Oregon Medicaid Opioid Policy Drawing Fire

Oregon Medicaid Opioid Policy Drawing Fire

By Ed Coghlan.

A proposed policy that would restrict Oregon chronic pain patients on Medicaid access to opioids for chronic pain may be hitting a wall of resistance. A group of individuals called the Oregon Pain Action Group organized a protest on Thursday and it attracted media coverage both in Oregon and through an article on the National Pain Report.

The Oregon Health Evidence Review Commission (HERC) and its subcommittee Value-based Benefits Subcommittee (VbBS)will be submitting their proposed changes to Medicaid to discontinue long term opioids for chronic pain and fibromyalgia before August 9th meetings. The result of the media coverage is an increase in public comments to HERC from people living in Oregon and beyond which will become part of the public record.

More comments are expected.

While this policy is aimed specifically at Oregon’s Medicaid population, organizers in Oregon believe that whatever policy is adopted will be adopted by every insurance company.

Reaction to our story was swift and overwhelmingly critical. In less than a day several dozen persons, mostly chronic pain patients, wrote in the comment section of the National Pain Report and were unanimously opposed to the forced taper provision.

Other leaders from the pain community also weighed in over the weekend.

Bob Twillman, Ph.D., is the Executive Director for the Academy of Integrative Pain.  On Twitter, he said, “Beware the negative unintended consequences! This is just WRONG! Need patient-centered care, not draconian blanket regulations.”

Richard “Red” Lawhern, who is Co-Founder and Corresponding Secretary of the Alliance for the Treatment of Intractable Pain already has submitted a comment to HERC that included the following. “No non-pharmacological therapies for chronic pain have yet completed Phase II or Phase III trials.  Proposals to substitute these experimental methods for FDA-approved opioid therapy comprise a profound violation of widely accepted standards of medical evidence.  Denial of opioid therapy also constitutes a substantive risk to patient welfare and even life itself.”

Terri Lewis, Ph.D. pointed out the Oregon situation is another example of where states are pursuing policy in the absence of a national approach. It’s creating chaos for chronic pain patients.

“The situation in Oregon illustrates clearly the problem of our failure to uniformly define the range of public health care interventions that must be maintained to serve people on a continuum of health care no matter their age, illness, or geographic location. The cure for this conversation is for us to legislative append a definition of palliative care into Medicare law that is consistent with existing world health organization language.

“CMS should then define and flow down to Medicaid and other insurance plans the palliative care codes that enable appropriate care and require states to provide evidence that they are meeting the obligation to provide for and maintain resources for those with multiple chronic comorbid conditions.

“What is the matter with the Oregon Health Authority, that they believe it is okay to deny palliation for their citizens?  Have they found a cure that they refuse to share with the rest of us?  This is not the practice of medicine and it will cause great harm to their citizens.”

If you want to comment on the policy, you may via email. The address is herc.info@state.or.us. The Oregon Pain Action Group suggest you submit the comment by August 2nd. The limit, by the way, is 1000 words.

The comments are limited to 1000 words and it is recommended you put “VbBS” in the subject line to assure your comment is part of the record.

Subscribe to our blog via email

Enter your email address to subscribe to this blog and receive notifications of new posts by email.

Authored by: Ed Coghlan

23
Leave a Reply

2500
23 Comment threads
0 Thread replies
0 Followers
 
Most reacted comment
Hottest comment thread
22 Comment authors
  Subscribe  
newest oldest
Notify of
Marin5

I am on Medicare/medicaid And also United Health Care, and have been prescribed Vicodin for my chronic pain for more than 2 years. it does not take away my pain, just
makes me able to function a little better, but would be unbearable without it! I am 85 years old and
disabled Female. I am on Oxygen and inhalers for COPD Chronic lung disease diagnosed in 1998
after being exposed to Asbestos
being removed in my cellar. Also Hashimoto’s Thyroiditis disease
diag. 35 years ago, and Fibromyalgia, osteoarthritis, Bursitis, Tenddonitis,all diag in 2011, degenernative disc disease,
unstable cervicle Spine, A-Fib heart, and heart murmur, Lichen
Sclerosis, and about 6 months ago my pharmacy, Rite aid said they couldn’t get it anymore, and wasn’t even trying, I was panicing,
until Inwas able to get it filled at a Wallgreens. Now after all this,time they have also said they can’t get it and I have never asked my doctor for an increase , or a change in drugs, they said the DEA took it off the market! But I called another Wallgreens and told them I had a script and for how many and asked if they could fill it and she said yes. But now, reading how Omaha is trying or actually stopping people on medicaid who are chronic pain suffers, to be refused opioids, It seems to be trickling down here, as they said it might! The republicans who have spent the S.S. funds that belong to the people want to get rid of all the old people so they don’t have to send their checks every month.I also have my right hip and leg 1 1/4″ higher(shorter) than the left that makes me crippled!

marin5

I am working with two other nationally recognized journalists to assure that the malpractice and malfeasance of the Oregon Health Plan are prominently discussed and debated in national media. I am also lobbying House and Senate staffers to inform their legislators of the unsupportable idiocy of this group of anti-opioid partisans. Many of us in the Alliance for the Treatment of Intractable Pain are supporting efforts to “out” these fools and reveal the fundamental frauds they are pushing. As Ed notes, the so-called “alternative” treatments they are trying to substitute for safe and effective opioid therapy have no record of large-scale trials, and no record of efficacy as substitutes.

Thanks Ed, for continuing to push for balance and fairness in public policy on opioid therapy in chronic pain.

Tiffany

VbBs:
I believe this falls under cruel and unusual punishment. I have PERMANENT spinal damage, fibromyalgia, and arthritis in my neck and lower back. If not for opiates walking upright would be distant memory. As it is I have literally crawled up the stairs to get to my home. I’m still persuing treatments. I had surgery on my neck where they put in fake discs and a titanium plate. They couldn’t fix everything, there is too much damage. I cry from the constant pain. Opiates mask it, but completely. I suffer from bipolar/ptsd as it is and have made attempts on my life. I fear if the pain on full blast I won’t fail again. Please don’t do this to us.

Those of us who suffer from chronic pain should not be underestimated, because we are very strong and persistent people. We have learned this in order to survive with pain everyday and still function and provide for ourselves. I am a 53 year old woman with a severely painful disorder called Ehler’s Danlos Syndrome, Crohn’s Disease and arthritis throughout my body. I have lived a very healthy lifestyle, but unfortunately my conditions are inherited. I’ve spent over 50% of my adult income, when I was able to work on getting a proper diagnosis and trying every possible therapy in order to keep my pain under control. I was a single parent, guardian for my mother with Alzheimer’s and became self employed, in order to earn income with my disabilities. I cleaned houses until I was unable and then I became a caregiver. Two years ago, I had to quit working due to pain. I have tried every single alternative therapy, and injection therapy. Last year, I had surgery for an electronic spinal cord stimulator, which insurance doesn’t pay for unless a person has tried just about every option to alleviate pain.
I am prescribed a small amount of narcotics in order to remain functioning, but my pain level never goes below a 7 on a scale to 10. I am writing a book, very slowly from bed, because I am unable to stand or sit up for long periods of time.
Without pain medication, my pain level is excruciating, due to nerve damage. I can’t think straight and would not be able to live without agony. I want to remain independent and have always taken my medications carefully. I am not addicted and have been on meds for over 5 years. I take a holistic approach, for pain management, and all my doctors agree I’ve been tried all I can. Surgery, creams, Tylenol, breathing, stretching, ice, heat, massage, distraction therapy, laughter and narcotics all play a role in keeping me functioning. So many people are responsible with their medications and need them to function, so screening patients is a better approach to preventing addiction of opioids. Please don’t rob those of us in pain from the little good quality of life we have. Pain medication seems to be the only way I receive just enough pain relief to function. Some of us want to use our pain experience to help others. I cannot even sit up to write my book, if I can’t receive pain relief. My condition will get worse.. It’s unethical to punish hurting patients because others abuse. Please take another approach.

Sheldon

Look when is our state governments going to understand that chronic pain patients have no age, gender or Creed nor rich or poor. If your suffering in intractable chronic pain then it alot of instances opiods are the one good sent those patients have. Alot of patients like myself who have done all the right things to abide by these ludicrous laws that our state and federal agencies have put on the most needy and suffering in our society now are trying to make the suffering go away by pushing those to suicide and needless suffering. When are our paid legislation gonna wake up and understand that this medication just like any other you need to survive is very much so needed. Long term opiods have been my saving Grace in regards to me having any life with my children and now that want to take my kids father. I don’t think so. To everyone who is subscribed and has any humanity in them FIGHT for patients rights. Stop this biased notion that we’re all just drug attics and speak to the people who suffer like myself. Most of those that are biased never have suffered in chronic pain. We are doing everything we can to have a life close to those that don’t suffer. Please stop the abuse of our citizens suffering, they do enough of that without government hindering there well being. People you have to get involved and stand up for what’s right. Organize and educate the ones who have been brain washed by these ignorant policies. It’s a fight for my life and I won’t ever stop fighting for my family. Stand up Oregon you have a right to the best healthcare don’t allow this to happen

One brief comment (still working on my letter to HERC); i do not believe that the consequences are “unintended.” It’s blazingly obvious to even the most blinkered politician that cutting off medications to chronic pain patients puts them into a tortured Hell….”Duh” doesn’t begin to cover it. They either don’t care or are actively in favor of sentencing such “parasites” to Hell.

The fact that it won’t address the real problem hasn’t slowed any of them down, nationwide. They don’t care about that, either; they just want to be able to prance around, loudly proclaiming how virtuous they are for “combatting” the “crisis.” All those thrown into the torments of the damned are being justifiably punished for creating the “epidemic” –reality be damned.

Wendy Sinclair

This is a tragedy in the making. We are fighting this! We will be having another protest on August 9th outside the meeting. Please come to the protest, if you are in Oregon. And for Oregonians and all other US citizens, send in your comments to HERC about this. This will spread to all other states, if passed. It will set a precedence. We can’t let that happen. Please join together with us and say NO, you can’t bully the vulnerable, chronically ill and in chronic pain law abiding citizens.

Terri McFarland

This is exactly how they started the forced tapering to 90mg eq. The state started with the poor who have no voice and then the other insurance companies jumped on the bandwagon. I’m convinced the consensus was and is that they could save a lot of money and if the state could get away with discriminating and hurting pain patients well then they would give it a try as well. I had been stable on pain medication for 14 years until I got a letter from OHP (Oregon Health Plan) stating that the medication I was taking needed to be discontinued or I would die. I believe 14 years would have been enough of a trial run to disprove that statement, but when I called they had no other reasons for discontinuing the medications.

Cin Har

It is truly a sad situation that people with conditions that have no cure are losing there medications that give them some sort of relief even if it might be temporary sometimes it still allows that person to have some sort of a life to be able to visit with their family and friends and feel like a human being I have had an incurable painful burning non-stop 24/7 bladder disease called painful bladder or intercystitial cystitis for over 30 years I had a doctor that was a true humanitarian and would hold my hand if I was having a bad pain day we need more humanitarians like him he was an angel to me he just retired but what I’m trying to say is to take away pain medications from senior citizens that have worked 40 to 50 years and paid into the system paid their taxes paid into Social Security Etc these elderly aging people that just want to go out of this world with some sort of dignity instead of being left to slowly rot away from not having their pain meds is the most inhumane thing I’ve ever heard of 20 & 30 year olds are the ones that have abused the pain meds not the 60 to 80 and 90 year old senior citizens it is truly sadistic and inhumane to take away pain meds and God forgive those that hv done such a horrific thing like that to people that just want to live their lives and continue to pay their bills and die with dignity and a little bit of relief I believe in heaven and I believe in hell and it’s very sad to think that come Judgement Day God will sit down and review the people that have intentionally hurt us with Non-Stop and intractable pain may God forgive you for what is being done to us God bless us all that are sick May some miracle cause things to change for us for the better thank you for reading

Heather

Sent a message today. Thank you for the information!

Michael

I’m sorry I’m from Oregon now.What has happened there?It used to be a state that helped people. Now they must have a bunch of bleeding heart idiot’s.They are probably from out of country. Who put these idiots in office.Send them back to where they came from.Let real Oregonians run the state not idiot’s that don’t know what their doing. Oregonians take our state back.

Kara

How utterly heartbreaking, inhumane, and downright evil!

Oregon, what are you thinking!?

This time in history will be remembered as the Dark Ages of medicine.

What Oregon is planning to do to all its innocent citizens makes me want to cry and scream! The daily agony is just too much to bare and people need access to relief that works best for their individual needs.

The first comment below by Dr. George really says it all!

It’s time for a revolution of minds & policies that benefit profiteers, and harm innocent and unwitting people. It’s time for the people to take back their government.

Taking away opioids from people that need them to manage pain will NOT cure addiction or stop people from abusing drugs.

The rate of addiction has NOT changed since 1920. It’s an illness and like any illness it doesn’t affect every single person. Simply taking an opioid does NOT make someone an addict. There must be a biological predisposition along with other external factors in order for addiction to occur. The general population is said to have a roughly 3 to 5÷ risk of addiction and it’s even less among people in chronic pain.

So, it has got to make people wonder … what’s their real motive (for their genocide)? Why are they okay with people committing suicide due to their pain no longer being relieved? So many questions with NO real justification and certainly NO real scientific evidence to back them up!

Angela Iacobucci

It is absolutely disgusting, unlawful, unethical, and , frankly, immoral to remove opiod therapy as an option for chronic pain patietoents. I am 9ne of those patietient that has been on opiod therapy for more than three years. The therapy allows me to successfully manage my pain while maintain a job, paying taxes, and being a supportive member of society. Without this medical care, i would be in debilitating pain every day. I would not be able to work. As a result, my family would be without a way to pay bills, maintain a mortgage, and live a normal life. The alternative is for my family to lose everything i have tried to build over the last 35 years because my back has developed degenerative disc disease. I am frightened that with these nee policies i will find myself and my family a drain on the system if we dont become homeless. The only outcome for those of us on chronic pain that will NEVER go away is seeking out illegal drugs to help manage the pain or suicide. It is NOT right that beaucrats with the stroke of a pen can ruin my life. I take my meds exactly as prescribed, my pain is contolled, and i can continue to function normally. Why is this a bad thing? Why can these jerks play god? Whay about the ten of thousands of people were are benefitimg every day from successful opiod therapy? Why are we getting punished? If this comes down across the board, many people will lose everything including their lives.we are already to focus and topic of harassment, dirty looks, and hateful moral judgements from pharmacists who want to play doctor. I’m so sick of being treated as a lesser citizen or a ‘junkie’ by incompetent pharmacists that know nothing of my condition. I shouldn’thave to explain my medical condition to anyone especially in a public drugstore. I know I am ranting but I’m so angry and sad that us chronic pain sufferers are being forgotten for the quote ‘good of all’. Where are the statistics on the success of opiod therapy?

Bruce

Seems like the corrupt governments are following the eugenics program of the UN for depopulation. Killing off pain patients by denying them care is just one resource they use. It’s larger than money, they want us dead.

Terri McFarland

Thank you, Ed Coghlan, for this article. We need everyone’s voice to stop this madness here in Oregon and across the united states. If this passes it will be disastrous for those in intractable pain and for future patients. I still cannot wrap my head around the fact that this has been happening here in our country. For our very own government to put people in a place of torturous pain it just does not seem real. It seems like something we would be disputing with another country as a violation of human rights and decency. In their rush to stop overdoses they have inadvertently gone after the wrong people, these are patients, not drug addicts. it sees to be snowballing out of control as a political platform forgetting these are real people with debilitating pain.

Mark G.

The Hippocrattic Oath states “First do no harm”. But Hippocrates didn’t know about insurance companies who seem to have taken the oath to “First do harm to save money” What will be the outcome of millions of patients unable to get effective treatment for pain? It is not difficult to imagine the result and all possibilities are more than frightening!

William Dorn

They are putting the Final Solution in place. The government plans to eliminate all sick and injured chronic pain patients. The millions of people in pain had better start speaking out or there wont be anyone left to speak.

Even if the Oregon Health Authority does not cut off opiates to their chronic pain patients, the individual CCO’s around the state have already been doing that and will continue to do it. Umpqua Health Alliance in Douglas County has been denying chronic pain patients opiate medications since 2013. They also deny many other medications in their efforts to “control” costs. Despite the fact that the Oregon Health Plan says certain medications should be and are covered expenses, Umpqua Health Alliance clinics and doctors deny patients these medications so they can save their program money that gets distributed to those providers at the end of the year as “bonuses.” Denying patients governmentally approved treatments and more all for the sake of bigger year-end bonuses is unethical but common practice here in Oregon. Taxpayer money to pad their wallets. When Oregon agreed to accept billions from the federal government to overhaul the Oregon Health Plan and promised the feds that they could make the program better, more effective, and save money, they also promised that if they didn’t make it work, they would have to pay back all those billions. Guess what? They don’t want to pay that money back, so they are cutting every service they can to save money, and if that means denying care, they WILL do it. Douglas County medical providers delay referrals to save money. They delay ordering imaging and tests to save money. They don’t call patients back with test results. They cancel appointments to avoid certain patients. Providers jump from one clinic to another due to poor administrators that run these clinics. The turnover is ridiculous. The 5 to 10 minute visits you get with cut-and-paste chart notes is tantamount to medical fraud, especially when they claim to have stayed 15 to 20 minutes. They claim to have performed a physical examination, but patients report they never get touched. Just more fraud, all for the sake of getting paid for something they didn’t do. They know how to work the system and the Oregon Health Alliance continues to pay them for their fraud. I hope more OHP patients will stand up and fight for their healthcare rights because right now they are just pawns in a huge money transferring racket.

Joe

This is awful. I feel so bad for the great people of Oregon struggling with chronic pain. I wished there was something better than opioids to treat chronic pain. Unfortunately I live in the state of Nevada where doctors have implemented many regulations recently passed through legislature which make it extremely hard if not impossible to get access to the medication pain patients need. Also sadly I have been told “I am in that age bracket.” “If I give you pain meds than I won’t be able to see where your illness progresses.” <– I love this logic. I have been offered alternative quackery which has made my pain worse which includes spinal injections which do not target the neuropathic pain that resonates into my lower limbs, rhizotomy which has left me with numbness and weakness in my left shoulder and Neurontin which made me hallucinate and suicidal. My life sucks [edit] and my spine injuries have been untreated since my resistance to more injections and another rhizotomy. I didnt want this for myself and never thought as a teen or young adult conditions like this existed and nor did I care. You must live it to be able to accurately dictate treatment for people living with painful conditions. Opiates are a godsend for people like me. I no longer have access to the 15 pills that were prescribed to me monthly. I hope God has mercy on the people suffering around the globe. Especially the ones living in the U.S. A little mercy and empathy goes a long way!

nana

So it starts with medicaid.. Good example of socialism dictating what can and can’t be done. Thasnks Government.

Steven

The elimination of opioid medication is insanity. It only makes sense from one perspective and that is that if there are no opioids on the planet then there can be no abuse of opioids. Too bad this is a step backwards for medical science of a hundred years and the person with pain is faced with just one solution. The final solution. Has anyone for the elimination of opioids considered the possibility that there might be a major need for pain treatment such as a major earthquake or even a war? In those cases, we will have absolutely nothing to treat anyone. Heaven Help Us.

David Cole

Thanks for the info Ed! I’ll be letting these people have a little piece of my mind.

Christine Smith

I am so sorry to hear this.. with regards to medicaid! Oregan and other states have already chosen this to start with July 1, 2018 law however they KEPT SAYING IT WOULD ONLY EFFECT ACUTE PAIN PATIENTS! That was a lie ! Medicaid had chosen to pull long term opiates etc… that even long term patients would no longer be able to get! So they knew it would affect chronic pain patients! Before July 1, 2018 even private insurances such as (United Health) …had found a way by stating “ you are over the allowed limit something they never said before and in all the years never had difficulty paying for them before? !!!!! Now in order for me to get i will have to pay cash all bc they say their is now a limit /quantity drs must stay under and if they dont u have to pay cash! They say all u need is a pre auth? Lol …yea right ?!
u go back and forth one blames the other! The thing is now they have even started with reg meds… pharm sends me to my pain dr to get them to address this so called writing prior auth… so the dr’s office states they the insurance company or pharm hasn’t sent anything? Nothing showing in system yet ? sent us anything ? Hmmmmm we will need a request for prior auth so we can fill it out and send it back ?! WOW! This started in january and i have 7 emails feom insurance stating its the doctor….. its a game the government …pharmacies are playing !! I just watched a neighbor who was fighting lung cancer has chronic pain & he is on medicaid had a pain manager stopped any kind of treatment ! His med was no longer covered! He basicamly was forced to go on hospice! Tell me why? What will happen to us? How long until we are all made to go on hospice and made to go on hospice? Somebody needs to help us…and i mean fast !