts to improve the safety of acetaminophen through public health policies and that the best solution would be the development of safer, more effective analgesics.
However, Ghany and Watkins said, a safe dose of acetaminophen has not been well established. “The product label advises 4 g per 24 hours. However, the safety of the drug is influenced by many host factors (e.g., age, genetics, nutritional status) and environmental factors (e.g., alcohol) that make it difficult to determine what is a safe dose in a particular individual,” the editorialists said.
One study found that at the recommended dose of 4 g per day, alanine aminotransferase level elevations more than three times the upper limit of normal were seen in 31-44% of persons receiving acetaminophen combined with opioids or acetaminophen alone. Furthermore, Ghany and Watkins wrote, “doses as low as 200 mg daily have been associated with toxicity, and conversely doses of more than 12 g per day have not.”
Locke and co-authors analyzed data from the National Inpatient Sample, a large U.S. hospitalization database, and the Acute Liver Failure Study Group, a cohort of 32 U.S. medical centers. The researchers examined rates of hospitalizations related to acetaminophen-opioid products compared with hospitalizations due to acetaminophen alone before and after the FDA mandate.
The study included data from 1998 through 2019. During that time, there were 39,606 hospitalizations for acetaminophen and opioid toxicity. The median age of patients involved was 42, and 66.8% were women.
One study limitation, the researchers said, was the lack of a clearly defined washout period, because some individuals likely had combination products containing more than 325 mg of acetaminophen between the FDA announcement in 2011 and the mandate deadline in 2014. “This study used several different cut points, although lack of a defined washout period would likely bias toward the null,” the team said.
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5 women sue Texas over denial of appropriate medical care
Posted on March 9, 2023 by Pharmaciststeve
5 women sue Texas over denial of appropriate medical care
https://abcnews.go.com/Health/5-women-sue-texas-abortion-bans-lives-put/story
Five women are suing the state of Texas over its strict abortion laws, saying they were denied the procedure even though their lives were in danger.
The lawsuit — filed in state court Monday by the Center for Reproductive Rights — marks the first time that women, rather than doctors on behalf of their patients or advocacy groups, have taken legal action since the Supreme Court overturned Roe v. Wade.
According to the lawsuit, the women were “denied necessary and potentially life-saving obstetrical care because medical professionals throughout the state fear liability under Texas’s abortion bans.”
MORE: How some providers are working around abortion bans since Roe v. Wade was overturned
“It is now dangerous to be pregnant in Texas,” Nancy Northup, president and CEO of the Center for Reproductive Rights, said during a press conference outside the Texas Capitol. “Doctors and hospitals are turning patients away, even those in medical emergencies. Patients are being denied life-saving obstetrical care.”
Texas does not allow abortions after six weeks of pregnancy except for “medical emergencies,” which is not defined. The suit asks that physicians be allowed to determine what qualifies under the exception.
The five women — Ashley Brandt, Lauren Hall, Lauren Miller, Anna Zargarian and Amanda Zurawski — said they were all excited about their pregnancies but were denied care when their lives were in danger, the lawsuit states.
Lauren Miller, who had to travel to Colorado to have an abortion for one of her twins, at home in Dallas, March 5, 2023. Five women who say they were denied abortions despite grave risks to their lives or the lives of their fetuses sued the state of Texas on March 6.
Nitashia Johnson/The New York Times via Redux
Zurawski, 35, from Austin, was diagnosed with an “incomplete cervix” — which occurs when cervical tissue weakens and prematurely dilates the cervix — at 17 weeks and was told her baby would not survive, according to the lawsuit.
Under Texas’s abortion law, doctors said there wasn’t much they could do for Zurawski because cardiac activity still could be detected.
After she developed sepsis, Zurawski said she was induced so she could deliver the fetus. She developed sepsis again and had so much scar tissue from the infections that one of her fallopian tubes is permanently closed, the lawsuit states.
Hall, 28, from outside Dallas, was told her baby would not survive after a scan revealed the fetus had anencephaly, a condition in which a baby does not develop a skull and had a severely underdeveloped brain.
A maternal-fetal medicine specialist told her continuing the pregnancy could result in hemorrhage or pre-term birth but that she couldn’t have an abortion due to Texas’ laws. Hall was forced to travel to Seattle for the procedure.
MORE: Why doctors say the ‘save the mother’s life’ exception of abortion bans is medically risky
Miller, 35, from Dallas, learned she was carrying twins but a scan at 12 weeks showed one of them had trisomy 18, which is a chromosomal condition that results in severe abnormalities and developmental delays.
According to the lawsuit, she traveled to Colorado to receive a selective fetal reduction, which aborted the fetus with the chromosomal condition. Miller continued her pregnancy with the other twin, who has shown no signs of abnormalities, and she is due the end of the month.
“It shouldn’t be controversial for an individual to make health care decisions for themselves in consultation with their doctor, but you can’t get that in Texas anymore,” she said during the press conference.
Brandt, 31, from Dallas, Texas, also learned she was pregnant in May 2022 with twins. A scan, however, revealed that one had a condition known as acrania, which is when the fetus does not develop a skull, the lawsuit states.
The condition progressed to exencephaly, in which brain tissue is freely floating in amniotic fluid. Continuing the pregnancy could have increased her risk of miscarriage or premature labor. She, too, traveled to Colorado after being unable to obtain an abortion, according to the lawsuit.
The final plaintiff, Zargarian, 33, from Austin, was 19 weeks pregnant when she said she was diagnosed with preterm premature rupture of membranes, which occurs when the membranes break before a woman goes into labor.
Elizabeth Hernandez, a medical assistant at Women’s Reproductive Clinic of New Mexico in Santa Teresa, N.M., prepares mifepristone, the first medication in a medical abortion for a patient, Jan. 13, 2023. The abortion clinic, less than a mile from Texas, wh…
Evelyn Hockstein/Reuters
She was at high risk of sepsis or hemorrhaging if she continued the pregnancy but could not obtain an abortion. Zargarian also went to Colorado to obtain an abortion, legal filings show.
“You never know when you or someone you know will need [an abortion],” Zargarian said during the press conference.
In September 2021, the state passed the so-called Texas Heartbeat Act — better known as SB 8 — which bans abortions after fetal cardiac activity can be detected, which typically occurs around six weeks, before most women know they’re pregnant.
The law does not include exceptions for rape or incest or if the fetus has a fatal or untreatable condition. The only exception is for “medical emergencies,” but it is undefined, making it unclear what qualifies.
SB 8 also allows private citizens to sue anyone who “aids or abets” an abortion.
MORE: If an abortion drug is banned, could misoprostol be used as a safe alternative?
Additionally, after Roe v. Wade was overturned by the Supreme Court, Texas passed a trigger law making abortion a second-degree felony “for a person who knowingly performs, induces, or attempts an abortion.”
If the pregnancy is successfully aborted, the offense becomes a first-degree felony, according to the law.
According to the Texas Penal Code, the punishment for a first-degree penalty could be up to life in prison and a fine of up to $10,000. The penalty for a second-degree felony is up to 20 years in prison and a fine of up to $10,000.
In a statement, Vice President Kamala Harris expressed support fro the lawsuit.
“The lawsuit includes devastating, first-hand accounts of women’s lives almost lost after they were denied the health care they needed, because of extreme efforts by Republican officials to control women’s bodies,” she said.
The statement continued, “Like the overwhelming majority of Americans, the President and I believe women — in consultation with their doctors — should be in charge of their reproductive health care, not politicians.”
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Boards of Medicine Are a Sham
Posted on March 8, 2023 by Pharmaciststeve
Boards of Medicine Are a Sham
https://doctorsofcourage.org/boards-of-medicine-are-a-sham/
Here is a letter from Eric Dover, MD, on the deliberate attacks on doctors by their Boards of Medicine. This was in response to an Oregon ABC affiliate, KATU, media article by Wright Gazaway on Mar.1, 2023 pertaining to the revoking of physician licenses being nationally controlled instead of state controlled. Dr. Dover is an advocate for doctors who have been indiscriminately targeted by their state boards of medicine for removal from practice.
Mr. Gazaway
Where do I begin?
After reading your article it was clear neither you nor Wyden have any clue as to what you are talking about. In reality, Wyden knows the score, so all I can assume is he doesn’t care if he hurts physicians, their families or patients.
Wyden is a big part of the problem regarding the discipline issue you wrote about. He pushed through the HealthCare Quality Improvement Act of 1986 (HCQIA) which has allowed state medical boards and the 501(c)6 Federation of State Medical Boards (FSMB) to have absolute control over physician licensees. Typically, a nucleus of about 4-5 people at medical boards determine who they ‘discipline’. It is typically an AAG from the DOJ, the Executive director, the Medical Director, the investigator for the case, and a Board member. The rest of the board members are a rubber stamp. They also revoke licenses of those they ‘don’t like’ for any reason. Licensees are defenseless, because medical boards control the entire process. As far as ‘legal representation’ for physicians, there is no ‘effective’ representation available. Legal representation at the medical board consists of a lawyer “plea bargaining” on behalf of a licensee with the medical board. This concentration of power at medical boards allows them to full-on assault physician licensees, but at the same time allows medical boards to protect their friends, partners, associates, etc. from medical board disciplinary action for horrendous medical outcomes or criminal actions.
HCQIA has made it very easy for entities such as medical boards or hospitals to get rid of competitors or individuals they dislike for any reason. In the 1980s, a federal case was filed in Portland Federal District Court that involved a ‘physician competitor’ being attacked by the Astoria Hospital Executive Board in Astoria, OR and the Oregon Medical Board (OMB). There was a member on the Executive hospital board and a member of the OMB that were from the Astoria Clinic whom Dr. Timothy Patrick had snubbed regarding employment. The case went all the way to the SCOTUS. PATRICK v. BURGET, 486 U.S. 94 (1988) https: //caselaw.findlaw.com/us-supreme-court/486/94.html. Dr. Patrick won his case at the District Court and Supreme Court. This is the last time a physician was able to protect themselves from a medical board. While this case wound its way through the Federal courts, HCQIA was put together by Wyden. He had full knowledge of how this would ultimately affect the practice of medicine in the United States.
Physician licensees have no constitutional or due process rights. Medical boards control the entire process; they act as the investigator, jury, judge and executioner – a completely closed loop so that only their story of the situation is given to the media, general public, NPDB and the FSMB Data Bank. Medical boards control every aspect of the sham hearing process, which in reality is a sham trial to revoke the licensee’s license, i.e. their property. Licensees have no access to ‘effective’ counsel because medical boards like the OMB have control over lawyers who are involved with representing licensees. The control mechanism is the lawyer’s access to investigators, administrators, lawyers, etc. at the medical board as they plea bargain on behalf of their client. If a licensee is scheduled for a hearing, they have already lost. Medical boards never lose a sham hearing, and why would they when they make the rules and run the show without any oversight. The Administrative Law Judge (ALJ) at the sham hearing is just for pretenses. The ALJ typically comes down on the side of the medical board, but just in case they don’t, most medical boards can simply overrule the ALJ’s decision.
Medical boards claim they have at least sovereign immunity, if not absolute immunity, as a result of Wyden’s HCQIA. The state courts and lower federal courts had looked upon the immunity issue similarly up until the North Carolina State Board of Dental Examiners v FTC 135 S. Ct. 1101 (2015) decision which defined the requirements needed for board members to obtain sovereign immunity from lawsuit.
Physicians are being heavily disciplined, don’t think otherwise. There are physicians who do bad things – no doubt. Unfortunately, the system many times chooses to ‘discipline’ licensees who have harmed no one. Every year, the equivalent of almost 20% of each year’s graduating class has their license revoked and/or their careers irreversibly crapped on. That data comes straight from the FSMB’s website. Do you believe that the medical schools and residency programs are doing that poor of a job selecting candidates? I doubt that. It’s more likely medical boards and the FSMB harvesting their own for monetary gain.
There are 350 to 400 plus physician suicides every year, most being tied to current or past medical board cases that have robbed physicians of their dignity and income. I personally know two physicians who have committed suicide.
Medical boards are under the direction of the FSMB.
The FSMB is a tax exempt 501(c)6. The FSMB states it’s lobbying for medical boards, but in the past, they have been open to corporate influence. They have legal and legislative programs to push their medical board agenda. This makes it very easy for them to take in ‘donated’ money and spin their lobbying in a beneficial way for a ‘donor’.
We know of at least one instance of the FSMB taking millions of dollars from a drug manufacturer. It involved Purdue Pharmaceuticals and Oxycontin. Senators Grassley and Bauchus of the Senate Finance Committee opened an investigation because of public concern about opiate prescribing and deaths. The entirety of the investigation was later sealed from the public by Senate Finance Committee members Grassley and Wyden. After the investigation, the medical boards began attacking chronic pain physicians for prescribing too many opiates. Pain patients have suffered severely
Once a physician’s private property medical license is revoked, they will never work in any capacity in medicine again. The physician can’t get licensed in any other state. The FSMB notifies every state board about the licensee’s revocation, in particular those states that the licensee is additionally licensed in. I know a licensee who simply had his license restricted for opiate prescribing. He has no idea who made the complaint or what the complaint was. His license was restricted 9 years ago. It was only supposed to be restricted for 5 years. His twin boys who were 5 years old at the time are now 14. They suffer from PTSD and anxiety. Their parents divorced as a result of financial and emotional stress. Their father can only find minimum wage work, has no car and lives in a rusty RV as a homeless man. The State of Oregon wouldn’t even let him drive a school bus because of the OMB license restriction. He eventually got a medical license in Utah, but no one will hire him, he can’t get hospital privileges, no one will sell him medical malpractice insurance and insurance companies will not contract with him to see their patients. Every ‘medical’ entity has the ability to go to the National Practitioner Data Bank (NPDB) and FSMB Data Bank and find out anything related to the physician licensee that these data banks have available. So, ‘Shuck and Jive’ Wyden’s and your take on physician discipline is nowhere near reality. Question, why is physician ‘discipline’ suddenly an ‘issue’?
I know many physician licensees from Oregon and across the United States that would be happy to relate their medical board stories to you. Medical boards and the FSMB especially love to attack and revoke Integrative Medicine physicians (MDs or DOs who incorporate both allopathic and naturopathic medicine). The FSMB hates Integrative Medicine physicians and I have their internal document that specifically states that they are directing medical boards to attack and remove these physicians from medical practice. The reason: The public makes more visits and spends more money out of pocket for Integrative Medicine physicians than allopathic primary care physicians. As usual, it’s about money. The medical boards have had a hard on for Integrative Medicine physicians since this document. See (SPECIAL REPORT BY FSMB ON INTEGRATIVE MEDICINE DOCTORS).
If you’d like to know more about me, the OMB, the FSMB, other licensees, my published chapter “Functioning as a Physician in a Regulatory Environment [Controlled by Medical Boards and the Medical Industrial Complex] (January 2016) and numerous documents, go to drdovervsomb.weebly.com
Respectfully,
Eric Dover, MD
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Former DEA agent: assets can determine whose office practice they raid
Posted on March 8, 2023 by Pharmaciststeve
start watching video around 00:30 https://www.tiktok.com/@bilkedtothebrink/video/7170431661136465194?_r=1&_t=8aUCzL4beaQ Here is a “help wanted ad” from the DEA https://www.pharmaciststeve.com/forfeiture-financial-specialist-supporting-the-dea/
BIRMINGHAM, Ala. (WHNT) – A federal judge sentenced a Tennessee physician and his wife on Monday for unlawfully distributing opioids and defrauding insurers through their now-shuttered Alabama clinics.
Mark Murphy, 65, and his wife, Jennifer, 65, both from Lewisburg, Tenn. were convicted of conspiracy to distribute controlled substances and conspiracy to commit health care fraud, along with various substantive counts related to the same, and conspiring to defraud the United States and receiving kickbacks.
The Murphys were sentenced to twenty years each in prison
The Murphys owned and operated North Alabama Pain Services (NAPS). The couple closed both the Decatur and Madison offices in early 2017.
The U.S. Department of Justice (DOJ) said over a five-year period before the clinics closed Murphy wrote prescriptions for more than ten million opioid pills, including millions of oxycodone 30 mg tablets. The Murphys also ordered tens of millions of dollars of unnecessary items and services that were paid for by taxpayer-funded and private insurance programs.
The DOJ said Murphys received kickbacks for those orders and prescriptions. In all, Medicare, TRICARE, and Blue Cross Blue Shield of Alabama were billed more than $280 million as a result of the fraud and kickback schemes and paid more than $50 million.
After Mark Murphy closed the Alabama clinics he continued to work from his Tennessee practice in Lewisburg which was raided by FBI agents in 2018 and was indicted in 2020 along with his wife and four other people.
“Dr. Murphy and his wife preyed on countless vulnerable patients and stole tens of millions of dollars from Medicare and other taxpayer-funded health insurance programs,” said U.S. Attorney Escalona in a statement. “Our office will continue to prosecute drug dealers and health care fraudsters to the full extent of the law.”
“The abuse of prescription drugs, especially opioids, is a serious problem in our communities,” said DEA Assistant Special Agent in Charge Towanda Thorne-James. “All too often, this abuse leads to addiction, shattered lives, and even death. For the health and safety of our citizens, DEA and our law enforcement partners will continue to target those who illegally distribute these potentially dangerous drugs. We hope that the sentences, in this case, serve as a reminder to anyone who might illegally divert pharmaceuticals that they will be held accountable for the harm they cause.”
“Mark and Jennifer Murphy learned today that unlawfully distributing controlled substances, committing health care fraud, and receiving kickbacks comes with hefty legal consequences,” said James E. Dorsey, Special Agent in Charge, IRS Criminal Investigation, Atlanta Field Office. “Their conviction today serves as a lesson to others who think no one is paying attention.”
Mark Murphy and Jennifer Murphy were each ordered to pay more than $50 million in restitution. Jennifer Murphy was also convicted of tax-related charges for underreporting clinic income.
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